The week of September 5 to September 11 is National Suicide Prevention Week. Suicide is a tragic event that touches many lives, the lives of its victims, the families, the friends, and the medical community. It's important to talk about suicide; bring the topic into the light instead of leaving it relegated to the dark. Suicidal thoughts, suicidal ideation, and plans for suicide can be interrupted when we are willing to discuss it, willing to have compassion, and willing to seek help.
Suicide Facts for the U.S. for Suicide Prevention Week
The following suicide facts are taken directly from the Centers for Disease Control and Prevention (CDC) site.
- Suicide is the 10th leading cause of death in the United States.
- Among the age range of 10 to 34 years old, suicide is the second leading cause of death.
- In 2019, over 47,500 deaths were attributed to suicide which is almost one suicide every 11 minutes.
- In 2019, 3.5 million U.S. Americans planned a suicide attempt, and 1.4 million actually attempted suicide.
- Suicide is preventable.
Suicide Awareness: Warning Signs
- Reckless behavior
- Increased alcohol or drug use
- Aggression
- Social withdrawal from family and friends
- Drastic changes in mood
- Getting rid of personal belongings
- Gathering pills
- Purchasing a weapon
Suicide Among Nurses
The aforementioned statistics and warning signs are general information that applies widely to the public. As clinicians, it's likely that you've witnessed suicide attempts, specifically if you work in a psychiatric or emergency department setting. It can be easy to relegate suicide to the category of a problem our patients have. Consequently, that thinking can be dangerous because actually suicide touches nurses to a disturbing degree.
Suicide among nurses isn't as uncommon as we'd wish it. All the more devastating because we are clinicians who are trained for what to look for, and we see the traumatic consequences that suicide or suicide attempts can have on our patients and their loved ones when they're brought to our workplace. Our training and our knowledge don’t make us immune, however. Moreover, there is some new research that suggests nurses are at a higher risk.
Nurse Suicide Study
This last April, a study, authored by a team of doctors and one nurse, was published in the JAMA Psychiatry Journal titled, Association of US Nurse and Physician Occupation With Risk of Suicide. The study sought to determine if the two professions were at elevated risk of suicide when compared to the population in general.
The study pulled data from the National Violent Death Reporting System for suicide deaths from 2007 to the year 2018, which was 159,372 in total. The results of the study found that nurses were indeed at higher risk for suicide than the general public, and even more so for female nurses. Furthermore, 24.9% of the nurse suicides were poison as opposed to the general public at 16.8% and: "The presence of antidepressants, benzodiazepines, barbiturates, and opiates was more common among clinician suicides than suicides in the general population."
The study itself did not find evidence that doctors are also at an elevated risk, but one critique of the study is that it did not include doctors under 30 years which therefore eliminated consideration of a cohort of young doctors that are battling the intense pressure of residency programs which are known to have a higher risk of burnout, depression, and suicide.
Earlier Research on Suicide and Nurses Difficult to Find
Despite the fact that registered nurses number over 3.8 million, and there are around 900,000 LPN/LVN (licensed practical or licensed vocational nurses), and an estimated 1.45 million CNAs in the United States, prior to the above-summarized study that was recently published, the topic of suicide among nurses has scarcely been explored.
In 2018, a discussion paper was published by a group of nurses and professors decrying the absence of research or attention to the subject titled, Nurse Suicide: Breaking the Silence. The discussion summarizes their attempts to locate research, statistics, and general information about the topic with little to no success.
In 2019, a study was published by a research team from UC San Diego that took data from the National Violent Death Reporting System from the year 2014. These results were shocking, concluding that the rate of suicide among female nurses was just under 58% higher and for male nurses 41% higher than that of the general population.
Conclusions
Both 2019, and the 2021 studies' findings raise flags because not only does the data show that nurses are at higher risk of suicide, but the data was pulled for time periods all pre-COVID. We know that all our compatriots in healthcare staffing are suffering in the nursing industry these last two years, and don't want to imagine how the data would change if reviewed again in another year. The fact that it's a topic largely unexplored does not mean we should let it lie. We must be willing to talk about it. We must be willing to check in with our coworkers. Most importantly, we must be willing to take care of ourselves.
What Can You Do?
Here are some simple things that you can do as a PRN nurse, as a friend, as a family member, and as a part of your community in an effort to prevent suicide:
- Prioritize your own self-care.
- Reach out to others.
- Keep a list of crisis resources on your phone.
- Be open about the value of mental health resources.
- Be cognizant of your language and tone when a discussion turns toward mental health.
- Talk to your supervisor at work about suicide education or resources to be available.
- Talk to your membership groups about any advocacy opportunities.
- Contact the National Suicide Prevention Lifeline
- Have a #RealConvo.
- Call 1-800-273-TALK (1-800-273-8255)
