Suicide rates among doctors have fallen, but female doctors are still at high risk

Suicide rates among doctors have fallen over time but are still significantly higher among female doctors compared with the general population, according to an analysis of evidence from 20 countries published by The BMJ Today.

The researchers acknowledge that the risk of suicide among physicians varies by country and region, but say the findings highlight the need for continued research and prevention efforts, particularly among female physicians.

According to some estimates, one doctor commits suicide every day in the US, and about one every ten days in the UK. However, the evidence on physician suicide rates varies between countries.

To address this problem, researchers analyzed the results of observational studies published between 1960 and March 31, 2024, comparing suicide rates among physicians with those in the general population.

A total of 39 studies from 20 countries (mainly Europe, the US and Australasia) were included. Together they reported 3,303 male and 587 female suicides over two observation periods (1935-2020 and 1960-2020).

In all studies, researchers found no overall increase in suicide risk for male physicians compared to the general population. However, for female physicians, the suicide risk was significantly higher (76%) than for the general population.

An analysis of the 10 most recent studies versus older studies found that suicide rates among both male and female physicians decreased over time. However, suicide rates among female physicians remained significantly higher (24 percent higher) compared to the general population.

The exact causes of this decline are unknown, but increased awareness of mental health and the support doctors receive in the workplace in recent years may play a role, the authors say.

The high degree of variation (heterogeneity) between studies also suggests that the risk of suicide in physicians is not consistent across different populations, they add. This is likely due to training and work environments in health care systems, and different attitudes and stigmas regarding mental health and suicide.

Additional analysis showed a significantly (81%) higher suicide rate among male physicians compared to other professional groups with similar social and economic status. Results appeared similar for female physicians, but the number of eligible studies was too low to draw definitive conclusions.

The researchers acknowledge several limitations, including a paucity of studies from outside Europe, the US and Australasia and likely underreporting of suicide as a cause of death due to stigma. Nevertheless, their analysis was based on a full review of the available evidence and examined a range of factors as possible causes of the variation.

The researchers therefore call for continued efforts to investigate and prevent deaths by suicide among physicians, particularly among female physicians. They also say that future research is needed to assess the potential effects of COVID-19 on physician suicide rates worldwide.

In an accompanying editorial, Dr. Clare Gerada and colleagues explain that while physicians share the same risk factors as their nonmedical colleagues, they also face additional risks, such as burnout and barriers to obtaining timely help for poor mental health.

Selection into the medical profession also favors personality traits such as perfectionism, obsessiveness, and competitiveness, which in highly stressful work environments can result in a triad of guilt, low self-esteem, and a persistent sense of failure. Doctors also have access to potentially dangerous drugs.

Some studies have also shown a link between mental illness and suicide, and being the subject of complaint or regulatory proceedings.

They argue that measures to reduce psychological distress and the risk of suicide among physicians, particularly women, will require addressing long-standing systemic issues that contribute to stress. This includes tackling poor working and regulatory cultures, providing physicians with a sensible work-life balance, and addressing the basic emotional and psychological needs of all staff.

Finally, they say all doctors should have access to early intervention and confidential treatment services so they don’t have to suffer in silence.