Physician and Medical Student Depression and Suicide Prevention
Placing a priority on mental health enables physicians to better take care of themselves and their patients.
After a Suicide: A Toolkit for Residency/Fellowship Programs
In the event of a trainee’s death by suicide within a physician residency or fellowship program, it is critical to have a plan of action in place. This practical handbook provides guidance for hospital and program leaders.▲ Back to Top
Facts about physician depression and suicide
Physicians have higher rates of burnout, depressive symptoms, and suicide risk than the general population. Physicians and trainees can experience high degrees of mental health distress and are less likely than other members of the public to seek mental health treatment. Physicians report several barriers to seeking mental health care, including time constraints, hesitancy to draw attention to self-perceived weakness, and concerns about reputation and confidentiality. Other facts include:
- Suicide generally is caused by the convergence of multiple risk factors — the most common being untreated or inadequately managed mental health conditions.1, 2
- An estimated 300–400 physicians die by suicide in the U.S. per year.3
- Physicians who took their lives were less likely to be receiving mental health treatment compared with nonphysicians who took their lives even though depression was found to be a significant risk factor at approximately the same rate in both groups.4
- The suicide rate among male physicians is 1.41 times higher than the general male population. And among female physicians, the relative risk is even more pronounced — 2.27 times greater than the general female population.5
- Suicide is the second-leading cause of death in the 24–34 age range (Accidents are the first).6
- Twenty-eight percent of residents experience a major depressive episode during training versus 7–8 percent of similarly aged individuals in the U.S. general population.7
- Among physicians, risk for suicide increases when mental health conditions go unaddressed, and
self-medication occurs as a way to address anxiety, insomnia or other distressing symptoms. Although
self-medicating, mainly with prescription medications, may reduce some symptoms, the underlying health problem is not effectively treated. This can lead to a tragic outcome.
- In one study, 23 percent of interns had suicidal thoughts. However, among those interns who completed four sessions of web-based cognitive behavior therapy, suicidal ideation decreased by nearly 50 percent.8
- Drivers of burnout include workload, work inefficiency, lack of autonomy and meaning in work, and work-home conflict.
- Unaddressed mental health conditions, in the long run, are more likely to have a negative impact on a physician’s professional reputation and practice than reaching out for help early.
The truth is that physicians who proactively address their mental health are better able to optimally care for patients and sustain their resilience in the face of stress.
Mental health problems are best addressed by combining healthy self-care strategies (which should not include self-medicating) along with effective treatment for mental health conditions.▲ Back to Top
Resources for physicians
Accreditation Council for Graduate Medical Education (ACGME) Resources – Resources to share with programs, institutions, residents, and fellows that promote a culture of physician well-being and provide support in the case of burnout, depression, or suicide.
Breaking the Culture of Silence on Physician Suicide – A sharable graphic and information about physician suicide from the National Academy of Medicine.
Creating a Safety Net: Preventing Physician Suicide – An article by AFSP Chief Medical Officer Christine Moutier, M.D., for the Association of American Medical Colleges’ AAMC News.
Reducing the Stigma: Faculty Speak Out About Suicide Rates Among Medical Students, Physicians – An article by Dana Cook Grossman, for the Association of American Medical Colleges’ AAMC News.
Preventing Suicide in Physicians, Residents and Medical Students (Video) – Dr. Christine Moutier addresses the American Psychiatric Association, May 20, 2016.
Symposium on Physician Well-Being – A symposium held on November 17-18, 2015 by The Accreditation Council for Graduate Medical Education (ACGME).
Leaders in Academic Medicine Address Physician Well-being and Resilience – A news release from the Association of American Medical Colleges.
Preventing Physician Distress and Suicide – Tools for identifying at-risk physicians and facilitating access to care from the American Medical Association.
Make the Difference: Preventing Medical Trainee Suicide (Video) – A 4-minute PSA from Mayo Clinic and the American Foundation for Suicide Prevention that explains how everyone can help prevent suicide by being alert for the signs of depression and escaping stress and how to be most helpful. This film can be used in medical school physician wellness, humanism and professionalism curricula. Featured at top of this page.
Why Physicians Die by Suicide – Dr. Michael Myers guides readers through the variety of factors that contribute to physician suicide. He then makes practical, across-the-board recommendations in an effort to prevent this tragedy, arriving at the encouraging conclusion that everyone has a role to play in saving a doctor’s life.
Struggling in Silence: Physician Depression and Suicide (DVD) – An award-winning, one-hour documentary from AFSP, that sheds light on the topic of physician mental health and suicide prevention, featured on public television stations nationwide. This film can be used in medical school physician wellness, humanism and professionalism curricula.
Struggling in Silence/Out of the Silence (DVD) – Two short videos (15 minutes each) describing physician and medical student depression and suicide risk. A printable resource guide and slide set are available for both films. These films can be used in medical school physician wellness, humanism and professionalism curricula.
Collateral Damage: The Impact of Patient Suicide on the Physician, a DVD film of several physicians speaking about their experience of patient loss to suicide, and group discussion. Psychiatrists featured in this educational film include Drs. Glen Gabbard, Sidney Zisook, and Jim Lomax. This resource can be used to facilitate an educational session for physicians, psychologists, residents or other trainees. Please contact [email protected] to request the DVD.
American Medical Student Association – The oldest and largest independent association of physicians-in-training in the United States.
Suicide Risk in Physicians – Emergency Physician Dr. Mel Herbert produces a popular podcast called EMRAP for healthcare professionals in Emergency Medicine. In this 26-minute podcast he speaks with Dr. Christine Moutier about suicide risk and prevention for physicians and trainees.▲ Back to Top
Interactive Screening Program (ISP) – AFSP’s signature intervention program, the ISP is an online tool used by medical schools across the country as a method of connecting to students, residents and faculty, and encouraging them to utilize available mental health services before crises emerge. ISP is listed as a Best Practice for Suicide Prevention and is an integral part of a comprehensive suicide prevention and mental health promotion strategy.1, 2, 3, 4
Web-Based Cognitive Behavioral Therapy for Medical Trainees (Guille, C., et al., JAMA Psychiatry, 2015)
Intervention to Promote Physician Well-being (West, C.P., et al. JAMA Intern Med., 2014)
Stanford’s Burnout Prevention Approach (Schulte, B., Washington Post, 2015)
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