Newly-updated research point to hopeful shifts, as well as enduring risk factors, in the risk factors that surround of U.S. physician suicide. In 2013, Katherine Gold, M.D., M.S.W., M.S., associate professor of family medicine and obstetrics and gynecology, and colleagues published a report in General Hospital Psychiatry that revealed details on the nature of physicians’ experiences before suicide. In her original analysis, Gold found that physicians at risk for suicide were less likely than the general population to seek out and and receive mental health care diagnosis and treatment prior to their death. The work utilized 2003-2008 data collected from the U.S. Centers for Disease Control and Prevention in the National Violent Death Reporting System (NVDRS).
Today, Gold has updated the original study with NVDRS data from the 2010 to 2015 across 27 states. Among the key findings, male physicians are now more likely than non-physicians to have sought out and received mental health care, including diagnosis and treatments. Male physicians were also more likely now to have disclosed suicidal intent to a health care worker. However, these positive shifts appeared for male physicians only. Female physicians at-risk were neither more or less likely than non-physicians to have received mental health care. And notably, no female physician who died by suicide had disclosed suicidal intent to a health care worker. Gold writes,
“Not a single female physician disclosed intent to a health care worker, suggesting that female physicians with intent to die by suicide may be particularly hard to identify.” “Women physicians may feel increase stigma which contributes to their higher risk for suicide.”
One looming host of risk factors that persist are job-related stressors and actions which threaten physician identity. Physicians in the sample were more likely than the general population to have recent job crises. Gold notes that “state licensing boards often require disclosure of mental health conditions which increases stigma and inhibits treatment.” She continues, “a threat to job security or professional identity may be life-threatening events of physicians more than for non-physicians which may impact how we address self-expectations and sense of identity.”
The report recommends targeted support and care for physicians facing professional-identity threats and paying special attention to female physicians at risk of suicidal crises who would benefit from mental health care, including supportive disclosure, evaluation, and treatment.
The results are available in-press in a 2020 update, published in General Hospital Psychiatry.
Article Citation: Gold KJ. Mental health and job crises as risks for physician suicide: Updates from the National Violent Death Reporting System. General Hospital Psychiatry. 2020. doi: 10.1016/j.genhosppsych.2020.03.010.