Mental illness and suicide among physicians

Samuel B Harvey, Ronald M Epstein, Nicholas Glozier, Katherine Petrie, Jessica Strudwick, Aimee Gayed, Kimberlie Dean, Max Henderson, Samuel B Harvey, Ronald M Epstein, Nicholas Glozier, Katherine Petrie, Jessica Strudwick, Aimee Gayed, Kimberlie Dean, Max Henderson

Abstract

The COVID-19 pandemic has heightened interest in how physician mental health can be protected and optimised, but uncertainty and misinformation remain about some key issues. In this Review, we discuss the current literature, which shows that despite what might be inferred during training, physicians are not immune to mental illness, with between a quarter and a third reporting increased symptoms of mental ill health. Physicians, particularly female physicians, are at an increased risk of suicide. An emerging consensus exists that some aspects of physician training, working conditions, and organisational support are unacceptable. Changes in medical training and health systems, and the additional strain of working through a pandemic, might have amplified these problems. A new evidence-informed framework for how individual and organisational interventions can be used in an integrated manner in medical schools, in health-care settings, and by professional colleagues is proposed. New initiatives are required at each of these levels, with an urgent need for organisational-level interventions, to better protect the mental health and wellbeing of physicians.

Conflict of interest statement

Declaration of interests SBH and KP reports grant income from iCare Foundation and NSW Health. MH was a consultant psychiatrist at the Practitioner Health Programme between 2010 and 2015. All other authors declare no competing interests.

Copyright © 2021 Elsevier Ltd. All rights reserved.

Figures

Figure 1
Figure 1
Estimated prevalence of common mental disorders in physicians compared with other occupational groups Comparison between rates of common mental disorder (as measured by self-reported symptoms using the General Health Questionnaire) among physicians and other occupational groups (including teachers, academics, manual workers, military personnel, social workers, and white-collar workers).,
Figure 2
Figure 2
A model for how individual and organisational measures could operate to improve physician mental health throughout a physician's career

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