Medical doctors are more likely to die from suicide than members of any other profession in the US, suggests new research presented this week at the annual meeting of the American Psychiatric Association. And worse than that, few interventions seem to have helped make these suicides less common.
Studies have consistently shown that doctors die from suicide at a higher rate annually than people in any other profession, and some research has found that a majority of medical professionals suffer from serious work stress and burnout. But the authors behind this latest work wanted to not only get a clearer picture of how often these deaths happen, but whether any programs have successfully helped lowered rates. So they examined relevant, peer-reviewed studies dealing with both issues over the past 10 years.
They found that anywhere from 28 to 40 doctors per every 100,000 a year die from suicide in the US (in raw numbers, that might amount to anywhere from 300 to 400 suicides a year). By contrast, the annual age-adjusted rate of suicide among all Americans was 13.42 deaths per every 100,000 people in 2016. Women doctors attempted suicide far less often than American women overall, but they died from suicide at roughly the same rate as male doctors. Generally, women are known to have suicidal ideation and to attempt suicide more often than men, but are less likely to die from it.
When the researchers looked at studies of interventions meant to reduce suicide ideation or symptoms of depression among doctors, they found disappointing results. Overall, there was no real reduction in suicide rates or other related metrics following the implementation of these interventions, such as physician health programs offered by hospitals.
“Suicide amongst physicians is an under-recognised public health concern,” the authors wrote in their abstract (the study in full has yet to be published in a peer-reviewed journal). “To date, treatment interventions have not lowered the rates of physician suicide.”
The review also highlighted some preventable risk factors that might make doctors more vulnerable to suicide. Prior to their suicide, many doctors had been diagnosed with mood disorders, or had alcohol and substance use problems. And the most common method of suicide was medication overdose, followed by firearms.
Many doctors struggling with suicidal ideation or depression, however, never seek any psychiatric help. One study the authors reviewed, based on a Facebook survey of over 2,000 doctors, found that half reported fitting the criteria of a mental disorder but avoided seeing anyone for it because they feared being stigmatised. That hesitance, the authors say, might be the greatest obstacle to effective, early treatment.
“To reduce the number of physicians taking their life, fear of stigma and other risk factors have to be addressed through more research aimed at effective and early intervention,” they wrote.
The findings, sobering as they are, weren’t entirely bleak. One study of a web-based program that provided cognitive behavioural therapy to medical interns did find it was associated with lower rates of suicidal ideation. And by showcasing their research, the team hopes more doctors will become willing to discuss their mental health issues, and that more hospitals will create evidence-based programs that can help doctors struggling with work burnout and depression.
If you or someone you know is having suicidal thoughts, please call the Samaritans on 116 123. [APA 2018 via WebMD]