Crying About Physician Suicidology

Nina Lawrenson/peopleimages.com/AdobeStock

PSYCHIATRIC VIEWS ON THE DAILY NEWS

“Suicide is a very important issue in the medical profession - too much pressure, no rest, no psychological support. We need better assessment and treatment.” - A California family physician

Besides their annual surveys about physician burnout, Medscape conducts intermittent surveys on physician suicide. Despite similar limitations in survey methodology, it seems important to review “Medscape Physicians and Suicide Report 2025: ‘A Lot More Still Needs to Be Done’”¹ for what it seems to be telling us regardless.

Perhaps at first glance, the data does not look overly worrisome. A little over “1 in 6 physicians thought about or attempted suicide” in 2024, and about 38% knew a colleague who struggled with suicide ideation. No more than 1% reported ever attempting suicide. But over half still reported that physician suicide issues were significant.

One accompanying problem seems to be the lack of resources, understanding, collegiality, and licensing risk. Taking time off for mental health is still frowned upon.

There is also still a common misperception that admitting psychological problems is a sign of weakness. That can be reflected in physicians ignoring their emotional responses, including crying when appropriate. Doctors do cry, but not enough.² In our age of internet self-disclosure, the public tends to expect more emotional expression by physicians.

At least 300 to 400 physicians a year die by suicide in the United States. Data on physician suicides indicate that male physicians have a rate higher than other professions, but that female physicians are even higher in their rate above that of the general public.³

A conclusion seems to be that much more needs to be done to reduce physician suicidality. One key seems to be noticing and processing early signs of mental deterioration in colleagues, such as continuing to look sadder, irritated, or more withdrawn than usual. A simple asking of “How’s it going?” can prove helpful.

It appears like the essential causes of physician suicidality overlap that of burnout and depression. That means that systems need to be more supportive, and mental health care resources need to be more normalized, confidential, and effective. It seems like a terrible paradox that we physicians have more ways to help patients, but that is more and more compromised by obstacles in the systems for which self-care only goes so far.

We have to be our brothers and sisters’ keepers in systems of care that support that.

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He presented the third Rabbi Jeffrey B. Stiffman lecture at Congregation Shaare Emeth in St. Louis on Sunday, May 19, 2024. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.

References

1. Medscape physicians and suicide report 2025: ‘a lot more still needs to be done.’ Medscape. February 21, 2025. Accessed February 25, 2025. https://www.medscape.com/slideshow/2025-Physician-Suicide-Report-

2. Goel A, ed. Doctors Do Cry . . . The Stories Doctors Rarely Tell! 2nd edition. Paras Medical Publisher; 2025.

3. Zimmermann C, Strohmaier S, Herkner H, et al. Suicide rates among physicians compared with the general population in studies from 20 countries: gender stratified systematic review and meta-analysis. BMJ. 2024;386:e078964.