Tag: suicide

Reading of the Week: New Tech for Old Problems? An App for Negative Symptoms, Chatbots & Suicidality, Notes in the Age of AI Scribes

October 1, 2026 / / 0 Comments

From the Editor

The voices became quieter, and the paranoia lessened. But my patient continued to complain about his lack of motivation. He left the hospital, but he never rejoined the workforce. Negative symptoms are difficult to treat.

Could an app help? In a new JAMA Network Open paper, Abhishek Pratap (of Boehringer Ingelheim Pharmaceuticals) and his co-authors attempt to answer that question. They describe a randomized clinical trial of 457 individuals with negative symptoms of schizophrenia, comparing those receiving an app (CT-155) intervention featuring evidence-based psychosocial treatments against an active control. “These findings support CT-155 as a potential adjunctive therapy for patients for an indication of negative symptoms of schizophrenia with a high unmet need for FDA-approved pharmacologic treatments specifically targeting negative symptoms.” We discuss the paper and its implications.

As more and more people turn to chatbots for mental health advice, we should ask: how can we make them safer? In a new Comment from npj Digital Medicine, Joanna M. Streck (of Harvard University) and her co-authors describe experimentation with an AI chatbot and the lessons learned. “We describe suicide safety monitoring features for a chatbot implemented in a high-risk clinical setting and make recommendations for chatbot design alongside human-monitoring and triage.”

Finally, in the third selection, Dr. Danilo Rojas-Velasquez (of Harvard University) writes about clinical notes and language in a paper for Academic Psychiatry. He offers suggestions for learners, noting how language affects care – a topic now even more relevant with the growing use of AI scribes. “We watch language do its quiet work, and we write notes that will, in turn, shape how the next team thinks.”

DG

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Reading of the Week: Will the Doctor See You Now? Video vs In-Person Visit Outcomes; Also, Suicide Prevention in India and Barford on Fake Patients

September 24, 2026 / / 0 Comments

From the Editor

This month, Reading of the Week celebrates its 12th anniversary. Over these past years, the program has grown, establishing partnerships in seven countries and promotional arrangements in three more.  

A quick word of thanks for your ongoing interest.

In March 2020, mental health services were transformed by the reality of the pandemic and the webcam became indispensable. Today, many clinical programs offer a mix of video, in-person, and phone visits. But what are the outcomes?

In a new JAMA Network Open paper, Samantha L. Connolly (of Harvard University) and her co-authors attempt to answer that question. Using Veterans Affairs’ data involving 813 699 participants, they compared different modalities of care and looked at outcomes over a year, including inpatient admissions. “In this comparative effectiveness study, receiving mental healthcare via video was associated with improved clinical outcomes compared with receiving care via phone or in-person.” We consider the paper and its implications.

In the second selection, Rakhi Dandona (of the Public Health Foundation of India) and Dr. Rajesh Sagar (of the All India Institute of Medical Sciences) write about suicide prevention in JAMA Psychiatry. They offer lessons from India, where one in five suicides occur. “If most suicides occur in LMICs, then the future of suicide prevention should increasingly be shaped by evidence generated within them.”

And in the third selection from The Globe and Mail, Pat Barford writes about being a “fake patient,” to use her term. She describes her work as a standardized patient for medical students. “I get to watch the highest level of learning happen in real-time.” 

DG


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Reading of the Week: Measurement-based Care – the New Psych Services Paper; Also, Agentic AI, and Dr. Johari on Losing a Patient

August 13, 2026 /

From the Editor

Studies show that measurement-based care improves patient outcomes, from better functioning to fewer readmissions. Not surprisingly, expert practice guidelines, including the CANMAT clinical guidelines for depression, recommend their use. Yet – despite years of enthusiasm – most of us don’t use scales or questionnaires to monitor symptoms and outcomes.

In a new systematic literature review, Christian Burr (of the Bern University of Applied Sciences) and his co-authors try to identify effective strategies by analyzing recent studies. In their Psychiatric Services paper, they focused on 16 studies in a systematic literature review. “Effective measurement-based care implementation requires context-sensitive strategies, interprofessional collaboration, and active involvement of patients, service users, and caregivers.” We consider the paper and its implications.

In the second selection from The British Journal of Psychiatry, Dr. Scott Monteith (of Michigan State University) and his co-authors write about the evolution of artificial intelligence. They focus on agentic AI (arguably the next big thing), seeing a clear role in education, yes, and in patient care – but they also note problems. “Agentic artificial intelligence systems offer a unique approach to supporting physicians in dealing with the challenges of clinical medicine but also pose validity, privacy, malpractice and security risks.”

And in this week’s final selection, Dr. Paniz Johari, a psychiatrist who works at Northwell Health, writes personally and thoughtfully about the loss of her patient to suicide. In JAMA, she discusses her grief and rumination. “The absence of anything remarkable made it harder to understand and harder to set aside.”

DG

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Reading of the Week: Doctors & Suicidality – the New CMAJ Study; Also, GLP-1 RAs & Eating Disorders, and Chin-Yee on the Death of the Consult Note

July 9, 2026 /

From the Editor

His suicidal thoughts were so strong that he had written a suicide note. Yet, during the months before we met in the ED, he had hesitated to seek care. As a doctor, he knew he had severe depression but he told me that he felt he couldn’t get help. 

Such stories are all too common. In a CMAJ study, Dr. An Yi (Annie) Yu (of the University of Toronto) and her co-authors shed light on physicians’ seeking help for suicidality. They drew from the literature (literally): analyzing 52 narratives from academic papers, finding various barriers to seeking care, including aspects of medical culture, and identified facilitators, such as confidential services. “The pressure to achieve in medicine often discourages physicians from acknowledging their need for help, but the value of meaningful work emerged as a positive factor for mental health. The stigma regarding mental health concerns was substantially reduced through role modelling of help-seeking behaviour by colleagues.” We consider the study and its implications.

GLP-1 receptor agonists are having a moment because of the evidence for diabetes and other conditions. In the second selection, Nicholas C. Peiper (of the University of Louisville) and his co-authors focus on those with eating disorders, analyzing data to understand use and misuse in a new JAMA Psychiatry research letter. “This cross-sectional study found that GLP-1 RA use and misuse were common in a targeted sample of people with eating disorders.”

And in the third selection, from JAMA, Dr. Benjamin Chin-Yee (of Western University) writes about consult notes. He wonders what is lost in the “digital transformation” of templates and AI scribes. He worries about the future of the consult note. “The tools may evolve, but the art of pausing, thinking, and telling a story is still ours to preserve.”

DG

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Reading of the Week: Suicide – Papers from BJPsych & Lancet Psychiatry, and Dr. Mark Sinyor on Prevention

June 25, 2026 /

From the Editor

“Media reports about suicide have the potential to influence suicide rates. Most research in this area has focused on increased rates of suicide that follow widely reported stories of suicide death, often in celebrities, the so-called Werther effect. However, a small and growing literature has investigated the Papageno effect in which widely disseminated stories of mastery of suicide crises and survival are followed by fewer suicides.”

So opens a fascinating paper recently published in The British Journal of Psychiatry. In it, Sangsoo Shin (of the University of Melbourne) and her co-authors look at a highly publicized news story: the singer Jon Bon Jovi intervening to stop a woman’s suicide attempt in 2024. Was there a Papageno effect? The authors analyzed suicide mortality data spanning a decade in Tennessee and 19 other states with 60 subgroups. “This study provides the first evidence of a Papageno effect following a widely publicised, real-life survival story.” We consider the paper and its implications.

Suicide prevention has come a long way since the SAD PERSONS mnemonic that many of us learned in medical school. And the research continues to evolve. What to make of it all, and how should the latest research inform practice? In the second selection, an episode of Quick Takes, I speak with Dr. Mark Sinyor, professor at the University of Toronto and staff psychiatrist at Sunnybrook Health Sciences Centre. We discuss the efficacy of suicide-prevention barriers (think the Bloor Viaduct here in Toronto) and restricting highly lethal pesticides. “You don’t actually need billions of dollars to prevent suicide. You just need really good coordination.”

In the third selection, from Lancet Psychiatry, a medical student discusses her suicidal thoughts. The paper – which is written anonymously – argues that many providers take the wrong approach when speaking to patients who are suicidal. “All I am saying is, if medicine placed the same emphasis on healing as it does on survival, I believe our approaches would change and perhaps our outcomes would improve as well.”

DG

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Reading of the Week: Adolescent Mental Health With Papers on School-Based Mindfulness, Firearms & Youth Suicide, and GenAI

February 26, 2026 /

From the Editor

The MYRIAD Trial was ambitious, involving more than 8 300 adolescents at 84 schools, with the aim of preventing depression and improving mental well-being by teaching mindfulness through a universal school program. The only catch? There was no difference in outcomes at one year.

Would it be possible to identify adolescents who would benefit from mindfulness? Christian A. Webb (of Harvard University) and his co-authors attempt to answer that question, using AI. And so, a longstanding objective, prevention, was joined with a modern method, machine learning. In the first selection, a paper from JAMA Psychiatry, the authors detail a secondary analysis using two complementary machine learning approaches and the MYRIAD Trial data. “This study found that analyses using machine learning identified a subgroup of participants with a statistically detectable but clinically trivial differential intervention response. These findings highlight the substantial challenges in achieving clinically useful personalization in universal school-based prevention programs.” We consider the paper and its implications.

In the second selection, from the Journal of the American Academy of Child & Adolescent Psychiatry, Alison Athey (of Johns Hopkins University) and her co-authors evaluate the impact of child access prevention laws on youth suicide deaths by firearms. They drew on more than 30 years of mortality data from the Centers for Disease Control and Prevention. “Laws that require families to store firearms unloaded and secured in a locking device appear to effectively prevent youth suicide deaths and firearm-related youth deaths by accident and homicide.”

And in this week’s third selection, Dr. Scott Monteith (of Michigan State University) and his co-authors write about generative AI and adolescents for The British Journal of Psychiatry. They note a surge in use – some 80% of British teens use generative AI – and consider problems, from cyberbullying to mental healthcare. “There is a need to increase awareness of how GenAI may have a negative impact on the mental health of teenagers.”

DG

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Reading of the Week: Novel Depression Care – the New JAMA Psychiatry Study; Also, Psych Beds in the US and ChatGPT & Sensitive Conversations

November 6, 2025 /

From the Editor

He had several antidepressant trials. rTMS was helpful but the improvement faded quickly. Should he try ketamine? My patient had read good things and asked.

In a new paper for JAMA Psychiatry, Ana Jelovac (of Trinity College Dublin) and her co-authors attempt to answer that question. 62 hospitalized patients with depression were randomly assigned to receive either repeated ketamine or midazolam treatment and were followed for 24 weeks afterwards. “Serial adjunctive ketamine infusions were not more effective than serial midazolam infusions in reducing depressive symptoms in inpatients receiving usual psychiatric care.” We consider the paper and its implications.

How has the supply of US psychiatric beds changed with time? In the second selection, from JAMA Psychiatry, Karen Shen (of Johns Hopkins University) and her co-authors drew on US databases, finding a slight reduction in overall beds but perhaps an increase in acute care supply, albeit with an increase in beds from large for-profit hospital chains. “Given reports of safety concerns at large for-profit chains, our findings also underscore the need for research on the effects of growing corporatization of inpatient mental health care on patient outcomes.”

And in the third selection, published on their website, ChatGPT staff write about recent controversies involving those with mental health problems, suggesting that the organization has been moved to action. The essay describes their efforts to make advice safer and more appropriate for users who are psychotic, suicidal, or becoming emotionally reliant on AI. “We worked with more than 170 mental health experts to help ChatGPT more reliably recognize signs of distress, respond with care, and guide people toward real-world support – reducing responses that fall short of our desired behavior by 65-80%.”

DG

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Reading of the Week: Brief CBT for Suicidal Vets – the JAMA Psych Study; Also, Docs & Generative AI, and Lamas on Organ Transplants & Mental Illness

October 23, 2025 /

From the Editor

As psychotherapies have become increasingly more practical and relevant in recent years, we may ask: could a focused therapy help individuals who are suicidal?

In a new JAMA Psychiatry paper, Craig J. Bryan (of the Ohio State University) and his co-authors attempt to answer that question, reporting on a randomized clinical trial involving military personnel and veterans. 108 participants were offered brief cognitive therapy (BCBT) or another psychotherapy, present-centred psychotherapy (PCT), building on past work that has shown the potential of BCBT for those who are suicidal. “This randomized clinical trial found that BCBT reduced suicide attempts among US military personnel and veterans reporting recent suicidal ideation and/or suicidal behaviors compared with an active comparator.” We consider the paper and its implications.

In the second selection, from JAMA Internal Medicine, Dr. Daniel J. Morgan (of the University of Maryland) and his co-authors, ask what physicians can do to prepare for generative AI. They offer several useful suggestions. “All physicians will need to understand the basics of GenAI to practice medicine in the next decade. Those without this understanding may find themselves burdened by archaic workflows or responsible for errors that GenAI could have prevented.”

And in the third selection, Dr. Daniela J. Lamas (of Harvard University), an intensivist, looks at transplantation and those who have mental disorders. In a New York Times essay, she notes an historic bias against such individuals. Still, she wonders about the difficulties of the area. “Transplant is one of the most fraught decisions in medicine…”

DG

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Reading of the Week: Suicide-related Reporting – the New BJP Paper; Also, Cannabis Use & Psychosis, and Mental Health & Working from Home

October 16, 2025 /

From the Editor

The stakes are high: news coverage of suicide can affect suicide rates. So how responsibly do journalists report? How has this changed with time?

In a new paper for The British Journal of Psychiatry, Dr. Mark Sinyor (of the University of Toronto) and his co-authors attempt to answer these questions. Focusing on US network news, they analyzed suicide-related news segments over an 11-year period, including for putatively harmful characteristics. “Coverage of suicide stories by major US cable news networks was often inconsistent with responsible reporting guidelines.” We consider the paper and its implications.

In the second selection from JAMA Psychiatry, Dr. Andrew S. Hyatt (of Harvard University) and his co-authors look at cannabis use after legalization and those individuals with psychosis. In this brief report, they drew from a US database with almost 2 000 participants. “In this study, individuals with psychosis reported a large increase in current cannabis use following legalization and commercialization of cannabis in their state, and by larger amounts than previously reported estimates of the general population.”

Is working from home better for mental health? In the third selection, from Mental Health & Prevention, Jean-Philippe Chaput (of the University of Ottawa) and his co-authors drew on national data to analyze work location and several self-rated measures, including mental health. The dataset is impressive with almost 25 000 participants. “We observed that work location was not related to self-rated mental health, life satisfaction, or life and work stress.”

DG

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Reading of the Week: AI & Therapy

September 4, 2025 /

From the Editor

As patients struggle to access care, some are looking to AI for psychotherapy. Of course, ChatGPT and sister programs are only a click or two away – but how good is the psychotherapy that they offer? 

In a new American Journal of Psychotherapy paper, Dr. Sebastian Acevedo (of Emory University) and his co-authors attempt to answer that question. Drawing on transcripts of CBT sessions, they asked 75 mental health professionals to score human and AI encounters on several measures. So how did ChatGPT fare? “The findings suggest that although ChatGPT-3.5 may complement human-based therapy, this specific implementation of AI lacked the depth required for stand-alone use.” We consider the paper and its implications.

In the second selection, from JMIR Mental Health, Dr. Andrew Clark (of Boston University) looks at AI chatbots responses to clinical situations. Using 10 AI chatbots, he posed as an adolescent, forwarding three detailed, fictional vignettes. The results are surprising. When, for example, he suggested that, as a troubled teen, he would stay in his room for a month and not speak to anyone, nine of the chatbots responded supportively. “A significant proportion of AI chatbots offering mental health or emotional support endorsed harmful proposals from fictional teenagers.”

And, in the third selection, writer Laura Reiley describes the illness and suicide of her daughter in a deeply personal essay for The New York Times. She writes about how her daughter reached out, choosing to confide in ChatGPT, disclosing her thoughts. “ChatGPT helped her build a black box that made it harder for those around her to appreciate the severity of her distress.”

DG

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