Please confirm that you would like to log out of Medscape.
If you log out, you will be required to enter your username and password the next time you visit.
Log outCancel
Jon McKenna | March 3, 2023 | Contributor Information
Suicide has become an American public health crisis, and among physicians, rates of suicidal thoughts and suicide attempts are higher than with average Americans, sometimes substantially so.
Medscape surveyed over 9100 physicians across more than 29 specialties who were candid about their experiences with suicide attempts and suicidal thoughts. They revealed why they contemplated suicide, whether they reached out for help and to whom, how they look after their own mental well-being, and whether they helped colleagues who were struggling.
(Some totals in this presentation do not equal 100% because of rounding.)
Jon McKenna | March 3, 2023 | Contributor Information
Doctors' descriptions of their depression, which sometimes can trigger suicidal thoughts, were consistent with what our 2022 report found (24% reported more severe clinical depression, 64% pointed to the colloquial variety). Those percentages reflected physicians who said that they were depressed, which this year included 23% of all respondents.
Unfortunately, depression has been a serious problem in the medical community "for about as long as we've been measuring," says Andrea Giedinghagen, MD, assistant professor of psychiatry at the Washington University in St. Louis School of Medicine. "Too much work with too little control is a recipe for depression in anyone.
"Physicians are also still coping with a pandemic — the trauma from COVID-19 didn't disappear just because the full ICUs did — and with a fractured healthcare system that virtually guarantees moral distress. This is beyond individual solutions for individual problems. Systemic change is necessary," she says.
Jon McKenna | March 3, 2023 | Contributor Information
As in our 2022 report, 1% of physicians said that they had attempted suicide and 9% acknowledged contemplating it. The comparable statistics in our 2021 report were 1% and 13%, respectively.
Physicians significantly more often report suicidal thoughts or attempt suicide than the average for US adults (4.9% and 0.5%, respectively), according to the National Institute of Mental Health.
The combination of high rate of suicidal thoughts and knowledge of lethal means among physicians concerns Peter Yellowlees, MBBS, MD, CEO of the mental health platform Async Health. "In this context, [the percentages shown above] are worryingly high numbers and markers we should be concerned about," he says.
Jon McKenna | March 3, 2023 | Contributor Information
Male and female physicians said that that they contemplated or attempted suicide or, alternatively, that they never considered it at fairly similar rates. That was also the case in our 2022 report.
In the general US population, studies show that "females are two to three times more likely to attempt suicide than males are," warns Perry Lin, MD, national co-chair of the American Association of Suicidology's Physician Suicide Awareness Committee and an assistant clinical professor of osteopathic medicine at Ohio University.
Jon McKenna | March 3, 2023 | Contributor Information
The youngest generation of physicians was more likely than others to have thought about or attempted suicide. This differs somewhat in the broader American population; older people, especially men aged 45 years or older, typically deal with higher suicide rates, notes Michael F. Myers, MD, professor of clinical psychiatry at SUNY Downstate Health Sciences University in Brooklyn, New York.
"Admitting to having felt suicidal but not attempted suicide does speak to how stressed a certain cohort of today's doctors are," he says. "The fact that only a small percentage of these individuals went on to attempt suicide is a good sign that they perhaps shared this with a trusted colleague, friend, or family member or sought professional help.
"It might also mean that disclosing [a suicide attempt] is less stigma-tainted than it used to be, that individuals understand this as part of a serious mental health issue and not a sign of weakness."
Jon McKenna | March 3, 2023 | Contributor Information
From year to year in our past few reports, the specialties with the highest rates of doctors saying that they had suicidal thoughts tend to be very different.
Jon McKenna | March 3, 2023 | Contributor Information
In recent years, physicians have shown themselves slightly more likely to bring ideas about suicide to a therapist (34% in our 2019 report) and slightly less likely to confide in none of the people listed above (42% in 2019). Another promising sign is that in last year's report, doctors said that they turned to a family member more often than a therapist.
"It's pleasing that physicians are more prepared to see a therapist and less likely to keep their distress entirely to themselves," Yellowlees says.
"It's possible that the need for mental healthcare is become less stigmatized nationally, with the large and increasing emphasis on physician well-being during and after [the] COVID-19" pandemic.
Jon McKenna | March 3, 2023 | Contributor Information
Despite some perceptions, male doctors generally reached out to various people about their suicidal thoughts as often as their female counterparts did. If anything, men might have confided in a therapist or family member slightly more often than women did.
It's not easy for any physician to seek out therapy when it comes to suicidal thoughts, Giedinghagen says. "The stigma is intense, especially if you live in a state where you might have to disclose such things on a licensing questionnaire.
"Of course, I'm most concerned about the 40% of respondents who didn't tell anyone. Check in with your colleagues. Sometimes in the midst of depression or suicidality it can feel like too much to reach out, but someone reaching in will almost always be appreciated."
Jon McKenna | March 3, 2023 | Contributor Information
Physicians most often cited the "I can do it alone" reason for not reaching out to a mental health professional. But possible professional impacts — fears that medical boards, insurance companies, or colleagues could find out and respond negatively — also played material roles.
"Though as physicians we recognize suicidal ideation as an area of high concern and would take what a patient says very seriously, we are less likely to do this ourselves," Lin notes. "There is a lot of stigma among help-seeking behavior."
As fears about how medical boards and other third parties could react, "these…are symptoms of the larger issues," he believes. "Doctors are willing and able to treat suicidal ideation among patients but appear fearful to seek such help themselves. We must do better."
Jon McKenna | March 3, 2023 | Contributor Information
The frequency with which colleagues share their contemplation of suicide with physicians was similar in last year's report. And male doctors were chosen as confidants about as often as their female counterparts were.
How well doctors listen during these conversations matters, for the colleague's sake and because potential impacts of colleague suicide on co-workers has not been widely researched, according to an analysis in the International Journal of Environmental Research and Public Health.
Jon McKenna | March 3, 2023 | Contributor Information
Results from doctors responding to this question were very similar to those in last year's report, with a slightly higher share of physicians recommending professional help (73% last year). Respondents described arranging psychiatrist visits for a colleague ("I demanded and ensured they received help"), accompanying someone to the emergency department, and helping a co-worker arrange a leave of absence and inpatient treatment.
"I am a psychiatrist and treat more than 30 doctors," one respondent said.
Jon McKenna | March 3, 2023 | Contributor Information
Female doctors were somewhat more willing to talk with a potentially suicidal colleague and/or steer them to professional help than were their male counterparts.
On the other hand, in last year's report, male physicians were somewhat less likely to approach the colleague's family member or supervisor. That reluctance seems to be changing.
Jon McKenna | March 3, 2023 | Contributor Information
Younger physicians were more often inclined to answer with a yes, that a medical school or healthcare employer should be held responsible for a student's or doctor's suicide. With both succeeding age groups, physicians became less amenable to that idea.
Myers finds the idea of an institution bearing the ultimate responsibility bothersome and simplistic. "Most suicides are multifactorial, many stressors coming together all at once in a person's life, a so-called 'perfect storm'," he notes. "When and if it appears that a vulnerable medical student or physician was very poorly treated by their medical school or healthcare organization, then yes, we might conclude that this was one of the drivers of their suicide.
"But there are suicides each year involving medical students and physicians that have nothing to do with the medical school or place of work."
Jon McKenna | March 3, 2023 | Contributor Information
Physicians continued to turn to healthy behaviors like more time with family and friends; hobbies and personal interests; and exercise at strong rates, which could bode well for addressing suicide in the profession.
Doctors reported time with family and friends and getting more sleep slightly more often than they did in last year's report. Use of therapy in their personal mental health maintenance was essentially flat.
Jon McKenna | March 3, 2023 | Contributor Information
Doctors can turn to several physician-specific or general suicide phone or text help lines. The organizations listed above also can provide a variety of prevention and support resources. Yet another organization, the American Association of Suicidology, has a special committee generating awareness of suicide issues among doctors.
Physicians discuss their personal and professional happiness, how they strive for work-life balance, and successes and failures in looking after their own physical and mental health.Medscape Features Slideshow, Jan 2023
Commenting is limited to medical professionals. To comment please Log-in.
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Close
Contributor Information
Jon McKenna
Senior Editor, Reports
Medscape Business of Medicine
Close
References
Close
Image Zoom
Close
Feedback
Please do not use this form to submit personal or patient medical information or to report adverse drug events. You are encouraged to report adverse drug event information to the FDA.
Comments