Almost two-thirds of people in the U.S. who attempt suicide do so after having seen a physician in the previous month—a resounding statement of the importance of being alert to the warning signs of suicide risk. But this doesn’t apply only to nonphysicians. Doctors also need to be on the lookout for red flags among their colleagues and themselves.
Physicians are at a higher risk of suicide and suicidal ideation than the general population, according to a study published in Mayo Clinic Proceedings. Suicidal ideation has been associated with high workload volume and medical errors. Although previous research linked physician burnout to depression and suicide, recent research suggests that burnout and depression are separate experiences, with distinct consequences for physicians and their patients. Meanwhile, doctors who experience suicidal ideation have been shown to be less likely to seek the help they need.
CME developed by the AMA covering suicide screening and prevention for patients also addresses what physicians should look for to reduce the incidence of suicide in their own ranks.
The CME module “Identifying and Responding to Suicide Risk” is designated by the AMA for 1 AMA PRA Category 1 Credit™. It lays out how to:
- Recognize the prevalence and impact of suicide in the U.S.
- Identify characteristics to look for in patients who may be at risk for suicide.
- Recognize the warning signs of potential suicide risk in colleagues.
- Locate tools and resources to better support patients and colleagues at risk for suicide.
- Communicate with patients and colleagues about suicide prevention and the importance of seeking care.
The module is part of the AMA Ed Hub™, an online platform that brings together high-quality CME, maintenance of certification and educational content from trusted sources, all in one place—with relevant learning activities relevant to you, automated credit tracking, and reporting for some states and specialty boards.
A related AMA STEPS Forward® toolkit, “Preventing Physician Suicide: Identify and Support At-Risk Physicians,” helps learners identify risk factors and warning signs for suicide specific to physicians. It also outlines how to build an environment of support into your practice and make it easy to get help.
Learn more about AMA CME accreditation.
Acknowledging suicide’s toll
This learning activity emphasizes that anyone can be at risk for suicide, “which often occurs when stressors and health issues collide to create feelings of hopelessness and despair.” The activity sketches suicide’s scope and common signals.
According to the U.S. Centers for Disease Control and Prevention, suicide is the 10th leading cause of death in the nation. It is the second leading cause in ages 15–34, and the fourth leading cause in ages 35–54.
An estimated 250,000 people each year attempt suicide. It claims the lives of nearly 47,000 Americans every year, or about 123 every single day. And more than a million people per year in the U.S. have suicidal thoughts.
Many times, signs of personal crisis precede suicide. The toolkit provides an extensive list of these signs, which include increased substance abuse, mood changes, depression, anxiety, agitation, anger, loss of interest, humiliation and shame, or expressing no sense of purpose in life.
When a physician exhibits risk
The module emphasizes the value of routine patient screening for suicide risk factors, which span health, environment and history. But physicians often do not regard their colleagues as patients, and it’s unlikely that they will slide a screening questionnaire onto a colleague’s desk. So what to do?
The module provides specific insights for peer-to-peer interactions.
For starters, be alert to colleagues and the multiple stressors they face. These could include general job problems, recent loss of a patient, license restriction, malpractice, financial problems, a professional identity crisis or professional isolation.
The module includes the scenario of physician-to-physician encounter. In it, a physician finds a colleague sitting in her office and staring out into space with a worried look. She has confided previously to working more than 70 hours a week and feeling burned out.
When concerned, don’t worry too much about having the exact right thing to say. The goal is to just start the conversation. It is enough to ask, “How are you doing today?”
How you can help physician colleagues
Most importantly, encourage a colleague to share. Surveys show that many physicians indicate their workload is at capacity. In circumstances like that, a colleague may well be thinking, “I just don't know how I can keep going like this. Work is just too much and I feel like I'm not making a difference here.”
When warranted, the module advises, ask about self-harm. It will not increase the chances that someone will commit suicide.
Also, consider what assistance to offer. Physicians know that depression, stress and distress are temporary and treatable, but they could benefit from being reminded of this. The module suggests perhaps referring a colleague to a therapist or an employee-assistance program or offering help with managing a caseload.
This assistance should be offered in the spirit of, “Let's do this together and get you the help you need,” the module says. An AMA webpage on preventing physician suicide further explores the phenomenon of physician suicide and highlights AMA efforts and resources to prioritize well-being and mental health.
