Holding hope: Honoring National Physician Suicide Awareness Day

This year marks the seventh annual commemoration of National Physician Suicide Awareness Day. Each year during National Suicide Prevention Month, Sept. 17 is dedicated to honoring physicians who have died by suicide and promoting greater awareness of suicide risk in the medical profession. This day is also an opportunity for us to hold hope for a more sustainable professional future, and to recognize the progress already being made toward that goal.

Alarming statistics

We are estimated to lose 300-400 physicians to suicide each year in the United States, the equivalent of two to three graduating classes’ worth of doctors. Female physicians face the greatest increase in risk relative to their nonphysician peers, with rates of completed suicide up to four times higher in some studies. The exact numbers of estimated physician deaths by suicide can vary significantly, potentially due to the stigma around publicly acknowledging a suicide.

No matter which data sets are used, the loss of any physician to suicide is devastating. For many of us, the issue is deeply personal. Studies have found fluctuating rates of suicidal ideation throughout a physician’s career, with as many as one in four intern-year residents experiencing suicidal thoughts. Too many of us have had the heart-wrenching experience of losing a physician friend or colleague to suicide. The growing awareness of physician suicide has spurred a call to action to destigmatize physician mental health struggles and reduce the barriers to seeking help.

As we discussed last year, addressing this issue requires a multipronged approach. It is vital for physicians and physician trainees to engage in good self-care, like taking time to address our physical health needs, maintain meaningful social relationships and learn ways to manage stress. It is also crucial that we educate ourselves on the signs of depression and burnout in ourselves and others.

We can all contribute to a professional culture which normalizes seeking professional help when it is needed. Along with efforts to create change on a personal and cultural level, institutional and policy-level measures are necessary to address the workplace stressors contributing to physician burnout and suffering.

Resources and lifelines

The Dr. Lorna Breen Heroes Foundation, named in honor of Lorna Breen, MD, an emergency room physician who died by suicide in the midst of the COVID-19 pandemic, has done tremendous work advocating for policy-level changes throughout the United States. In their own words, “the Foundation’s mission is to reduce burnout of health care professionals and safeguard their well-being and job satisfaction. We envision a world where seeking mental health services is universally viewed as a sign of strength for health care professionals.”

The Foundation has received the explicit support of the American Foundation for Suicide Prevention, which also offers a wealth of information and resources for health care professionals struggling with suicidal thoughts.

The Dr. Lorna Breen Heroes Foundation has been instrumental in facilitating revisions to state licensing boards to remove stigmatizing or punitive policies which have historically discouraged physicians from seeking help for fear that it would negatively impact their careers. In just the past year, the number of states whose licensure policies meet the foundation’s standards increased by 50%, with a total of 26 states now achieving the foundation’s “WellBeing First Champion Badge for Licensing.”

The organization remains committed to ensuring 100% of states meet their standards. Additionally, the organization offers a toolkit for hospital systems seeking to implement changes supporting physician health, and, to date, has certified 75 hospitals and 59 urgent care centers.

In addition to fighting for improved policies, organizations like The Physician Support Line seek to provide direct and immediate help to physicians in need. The Physician Support Line was launched by Mona Masood, DO, and her psychiatrist colleagues during the COVID-19 pandemic, when the stresses of the pandemic were greatly exacerbating the already-existing challenges of physician life. The Physician Support Line offers a free, confidential hotline on which doctors and doctors in training across the U.S. can speak with a volunteer psychiatrist for peer support.

Ending the stigma

As physicians we experience unique stressors compared to many other occupations. Mistakes can feel like a personal failure, and minor missteps can lead to serious consequences, including the deaths of patients. Grappling with these dilemmas in silence can create a shroud of self-perpetuating isolation and shame. Resources like the Physician Support Line and other methods of peer support (including those at the institutional level) can help break that cycle and normalize the human emotions behind the physician experience.

This National Physician Suicide Awareness Day, I hope we can all take a moment to remember those who are no longer with us and commit to creating a better professional world for ourselves, our colleagues and our trainees.

Creating that world can look like financial support for physician suicide prevention organizations, volunteering our time and expertise to those organizations or the simple act of starting a conversation in our workplaces about the importance of National Physician Suicide Awareness Day. These conversations are critical to fighting the stigma around the mental health needs of physicians. Fighting that stigma might save a life.

If you are or someone you know is experiencing a mental health crisis, there are resources available now:

• You can seek immediate help in an emergency room or dial the Suicide and Crisis Lifeline at 988
• The national crisis text line can be reached by texting HOME to 741741
• The Physician Support Line, a free, confidential support service run by volunteer psychiatrists, is available Monday through Friday, 8 a.m. to 12 a.m. ET, at (888) 409-0141
• The AOA offers a robust physician and student wellness toolkit on their website designed to help you build and maintain wellness throughout your career
• The American Psychiatric Association offers a variety of self-guided tools for physicians experiencing burnout
• The Substance Abuse and Mental Health Services Administration answers substance abuse treatment referral calls 24/7/365 at (800) 662-HELP (4357)

Related reading:

We are not immune: Recognizing National Physician Suicide Awareness Day

Physicians and mental health: Making medical license applications less punitive to doctors who seek help

A candid approach to improving resident and physician mental health