In 30 years as a pediatrician, few work days go by without Uchenna Umeh, MD, seeing a child with symptoms of depression or some sort of suicidal feelings. But it was a 2008 case involving a 15-year-old boy that really brought the issue to her full attention.
The boy’s mother took him to Dr. Umeh because he had stopped socializing with his friends and retreated from other family members. The mother was worried he might be using drugs. After a brief screening, Dr. Umeh realized that instead, the boy was depressed. She recommended medication and counseling. The mother wouldn’t hear of it.
“She said to me, ‘Well, I had depression, and I did OK. I think he’s going to be fine,’” Dr. Umeh said. “And on the Fourth of July, he put a double-barrel shotgun in his mouth and pulled the trigger in front of his family.”
In 2012, Dr. Umeh, tired of the administrative hassles of private practice and having divorced, decided to continue her medical career in the U.S. Air Force. She worked most of her time as a pediatrician at Lackland Air Force Base in San Antonio.
One of the first things she noticed was she treated a high number of emotionally fragile, depressed, anxious, and even suicidal kids. At the time, she chalked this up to the rigors of military life: Air Force families move a lot, and one or both parents can leave for long periods on deployments.
But when Dr. Umeh left the Air Force in 2016 to join a large multispecialty practice in San Antonio, she found that even more of the civilian kids she treated seemed to have the same problems.
“I thought it was military-related until I went [back] out into private practice and it didn’t go away,” she said. “There were more kids who were depressed. … I got an influx — every day two or three kids who are depressed or suicidal. It’s not race-related, it’s not sex-related, it’s not age-related. It’s across the board.”
Dr. Umeh’s experience reflects a national trend on suicide. (See “Using Primary Care to Prevent Suicide,” November 2018 Texas Medicine, pages 16-21, www.texmed.org/FrontLine.)
Born and raised in Nigeria, Dr. Umeh says she had almost no idea what suicide was when growing up. But since then both she and one of her young sons have wrestled with depression, and she’s certainly seen it more among her patients.
“In May, I had one 8-year-old boy who attempted suicide not once, but twice,” Dr. Umeh said. “That was when I decided, OK, the universe is trying to tell me something. … It’s more prevalent than we think.”
Dr. Umeh made a career pivot. Last August, she left her multispecialty practice to focus as much as possible on suicide prevention. She still sees patients using telemedicine, but she focuses more of her attention on public speaking, coaching, app development — all in an effort to reach young people considering suicide.
Not all of her colleagues understand her switch. One physician friend took her to lunch recently. He pointed out that normally therapists try to become doctors, but it seemed as though she, a doctor, was trying to become a kind of therapist.
“I said, ‘I don’t want to be a therapist — I’m always going to be a doctor,’” Dr. Umeh recalled. “I’m just going to practice medicine different than you do. Why talk to two kids in a room when I can talk to 200 kids in a school? If I talk to them in school, they won’t ever need to come and see you.”
Other physicians are supportive and praise her initiative. And her speaking schedule has been filling up. Her website, teenalive.com, is gaining popularity, and she’s captured audiences as far away as Atlanta and Charlotte, North Carolina. Dr. Umeh does not focus on just young people but also their families and anyone else — including fellow physicians — who helps shape a child’s upbringing.
“I’ll speak to anyone,” she said. “Because indeed, it involves everyone. It could be a neighbor’s kid next. And it could be your teacher who tells you that your son has been bullied at school. [The cause of a child’s suicide] could be at the YMCA, at church, it could be anywhere. I don’t know who not to talk to.”
Tex Med. 2018;114(12):48
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