TagZaheer

Reading of the Week: Trends in Suicide Mortality in Canada (CJP); also, Suicide Prevention (Quick Takes) and Lawrence on Her Depression (Guardian)

From the Editor

Suicide is often discussed, but what do we know about the overall rate of completions? We hear that there are more suicides in the United States over the past few years – but was does the Canadian data say?

In the first selection, we consider a new paper by Mélanie Varin (of Indigenous Services Canada) and her co-authors. Drawing on a Canadian database, they consider suicide mortality. The good news: the suicide rate in Canada decreased by 24.0% between 1981 and 2017. But, in recent years, there hasn’t been a further decline.So – is the glass half full or half empty?

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In the second selection, we look further at suicide, considering a new podcast discussing suicide and suicide prevention. I talk with Dr. Juveria Zaheer (of the University of Toronto) about COVID-19, the literature, and, yes, her suggestions for clinical interviews. “If you have a room of one hundred people, one hundred people in that room have been affected by suicide.”

Dr. Rebecca Lawrence is a UK psychiatrist and we can assume that she has done many suicide risk assessments. In a Guardian essay – our third selection – she tells her story: as a person who struggled with mental illness, then made the decision to become a psychiatrist. “If my story helps anyone unsure of their capacity to take on the job, or worried about the ‘dark secret’ of their own psychological troubles, then I think it’s worth telling.”

DG

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Reading of the Week: Should Medical Education Stay in Its Lane? Drs. Zaheer and Berkhout Respond

From the Editor

Should medical education “stay in its lane?”

Two weeks ago, we discussed an essay by the University of Pennsylvania’s Dr. Stanley Goldfarb who warns that: “Curricula will increasingly focus on climate change, social inequities, gun violence, bias and other progressive causes only tangentially related to treating illness.”

This week, we feature two letters to the editor responding to this essay, both original content for the Reading of the Week, and both from physicians affiliated with the University of Toronto.

Drawing on the medical literature and her life experience, Dr. Juveria Zaheer wonders what makes a medical expert or a physician scientist. “Being a medical expert or a physician scientist isn’t just about learning about biology – it’s about committing to the creation of a society where every life is worth living.”

Looking at medicine and philosophy, Dr. Suze G. Berkhout questions the basic assumptions of Dr. Goldfarb’s argument. “Goldfarb misrepresents the place of values in shaping scientific and medical knowledge.”

2012_canada_highwayoftears_0Staying in Your Lane: Good for Drivers, not Med Ed?

Both letters are thoughtful and worth reading.

DG

 
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Reading of the Week: Ramadan and Mental Health Care – What are the Clinical Considerations?

From the Editor

For some patients, it carries deeply religious meaning. For others, it will be a time for reflection. And for us clinicians, it must be thought of in terms of patients’ management.

As our Muslim patients begin Ramadan, there are implications for care. About 80% of Muslims in North America will fast. Should medication times change? Would sleep be disrupted? Are patients on lithium at greater risk of toxicity? In a new paper, Dr. Zainab Furqan – a resident in the University of Toronto’s Department of Psychiatry – joins co-authors from three countries in considering Ramadan and care. They note that several groups are exempt from fasting but “many people who are exempt from fasting due to illness choose to fast during this month due to the spiritual significance of Ramadan for Muslim communities.”

They write: “It is important for clinicians not to undermine the importance of this spiritual practice for their patients.”

newmoon11A small moon and big challenges for care?

In this week’s Reading, we consider their new paper.

And an invitation: the Reading of the Week series invites guest contributions. If this is of interest, please let me know.

DG

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