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Friday May 12, 2017

Olympian's Tale Highlights Need to Remove Stigma of Depression

Allison Schmitt has had an Olympic medal placed around her neck seven times. But the honor she received this month in Washington, D.C., she said, was perhaps the most important award she has ever received.

Schmitt and fellow Olympic swimming champion Michael Phelps were given Special Recognition Awards May 4 during the Substance Abuse and Mental Health Services Administration's (SAMHSA's) annual event recognizing National Children's Mental Health Awareness Day.

Joy VanBuhler photo

U.S. swimmer Allison Schmitt waves to spectators at a Thanksgiving Day parade. Schmitt came home from the 2012 Summer Olympics with multiple medals -- and depression.

(I was there to participate in a panel discussion, but more on that later.)

Schmitt won five medals at the 2012 London Games, including three golds, but the then-21-year-old also came home with a severe case of post-Olympics letdown. Her depression lingered for years. Phelps, who also has battled depression, saw the warning signs in 2015 and urged her to talk about it. That was a turning point for Schmitt, and she entered therapy.  

The fact that two such successful young people have dealt with mental health issues underscores what we as family physicians already know -- depression can strike anyone. One in 20 Americans age 12 and older has depression, and half of them won't receive treatment.  This month's SAMHSA event was specifically about children's mental health, and it's worth noting that the percentage of children and adolescents presenting to U.S. hospitals for suicidal thoughts or self-harm nearly doubled from 2008 to 2015.

Schmitt started talking publicly about depression after her 17-year-old cousin committed suicide in 2015. Schmitt's goal, she said, is to reduce the stigma about depression so more people will seek the help they need. Her mantra is "It's OK to not be OK."

Schmitt, who won two more Olympic medals at the 2016 Summer Games in Rio de Janeiro, said she would not have been able to succeed without the many people who rallied to support her. That includes Phelps, the most decorated Olympian of all time.

The SAMHSA event included three panel discussions, and I had the opportunity to talk about the important role of primary care and the need to integrate it with behavioral health. I also talked about the fact that family physicians often see multiple generations of a family, which allows us to better understand a family's history. We also can build trust over time, which is critical when advising a patient to enter counseling.

Twenty percent of primary care visits include at least one mental health indicator, and I emphasized that primary care physicians need more time to adequately address these issues. It's been well documented that physicians are spending nearly twice as much time on "administrivia" as we are with our patients. That has to change.

The AAFP recently created a webpage on familydoctor.org that offers several resources to help families deal with teen depression and suicide prevention. I encourage you to check them out for yourself and your practice.

Wanda Filer, M.D., M.B.A., is Board chair of the AAFP.

Comments:

We need to work on making sure insurance companies COVER our care of mental health issues. We have had issues getting paid when using mental health codes. Some insurers outsource the mental health network to specialty mental health insurers like Magellan. These companies do not credential or accept primary care physicians and frankly I already work with the primary insurer, I don't need to be on the mental health panel as well. Sometimes these companies will discount the entire visit if a mental health code is used for the diagnosis. This has to be eliminated. Primary care physicians should be paid for caring for patient's mental health issues.

Posted by Jennifer Hollywood, MD on May 18, 2017 at 10:01 AM CDT #

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