The Laughter Clinic

TLC PULSE 5 Global Insights: Mental Health AI Chatbots, Suicide Prevention Training for Doctors and Humour as a Protective Factor.

• Mark McConville • Season 1 • Episode 13

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Content Warning:  This episode discusses suicide and suicide prevention. 
Listener discretion is advised.

Insight 1
• Pressures facing Australian mental health nurses and the need for formal support beyond AI Chatbots.
https://360info.org/australias-mental-health-services-are-buckling-due-to-rising-demand-staff-shortages-and-patient-violence/

• Early evidence for AI chatbots supporting clinicians mental health.
https://humanfactors.jmir.org/2025/1/e67682

Insight 2
• Adolescent mental health access gaps in India and how AI chatbots create early touch points. 
https://www.orfonline.org/expert-speak/ai-chatbots-for-teen-mental-health-augmenting-india-s-counselling-services

• Evidence for rapid therapeutic alliance with conversational agents.
https://www.researchgate.net/publication/390309549_Effectiveness_of_AI-driven_Conversational_Agents_in_Improving_Mental_Health_Among_Young_People_A_Systematic_Review_and_Meta-analysis

Insight 3
• Humour as a protective factor for nursing students against academic stress. 
https://www.researchgate.net/publication/395780108_The_protective_role_of_sense_of_humor_against_academic_stress_among_Indonesian_nursing_students_A_multivariate_analysis

Insight 4
• A call to mandate suicide prevention training for all doctors to lift preparedness and physican confidence. 
https://www.cureus.com/articles/383536-suicide-literacy-a-call-for-national-training-in-suicide-competencies-for-all-medical-doctors?score_article=true#!/

Insight 5
• A new organisational framework building on the recognized 4 styles of humour. Investigating humour intent, content, reaction.
https://news.clemson.edu/clemson-business-professor-is-rethinking-humor-in-the-workplace/

https://onlinelibrary.wiley.com/doi/10.1111/joms.13245

Thanks for listening. 
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Website: www.thelaughterclinic.com.au

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"If you or someone you know needs support, please contact one of these Australian mental health services. In an emergency, always call 000."

Lifeline Australia
Phone: 13 11 14 (24/7)
Web: lifeline.org.au

Suicide Call Back Service
Phone: 1300 659 467 (24/7)
Web: suicidecallbackservice.org.au

Beyond Blue
Phone: 1300 22 4636 (24/7)
Web: beyondblue.org.au

Kids Helpline (for people aged 5-25)
Phone: 1800 55 1800 (24/7)
Web: kidshelpline.com.au

MensLine Australia
Phone: 1300 78 99 78 (24/7)
Web: mensline.org.au

SANE Australia (complex mental health issues)
Phone: 1800 18 7263
Web: sane.org

QLife (LGBTIQ+ support)
Phone: 1800 184 527
Web: qlife.org.au

Open Arms (Veterans & Families Counselling)
Phone: 1800 011 046 (24/7)
Web: openarms.gov.au

1800RESPECT (sexual assault, domestic violence)
Phone: 1800 737 732 (24/7)
Web: 1800respect.org.au

Headspace (youth mental health, ages 12-25)
Phone: 1800 650 890
Web: headspace.org.au

13YARN (Aboriginal & Torres Strait Islander crisis support)
Phone: 13 92 76 (13YARN) (24/7)
Web: 13yarn.org.au

Music by Hayden Smith
https://www.haydensmith.com


SPEAKER_00:

Welcome to Alapter Clinic Podcast with comedians and psychologist Matt McCumfill. Bringing you practical, evidence-based self-care strategies, the latest research in mental health, along with conversations that inspire, educate, and entertain. This is the Lapter Clinic Podcast with your host, Matt McCumpy.

SPEAKER_01:

Hi my friends, welcome to this episode of Pulse, where I share with you five global insights that have caught my attention in the field of mental health, suicide prevention, and the research into humor and laughter. And let me tell you, I really struggled to narrow it down to five because I've found some really interesting stuff lately. So in this Pulse episode, the five that we're going to be looking at are firstly we're going to look at the challenges that are facing Australian mental health nurses. Interesting article there. We're going to go to India to look at how AI chatbots are being used for youth mental health. Very interesting. Then we're heading over to Indonesia to study where humor has been looked at as a protective factor against academic stress for nursing students. That's very interesting. Then we head over to the USA, where there's been a national call for national approach to suicide prevention training for medical doctors. And then while we're in the US, there's actually a really interesting study that's come out. A business professor is rethinking, not only rethinking, but redefining uh humor in the workplace. So some really cool things to go through in this pulse episode. So stick with me. I hope you enjoy the information and uh and what we can uh what we can take away from all of these learnings from around the world. So let's look at the first one on the hit list, which is an article published and and all of these articles will be the links will be put on the show notes. And for those of you that may not realize, I'm actually these are all these podcast episodes are actually being filmed as well. So they are all available on the Laughter Clinic YouTube channel. And if you go to the YouTube channel on this episode, uh this is where we're actually trialing, actually showing you the articles that I'm referring to as I go through them. So first things first, first article is from One World Many Voices, and this is Australia's mental health services are buckling due to rising demand, staff shortages, and patient violence. I mean, this is a really incredible story. Interventions such as formal support systems are needed for Australia's exhausted, overwhelmed mental health nurses. Despite their importance, mental health nurses face unique occupational challenges, including high emotional demands, frequent exposure to workplace violence and harassment from clients. I mean, you know, they're really on the front line, they're on the coal face, these guys, these men and women. Mental health nurses are the backbone of Australia's healthcare system, but they are buckling under system level pressures, inadequate staffing ratios, ensuring the right level of experience and expertise, rising workloads and casual employment. Despite their importance, mental health nurses face unique occupational challenges, including high emotional demands, frequent exposure to workplace violence and harassment from clients. The toll is bigger where the risk is highest. Australian data shows that the healthcare workers, especially those in mental health settings, experience high rates of work-related violence and traumatic exposure, with many encountering threats or assault from clients in the course of care. It's hard to imagine, really, isn't it, going to work and being exposed to that? They're really putting themselves in harm's way, you know. Such demands lead, uh the article goes on to say, such demands lead to high levels of stress and a high risk of burnout. The impact is twofold. Not only does it compromise the well-being of the nurses themselves, but it also affects their capacity to provide quality of care. So, what sort of support are we talking for our mental health nurses? We've got a part of the article here that talks about social support is crucial, and we all know that, you know, not only for our nurses, but social support for all of us is crucial. The article goes on to say: unlike other roles amongst mental health care staff, nurses provide 24-7 frontline care for clients with acute mental health disorders. This constant demand can lead to high stress and burnout, making social support essential. Social support encourages emotional resilience and provides practical assistance, helping them deliver compassionate care and maintain a sense of belonging in a challenging work environment. Sense of belonging. The article goes on. Through interview-based surveys, RMIT uh university researchers studied the lived experience of uh mental health nurses in Australia. Their words paint a grim picture. Formal social support is scarce and a culture of self-reliance dominates instead of structured organizational support. Nurses lean on each other. Well, let me just say right here that it is really promising that they are listening to the voices of lived experience. They are asking the nurses what their experiences are. Very important. Now, this is quite an interesting paragraph, this next one, and it actually, you know, yeah, there's a couple of articles on the Pulse 5 today that are talking about AI. And this is the first one. So the article goes on to say down here at the bottom, with the rise of AI-assisted technologies, organizations should also explore how technology can be integrated as an additional source of social support. Early evidence suggests chatbot-based interventions can help to reduce stress and anxiety for health professionals, but they should complement and not replace human and organizational support. Well, I've got to tell you, when I saw that, I went, really? There's evidence into this. They've started to study this, and I I found that that study that they're actually referring to there, and this is it here. This is a study published on the 19th of March 2025. AI chatbots for psychological health for health professionals, a scoping review. So I won't go into the whole thing here because the it is quite an extensive review what they've done here, but what I will talk about is the uh results and the conclusion, right? So among the among the 10 studies, six chatbots were delivered via mob mobile platforms and four via web-based platforms, all enabling one-on-one interactions. So remember, this is a study into AI chatbots for psychological health for health professionals. Natural language processing algorithms were used in six studies, and cognitive behavioral therapy techniques were applied to psychological health in four studies. Usability was evaluated in six studies through participant feedback and engagement metrics. Improvements in anxiety, depression, and burnout were observed in four studies, although one reported an increase in depressive symptoms. That's interesting. That's interesting right there. The conclusion of this article AI chatbots show potential tools to support the psychological health of health professionals by offering personalized and accessible interventions. Nonetheless, further research is required to establish standardized protocols and validate the effectiveness of these interventions. Future studies should focus on refining chatbot designs and assessing their impact on diverse health professionals. Well, isn't that interesting? AI chatbots show potential tools to support psychological health of health professionals by offering personalized and accessible interventions. Wow, so they're looking into this. It's the future, my friends, you know, it really is. So going back to our 360 article, the last paragraph goes on to say organizations need to take a multifaceted approach, combining the strengths in informal networks with the structural sorry, with the structure of formal support services and the foundations of safe staffing and skills to address their current crisis. By doing so, we reduce burnout and turnover, protect care sorry, protect care quality, and retain highly skilled mental health nurses in their crucial roles. If we fail to act, we entrench risk for mental health nurses and for the people they care for. Well, what an interesting article to start with. You know, the mental health nurses are really under the pump here in Australia. So I think my three main takeaways from that one are early intervention. Let's let's make sure that these nurses are supported right from the outset. Early intervention support systems, strengthening all of the employee-assisted programs, the AAPs, is is crucial. And look, if they are going to investigate AI support services, and I get it, that's you know where the future's heading. I just really hope that all of these places that are starting to investigate this make sure that it is it is not designed to replace human real support services. You know, it's it's an add-on because we really don't want to go down that rabbit hole of it, it only being, you know, your support services, only AI. Right, so that's number one, my friends. Number two on the pulse list today, AI chatbots. Once again, this is very interesting stuff. This one this uh pulse episode. I got I I found these so fascinating that there's so much research that is starting to be done into this now because these AI chatbots are obviously becoming so prevalent. So this article is from Observer Research Foundation, and it is AI chatbots for teen mental health augmenting India's counseling services. Really? So published on the 26th of September 2025, the article goes on. AI chatbots, if responsibly designed and integrated into India's telehealth uh telemental health system, can help bridge critical gaps in adolescent counseling services by widening access, safeguarding privacy, and ensuring timely escalation to human care. Jeez, I tell you what, there's some there's some staggering statistics here in in relation to in the opening introduction for this article. So, the introduction. Adolescent mental health has emerged as a critical public health challenge in India. Mental health disorders account for a significant share of disease burden amongst young people, yet limited resources and inadequate early intervention systems continue to compound the crisis. Suicide is the fourth leading cause of death amongst adolescents aged 15 to 19 in India, underscoring the unmet need for early accessible support and reliable pathways to counseling services as part of a broader continuum of care. AI enabled chatbots are emerging as a low threshold support mechanism offering immediate, affordable, and approachable entry points to care. Now, how's this for a statistic? The shortage of adolescent mental health professionals compounds the problem. India has fewer than 50 child and adolescent psychiatrists nationwide, translating to less than 0.02 psychiatrists per 100,000 adolescents. Wow, that's staggering, isn't it? With so few specialists, core prevention functions such as school-based screening, psychoeducation, and early identification remain underdelivered, while adolescents who seek help face long waits and referral delays. Adolescents in India face multiple barriers to mental health care. Stigma, financial costs, geographical inequities, and limited ability to seek services independently often delay help seeking until a crisis emerges. Generative AI chatbots that create free form replies are increasingly used for emotional support and self-discovery with users, often describing them as offering an emotional sanctuary, providing insightful guidance and a sense of connection. Wow. A sense of connection from a chatbot. Now this is really fascinating. So in mental health and and not only in mental health, but the relationship between any clinician and their patient, their client is referred to as the therapeutic alliance. And it's the therapeutic alliance is built on trust, you know. It's it's you a patient is obviously is more likely to be treatment compliant and do what their health professional is telling them when they trust their health professional, you know, and and it's a relationship, you know, and in the medical terms we've refer to it as the therapeutic alliance. This is fascinating. The article goes on to say why a global mental health chat bot that has already served over half a million users in India has been shown to foster a therapeutic alliance within just five days. A therapeutic alliance in five days from a chat bot. I've got to tell you, I thought I I I found that inconceivable. I really did. And I thought, where are they pulling that information from? So the article goes on to say here, the next paragraph is research on co conversational agents, conversational agents indicates, so that's what the chatbot is to like an AI conversational agent, right? Uh research on conversational agents indicates measurable reduction in distress amongst adolescents with early or mild symptoms, with users reporting feelings of being liked, respected, and cared for by this chatbot. Evidence from India echoes this trajectory with a youth pulse sur pulse, with a youth pulse survey finding that 88% of school students had turned to AI tools during periods of stress, and anonymity was cited as a key reason adolescents were more willing to participate than with the formal services. So it's it's anonymous, right? They just get online and they go, fuck, I'm just gonna talk to this fucking chatbot, right? So I've got to tell you, I was fascinated by this claim where they talk about creating a therapeutic alliance, fostering fostering a therapeutic alliance in five days. So in actual fact, where they're pulling that from is this study here, right? Where this is uh on ResearchGate. It is from the Journal of Medical Internet Research, published May 2025, and the journal the article, the literature review, is effectiveness of AI-driven conversational agents in improving mental health among young people, a systematic review and medical analysis. So there you go. Like I said, this stuff is being really looked into full on. So, right now, for those of you that don't know, a lot of these re all these research studies, they have an abstract at the start, right? Which basically gives you an overview of the entire research that's been done, right? So abstracts have a background objectives, methods that the researchers used to uh to get their data, what the results are, and then usually a conclusion. Okay, so the abstract in this one, once again, for those of you, effectiveness of AI-driven conversational agents in improving mental health amongst young people, systematic review of meta-analysis. Background. The increasing prevalence of mental health issues amongst adolescents and young adults, coupled cop coupled, copy coupled, get that right, coupled with barriers to accessing traditional therapy, has led to growing interest in artificial intelligence, AI-driven conversational agents, as a novel digital mental health intervention. Despite accumulating evidence suggesting the effectiveness of AI-driven CAs for mental health, there is still limited evidence on their effectiveness for different mental health conditions in adolescents and young adults. The objective of this study aims to examine the effectiveness of AI-driven CAs, conversational agents, for mental health amongst young people and explore for potential moderators for efficacy. The findings highlighted the potential of AI-driven CAs, conversational agents, for early intervention in depressive in depression amongst this population. Let me repeat that. That article there, effectiveness of AI-driven conversational agents. That's what this was referring to back here, where we're talking about the AI chatbots in in India. Let's look at the conclusion on this on this article. The conclusion adolescent mental health needs in India continue to outpace traditional services, creating a persistent gap that existing approaches cannot close. As AI becomes part of everyday tools and public services, integrating adolescent-facing chatbots with within mental health programs offers a feasible and forward-looking way to expand coverage. These tools are not a substitute for counselors, but when designed with safety, privacy, and inclusivity at their core, they can extend the reach of scarce professionals and create earlier touch points for support. Their value will depend on how effectively India aligns technical innovation with human capacity, governance, and trust, ensuring that chatbots act as responsible bridges that help more young people find timely, reliable care. Yeah, there's a few things to unpack in that closing there. Like inclusivity at its core, very important. Scarce professionals, yes. Early touch points for support, that is a big one. That is a big one. Early touch points for support is uh is really important. So look, I think my takeaways for for this article really is that firstly, is the massive shortfall in mental health professionals in India. And and look, this is something that's not only unique to India, this is something that's happening around the world, really. So many we just we just need more psychologists and psychiatrists globally. It's real I'm really fascinated at the fact that these chatbots are being able to establish a therapeutic alliance within five days because that's therapeutic alliances a relationship. You know, it's a relationship between a clinician and and a patient, a client, you know. And it it's fascinating that they're they're they're researching this, you know, they're really looking into how they how these chatbots actually can create a relationship with these kids. These right and yeah, look, my my last one on this is uh which reiterates what I said in relation to the first one about the first article where we talked about AI supporting mental health nurses in Australia. I just really it it's just screams caution to me, you know. It just screams exercising caution that yes, we embrace modern technology and we embrace these support services and all this, but in no way should any of this ever replace human connectedness. And so I just I I just really implore these powers that be to please exercise caution and don't be blinded or overwhelmed by you know the research that shows its effectiveness, you know, really it's yeah, it's a holistic approach to mental health, and this is just one tool, but it should never ever replace human connection. Right, so that's that. There we go. So we've covered the we've covered the nurses, we've covered the AI chat bots looking up, you know, in India. Our next uh one we're talking about. Now, this is interesting, I really like this one. So this is an article from the Journal of Holistic Nursing Services, uh Science, sorry, Journal of Holistic Nursing Sciences. It was September 2025, and the article headline is The Protective Role of Sense of Humor Against Academic Stress Amongst Indonesian Nursing Students, a multivariant analysis. Now, why this is so cool to me personally, because I have been a longtime campaigner that increased use of self-enhancing humor should be included in the list of recognized protective factors for your mental health and in relation to reducing suicidality. So the fact that this article has come out and it uses the term protective role of sense of humor is very significant to me. So, what did they do? So this is Indonesia, nursing students, right? Abstract in figures, nursing students often face academic pressure due to dual demands of theoretical coursework and clinical responsibilities. This stress can impact their psychological well-being and academic performance. Recent studies suggest that humor may function as a psychological buffer that enhancing emotional resilience and students' capacity to cope with academic challenges. However, few studies have investigated this topic specifically amongst nursing students worldwide. Therefore, this study aims to examine the relationship between sense of humor and perceived academic stress amongst undergraduate nursing students in Indonesia. It also seeks to evaluate whether humor serves humor serves as a protective psychological factor after adjusting for relevant demographic variables. A quantitative observational study with a cross-sectional data collection method was conducted involving 300 final year nursing students. The study used the multidimensional sense of humor scale and an adapted perceived stress scale as instruments to analyze the data. The study used descriptive statistics and bivariant analysis to identify variables and multivariant logistic regression models. Oh my God, I gotta tell you, researchers just I have so much respect for these guys. So uh yeah, I'm not even gonna try to bore you with all of that, those numbers and all that. What I am gonna do, right? Let's go down to some results here. Okay, results that's in the abstract. Let's go down to here. Sense of humor may serve as a beneficial coping resource for reducing academic stress in high-pressure educational environments. Although the explained variance is modest, the findings support the inclusion of humor promoting strategies in student mental health programs. Further nursing research is recommended to evaluate humor-based interventions across academic settings. That is cool. That is very, very cool. Yeah. Numerous studies confirm the protective role of humor against stress, particularly in high pressure professions such as healthcare, education, and public safety. Right? So that's what I mean, is this this this is being studied. Humor is a protective factor, is being studied. So we just need to, and I know my guest last week, Nikki Jameson, said I should be the one to do that research, but I'm not the guy, right? Okay, so I've got any researchers out there that are listening. The the the research task would be to include increased use of self-enhancing humour as a recognized protective factor in mental health and to reduce suicidality. That's it. Okay, going back to this study. Let's go into the discussion. This study demonstrates that HUB sorry, this this is the discussion. This study demonstrated that students with a high higher level of humor, as measured by the MSHS, were significantly less likely to report elevated academic stress. Our findings confirm that higher humor, particularly adaptive styles, which is self-enhancing humor, affiliative humor, which we actually will be talking about in the the last thing we're chatting about on the pulse episode today, the adaptive styles of humor. So uh back to the discussion. Our findings confirm that higher humor, particularly adaptive styles, relates to lower perceived stress in students and health professional populations. In nursing education, an integrative review concludes that humor in teaching reduces stress and improves attention and retention, while cautioning against negative humor styles, SARCA right, so negative humor styles are self-defeating and aggressive. So laughing at the expense of someone else, laughing at the expense of yourself. So while cautioning against negative style humor styles that may undermine learning climates, beyond educational settings, experimental and field study indicates that humor coping is associated with reduced perceived stress and more positive effect, and can moderate the link between maladaptive coping and stress. Right, so it's this is all good stuff here. Among nursing students, humor in learning context helps mitigate stress and improves a supportive atmosphere that is consistent with protective factors. After adjusting for study duration, those with higher humor scores were approximately 2.75 times less likely to report higher stress than indicated a potentially meaningful protective relationship. The results of this study support previous research suggesting that humor may promote may promote resilience in the face of stress. Humor can enable individuals to reinterpret challenges through a more positive lens. So, once again, this is the conclusion for the study the protective role of sense of humor against academic stress amongst Indonesian nursing students. This study provides evidence that a higher sense of humor is associated with a lower likelihood of experiencing academic stress amongst students in Indonesia. After adjusting for study duration, students with a higher humor levels were approximately 2.75 times less likely to report higher perceived stress. These findings support the conceptualization of humor as a protective psychological factor, consistent with cognitive stress appraisal theory. Therefore, humor should be understood as a complementary. Not primary component in broader strategies aimed at enhancing student well-being. From a practical perspective, the accessibility and low cost of humor-based approaches make them attractive for inclusion in academic mental health promotion. Educators and institutions are encouraged to explore ways of embedding constructive humor into curriculum delivery. Peer support initiatives and stress management programs. Future studies should further explore humor's long-term effects through experimental designs. Investigate its interaction with other psychological traits, resilience and optimism, for example, and evaluate humor interventions with academic environments. Well, that's a cracker. This is an absolute cracker. Yeah, so there you go. That's a beauty. So Indonesia, studying humor in the nurse humor for reducing nurse nurses stress, stress amongst nursing students. Really important. So I suppose my uh takeaways for that one, it really does continue the learning in relation to humour being used, being a recognized protective factor, and hopefully it's a step closer to having humor use included in the recognized protective factors against suicidality because it is really important. I I also find it interesting that the this can also open the door for recognizing the protective role of humour in relation to various other professions, I think. Obviously for students, yes, but also various other professions. I think we could really get a lot of research happening into the protective factor of humour for first responders and all that sort of stuff as well. I know there's research out there, but as a specific protective factor, I think is important. And not only that, aside from the perceived lower levels of stress, it increases uh levels of connectedness and belongingness because increased sense of humor is going to be associated with increased laughter, connection with people. So, yeah, there's a lot going on in that article. I'm really glad I found that one. The protective role of sense of humor against academic stress amongst Indonesian nursing students of multivariant analysis, September 25. Check out the show notes, go to YouTube, uh, the link's gonna be there. Right, so moving along, while we're talking about the medical profession, let's head over to the United States, and this is a really interesting story. All right, so let's get into this interesting article published via the Florida Medical Student Research Publications in September 25. Suicide literacy, a call for national training in suicide competencies for all medical doctors. This is out of the United States. So let's get into the abstract, my friends. Suicide represents a critical global health crisis with hundreds of thousands of lives lost each year. Despite its widespread impact, current practices identifying and managing suicide risk in health care remain inconsistent and often inadequate. Primary care physicians are frequently the first and sometimes only point of contact for individuals experiencing suicidal thoughts. They also serve as the leading prescribers of mental health medications. However, formal training in suicide risk assessment and prevention remains highly variable, as standardized instruction has only recently gained national attention. At present, only a few states require suicide prevention training as part of physician physician licensure, underscoring a significant gap in preparedness. As suicide continues to rise as a leading cause of death, particularly among young adults, there is an urgent need to implement a nationally a national structured training requirement. This narrative review draws upon published studies, national reports, and publicly available CDC data to highlight deficiencies in physic physician training and advocate for a unified evidence-based approach to ensure that healthcare providers are equipped to recognize and respond to suicide risk effectively. We conclude that integrating mandatory, mandatory, that's the big thing, that's the word there, that one. We conclude that integrating mandatory structured suicide prevention training into physician licensure requirements is a necessary step to enhance clinical preparedness, improve patient outcomes, and contribute to reducing suicide rates. How this isn't something that isn't just a standard core competence, core competency for physicians is beyond me. So, in the introduction and background, it goes on to talk about a lot of data in relation to suicide. Suicide is a global challenge, claiming over 800,000 lives annually in the United States. It ranks as the 11th leading cause of death, with nearly 500,000 lives lost in 2023. It goes on to say in 2021, 12.3 million adults reported suicide ideation, 3.5 million made plans, 1.7 million attempted suicide, and 48,183 died by suicide. That's in 2021. While this paper focuses on the US, similar similar gaps in physician preparedness are seen internationally underscoring the global relevance of this issue, and it is globally relevant. You know, it's it's definitely relevant here in Australia. Over 75% of individuals who died by suicide had seen a health care provider in the previous year, and 44% had seen a primary care provider uh within the last month. Those figures are probably not too different to what we've got here in Australia. I think that 44 might that 44% in the last month. I think in Australia it might be about 36 thereabouts. These findings highlight the need for all physicians to acquire skills in suicide risk assessment and prevention. The role of primary care physicians is especially critical as they prescribe more than 75% of antidepressants and are often the first point of contact for patients with mental health needs. Yeah, so that's psychiatrists who make up only 4% of the physician physician workforce face overwhelming demand with caseloads averaging 8,400 individuals compared to 2,714 per primary care per physician. Isn't that incredible? That's a that's a big number there. Cafeloads averaging 8,400 individuals compared to 2,000. That's for the psychiatrists. Wow. This shortage leads to long waits, 67 days for in-person, 43 days for telehealth visits, and many psychiatrists no longer accept insurance, creating financial barriers. Patients presenting to emergency rooms with suicidal ideation often face high suicide and mortality risk in the year following discharge, revealing a gap in continuity of care. Even brief evidence-based interventions in healthcare settings reduce future suicide attempts and increase follow-up with mental health providers. These findings support integrating comprehensive suicide risk training into physician licensure. Well, yes, of course it does. This is I seriously, this is a no-brainer. So let's let's see what they do actually do. This is this is incredible to me. Only three states in the United States, right? Only three states currently require physicians to receive suicide assessment training, and even among those, there is no continuity of in the requirement, right? So this is what they are. The state of Nevada, the requirement is two hours of training within two years of initial licensure, then two hours every four years after that. That's pretty bugger all, isn't it? Two hours of training in the first two years after you get your license to practice as a doctor, and then two hours every four years after that. It's a joke. In the state of Utah, they have a minimum of one online suicide prevention course from a list of from a list provided by the Utah Department of Commerce division of occupational and professional licensing. So it's it's a list provided by the Department of Commerce Division of Occupational and Professional Licensing. Yeah. ACERAP, the Australian Institute for Suicide Research and Prevention, that's where they should be sending these people for training. Griffith University, Brisbane, Australia. And in the state of U Washington in the United States, what they require is one a one-time six hour CME, which is continued medical education, one a one-time, six hour session on suicide prevention during the first full CME reporting period. So bugger all it's frightening, isn't it? But let's go down here to where it talks about the impact of training on physician competency. This is interesting. Medical students, residents, and physicians often report feelings of discomfort when dealing with suicidal patients. We know this. We study it when we do the master's degree of suicidology. They talk to us about it. Many studies reveal that most medical students, regardless of location and nationality, carry negative attitudes towards suicidal clients. More specifically, most believe that suicidal patients are lonely and depressed and believe that suicidal behavior stems from traits associated with weak personality and self-destructive tendencies. In another study, about 40% of pediatric residents indicated that they were uncomfortable conducting patient suicide risk assessments, despite about 75% of respondents reporting seeing a suicidal patient on a regular basis in their primary care practice. Another qualitative study of young physicians experienced highly highlighted challenges in establishing connections, maintaining competence, and maintaining emotional reactions when dealing with suicidal patients. They reported emotional distress, grappling with practical concerns, fears of making incorrect decisions, and the weight of responsibility for the patient's life, while also citing drawing on their own personal experiences to inform their approach. We know this is the case. You know, there's been a lot of literature around that. There's the case of, you know, do they do too little or do they do too much? It's it's you know, it's almost an impossible situation to be in. That's why this need for training is just a given. It's a no-brainer. Research consistently demonstrates that training significantly boosts doctors' confidence and ease in addressing suicide prevention. For instance, a study involving over 2,000 healthcare professionals revealed a notable increase in their assurance in managing suicide risk following training sessions. Similarly, an evaluation of a training program including 873 healthcare professionals in Washington state showed enhanced knowledge and attitudes towards suicide prevention. Furthermore, a study of 500 primary care providers in Stockholm demonstrates that after receiving adequate training, they experienced heightened clarity, job confidence, and a positive outlook regarding their effectiveness in suicide prevention. Go the Swedes. Like I said, this is a no-brainer. I mean, seriously. Impact of training on patient care, trust within the doctor-patient relationship, which is what we talked about before, that therapeutic alliance, that's what they're talking about here. Trust within the doctor-patient relationship is always important, but this trust becomes essential in the areas of mental health and suicidality. Patient trust increases the likelihood of patterns, patients disclosing suicidal ideation, which is crucial for timely intervention and intervention and effective suicide prevention. Research has demonstrated that programs like the Mental Health First Aid, Applied Suicide Intervention Skills Training, and the Zero Suicide Framework help to equip providers with the tools to recognize warning signs and engage in meaningful conversations with at-risk patients, empowering providers to have the knowledge and comfort needed to help patients who have disclosed suicidal ideation. There really is no excuse for a doctor, a GP, a primary care physician to not be trained in suicide prevention, recognizing suicidality and risk assessment. There's no excuse in this day and age, really. The discussion despite suicide being a major public health issue, claiming over 800,000 lives worldwide yearly, many physicians lack the skills and confidence needed to assess suicidal patients and implement effective interventions. Most patients who die by suicide visited their primary care physician in the year before their death, and almost half had visited their primary care physician in the month before their death, placing physicians in the unique position to assess and treat suicidal patients. Like I said, it is just it is inexcusable that they're not trained in this now. In a landscape where psychiatrists are in high demand and relatively low supply, same as in India, like I said, this is a global thing. Primary care physicians are often the first and most consistent point of contact for patients with mental health concerns. Primary care physicians prescribe prescribe a p s a significant percentage of any anxiety and antidepressant medications, yet their training in suicide prevention varies widely. This inconsistency results in significant differences in their preparedness to handle mental health crises, highlighting a systemic failure to equip them with the necessary skills to address and manage suicidal patients. Many studies have revealed that physicians feel uncomfortable and ill-equipped to manage suicidal patients, despite frequently seeing patients at risk for suicide and the subsequent need for despite frequently seeing patients at risk for suicide and the subsequent weed for primary care physicians to receive standardized training, only three states mandate mandate suicide prevention training for all physicians. And seven additional states recommend training. I mean, seriously. Fuck, you recommend it, but you don't mandate it. Due to the critical role and likelihood of contact between physicians and persons at risk of suicide, integrating comprehensive suicide prevention training as part of licensure requirements for all physicians is essential to increase skills in literacy, confidence, and comfort levels. This will, in effect, improve consistency and quality of care across the medical community and make a strong contribution to the national suicide prevention efforts as well as commitment to prioritizing mental health and saving lives. Well, fuck. Yes. And it is the same globally. I mean, seriously, we have the same problem in Australia. There are so many doctors and GPs out there that have a limited amount of exposure to suicide risk assessment training protocols. You know, so it really, you know, my my I've got four takeaways from this one because I'm I'm so pissed off about it. I mean, I mean, really, firstly, I mean, how is this allowed to happen? Is is my first question. How is this not or how is this not already happening in relation to our GPs and our physicians being trained in suicide risk assessment and identifying suicidality and how to treat it? I mean, do we have a global mental health crisis and this is not and this and we've still got articles calling for training competencies. I call on the in educational institution to make this a core competency of, you know, you can't pass, you know, they you you can you can't become a GP, you can't become a psychiatrist, uh uh primary care physician until you've had adequate training in suicide prevention protocols. I mean, come on, people, it's a no-brainer. And and let's talk about the duty of care for the doctors, the self-care, you know, being able, putting themselves in that stressful situation, dealing with the high exposure to suicidal clients and and being ill-equipped and feeling uncomfortable and and not knowing how to deal with these people that have come in in in in a crisis, you know, and so we really need our health professionals to step up and and aside from the health well it's not the health professionals that need it's the the governing organizations that that say what you know what you've got to pass to become a doctor, basically, you know, suicide prevention training, it's a no-brainer. Make it a core competency. And at the end of the day, let's talk about return on investment. I mean, return on investment, however much you want to spend, the government wants to spend on making sure that their physicians, their primary care providers, their GPs, whatever money it costs for them to include core competencies in suicide prevention training, the return on investment will be significant. It will be significant. It will be significant in relation to lives saved. So anyway, I just get pissed off about this. I go, fuck, how is this not a thing? That this is anyway, the fact that there are articles like this coming out where people are calling for a national training in suicide prevention, uh, suicide competencies for all doctors. This is important. This is great. So I applaud the authors uh for putting this out there, and it yeah, it's it's really important. So I I do applaud them for putting it out there. All right, my friends, let's wind this up and let's talk about the last on our pulse list in this episode. Been chatting your ear off for I don't know how long now. How a Clemson Business Professor is rethinking humor in the workplace. The article that I'm about to read is significant, but the research article they're referring to in this article is even more significant, and I'll I'll tell you about it briefly, and and then you can go and do the research if you're interested. So here we go. This was published in October the second, twenty twenty-five, the beginning of this month. How a Clemson Business Professor is rethinking humour in the workplace. Here we go, in the workplace. Humor can be a valuable commodity, humor can lighten the mood, ease stress or tensions, and even build stronger connections. But what makes humor effective in the workplace, especially in leadership roles? Interesting. That's the question. Sharon Sheridan, assistant professor of management at Wilbur O and Ann Powers College of Business, and co-authors Cecilia Cooper, professor at Miami Herbert Business School, and DuJon Tony Kong, professor at the University of Colorado, Boulders Leeds School of Business, set out to find their study, rethinking interpersonal humor and organizations, clarifying constructs and charting a path forward, challenges the way organizational scholars have historically measured humor and offers a new framework that could reshape how researchers and leaders can think about laughter at work. That's interesting. The study's interesting, we'll get to that shortly. So let's just finish off what she's uh what this article's talking about here. Much of the existing research on humor comes from personality psychology, which looks at how someone's style of humor affects their own well-being, Sheridan said. But when you move humor into an organizational setting, it's not just about the individual anymore, it's about how others interpret and respond to it. Those are very different things. So beyond the humor styles. So past studies often past studies often group workplace humor into four main styles, right? So she's actually they're referring to here as the humor styles is put forward by Martin Adell back in 2003. It's based on the humor styles questionnaire. This has been the benchmark for a long, long time. I talk about it in the Laughter Clinic. It's something that I talk about a lot because you have I well, actually, I'll go through it. Four main styles of humor according to this the styles, the humor styles questionnaire. So we've got affiliative humour, which is basically what comedians do. We make other people laugh. You're the people at a barbecue, you've got snappy comments, boom, you're you're doing that. Affiliative humor positive. Self-enhancing humour is using humor as a way of coping with stress, negative life events, using humour as a way of building resilience, right? Very important. Lots of research to support the importance of self-enhancing humour. Self-defeating, laughing at the expense of yourself, aggressive, laughing at the expense of others, right? So that's what she talks about here. Past studies that group workplace humor into four main categories: affiliative, self-enhancing, self-defeating, aggressive. However, the research team found that these categories didn't take key factors into consideration that were important. These factors included the intent behind the joke, the content itself, and the audience reaction. Interesting. From a comedian's point of view, I find that interesting. The intent, the content, and the audience's reaction. Someone's motive for telling a joke, well, comedian's motive for telling a joke make people laugh. Someone's motive for telling a joke, the way it comes across and how people respond are all distinct, Sheridan explains. But the existing measures mixed them up, which created a lot of problems. To test this, the team collected data from over 1,000 working adults across various industries. They found evidence that showed leaders' humor was most effective, not because of a particular style, but because of how their intentions and concern for their employees was perceived. In other words, whether leaders joked to build relationships, cope with stress, or show they did not take themselves too seriously, the effect on employees was similarly positive. This research opens new questions about the role of context and intent. Sheridan's work shows that workplace humor is most effective when employees feel their leaders genuinely care about them. Of course, who doesn't want to know that your leaders care about you? It's less about telling the perfect joke and more about the message behind it and how leaders show support, give guidance, and create a positive environment. She plans to continue exploring how different workplaces shape how humor is received. Ultimately, we hope that this helps the field move forward with stronger tools and better questions, says Sheridan. Our work provides scholars with a clearer framework to study humor. By separating intent, content, and audience reaction, we can start asking the right questions about building a foundation for humor studies and organizational behavior. So the leaders out there, humor is a key, building relationships, all that sort of stuff. So what makes this so significant, really, this is the study that she's referring to up here, right? Which is rethinking interpersonal humor and organizations, clarifying constructs. So I found that, and that is here. Published 27th of May, 2025, a Journal of Management Studies, rethinking interpersonal humor and organizations, clarifying constructs, and charting a path forward. I'll read the abstract for you. Right? Organizational humor research is accelerating. However, scholars seem to disagree how to conceptualize and operationalize interpersonal humor. A widely used approach draws from personality psychology and conceptualizes humor as a typology of four styles. The humor styles approach possesses conceptual shortcomings and introduces important questions about construct validity. Specifically, do humor styles tend to conflate inferred motives and outcomes within the definition of each style, raising concerns about circularity and tautology. Moreover, its topology, typological foundation originally developed for an interpersonal context, becomes less tenable when applied interpersonally. To support the progression of humor scholarship, we begin by clarifying the core construct of humor, which serves as the basis for a broader conceptual critique of the humor styles approach. We conclude by proposing the MOHM. So this is a new model that they're proposing here, which is called the Model of Organizational Humor Motives. We all love our acronyms, don't we? I've got one. Hail, the Humor and Laughter Education Program. Yeah, we all love it. As a conceptually grounded alternative to guide future research on interpersonal humour, this research contributes to humor scholarship by clarifying the core humor concept, criticizing critiquing a popular approach, which is reducing construct clarity and offering a forward-looking framework to inspire more precise and impactful research on humor organizational set in organizational settings. So it's a very well documented study, this conceptual critique of the humor styles approach. Yeah, it's all very good. So I'm just going to go down here. Positive emotions, a sense of power. This is a fascinating study. Like I like there's so much to this. Hypothesis testing, discussion, a way forward, the conclusion as research progresses in any domain, scholars need to intermittently take a step back, survey the process being made, progress being made, and identify whether any course correction is needed to collectively improve the potential of a body of work. Right? So fundamentally it's like evidence-based practice, right? You've got something, you implement it, you evaluate it, you improve it, you implement it again, you evaluate it, improvement. So that's what you know, this like course correction is. Because for a long time, the humor styles and the humor styles questionnaire have been the benchmark since back in 2003. In this spirit, we offer a critique of the increasingly popular humor styles approach that is being used by organizational scholars to recommend a more promising path for organizational humor scholarship. We propose the MOHM as an alternative framework for addressing unanswered questions about organizational humor. The MH MOHM accommodates the seeming desire to study human motives and specifies the distinction between human motives, human expression, human judgment, and outcomes. Hopefully, a messaging and empirical demonstration will encourage scholars studying organizational humor to carefully carefully attend to construct clarity and validity when designing future studies. Charting this more rigorous path forward will benefit not only humor scholarship, but also scholarship related to the broad array of topics, diversity, creativity, leadership teams, etc., being studied with humor. So it's it's really full on. So once again, the links will be in the show notes. I think my takeaways for that one is I'm fascinated, fascinated how the article looks at motives and intent. How exciting is it that this stuff is being researched as well, you know, like around the world, like all the these research studies from around the world, from Indonesia, you know, from India, all of this stuff, it's it's just fascinating. And the fact that these people that are actually looking to research about Interpersonal humor and organizational context is very important. Very cool. Very, very cool. Okay, so my friends, I gotta tell you, it's been a uh it's been a journey to get to get through this, and I I really appreciate you sticking with me for the for the uh for the duration. If you are still with me, that is. There are so many research articles out there that I am finding as I go through looking for things to put in these pulse episodes. And these are ones that I think I find interesting, and I hope that you do too, you know. So like if you've if you've got something out of this episode, fantastic. I really appreciate you sticking with me for the journey because you know, there's we've covered a lot. We've covered a lot, but you know, there's nurses, India, Indonesia, we've been around the world, right? Basically. So yeah, that's it. Winding it up, my friends. So for this pulse episode, as always, I really appreciate your time. I really do. And wherever you are listening, thank you very much for tuning in. Please look after yourself and look after those around you. You can view this stuff on YouTube as well if you are interested in the video. But like I said, all links to articles that I'm referring to will be in the show notes. So until next time, my friends, take care, be kind to yourself, be kind to those around you. I'll talk to you later.

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Thank you for listening. The information contained in this podcast is for educational and entertainment purposes. It is not intended, nor should it ever replace advice received from a physician or mental health professional. Want more info? Visit thelumterclinic.com.au. If you enjoyed the episode, please share and subscribe. Thanks again for listening to the Lumpter Clinic Podcast with your host, Mark McConville.