Suicide in anaesthetists: a systematic review

Abstract

Summary Evidence suggests that healthcare professionals are at an increased risk of dying by suicide, with anaesthetists at particularly high risk. However, much of the data on which this is based are historical. With a focus on the epidemiology and methods used, we conducted a systematic review of evidence regarding suicide and suicidal behaviour among anaesthetists to provide a more contemporary summary. The systematic review process was adapted from a previous similar study in veterinary surgeons and was consistent with recommended guidance. We identified 54 articles published in or after 1990 that had anaesthetist‐specific data and met the inclusion criteria. Seven of these reported epidemiological data, of which four were published after 2000. Although none of the more recent studies reported standardised mortality rates specific to suicide in anaesthetists, the proportion of anaesthetists dying by suicide was increased with respect to comparator groups, which is consistent with previous findings. Eleven studies that included information on suicidal behaviour reported suicidal ideation in 3.2–25% of individuals (six studies) and suicide attempts in 0.5–2% (four studies). Studies reporting methods of suicide highlighted the use of anaesthetic drugs, particularly propofol, supporting the suggestion that the increased risk of suicide in anaesthetists may be related to the availability of the means. We discuss our findings in relation to other recently published data and guidance concerning mental health problems in anaesthetists.

The burden of peri-operative work at night as perceived by anaesthesiologists

“…patient's outcome) was outside the scope of our study. The body of evidence suggests that anaesthesiologists/intensivists are at high risk of burnout, 12–14 poor mental health status, 15 suicidal idea and attempts 16 and poor work–life integration 17 . All these phenomena can be associated with specific types of stressful activity (including night work), personal characteristics, fatigue and workload, organisational factors, perceived lack of support and negative perceptions of the process of care 18,19 …”

Mental health and well‐being of anaesthetists during the COVID‐19 pandemic: a scoping review

“…There was also minimal overlap in identified risk factors across studies, primarily because studies measured different predictors and psychological outcomes. Finally, no studies in the review measured other important mental health outcomes such as suicidal ideation, self‐harm or suicide attempts, despite prior evidence that anaesthetists have increased suicide risk and access to means [ 17 , 18 , 52 ].…”

“…Burnout and poor well‐being are associated with: lower work performance; impaired decision‐making; risk of medical errors and reduced patient safety [ 10 , 11 , 12 ]; depression and suicidal ideation [ 13 ]; sleep disorders [ 14 ]; alcohol and drug use [ 15 ]; and clinician attrition [ 16 ]. This compounds the existing concern that anaesthetists are already at increased risk of suicide compared with the general population [ 17 , 18 ].…”

“…sleep disorders [14]; alcohol and drug use [15]; and clinician attrition [16]. This compounds the existing concern that anaesthetists are already at increased risk of suicide compared with the general population [17,18].…”

Self-Harm by nurses and midwives: a study of hospital presentations

“…The present study contributes to the discussion of whether self-poisoning among nursing professionals is related to access to medication in the workplace, and/or knowledge regarding lethality. Like other studies examining suicide in nurses (Davidson et al 2020), prescribed or over-the-counter medication (other than recreational opiates) were most frequently used, suggesting workplace access is not often a contributor, unlike suicidal behaviour in other health-related professions such as anaesthetists (e.g., Plunkett et al 2021).…”