Experts are calling for system-wide reform to improve mental health in the profession.
The suicide rate for female doctors has risen almost fourfold in the last two decades, new Australian research has shown.
In the early 2000s, suicide rates in this group were around three in 100,000, but by 2013-17 this had risen to 15 per 100,000, according to the research published in the Australian & New Zealand Journal of Psychiatry,
“This is the first time this worsening risk over the last two decades has been identified only in this particular group of health professionals, [which] suggests a set of specific workplace, professional and gender-specific factors may be underlying this trend,” lead author Katherine Petrie told TMR.
Researchers from NSW and Victoria used data from the National Coronial Information System to examine the relative risk of suicide among healthcare professionals compared to other occupations and how it changed over time.
They found health professionals were 30% more likely to die of suicide compared to those in other occupations. They represented 4% of all 13,800 deaths by suicide recorded among employed adults aged 20 to 69 over the last two decades. Around 56% of the health professionals were female and 57% were aged 40 to 59.
Suicide rates among female health professionals other than doctors, and women working in other occupations remained at around three per 100,000 over the 17-year period, while the rate for female nurses and midwives declined from around seven per 100,000 to about five per 100,000.
The overall number of suicides recorded among female doctors was lower than for male doctors, with women accounting for 31 of the 121 total suicides recorded. But rates of suicide among male doctors largely remained stable between 2001 and 2017. There was only a slight rise in men, from around 11 per 100,000 in the early 2000s to around 14 per 100,000 in 2006-12, and there was no change from 2012 onwards.
The highest rates of suicide overall were among men employed in nursing and midwifery, with around 22 deaths per 100,000 person-years compared to a total rate of 8 per 100,000 person-years for all health professionals.
“[O]ur results highlight the role that gender plays in suicide among certain healthcare professions, particularly in those who represent the non-traditional gender within that occupation, i.e., women in the traditionally male-dominated medical profession and males in the traditionally female-dominated nursing/midwifery profession,” the authors wrote.
“[They] emphasise the need to consider and address gender-related suicide risk factors within the context of occupational variations in suicide within the healthcare sector.”
The methods of suicide were different among different occupations. Medical professionals were far more likely to self-poison with chemicals or other substances, with almost half using that method compared to 8% in the rest of the group. In contrast, hanging accounted for half of the suicides in other professions, and only one in four of the medical professionals. This could be due to the greater knowledge of and access to high lethality means of suicide, the authors said.
The authors also acknowledged the ongoing impact of the covid pandemic which has raised further attention and concern about healthcare workers’ mental health. They highlighted a surge of studies published over the last year that have documented increased levels of distress and greater workplace stressors among health professionals over the last two years.
The findings were a cause for concern for all healthcare workers, according to AMSA Chair of Mental Health Elizabeth Middleton, who said mandatory reporting laws and the ongoing stigmatisation of mental health are major barriers preventing doctors and medical students from seeking mental health support, with systemic gender-based discrimination and stereotyping making it even harder for women.
“I would urge workplaces, governing bodies and policy makers to consider system-wide reform [to improve] mental health support for women across the medical profession, because this increasing trend is quite concerning,” she said.
“Challenges do arise in our profession when people attempt to seek help for mental health reasons or if people disclose thoughts of suicidal ideation since this [can] impact employability and [people’s] livelihoods, due to the current mandatory reporting legislation.
“[Reforming] this area would potentially encourage earlier mental health seeking behaviours, destigmatise mental illness in our profession and hopefully contribute to reducing suicide rates.”
