Breaking the silence: the importance of discussing suicide within the medical profession

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Data shows that medical professionals are more likely to die by suicide than the general population.

Australian research published in the Medical Journal of Australia shows female doctors take their own lives at 227 per cent the rate of the general population. Male doctors commit suicide at 141 per cent the rate of other Australians.

Dr Ann McCormack, a staff specialist in endocrinology at St Vincent’s Hospital Sydney, was prompted to write by the suicides of three doctors in her circle. “In recent Australian surveys, one in five medical students reported suicidal ideation in the preceding 12 months, while 50% of junior doctors experience moderate to high levels of distress,” she wrote.

In the realm of healthcare, discussions on suicide often revolve around patients, obscuring the harsh reality that physicians themselves can be profoundly affected by this issue. Despite its gravity, the topic can be stigmatised, a taboo subject that many shy away from.

It is important to address suicide within the medical profession to protect the well-being of our healers and foster a healthier medical community. In light of this, a Medrecruit staff member has volunteered up her story she recently shared at a community event on suicide awareness called "Toa - It's time to talk". We have also included resources at the end of this article.

TRIGGER WARNING: This story covers sensitive and potentially distressing topics such as suicide. Names and dates have been changed to protect identities

Over 20 years ago, I worked as a Lifeline counselor. I was trained in suicide intervention, so I was used to being on the other side of these conversations. I couldn't have known that 5 years later, I would lose my partner, John, the love of my life, to suicide, and that many years later, I would find myself in that same space.

What I want to share with you is what I have personally learnt by being on multiple sides of the conversation, what I wish I had known back then, and what it means to me now to hear "It’s time to talk" as a community.

In 2013, I made the decision to move from Australia to New Zealand to be closer to my mum, who had health issues. John was my soulmate. We had a connection since we were 15 that is difficult to explain. I would know when he was going to call before he even did. Like a lot of others, he had trauma in his life, which made life and our relationship challenging at times.

Even though I moved to New Zealand, there was no doubt for either of us that we were meant to be together, and it was just a matter of time before he came here, or I moved back.

Two weeks after I arrived, I received the message. John had taken his own life.

His family wouldn’t speak to me. I blamed myself and, to be honest, sometimes him as well.

Back then, you didn’t speak about grief if it was related to suicide. So I did the only thing I knew how to do, I packaged up that grief into a little box, outwardly ignoring it while inwardly punishing myself for the next 10 years.

I asked myself those questions. Why didn’t he reach out? If I was there, could I have stopped it? I made the decision that loving anyone else was betraying him, and I punished myself.

I couldn’t even speak his name 10 years later without breaking down.

As you can imagine, was this a road to healthy wellbeing? Not so much.

11 years later, my unprocessed grief was one of the contributing factors to finding myself in a situation where I wasn’t safe to be alone and was contemplating taking my own life. Since then, I have been saved in that moment once by a crisis line, once by a work colleague, and once by myself…

I am not an expert in trauma, but I do have experience in that moment of decision when considering taking your own life.

Someone much smarter than me once said people contemplate suicide due to 3 reasons;

  1. I am in pain and I want it to stop,
  2. I am causing pain and I want it to stop and
  3. I want to cause pain.

Number 3 is very rare, but I personally knew Number 1 and Number 2 very well.

I have spoken to suicidal people, I have been suicidal myself, and I have spoken to the person who saved my life, and this is what I would like to share;

If you find yourself in a suicidal space or find yourself in that space in the future, you need to know it's ok to say to ANYONE, "I am not ok to be alone…. I am not safe right now…. I am suicidal," whatever words you need to be explicit that you're not safe right now. As scary as it feels, almost as scary as standing up here, this is what keeps us here in the moment, it delays the decision until you can get help.

If you find yourself on the other side of the conversation; It is ok to ask someone if they are feeling suicidal. For me, it was the greatest relief being able to say it and thus get some professional help. I did. I now can honor John, remembering him not with pain and blame but with love and gratitude. It's a good thing I got help before I started working with my new boss, also named John, because I don’t know how I would have explained breaking down every time I saw his name.

The other thing I want you to know is if you are on the other end of that conversation, it doesn’t mean you're responsible for "fixing" someone. It is ok to say "SHIT, I don’t know what to do, but I am here with you until we find a way to keep you safe" (i.e. let the professionals take over).

It’s ok to be awkward and scared. I know from talking to people that they worry about making it worse. There is no worse in that moment. The goal is to keep the person here by connecting them to something other than their pain which, if they have reached out to you… you.

Be you…

Be human...

It’s enough for that moment.

I know there is not a single person in here that wouldn’t sit with even a stranger if they knew it would save their life. _ So let’s bring it back to "it’s time to talk"._

I believe it’s our community, made up of all of us imperfect, kind-hearted humans, that will keep people here in the moment while the professionals do their best to help people with the longer-term suffering.

It’s talking about suicide with your friends and family that will allow more people to say "I am not safe" and more people to say "shit, I don’t know what to do, but I am here until we get help".

That’s how we unravel the stigma and have conversations that help our loved ones feel safe.

The hidden crisis

Medical professionals, despite being caregivers, are not immune to mental health struggles. The pressure of life-or-death decisions, long working hours, emotional demands, and high expectations can take a toll, leading to burnout, depression, and even suicidal thoughts. Tragically, physicians have a significantly higher suicide rate compared to the general population, making this a silent crisis that demands attention.

Breaking the stigma

The stigma surrounding mental health issues, including suicide, can discourage doctors from seeking help. The fear of appearing weak, jeopardising their medical licensure, or facing judgment from peers often silences their struggles. It is crucial to dismantle this stigma, fostering a culture where it's okay to talk about mental health issues openly and seek help without fear of professional consequences.

Implementing support systems

Discussing suicide within the medical profession is the first step towards developing effective support systems. By understanding the extent and nature of the problem, healthcare organizations can create initiatives like confidential mental health services, peer support groups, wellness programs, and suicide prevention training, all aimed at addressing mental health proactively.

Enhancing education and training

Medical education and training must incorporate mental health awareness and self-care. Teaching future doctors to recognise signs of distress in themselves or their peers can lead to early intervention, potentially saving lives. Additionally, fostering resilience and healthy coping strategies can equip them to manage the stressors of their profession better.

Advocacy and policy change

Open conversations about suicide within the medical profession can drive policy changes at the institutional and national levels. Policymakers must ensure that mental health services are readily available to medical professionals and that seeking help does not result in punitive action.

Collective responsibility

Talking about suicide in the medical profession is a collective responsibility. Everyone, from medical students to senior physicians, administrators to policymakers, has a role to play in acknowledging and addressing this issue.

In conclusion, suicide within the medical profession is a pressing issue that cannot be ignored. By openly discussing it, we can break down the stigma, implement effective support systems, enhance education and training, and advocate for necessary policy changes. It's high time we cared for our caregivers and fostered a culture of openness, empathy, and support within our healthcare community.

If you are seeking mental health support or want to talk to someone in Australia or New Zealand, please find resources below.

Hand N Hand Peer Support - free confidential support for healthcare professionals in Australia and New Zealand

Australia: Need to talk? Suicide Call Back Service Call 1300 659 467 Lifeline 13 11 14

New Zealand: Need to talk? Free call or text 1737 any time for support from a trained counsellor Lifeline 0800 543 354 or 09 522 2999 or free text 4357 (HELP) Suicide Prevention Helpline 0508 828 865 (0508 TAUTOK0)

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21 August 2023Article by Julia Medrecruit Editor