In lieu of an abstract, here is a brief excerpt of the content:

  • The Crisis of Clinician Suicide Is Preventable:Organizations Must Take Proactive Steps to Foster Wellness
  • Virna Little, PsyD, LSCW-R, SAP, CCM and Rick Brown, MA (bio)

Since the founding of our membership network in 1996, the Association of Clinicians for the Underserved (ACU) has been committed to supporting, educating, and empowering health care workers of all backgrounds to practice in medically underserved communities. A vital component of this mission is fostering clinician resilience and wellness, particularly in the aftermath of the COVID-19 pandemic which stretched an already exhausted and burnt-out clinical workforce to the breaking point. As a national advocate for the clinical workforce, ACU strives to support health care professionals coping with myriad challenges to wellness, such as day-to-day experiences with vicarious trauma, moral injury, and potential suicidal ideation.

That last risk has come into sharper focus in recent years as advancing scholarship fills in the gaps of our understanding on a longstanding issue: that physicians and other clinicians face significantly higher rates of risk of suicide than the general public. While health care professionals of all disciplines work to improve the health of others, they often deprioritize or sacrifice their own wellbeing to do so. This professional culture and other factors such as stigma and institutional barriers have contributed to a preventable crisis of suicide among clinicians, one recognized in part by National Physician Suicide Awareness Day (September 17). To foster a stronger clinical workforce and allow clinicians of all disciplines to better care for others, health care organizations should prioritize staff wellness and take proactive steps to address the risk of suicide in their staff. [End Page xii]

The Scope of the Crisis

Suicide rates increased by 37% between 2000–2018 and after a brief decline, they later rose again in 20211 and reached their highest reported levels in 2022.2 Health care professionals are no exception to this trend. For nearly 150 years, it has been known that physicians have an increased propensity to die by suicide.3 Male physicians are 1.4 times more likely to die by suicide than the general male population, and female physicians are 2.27 times more likely to die by suicide than the female population.4 Studies differ in their estimates of the scope of physician suicide: one analysis estimated that 119 physicians die by suicide each year—likely representing a lower boundary5—while another estimated that approximately 300 physicians die by suicide each year.6 Additionally, a 2023 national survey found that more than half of physicians know of a colleague who has either considered suicide or ended their lives by suicide.7

Similar issues have been found among nurse practitioners (NPs) and physician assistants (PAs), who are increasingly overtaking physicians as primary care providers, particularly in community health centers.8 Female PAs and NPs, particularly, have significantly elevated rates of suicide when compared with women of working age in the general population.9 Nor is this issue limited solely to physicians, PAs, or NPs. Nurses constitute the largest share of the U.S. health care workforce, and they, too, are at significantly higher risk of suicide than the general population.10 Female nurses, particularly, are more likely to die by suicide than women in the general population.11

Unfortunately, many health care professionals do not seek care for suicidal ideation. Indeed, 35% of physicians who reported ideation in one study stated that they would not likely seek help,12 and only 16% of medical students with depression sought treatment despite data indicating that nearly a third coped with depressive symptoms that worsened year-over-year.13 The professional culture of clinicians often emphasizes stoicism and a lack of regard for self-care, and stigma against mental illnesses in clinicians is pervasive in the medical community.6 Despite findings that burnout, not depression, is associated with self-reported medical errors,14 fears of having a mental health diagnosis on their professional record also lead many clinicians not to seek help.15 Therefore, many clinicians simply forego treatment,16 leading to sometimes devastating results.

What Organizations Can and Should Do to Help Prevent Clinician Suicide

Health care professionals should not have to...