You’ll see physician suicide statistics published online, or perhaps you’ll even hear them in conversations around you, but statistics don’t have the same impact as hearing a personal story. In late 2019, Dr. Matthew Gall was one of those physicians who tragically died by suicide, leaving his family and friends reeling to understand what happened. By all accounts Dr. Gall was a lover of life and happy guy. His suicide was an unexpected, heartbreaking and traumatizing event for his family and friends, that they continue to cope with today. This interview with Betsy Gall, Matthew’s wife, shares their story, the impact his death has had on their lives, and what they hope to accomplish by sharing it.

On March 1, 2022, President Biden announced his administration’s strategy to address our nation’s mental health crisis as outlined in the 2022 Presidential Unity Agenda. This national mental health strategy seeks to strengthen system capacity, connect more Americans to care, and create a continuum of support –transforming our health and social services infrastructure to address mental health holistically and equitably. A primary goal outlined within this strategy is accelerating the universal adoption, recognition, and integration of the peer mental health workforce across all elements of the healthcare system. This included the development and implementation of a national certification program for mental health peer specialists1. To meet this goal, SAMHSA collaborated with federal, state, tribal, territorial, and local partners including peer specialists to develop the National Model Standards for Peer Support Certification, inclusive of substance use, mental health, and family peer certifications. These National Model Standards closely align with the needs of the behavioral health (peer) workforce, and subsequently, the over-arching goal of the national mental health strategy. SAMHSA acknowledges the nuances across the peer workforce and the communities being served, as states often reflect needs that are unique to their community within a certification. Further, SAMHSA’s National Model Standards for Peer Support Certification are not intended as a substitute for any state certifications but instead have been developed as guidance for states, territories, tribes, and others, to promote quality and encourage alignment and reciprocity across often disparate state peer support certifications. Since the 2015 release of the SAMHSA’s Core Competencies for Peer Workers in Behavioral Health Services2, the peer workforce has flourished, resulting in the implementation of state-endorsed or state-run peer certification programs across 49 out of 50 states3. The National Model Standards are designed to accelerate universal adoption, recognition, and integration of the peer workforce, and strengthen the foundation set by the peer workforce, reinforced by the Core Competencies, and implemented by our state, local, and tribal partners.

In 2020, Congress designated the new 988 dialing code to operate through the existing National Suicide Prevention Lifeline. The Substance Abuse and Mental Health Services Administration (SAMHSA) is the lead federal agency, in partnership with the Federal Communications Commission and the Department of Veterans Affairs, working to make the promise of 988 a reality for America. Moving to a 3-digit dialing code is a once-in-a-lifetime opportunity to strengthen and expand the existing National Suicide Prevention Lifeline (the Lifeline). Of course, 988 is more than just an easy-to-remember number—it is a direct connection to compassionate, accessible care and support for anyone experiencing mental health related distress – whether that is thoughts of suicide, mental health or substance use crisis, or any other kind of emotional distress. Preparing for full 988 implementation requires a bold vision for a crisis care system that provides direct, life-saving services to all in need. In pursuit of this bold yet achievable vision, SAMHSA is first focused on strengthening and expanding the existing Lifeline network, providing life-saving service to all who call, text or chat via 988. Longer term, SAMHSA recognizes that linking those in crisis to community-based providers—who can deliver a full range of crisis care services— is essential to meeting crisis needs across the nation.

In 2017, for the first time in American history, more women than men were enrolled in the first year of medical school. In 2019, according to the Association of American Medical Colleges (AAMC), women made up the majority of med students.1 On the horizon: a medical profession in which women outnumber men. This very significant gender shift requires some major changes in policies, attitudes and procedures—because women in medicine today face daunting challenges and disadvantages, ranging from compensation to treatment by colleagues to family-centered issues and beyond. Addressing their well-being and satisfaction with the profession will be one of the most important responsibilities of healthcare leadership in the years ahead. What Medical Women Want One of the most important responses to the AAMC’s 2019 findings about med school enrollment was a survey made the following year by Medscape, “Women Physicians 2020: The Issues They Care About.”2 The researchers discovered that the 3,003 practitioners surveyed were most concerned about:

This applied naturalistic study examined the background and service use characteristics and also the work and clinical outcomes of employees who were formally referred by their employer to use brief counseling services from an employee assistance program (EAP) at CuraLinc Healthcare. The data was from 41,986 employees who worked at over 1,750 different employers located in the United States. The study period spanned 7 years, from January of 2017 through March of 2023. The majority of employees voluntarily used EAP counseling, with about only 3% of the total clients being formally referred to use the EAP by their employer – typically due to issues related to employee job performance or substance abuse. The two types of referral clients (Formal Management Referral or FMR n = 1,215 and Self/Other Referral or SOR n = 40,771) were similar or had only small differences on most of the profile factors. Factors with meaningful differences included the reason why the service was used (i.e., presenting issues of alcohol, drug, work stress and anger management were far more common among formal referrals than SOR; 77% > 13%), the gender of the client (FMR more males; 68% > 38%) and certain industries of the employer. All of the longitudinal test results found improvements in work and health outcomes at 30-days after the use of EAP counseling with large size statistical effects for both referral types, yet the FMR clients tended to have significantly greater relative improvement, which was due in part to their starting out at greater severity levels for work deficits and hazardous alcohol use than self-referral clients. More of the FMR clients were at a problem level at the start of EAP use for both work outcomes and they also had greater improvement afterwards (absence: FMR Pre/Post 46% to 1% > SOR Pre/Post 31% to 7%; productivity FMR Pre/Post 42% to 5% > SOR Pre/Post 35% to 5%). The typical FMR client reduced their average hours of unproductive work time per 30 days by more than the typical SOR client (Pre to Post change: FMR 56 fewer hours > SOR 39 fewer hours). The largest change was from 12.2 to 0.3 hours of absence on average per month for the FMR clients compared to 7.0 to 1.5 hours for the SOR clients. Referral types also differed on certain health risk factors. More of the FMR clients started EAP use at-risk for hazardous alcohol use and also improved more after use (FMR Pre/Post 30% to 5% > SOR Pre/Post 12% to 3%). However, fewer of the FMR clients started EAP use at-risk for mental health (anxiety and/or depression) and yet the FMR clients had greater improvement after counseling (FMR Pre/Post 22% to 3% > SOR Pre/Post 32% to 10%). An important implication of this study is that employers can be confident that when they make a formal management referral of a troubled employee to their EAP that the counseling will likely be successful, both in reducing absence from work and restoring work productivity to normal levels and also in recovering from the clinical problems that are part of the cause of the work-related distress history that likely prompted the referral. Companies that use their EAP for this kind of referral support can likely see results in better risk management of these kinds of common performance and behavioral health issues among their workforce.

Where We Were: The Day the Earth Stood Still... • COVID 19 was an unknown but very visceral threat in early 2020 • Pandemics have historically elicited a Primal Fear, triggering a raw Survival Response • Remember the term Novel Coronavirus? Novel means new and different – there was so much we didn’t know • In the absence of real information, it is human nature to plug in our worst possible fears

It's been three years since bystander footage went viral of a white Minneapolis police officer kneeling on a Black man's neck for more than nine minutes. The ensuing outrage and empathy surrounding George Floyd's death brought issues of systemic oppression and discrimination to the forefront of public consciousness, sparking conversations and debates regarding diversity, equity and inclusion (DE&I) in society and the workplace. "George Floyd's murder ushered in an era of awareness," says Theresa M. Robinson, a Houston-based author and DE&I coach. "More people now know what they had not known previously." Police brutality, workplace discrimination and other offenses against historically marginalized communities have buoyed social movements—including Black Lives Matter and #MeToo—and have given rise to the concept of "wokeness," a slang term that has become a staple in the political lexicon.