Linda Lang, MD, is a board certified psychiatrist and serves as the Chairperson and President of Inova Behavioral Health Services.
When we’re sick or injured, we turn to our doctors. We trust that they’ll always be there to help us, treat us with compassion, and support us through our dark times. But what happens if it’s our doctors who are struggling?
Physicians are at higher risk of suicide than the average person, according to the American Medical Association. More than 300 doctors die each year by suicide. It’s the second leading cause of death among people ages 10 to 34 in the United States and the twelfth leading cause of death overall, according to the National Alliance on Mental Illness. Among physicians, women are more likely to die by suicide than men are.
In 2021, the Lorna Breen Health Care Provider Protection Act became law. Named for an ER physician who took her life during the height of the COVID-19 pandemic, a death to which burnout contributed, the law promotes mental health in healthcare workers by requiring hospitals to establish programs to address frontline workers’ mental health needs.
To decrease these preventable deaths, we must take concrete steps to increase awareness of suicide among doctors and decrease the incidence of burnout among physicians (and other healthcare workers) that contributes to it.
What factors contribute to suicide rates among physicians?
- Rigorous training requirements
- Dealing with life-and-death situations
- Pressure to be perfect/perfectionism/pressure to be successful
- Very little room for error or mistakes
- Lack of sleep, in some cases
- Stigma for physicians and healthcare professionals in general around getting help
- Left untreated, mental health or substance use challenges get worse, raising suicide risk
- Negative perception on their reputation if it becomes known that people are under the care of a psychiatrist or on psychiatric medication
- Lack of understanding of burnout, a lot of judgment
- Heavy workloads
- Personalities that are self-sacrificing in general, putting mental health (and physical health) last on the priority list because they’re too busy taking care of others
Burnout is a big contributor to depression and suicidality among physicians. They spend an immense amount of time in medical school, residency, and fellowship. There’s often a profound exhaustion, but they can’t take a break because it impacts their fellow colleagues who are equally exhausted. They often have less time for coping mechanisms that would help them feel better, like exercise, hobbies, or time with family.
What can physician colleagues and healthcare organizations do to address the prevalence of physician suicide?
- Licensing organizations need to encourage people to seek mental health or substance use treatment
- Because the cost of care can sometimes be unmanageable, particularly for residents, subsidies for early-career physicians could help people get support early on.
- We must normalize that it’s okay not to be okay – physicians are highly resilient in general, but people are not always going to be resilient to the symptoms of burnout.
- Support the idea of work-life balance for physicians, so they have time to exercise and socialize to create wellness and a sense of belonging.
- Hospitals should consider chief wellness officer positions to address health and wellbeing on an organization-wide level.
- Give doctors more scheduling flexibility to promote healthy boundaries.
- Help physicians reduce time spent on documentation by using technology and digital strategies to intervene.
Overall, we need a culture shift in healthcare, so we can talk about and prioritize mental health and wellness. Without mental health and wellness, where do we go next? It’s absolutely critical, because it’s the foundation of our ability as physicians to help our patients.
Four action steps to reduce physician suicide risk
- For individuals who are struggling: The new 988 suicide and crisis line offers 24/7 confidential support.
- For colleagues: Be familiar with, and aware of, the signs of depression and suicide risk, so we can have each other’s backs as we work together to serve our patients.
- For organizations: Have easily accessible resources available, so physicians know how to find help quickly.
- For the medical field as a whole: Focus on prevention by holding licensing organizations accountable and reducing stigma so people can get the help they need.
Together, we can work toward a world where physicians are not at high risk of suicide.
If you are dealing with feelings of depression, anxiety or chronic stress and if you do not have a primary care physician, we welcome you to make an appointment with a provider at any of our Primary Care locations. Or you can also contact a mental health professional can help you to develop the tools to help improve your mental wellbeing.