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Nearly half of patients keep suicidal thoughts, abuse, secret from doctors

Up to half of patients don’t tell their doctors information that might put their lives in peril – like suicidal thoughts, domestic violence, depression and sexual abuse, a new study finds. 

Healthcare professionals are one of the few first-hand connections an average person might have to mental health resources or ways out of dangerous homes. 

But many patients still feel ashamed of these problems or suspicious that doctors will judge them or put this personal information in their medical records, according to a new University of Utah and Middlesex Community College study. 

Not only does withholding this information deprive patients of access to valuable resources, these struggles raise a person’s risks for all manner of other health problems like high blood pressure and post-traumatic stress disorder.  

Nearly half of patients that have faced depression, suicidal thoughts, sexual or domestic abuse kept these life-threatening issues secret from their health care providers, a study found (file)

So-called deaths of despair – those that result from drinking, drug use, and suicide – are a top-priority public health problem in the US. 

Suicide is the second leading cause of death for people between 15 and 34, and 85 percent of women murdered in the US each year are killed by current or former boyfriends husbands or other romantic partners.

There issues are clearly life-threatening. 

The distress in people’s home and professional lives is no longer seen as separate from, but rather a significant risk factor for their health and well-being. 

Despite campaigns to encourage people to be aware of their mental health and to seek help when they need it, stigma still lingers. 

And its effects are perhaps most problematic in a health care setting. 

Doctors are typically required to take at least some psychiatric training and have better access to resources like crisis intervention groups and shelters than your friends or family might. 

Previous research has found that people are reluctant to admit bad habits like drinking, smoking or slacking on physical activity, to their doctors out of shame or fear of judgement and lectures. 

The same team of researchers that conducted the new study found that between 60 and 80 percent of patients keep their lips sealed about their diet and exercise choices when talking to their doctors.  

These are risk factors for many health problems – but their danger accumulates over time.  

Public health experts would at the very least hope that patients would be more forthcoming about immediate dangers. 

But a survey of 4,500 Americans suggests they aren’t. 

People were asked if they had survived sexual assault, faced domestic violence, struggled with depression or harbored suicidal thoughts. 

More than half of the total participants surveyed for the study, published in JAMA Network Open, had dealt with at least one of those harrowing threats. 

And of those, 40 to 47.5 percent kept their potentially life-threatening problems from their doctors, nurses, or other healthcare providers. 

The overwhelming majority – 70 percent – cited embarrassment as the reason for their secrecy. 

But for most, there were many reasons for keeping quite. 

About half or more of those that had dealt with these traumas said they were also wary of getting judged and lectured, had no desire to take up the solutions – like starting therapy or an antidepressant – they suspected health care providers would suggest, or having their disclosures documented in medical records. 

Ironically, patients (anonymously) who took the survey ultimately admitted to healthcare professionals not only the problems they’d faced, but the fact that they’d denied them. 

That made first study author, Dr Andrea Gurmankin Levy, a social sciences professor at Middlesex Community College wonder: ‘Is it easier to tell a piece of paper something sensitive than to look into your clinician’s eyes and say it?’ 

If that’s the case, follow-up questionnaires sent home with patients might better encourage them to disclose depression, abuse, sexual violence and suicidal thoughts. 

But Dr Levy wants to try interviewing people in person. 

‘If we are there, we can ask them right in the moment so they can more easily put their finger on exactly what was at issue – why they didn’t share such crucial information,’ she says. 

What may seem like personal divulgences to patients are actually very real risk factors to their health, according to senior study author, Dr Angela Fagerlin of the University of Utah. 

‘For primary care providers to help patients to achieve their best health, they need to know what the patient is struggling with,’ she says. 

‘These are numerous ways providers can help patients with such as getting resources, therapy and treatment.’