{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:17:33Z","timestamp":1787847453880,"version":"build-2784847793"},"reference-count":5,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>Primary-care providers are most often the first point of contact for patients presenting with mental illness. Highly stigmatized and with a litany of other medical issues requiring redress by providers, it may receive inadequate attention, despite its unintuitive consequences. Therefore, the purpose of this case is to demonstrate the potential catastrophic consequences of untreated mental illness by providers. As a result of a serious suicide attempt by a patient afflicted with bipolar disorder, this patient presented with significant blood loss secondary to multiple self-inflicted lacerations to the wrist, parasternal stab wounds, and a resultant hemopneumothorax. By juxtaposing this patient's mental illness with his other traditionally \u201cmore\u201d concerning medical history (i.e., multiple myeloma, Factor V Leiden, and recurrent DVTs), we are forced to reexamine where mental illness resides in the hierarchy of treatment.<\/jats:p>","DOI":"10.4103\/jfmpc.jfmpc_180_20","type":"journal-article","created":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T05:57:47Z","timestamp":1598939867000},"page":"4412-4414","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["A unity of opposites: A prototypical case for the importance of primary-care providers in addressing mental health issues"],"prefix":"10.4103","volume":"9","author":[{"given":"Kevin M.","family":"Lamm","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Cape Fear Valley Medical Center, Fayetteville, United States"},{"name":"Associate Program Director for the Cape Fear Valley Psychiatric Residency Program with Campbell University, Fayetteville, United States"},{"name":"Jerry M. Wallace School of Osteopathic Medicine, Lillington, NC, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cooper L","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Research, Campbell University School of Osteopathic Medicine, Lillington, NC, University of Mary Washington, Fredericksburg, VA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevieve","family":"Rebon","sequence":"additional","affiliation":[{"name":"University of California Santa Barbara, Santa Barbara, CA United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,8]]},"reference":[{"key":"R1-20260817","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1001\/jamapsychiatry.2014.2502","article-title":"Mortality in mental disorders and global disease burden implications: A systematic review and meta-analysis","volume":"72","author":"Walker","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"R2-20260817","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/s12913-019-3894-7","article-title":"Characteristics and behavioral health needs of patients with patterns of high hospital use: Implications for primary care providers","volume":"19","author":"Rentas","year":"2019","journal-title":"BMC Health Serv Res"},{"key":"R7-20260817","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1001\/archpsyc.62.6.603","article-title":"Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication","volume":"62","author":"Wang","year":"2005","journal-title":"Arch Gen Psychiatry"},{"key":"R8-20260817","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1111\/j.1475-6773.2004.00224.x","article-title":"Delays in Treatment for Mental Disorders and Health Insurance Coverage","volume":"39","author":"McLaughlin","year":"2004","journal-title":"Health Serv Res"},{"key":"R9-20260817","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1192\/pb.bp.113.044016","article-title":"Personal experience: Coming out-the psychotic psychiatrist- an account of the stigmatising experience of psychiatric Illness","volume":"38","author":"Tagore","year":"2014","journal-title":"Psychiatr Bull"}],"updated-by":[{"DOI":"10.4103\/2249-4863.299412","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000}}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_180_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:18:43Z","timestamp":1787843923000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_180_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8]]},"references-count":5,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_180_20","relation":{},"ISSN":["2249-4863","2278-7135"],"issn-type":[{"value":"2249-4863","type":"print"},{"value":"2278-7135","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8]]},"assertion":[{"value":"2020-01-29","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-26","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}