A basic Google search for mental health and healthcare workers yields plenty of resources for prospective patients, but the other aspect of this reciprocal relationship is often overlooked. It’s important that we recognize healthcare workers are more than resources and that we attempt to understand their unique mental health struggles as well. Due to the pandemic recently propelling doctors and nurses into the limelight, it has highlighted how integral their sacrifices have been to the well-being of the general public, however, many of these issues extend beyond COVID-19. Despite this recent surge in appreciation, the unique and long-standing mental health challenges of PAs, NPs, MAs, nurses, doctors, and EMS personnel among other related professions dutifully demand our attention.
Though they are often viewed as superhuman, doctors are people too, and they are still subject to common risk factors like relationship mishaps, trauma, and bereavement. In addition to these everyday challenges and the unusual stress their jobs entail, certain personality traits put them at an increased risk for suicide compared to the general population. While perfectionism, obsessiveness, and radical selflessness can mean the difference between life and death for their patients, these attributes can wear doctors out in return. In the face of demanding situations, they must remain driven, leaning into their competitiveness and ambition. This can help them do their jobs efficiently in the short term, keeping them focused on the task at hand, but it can be maladaptive as well. Because the stakes are always so high, they tend to default to guilt when the desired outcome isn’t achieved even if it was out of their control. This can elicit feelings of helplessness which can take a mental toll over time. Doctors are also more likely to resort to dissociation and emotional distancing as coping mechanisms, which may prevent them from seeking help for their mental health (Gerada, 2018).
Considering that males are generally more likely to die from suicide attempts, it’s interesting to note that female physicians are at an increased risk for suicide compared to male doctors. Some studies point to the stress induced by trying to balance the demands of their careers and their families (Dutheil, 2019). Patients also have unparalleled expectations of empathy when communicating with female doctors and are comfortable sharing more information with them. This might make for more thorough examinations, but it also predisposes the doctors to more burnout. Over 70% of women report facing discrimination on the job as well (Smith, n.d.).
Many of these challenges are not unique to doctors, as most healthcare workers put the mental and physical needs of others in front of their own. According to Centers for Disease Control and Prevention National Violent Death Reporting System, data collected from 2007 to 2018 showed that, “Among female nurses, the risk of death by suicide was approximately twice the risk observed in the general population, and 70% more likely than female physicians” (Lee, 2021). This is cause for concern, especially considering that numbers have climbed since the onset of the pandemic.
The problem doesn’t stop there, as an astounding 37 percent of fire and EMS professionals experience suicidal ideation, which is nearly 10 times the rate for the average civilian. Six point six percent also reported having attempted suicide compared to just 0.5 percent of the general public (SAMHSA, 2018). First responders often suffer from second-hand trauma and PTSD, but can be afraid to ask for help because they feel they need to be there for others. Many of them even struggle with hyperarousal and anxiety, as they must be prepared to react to the unexpected (Jagoo, 2021).
While COVID-19 has deepened our gratitude for healthcare workers, we should also be seeing this appreciation play out in more concrete ways. In addition to advocating for more resources to help healthcare workers cope with their stress, large-scale research efforts are necessary to elucidate the specific factors contributing to these jarring statistics.
Dutheil, F., Aubert, C., Pereira, B., Dambrun, M., Moustafa, F., Mermillod, M., Baker, J. S., Trousselard, M., Lesage, F.-X., & Navel, V. (2019). Suicide among physicians and health-care workers: A systematic review and meta-analysis. PloS one. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6907772/
Gerada, C. (2018). Doctors, suicide and mental illness. BJPsych bulletin. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436060/
Jagoo, K. (2021). We need to talk about the mental health of First Responders. Verywell Mind. https://www.verywellmind.com/first-responders-mental-health-5207002
Lee, K. (2021). Deaths by suicide among nurses: A rapid response call. Journal of Psychosocial Nursing and Mental Health Services. https://journals.healio.com/doi/10.3928/02793695-20210625-01
SAMHSA. (2018). Disaster Technical Assistance Center Supplemental Research Bulletin First Responders: Behavioral Health Concerns, Emergency Response, and Trauma. https://www.samhsa.gov/sites/default/files/dtac/supplementalresearchbulletin-firstresponders-may2018.pdf
Smith, J. A. (n.d.). Why are so many female doctors burning out? Greater Good. https://greatergood.berkeley.edu/article/item/why_are_so_many_female_doctors_burning_out