Magazine article American Nurse Today

Suicide among Nurses: What We Don't Know Might Hurt Us: Research, Prevention Programs, and Open Discussion Are Required to Reduce Nurse Suicide

Magazine article American Nurse Today

Suicide among Nurses: What We Don't Know Might Hurt Us: Research, Prevention Programs, and Open Discussion Are Required to Reduce Nurse Suicide

Article excerpt

Depression is a treatable illness. If you or someone you know needs help, contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

WHEN CELEBRITIES die by suicide, discussion of this stigmatized topic makes its way into the headlines and conversations at work and home. That was true this year when Kate Spade and Anthony Bourdain died by suicide. These shocking deaths of two people who appeared to have it all once again brought our attention to this serious public health issue. We must remember, though, that no group--occupation, race, gender, socioeconomic status--is immune to suicide. (See Troubling numbers?) That includes nurses, who work in a profession that's strenuous and stressful and requires a high level of compassion and empathy.

Unfortunately, nurse suicide has been a hidden phenomenon and hasn't been adequately studied in the United States. The loss of a nurse coworker to suicide is more common than we realize because it's frequently concealed by the family and organization. However, when we talk about suicide--its causes, who's at risk, and how we can help to prevent it--we can save lives.

Research and epidemiology

A 1990 report on occupational suicide risk in the United States showed that when adjusted for gender, the odds ratio for a nurse dying by suicide was 1.58 times greater than the general population. Although more recent data for this country isn't readily available, we can turn to others who have been studying nurse suicide on an ongoing basis. In 2017, the United Kingdom released a report from its Office for National Statistics that reviewed 18,998 suicides between 2011 and 2015 in England and Wales among people age 20 to 64. The report revealed that suicide among female nurses was 23% higher than the average for women in general and the highest among female professionals. The study also showed that most suicides among nurses were by poisoning, which may be linked to their knowledge of and access to drugs. It's worth noting, however, that identifying occupational risk for suicide is difficult, given the complexity of the relationship.

A general internet search produced no public data identifying a national nurse suicide rate in the United States, yet data on suicide rates are readily available for physicians, teachers, police officers, firefighters, and military personnel. The Centers for Disease Control and Prevention (CDC) maintains a restricted National Violent Death Reporting System (NVDRS), which is the most comprehensive death registry by suicide coded by occupation. It has been growing yearly, with data available for 40 states, the District of Columbia, and Puerto Rico. The dataset has not been queried for nurse suicide statistics.

To address nurse suicide, we must do more, starting with increasing our knowledge and awareness of suicide within the profession, including the cost to society, risk factors, prevention, and barriers to care. (See What's the cost?) In addition, we need to provide support at all levels with proactive education and risk screening tools (other professions, including physicians, have developed protocols and toolkits specific to their workforce). Individuals, policy makers, professional organizations, and healthcare system leaders (specifically nurse executives and educators) are potential stakeholders for promoting awareness of nurse suicide and implementing programs designed to prevent it.

A better understanding of health determinants and their interactions and impact is key to improving and maintaining mental health. Individual and institutional attention to nursing stressors (workload, long hours, lateral violence, bullying, staffing, lack of resources, and dissatisfied patients) may enhance employee engagement and nurse well-being.

Risk factors

With no data to determine the suicide rate for nurses in the United States, risk factors for nurse suicide haven't received the attention they deserve. …

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