Nurses at significantly increased suicide risk compared with general U.S. population
Click Here to Manage Email Alerts
Nurses in the United States had a significantly increased risk for suicide compared with the general population, according to results of a retrospective cohort study published in JAMA Psychiatry.
This risk was not significantly greater for physicians.
“Many studies have examined physician suicide, but we noticed that nurses have been left out of the spotlight,” Benjamin A. Y. Cher, MS, of the University of Michigan Medical School, told Healio Psychiatry. “In this study, we determined suicide rates among nurses and made comparisons with those of physicians and the general population. We examined men and women separately because these groups are known to have different suicide rates and different risk factors for suicide.”
Cher and colleagues used the National Violent Death Reporting System to analyze U.S. data of 159,372 suicides between 2007 and 2018, and they created sex-specific suicide incidence estimates for nurses, physicians and the general population of those aged 30 years or older using workforce denominators. Further, they calculated associations between clinician type and method of suicide and toxicology examination results at death, which they adjusted for sociodemographic characteristics.
Results showed 2,374 suicides among nurses (women, 80.5%; mean age, 52.8 years), 857 among physicians (men, 84.4%; mean age, 59.8 years) and 156,141 among the general population (men, 77.8%; mean age, 53.1 years). Nurses had higher rates of suicide than the general population, for a sex-adjusted incidence between 2017 and 2018 of 23.8 per 100,000 compared with 20.1 per 100,000 (relative risk [RR] = 1.18; 95% CI, 1.03-1.36). The suicide incidence for female nurses between 2017 and 2018 was 17.1 per 100,000 compared with 8.6 per 100,000 for the general population of women (RR = 1.99; 95% CI, 1.82-2.18). In absolute terms, female nurses exhibited an additional 8.5 suicides per 100,000 compared with the general population of women. Aside from among female physicians between 2011 and 2012, suicide rates for physicians were statistically the same as those of the general population according to sex. Poisoning was more common among clinicians than the general population, with 24.9% (95% CI, 23.5-26.4) of nurses having used poisoning vs. 16.8% (95% CI, 16.-17) for the general suicide population. Clinician suicides were more likely to feature antidepressants, benzodiazepines, barbiturates and opiates than suicides among the general population.
“Efforts to improve mental health among health care workers should focus on all members of the health care team, especially nurses,” Cher said. “Also, our study was conducted before the COVID-19 pandemic, which has likely led to increased stress for nurses. There is an urgent need for addressing nurse well-being in 2021 and beyond.”
In a related editorial, Constance Guille, MD, MSCR, of the department of psychiatry and behavioral sciences at the Medical University of South Carolina, emphasized the importance of addressing nurses’ mental health care needs.
“Given that nurses alone make up the largest number of health care workers in the United States and are the backbone of patient care and the health care industry, we cannot afford to ignore the mental health and workplace stressors health care professionals endure,” Guille wrote. “The Davis [and colleagues] findings serve as a call to action by health care systems and leaders to address the proximal risk factors for suicide and improve the mental health and lives of our health care workforce and, in turn, the patients they serve.”