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Surprising discrepancy between high prevalence of suicidality and low BSI scores

Published online by Cambridge University Press:  02 January 2018

Paul Whelan
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The Psychiatrist , Volume 35 , Issue 8 , August 2011 , pp. 317
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Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Copyright © Royal College of Psychiatrists, 2011

I would like to congratulate Meerten et al Reference Meerten, Bland, Gross and Garelick1 on their excellent paper about MedNet, a service for doctors experiencing psychological problems; and, furthermore, for setting up and running the service in the first instance.

The authors cite that doctors are a vulnerable group with high rates of psychological disorders. This is in keeping with previous work myself and colleagues conducted on junior doctors using the 12-item General Health Questionnaire, albeit at a time when they were undergoing a period of extreme stress (the MTAS fiasco). Reference Whelan, Jarrett, Meerten, Forster and Bhugra2,Reference Whelan, Meerten, Rao, Jarrett, Muthukumaraswamy and Bughra3 We found that 79% of the sample scored above the cut-off point for psychological distress and 21% for severe distress (i.e. caseness for treatment). Reference Whelan, Meerten, Rao, Jarrett, Muthukumaraswamy and Bughra3

What perplexed me about the paper, however, were the high rates of suicidality in the MedNet sample (nearly half) but the relatively low scores on the Brief Psychiatric Interview. I am not sure that this discrepancy is explained sufficiently in the discussion or, indeed, why the suicidality persisted post-treatment despite the other range of outcome measures used indicating improvement.

I would like to hear more from the authors about their views about this phenomenon.

References

1 Meerten, M, Bland, J, Gross, SR, Garelick, AI. Doctors' experience of a bespoke physician consultation service: cross-sectional investigation. Psychiatrist 2011; 35: 206–12.CrossRefGoogle Scholar
2 Whelan, P, Jarrett, P, Meerten, M, Forster, K, Bhugra, D. MTAS fiasco: lessons for psychiatry. Psychiatr Bull 2007; 31: 425–7.Google Scholar
3 Whelan, P, Meerten, M, Rao, R, Jarrett, P, Muthukumaraswamy, A, Bughra, D. Stress, lies and red tape: the views, success rates and stress levels of the MTAS cohort. J R Soc Med 2008; 101: 313–8.Google Scholar
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