In the spring of 2020, the New York Times reported the heartbreaking story of Dr. Lorna Breen, an emergency medicine physician in Manhattan. After endless days of treating and often losing patients with COVID-19, Lorna fell victim to suicide. Her story made headlines, even making an appearance here on the Jackson Physician Search blog. However, it is sadly not unique. While the exact figures on physician suicide rates are unknown, it is estimated that nearly one physician dies by suicide every day. These numbers indicate that physician rates of suicide — 40 per 100,000 physicians — are considerably higher than the rest of the population. (Medscape)
As we enter suicide awareness month, with National Physician Suicide Awareness Day occurring on September 17th, we must take a hard look at physician mental health struggles and steps to help alleviate them.
Physician Depression and Suicide Rates
A 2023 report from Medscape summarizes the findings of a survey of 9,000 physicians on the topic of suicide and depression.
- One in four (24%) physician respondents report being clinically depressed
- 9% have thoughts of suicide
- 1% have attempted suicide
- Women and younger physicians are more likely to report suicidal thoughts
- Specialties with higher suicidal ideation include otolaryngology, psychiatry, family medicine, anesthesiology, OB/GYN, and emergency medicine
- The most common reasons for not disclosing suicidal thoughts are not wanting to disclose to the medical board (42%) and concerns about it being on insurance record (33%)
Another startling statistic, as noted on the Physician Suicide Awareness website, is that more than half of physicians know a physician who has either considered, attempted, or died by suicide. The reality of physician suicide leads to the question of “why?” Certainly, physicians have stressful jobs, often leading to burnout. However, the relationship between burnout, depression, and suicide is complex.
Although burnout and depression are frequently mentioned together, they are not inherently linked. In a conversation with AMA News, Dr. Christine Sinsky, AMA Vice President of Professional Satisfaction, explained that burnout is an occupational syndrome driven by external, work-related factors. In contrast, depression is a medical condition influenced by a range of causes, both biological and environmental. She also pointed out that while many physicians with depression also experience burnout, only a small fraction of those suffering from burnout meet the criteria for clinical depression.
However, untreated burnout can contribute to depression, anxiety, and other mental health disorders, which are risk factors for suicide ideation. As noted in the Medscape report, physicians are often reluctant to seek help due to the stigma associated with mental illness within the medical community. Many fear professional repercussions, such as loss of licensure or damage to their reputations, if they disclose their struggles.
The Role of Physician Suicide Awareness Day
National Physician Suicide Awareness Day, observed annually on September 17th, aims to break the silence surrounding physician suicide by fostering a culture of openness and support. The NPSA Day initiative emphasizes the importance of awareness, education, and action to reduce the stigma associated with mental health struggles among physicians. It encourages healthcare organizations to create environments where physicians feel safe discussing their mental health without fear of professional consequences.
NPSA Day also aims to highlight the importance of mental health screenings, peer support networks, and providing mental health resources tailored specifically for physicians. The goal is to raise awareness and promote meaningful change in the culture of medicine, where physicians are supported holistically and feel empowered to seek help when needed.
Strategies to Mitigate Burnout and Its Effects
- Creating Supportive Work Environments: Healthcare organizations must take active steps to create a culture that prioritizes mental health. This includes reducing administrative burdens, optimizing workloads, and ensuring adequate staffing levels. Encouraging regular time off and promoting work-life balance can help alleviate some of the pressures that contribute to burnout.
- Providing Access to Mental Health Resources: Physicians need easy access to confidential mental health services. Institutions should offer Employee Assistance Programs (EAPs), counseling services, and support groups specifically designed for healthcare professionals. Additionally, promoting digital health tools, such as teletherapy, can provide a more accessible and stigma-free option for those seeking help.
- Encouraging Open Communication: Healthcare organizations must foster a culture of openness, where physicians feel comfortable discussing their struggles without fear of judgment or professional repercussions. This could involve implementing regular check-ins, mental health days, and peer support initiatives. By normalizing conversations around mental health, institutions can reduce the stigma that often prevents physicians from seeking help.
- Implementing Peer Support Programs: Peer support programs can provide an invaluable source of comfort for physicians struggling with their mental health and/or burnout. These programs connect physicians with colleagues who have undergone similar experiences, creating a sense of community and understanding that is crucial for recovery.
- Advocating for Policy Changes: Legislative changes such as removing intrusive mental health questions from licensure and credentialing applications are also essential. The Dr. Lorna Breen Heroes’ Foundation champions this and other efforts to reduce and prevent suicide, burnout, mental health conditions, and substance use disorders.
A Call to Action
The statistics surrounding physician suicide are a sobering reminder that the healthcare community must take action. Burnout and suicide among physicians are not only personal tragedies but also systemic issues that affect the entire healthcare system. As we approach National Physician Suicide Awareness Day, it is imperative to reflect on the steps needed to protect the mental health of those who dedicate their lives to caring for others.
The call to action is clear. Healthcare organizations, professional bodies, and individual physicians must all play a role in creating a culture prioritizing mental health, where physicians feel safe and supported in seeking help. The future of medicine depends on the well-being of its practitioners. It is our collective responsibility to ensure that those who care for others are cared for in return.
About National Physician Suicide Awareness Day
National Physician Suicide Awareness Day (#NPSADay) is a reminder and call to action. It’s a time to talk – and to act – so physicians’ struggles don’t become mental health emergencies. Prevention begins with learning the signs, starting the conversations, removing intrusive mental health questions, and sharing the resources that can help those in distress seek mental health care. National Physician Suicide Awareness Day is an annual event that takes place on September 17, with a mission to break down the culture of silence around physician mental health. Learn more at NPSADay.org.
If you or someone you know is in crisis or struggling with thoughts of suicide, call or text 988 or chat 988lifeline.org.
