I don’t know if I have any right to talk about suicide. It hasn’t really affected my life like it has affected thousands of families across the country and I have a reverence for those who cope with the aftermath. I have a respect that tells me not to put your own spin on somebody else’s tragedy; you don’t know their truth.
When I was younger, one of the older ‘cool’ kids hung himself in the field behind my house. I had no real love for him, he had bullied and been very cruel to somebody who is very close to me. I don’t think I hated him, or at least I don’t now. I suspect he didn’t even know who I was, but I will remember him forever. The field is still there.
Suicide has been a notable topic among junior doctors of late. Recently when another junior doctor’s suicide was reported by the media I had a text message from my sister, she said ‘promise me you’d never do that’
My sister’s close friend died by suicide when she was a teenager.
She read about the junior doctor who worked hard and had written an emotional post about the NHS, it was shared tens of thousands of times and now she was dead; so she needed me to say I wouldn’t do that.
There was a time when I didn’t have any faces to put to doctor suicides; in the past year, I have more than a few. I look at these faces and genuinely feel anguish and immense sadness. I know this is at least in part because empathy is amplified when you can directly relate to something. As a doctor, I can relate and these people therefore become me, but for the grace of something.
I am doctor and so I feel obliged to look at evidence. I find myself asking; are these faces in my head the result of a spotlight, or a genuine snowballing problem? The latter seems fairly frightening, but the statistics and headlines I hear quoted for suicide in health professionals are frightening, and particularly if you’re female. To put that into perspective, the standardised mortality ratio (SMR) for female doctors in England and Wales has been reported as high as 201.8(1).
Yet the Office for National Statistics data for England tells us this; that between 2011 and 2015 there were 59 and 22 deaths in doctors due to suicide in males and females respectively. This number gives men who are doctors a 37% decreased risk compared to their gender generally. There was an increased risk for females who are doctors in that specific data set, but it was 1%.
In fact, that Office for National Statistics data also tells us that the higher SMR for female health professional as a multi-disciplinary group in England is felt to be largely explained by the number of suicides in female nurses; they had a 24% increase in SMR, when compared to females generally.
The statistics are of course subject to failures in reporting and coding and they only cover the four years up to 2015. On the whole, the combination of numbers presented throughout research papers and Office for National Statistics data sets paints a confusing picture. I read them and of course they don’t erase the faces; another one dead, another one missing.
The reality on the ground is now, when I have those passing moments where I might baulk at the thought of years of more training, when I consider working for a service that everybody is telling me is crumbling and doesn’t appreciate me, when I think about the pressure about being unyieldingly accountable to the rollercoaster of public opinion all the time, I ask myself;
Did they think that too?
I ask myself; does my choice of profession increase my risk of suicide?
Or does the media spotlight shine on doctor suicides because we still think that doctors ‘shouldn’t’ kill themselves? That we are somehow different?
Is that the real hurdle we are facing?; a society who still forgets all too readily that doctors have mental health problems too?
I can’t help but wonder if the media are really doing the fight against suicide a service, when they report a suicide for reasons of profession? Perhaps it does help combat the damaging stigma that seems to hinder the discussion of mental health problems among doctors . Yet I also wonder if they might do the complexities of suicide a disservice when they appear to separate these people out from all the other humans who had a different job or no job and tragically still found themselves so desperate?
Does that help the struggle to prevent every life lost?
I genuinely don’t know the answer to any of these questions and I have very little scope to talk about the complexities of suicide. But I do know this for sure, that every person lost is one too many.
So how do we help?
The BMA has a 24/7 helpline for Drs who are struggling : 0330 123 1345
You can speak to The Samaritans in the UK on : 116 123