Calling all Beyond The Body followers (especially medical students, residents, physicians, and other healthcare providers)! We are in the midst of working on a new project for medical students and residents, and we need your help!  

Specifically, we are looking for individuals to share their favourite motivational/inspirational quotes, as well as those who are keen to get involved by drawing mandalas or related pictures (like the one below).  

If you wish to contribute in either of these ways or to find out more, use our contact form or email Tara @ riddell.tara@dal.ca.

In an interesting and controversial case, a 20 year old woman is currently on trial in Massachusetts and is facing charges of involuntary manslaughter. The charge is related to the death of her boyfriend 3 years ago which was deemed a suicide; however, it has since been reported that prior to his death, the woman had been sending texts encouraging her partner to follow through on his plan to end his life.

The case is being followed closely as it could set legal precedent. Currently in the state there is no law against encouraging someone to commit suicide, and previous cases regarding others' involvement in an individual's suicide (i.e. encouraging online, bullying, and offering tips/support in carrying it out) have been generally unclear.

"The case against Ms. Carter is not without precedent, but such cases are rare and raise unusual challenges for prosecutors: To what extent can one person be responsible — and criminally liable — for the suicide of another person?

“The key issue is going to be causation, of who actually caused the death,” said Laurie Levenson, a professor at Loyola Law School in Los Angeles, who said people who kill themselves are generally considered to have acted of their own will. “Did she,” Ms. Levenson said, “or did the victim himself?”"

To find out more, visit:
https://www.nytimes.com/2017/06/06/us/suicide-texting-manslaughter-trial.html

When those in a high school in Oakland County, Michigan watched the Netflix series 13 Reasons Why, the premise and themes it focused on hit close to home as the school had also lost one of their students to suicide back in 2013.

While the show has been criticized, many feel it accurately and excellently portrayed present day issues that teens face today including bullying, body-shaming, social media use, abusive relationships, as well as consent and sexual violence, and even the increased risks associated with having access to weapons such as guns in the home. 

Despite this, many at the school including the dean felt the show portrayed little hope, and depicted suicide as the only way out, without highlighting the many mental health resources available and the care/support family and friends frequently provide. This sparked an idea for a project called "13 Reasons Why Not" ...

The project involved 13 recordings from students at the school being played over morning announcements. Each day, on the recording one teen would share a problem they had been struggling with, whether that would be bullying at school or issues in their home life. However, rather than placing blame, at the end of the recording, the student would thank someone, such as another classmate who has helped them and thus provided a sense of hope and encouragement to carry on.

​Since the project has been in place, students who have volunteered recordings have found an outpouring of love and support from their classmates, and have found that their school has become a community where individuals feel safe and comfortable sharing their mental health struggles. A bright idea not only to raise awareness and encourage ongoing discussions on these issues, but to show what 13 Reasons does not ... that help, hope, and support do exist. 

"“I watched the series. I thought it accurately depicted the problems that teenagers in high school are facing now. But it was incredibly troubling to me that suicide was portrayed as being, almost, inevitable, like she had no other option,” said Fine.
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“The idea was to come up with 13 reasons why not, because that was not portrayed in the show. … Even though it can get very dark, there is always hope. Our message is that there are no 13 reasons why. Suicide is not an option."

To find out more, visit:
"Oxford High School students begin project called '13 Reasons Why Not'" by Monica Drake (Oakland Press News)

The Netflix original series 13 Reasons Why has received considerable attention over the last few months since its initial worldwide release on March 31. The feedback has been mixed however, and has generated a fair bit of controversy over the portrayal of suicide and self-harm, leading Netflix to post advisory warnings. Many mental lhealth organizations and advocates, along with mental health professionals, have since been speaking out about their concerns regarding the show.

Psychiatrist Dr. Stan Kutcher in Halifax, has been working with the IWK Health Centre and Teenmentalhealth.org to generate an online resource for teens, parents, and educators on how to address concerns regarding the show and discuss mental health issues with young people. 

The resource (link below) specifically highlights concerns such as how the show glamorizes or romanticizes suicide/self-harm raising the concern that there may be an increase in such behaviours by vulnerable youth, presents adults/others as unknowing or unhelpful, and most importantly does not address mental illness which often underlies suicidal thoughts and behaviours. 

However, more importantly, the website provides visitors with a "set of talking points", an important document that should be provided to those who watch the series as it both addresses the above concerns, but also guides discussions between youth and their caregivers/educators, and highlights how hope and help are available to those in need.

To find out more, visit:
http://teenmentalhealth.org/news-posts/responding-13-reasons-considerations-schools/

Remember it's the last day of Mental Health Week, but there's still plenty of time to take action!

This year, mental health week's focus is on the long wait times Canadians experience when seeking publicly funded psychotherapy, counselling, and support form community-based mental health services and programs. 

Early diagnosis and treatment are critical for individuals with mental illness and are crucial to improving overall prognosis. So consider getting involved by writing your MP to push for increased funding for mental healthcare, as well as donating money to local initiatives, or simply speaking up about mental health and the great demand for increased services and supports.
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#SickofWaiting #Getloud

A powerful article written by a resident pediatrician, on how "resident wellness" while a great idea in theory, in practice is much more difficult to achieve without a major reform to the underlying culture of medicine, work hours, and immense demands, stress, and responsibilities placed on young physicians.

"But the fundamental barriers to well-being remain here as in other programs nationwide: our 80-hour workweeks, our massive debt-to-income ratios, and the accumulated grief of years of medical training. The first time I went to counseling was during my first month in the ER, when I had a week of day shifts, followed by a week of nights, then a week of days and then another week of nights. The therapist’s first question was about my sleep schedule—the likely cause of my distress, but also absolutely beyond my control...

...The goal of preventing physician suicide seems reasonable to me: suicide is concrete, measurable, and important. “Wellness,” on the other hand, is fishy and elusive. The duty to promote one’s own wellbeing can feel like another burden on our time, and the idea that we residents have control over our wellbeing—or much of anything in our lives—is laughable.

My residency program’s individualized learning plan survey asks us what we are doing to promote wellness. I am able to list a couple of things in the box—I walk to work, I have a husband who makes me food—but the fact is I do not believe wellness is available to me. Not in this environment, and not at 80-hour weeks."

To read the full article, visit:
"When Doctors Can't Afford to Feel" by Dr. Rachel Pearson (The Daily Beast)

Did you know that May 1-7 is CMHA National's 66th annual Mental Health Week?!

This year the theme is to #GetLoud!

"Getting loud means speaking up to stop the discrimination and the stigma that often go hand in hand with mental illness. It means using your voice to raise awareness and build support. For someone at home. For someone at work. For yourself."

Find out how you can get involved, by visiting http://toolkit.mentalhealthweek.ca!

In this powerful article, physician and University of Toronto physician Dr. Shelly Dev, shares her revelations and lessons on surviving (and enjoying) residency while also maintaining our sense of self and happiness. Her messages include having self-compassion, focusing on our patients, and having a work-life balance that allows us to enjoy our passions outside of medicine. A must read for all med students and residents!

"Our ability to show caring and compassion is not infinite. It gets depleted and can become replaced by dark humour, cynicism, anger, resentment, complacency and, worst of all, apathy. 

This job doesn’t make you a bad person. You don’t lose your empathy or your goodness. It’s just hard to care about other people when you don’t feel cared for, or are not caring for yourself. Knowing what refuels you back to your normal, good self is as important as knowing how to resuscitate someone who is sick."

To read the full article, visit:
"How Therapy Revealed the Ills of Residency" by Dr. Shelly Dev (University of Toronto)

Speaking out about a tragedy involving the suicide of one of their own medical students, Dr. David Muller, the dean at Icahn School of Medicine at Mount Sinai powerfully expresses how the culture of medical training programs and the expectations of those pursuing a career in medicine can be fraught with stress, leading to anxiety, depression, burnout and suicide. 

More importantly, beyond addressing some of these "root causes" of medical learner and physician mental health issues, he reminds us all of the importance of support, whether that be provided between peers and colleagues, or through more formal programs and initiatives in medical schools and residency programs. 

"All these questions will have to be addressed, and the answers incorporated into whatever plan we propose to implement. But in my opinion they will fall far short of addressing one of the root causes of this national epidemic of burnout, depression, and suicide: a culture of performance and achievement that for most of our students begins in middle school and relentlessly intensifies for the remainder of their adult lives. Every time students achieve what looks to the rest of us like a successful milestone — getting into a great college, the medical school of their choice, a residency in a competitive clinical specialty — it is to some of them the opening of another door to a haunted house, behind which lie demons, suffocating uncertainty, and unimaginable challenges. Students bravely meet these challenges head-on while we continue to blindly ratchet up our expectations.

From their very first shadowing experience to their first foray in the lab; from high school advanced-placement courses and college admissions tests to grade point averages and the Medical College Admissions Test (MCAT); with helicopter parents, peer pressure, violins and varsity soccer, college rankings, medical school rankings, medical licensing exams, and the residency Match, we never let up on them — and it’s killing them."

To read the full article, visit:
http://www.nejm.org/doi/full/10.1056/NEJMp1615141