​Estimates on physician suicide have said 300 to 400 physicians are lost each year to suicide, according to a report on physician suicide published August 1, 2018, on Medscape. Inaccurate death reporting or coding makes it difficult to know precisely how many physicians commit suicide each year, but the medical profession consistently ranks near the top of the list of occupations that have a high rate, the report says. Suicide can result when depression or other mental illnesses go untreated or are inadequately treated, and according to the report, depression is at least as common in the medical profession as it is among the general population, with 12% of men and 19.5% of women in the medical profession estimated to experience depression. Compounding the problem, medical professionals are highly likely to have the knowledge and access to lethal means to commit suicide, the report's author says. Worldwide, trainees in the medical profession experience even higher rates of depression, with one international study finding 15% to 30% of medical trainees screened positive for depressive symptoms, according to the report. Additionally, the report says, other international studies have shown higher rates of mental illness and suicidal ideation among both medical trainees and professionals. Medical professionals may also be more reluctant to seek mental health treatment because of fear of stigma, shame, or employment concerns, leading some physicians to attempt self-treatment. After the suicide of a 33-year-old physician, one Tennessee healthcare staffing company decided to confront physician burnout, which they believed was partially to blame for the young physician's suicide, according to a July 31, 2018, NPR article. At the heart of their organizational change was the idea that physicians should work a reasonable number of hours, according to the article, and the company reports their emergency room physicians now work an average of 40 hours per week. But according to another physician, confronting burnout is not enough. She said stigma around mental illness has led physicians she has known to seek therapy out of town and under fake names, according to the article. Learning about other physician's experiences with mental health treatment led her to create an anonymous helpline, and she has since gathered more than 900 accounts of physician suicides.

HRC Recommends: Despite physicians' responsibility to manage the health of others, management of their own wellness is often ignored. In addition to the barriers already described (e.g., fear of what colleagues will think, pressure to prove oneself), another significant barrier is required disclosure of a mental health history on applications such as state licensing forms. To avoid disclosure, some physicians choose to avoid treatment. Risk managers should ensure that their organizations provide a genuinely supportive environment for their healthcare professionals by providing tools and strategies for individual self-care and resiliency, opportunities to debrief after stressful situations, limits on moonlighting and consecutive workdays, and more. Healthcare providers who are experiencing depression or who are thinking of suicide or self-harm should have easy, rapid, anonymous access to a help line, service, or other support system. Risk managers should also be sure applicants and employees know that some behavioral health conditions are covered under the Americans with Disabilities Act of 1990.

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741 or chat online with a counselor at https://suicidepreventionlifeline.org/chat.