Up to half of the patients do not tell their doctor information that could endanger their lives – such as suicidal thoughts, domestic violence, depression and sexual abuse, a new study finds.
Healthcare professionals are one of the few first-hand connections that an average person can possibly have with mental healthcare resources or ways to get out of dangerous homes.
But according to a new study from the University of Utah and Middlesex Community College, many patients are still ashamed of these problems or suspect that doctors will judge them if they will include this personal information in their medical records.
Withholding this information does not only deprive the patient of access to valuable resources, these struggles also cause risks for all sorts of other health problems such as high blood pressure and post-traumatic stress disorder.
Almost half of the patients who have experienced depression, suicidal thoughts, sexual or domestic violence have kept these life-threatening problems secret from their caregivers, a study (file) showed
So-called despair deaths – those caused by drinking, drug use and suicide – are a public health problem with top priority in the US.
Suicide is the second leading cause of death for people between 15 and 34 years and 85 percent of women who are killed in the US every year are killed by current or former spouses of boyfriends or other romantic partners.
The suffering in people’s home and professional life is no longer seen as loose, but rather as an important 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, the stigma remains.
And its effects are perhaps the most problematic in healthcare.
Doctors are generally required to follow at least some psychiatric training and have better access to resources such as crisis intervention groups and reception centers than your friends or family.
Previous research has shown that people are reluctant to admit bad habits such as drinking, smoking or relaxing to physical activities to their doctors out of shame or fear of judgment and lectures.
The same team of researchers who conducted the new study discovered that between 60 and 80 percent of patients keep their lips sealed about their diet and make choices when they talk to their doctors.
These are risk factors for many health problems, but their danger accumulates over time.
Public health experts would at least hope that patients would be more aware of immediate dangers.
But a survey of 4,500 Americans suggests that they are not.
People were asked if they had survived sexual violence, endured domestic violence, struggled with depression or harbored suicidal thoughts.
More than half of the total study participants, published in JAMA Network Open, had addressed at least one of those shocking threats.
And 40 to 47.5 percent of them presented their potentially life-threatening problems to doctors, nurses, or other health care providers.
The vast majority – 70 percent – cited shame as the reason for their secrecy.
But for most there were many reasons to stay calm.
About half or more of those who had experienced these traumas said they were also wary of being judged and nominated, did not want to take the solutions – such as starting a therapy or an antidepressant – suspected the caregivers, or disclosures documented in medical records.
Ironically, patients (anonymous) who completed the survey eventually admitted not only the problems of caregivers, but also of the fact that they refused them.
That is what the first study author, Dr. Andrea Gurmankin Levy, a professor of social sciences at Middlesex Community College, wonders: “Is it easier to tell a piece of paper something sensitive than to look into your doctor’s eyes and say it?”
If that is the case, follow-up questionnaires sent home with patients can better encourage them to disclose depression, abuse, sexual violence and thoughts of suicide.
But Dr. Levy wants to try to interview people personally.
“When we get there, we can immediately ask them to make it easier for them to know exactly what was going on – why they didn’t share such crucial information,” she says.
What looks like personal disclosures to patients are actually very real risk factors for their health, according to senior research author, Dr. Angela Fagerlin from the University of Utah.
“If primary care providers want to help patients achieve their best health, they need to know what the patient is struggling with,” she says.
“These are countless ways in which providers can help patients, such as obtaining resources, therapy, and treatment.”