Physician Suicide: Sounding a Mental Health Alarm

By Ruchi M. Fitzgerald, MD

The life of a physician is incredibly challenging. Hours and hours of training and patient care with inadequate emotional and mental health supports built in to balance out chronic stress levels. It’s a labor of love, but it takes its toll.

Sept. 17, 2020, is National Physician Suicide Awareness Day. A staggering number of physicians and others working in the medical field die each year by suicide. In fact, the number is an estimated 300 physicians, with rates continuing to rise, according to a report in Missouri Medical, The journal of the Missouri State Medical Association.

This startling data that has not changed since 2003, when it was presented at the national American Psychiatric Association by researchers in 2018, which urges all of us to consider implementing more preventive strategies in our workplaces to address emotional supports for health care workers.

National Physician Suicide Awareness Day is a day that allows us to remember those in the medical field who have died by suicide. For me, it is a stark reminder to pause and make sure I am doing my part to continue to break the stigma surrounding depression, substance use/misuse and emotional distress that are at play for so many people in the medical field. It’s also a great time to review some specific action plans on how to help a colleague in distress by reviewing the resources available here at Rush and nationally.

I have had the privilege of treating many medical professionals in the course of my family medicine career who have reported suicidal thoughts and ideation. I would have never known unless I had asked the right questions. Doctors’ stories are especially important to hear as they often deal with so much trauma, grief and stress every single day at work, and then are expected to return home and function as “normal” humans.

September 17 is also a day of hope. We share stories of physicians who have recovered, and we work on suicide prevention strategies. Recovery is possible from severe depression and hopelessness with the right supports. I encourage every health care professional to read through the resources that are available as one never knows when they may be called upon to help a colleague in need. Asking colleagues, residents or medical students the right questions and directing them to the right resources can be a life-saving measure.

Putting support systems in place

I have also had the opportunity to work with the American Medical Association, the American Society of Addiction Medicine and the Federation of State Physician Health Programs on supporting pending legislation (Senate Bill 4349) that aims to reduce and prevent suicide, burnout, and address psychiatric disorders such as depression and anxiety among health care professionals. This bill, titled the Dr. Lorna Breen Health Care Provider Protection Act, also has a House companion bill HR 8094.

The bill is especially critical as it advocates for resources for health care professionals to receive confidential help during these unprecedented times of stress. Many medical professional societies are advocating for sustainable legislative changes so that physicians can receive more confidential help without fear of reporting to state medical boards or their workplaces — another way of abolishing the stigma associated with depression, anxiety and substance use disorders that are prevalent in the medical profession. Federal legislative precedent is one way to start breaking stigma and allow medical professionals to receive the help they may need — confidentially and without fear of losing their job.

As part of this day, I wanted to share resources on this highly stigmatized topic as the loss by suicide impacts all of our lives in different ways. My hope is that these resources provide some much needed support to my fellow clinicians.

We are so fortunate here at Rush University Medical Center to have a robust Center for Clinical Wellness that supports clinicians and students with an incredible array of resources available 24/7. Also having our chief wellness officer, Bryant Adibe, MD, in place is also part of a crucial strategy to protect clinicians’ well-being and resilience, according to the journal Health Affairs. To learn more about the Rush Wellness initiative, click here.

Additional resources

  • The American Association of Suicidology is hosting a day of Facebook interviews starting at 11 a.m. EDT, where experts will be talking about physician suicide and what we can do to help.
  • Therapy resources include:
    • The Emotional PPE Project offers free individual therapy for health care workers during the COVID-19 pandemic. The support is confidential.
    • Project Parachute offers individual therapy and in some states, peer support, for health care workers during the COVID-19 pandemic. The support is confidential.
  • Other resources:
    • A StepsForward learning module from the American Medical Association provides a checklist that helps identify physicians who may be at risk of suicide, facilitates access to appropriate care, and answers common questions about physician distress and suicidal behavior.
    • American Foundation for Suicide Prevention offers a full page of resources around physician suicidality, including links to toolkits for medical schools and residency programs for bereavement support after suicide, which could be adapted at a hospital or health system level.
    • Council of Residency Directors in Emergency Medicine (CORD) features support materials on its site.
  • For those in recovery, or struggling with a substance use disorder:
    • Recovery Dharma is an online community that offers healing with a Buddhist practice.
    • Smart Recovery, or Self-Management and Recovery Training, features an online community that offers mutual support and a four-point program.
    • Refuge Recovery is a peer-led movement using Buddhist-inspired practices and principles, combined with successful recovery community structures, to overcome addiction.
  • How to Reach Out to a Colleague in Distress: Dike Drummond, MD, from shares this five-minute video and walks you through some tips on how to reach out to a fellow physician or other human in distress.
  • Vital Signs by The Physicians Foundation: This project lists five vital signs to watch for in colleagues and features conversation tips sheet on having a difficult conversation with someone you recognize is struggling.

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