After more than a decade of decline in the ’80s and ’90s, the U.S. suicide rate has reversed course and climbed steadily over the past 15 years. From 1999 to 2014, the age-adjusted suicide rate rose 24% to 13 people per 100,000, according to the Centers for Disease Control and Prevention.
Trained to consider the whole patient, not just their symptoms, DOs are uniquely qualified to recognize early signs of depression and suicidal ideation in their patients. But training in the art of observation needs to start early, says Bruce Dubin, DO, the provost and dean of Kansas City University of Medicine and Biosciences College of Osteopathic Medicine in Missouri.
“We train our students to partner with patients in health maintenance and disease prevention, and a big part of that is teaching them strong observational skills, to look for outward signs of depression,” Dr. Dubin says, adding that even subtle aspects of a patient’s demeanor can reveal clues about their mental and emotional well-being.
Tapping into the power of observation is a key component of recognizing potential warning signs of depression, agrees Luke G. Nelligan, DO, the chair of the Department of Family Medicine at Marian University College of Osteopathic Medicine (MU-COM) in Indianapolis.
“As DOs, we place emphasis on the importance of our patients’ mental health. It’s a component of treating the individual as a whole,” says Dr. Nelligan.
Early mental health training
At MU-COM, students attend courses that promote active listening, proper psychiatric history taking, and discussion of clinical cases dealing with depression, anxiety and other mental health disorders.
Psychiatrist Jason Beaman, DO, says his osteopathic training—which emphasized establishing partnerships with patients and getting to know them—gives him an advantage when assessing early signs of depression and suicide risk among patients.
“The process of assessing suicide risk really embodies the osteopathic philosophy,” explains Dr. Beaman, the chair of the Department of Psychiatry and Behavioral Science at Oklahoma State University Center for Health Sciences College of Osteopathic Medicine in Tulsa.
“You’re not just looking at the patient and considering what they’ve said in the past 20 minutes, you’re looking at the broader picture,” Dr. Beaman says. “You’re taking into account everything that’s going on in the person’s life.”