41 After a Suicide | A Toolkit for Physician Residency/Fellowship Programs Appendix H: Facts about Physician Suicide and Mental Health Suicide is more common in physicians than in the general population. Accessing appropriate mental health treatment at key times is a critically important part of reducing suicide risk. General • Suicide is generally caused by the convergence of multiple risk factors, the most common being untreated or inadequately managed mental health conditions • An estimated 400 physicians die by suicide in the U.S. per year6 • In cases where physicians died by suicide, depression is found to be a significant risk factor leading to their death at approximately the same rate as among non-physician suicide deaths; but physicians who took their lives were less likely to be receiving mental health treatment compared with non-physicians who took their lives7 • The suicide rate among male physicians is approximately 1.41x higher than the general male population; and among female physicians the relative risk is even more pronounced — 2.27x greater than the general female population8 • Suicide is the second leading cause of death in the 24-34 age range (accidents are the first)9 • Although suicide is the second leading cause of death among young Americans age 15-34, suicide has a low base-rate (about 13/100,000 in the U.S.) so the numbers are still low • The prevalence of depression among residents is higher than in similarly aged individuals in the general U.S. population — 28 percent of residents experience a major depressive episode during training versus the general population rate of 7-8 percent10 • Culture and beliefs play a role in suicide risk; regional variations in culture are linked with suicide risk: the populations that have lower stigma related to mental health problems and help-seeking behaviors, have lower rates of suicide than those populations with higher stigma11 • Among physicians, risk for suicide may be particularly elevated when mental health conditions go unaddressed and when self-medication occurs as a way to address anxiety, insomnia, or other distressing symptoms; although self-medicating may reduce some symptoms, the underlying health problem is not effectively treated and this can lead to a tragic outcome7 • Access to (and knowledge regarding) lethal means elevates risk of suicide • A higher proportion of physician suicide deaths are by overdose compared with the general population suicide methods7 • Fears about the potential for seeking mental health care to negatively impact one’s professional reputation, ability to get or maintain licensure, or malpractice insurance are largely unfounded; what is more likely to harm a physician’s reputation, licensure and insurance, are unaddressed and worsening mental health conditions