About one in 18 US nurses report considering suicide within the past year — a significantly higher proportion than for other occupational groups, reports a survey study in the August issue of the American Journal of Nursing (AJN). The journal is published in the Lippincott portfolio by Wolters Kluwer.
Burnout and depression symptoms are independent risk factors for suicidal ideation in nurses, according to the new research, led by Elizabeth A. Kelsey, DNP, APRN, CNP, of the Mayo Clinic, Rochester, Minn. The study also suggests that nurses with suicidal thoughts are less likely to seek professional help for serious emotional problems.
High rates of burnout and suicidal ideation in US nurses — even before Covid-19
The researchers analyzed responses from 7,378 nurses to a 2017 survey — so pre-pandemic — sent to nearly 87,000 members of the American Nurses Association (ANA). The nurses were asked about suicidal thoughts over the past year and willingness to seek help for a serious emotional concern and completed rating scales of burnout and depression symptoms. Nearly all nurses responding to the survey were women; median age was 51 years.
Responses were compared to those from a probability-based sample of 5,198 US workers.
Overall, 5.5 percent of nurses reported considering suicide within the past year, compared to 4.3 percent for other US workers. Thirty-eight percent of nurses had at least one symptom of burnout, most commonly emotional exhaustion.
“Nurses with high levels of emotional exhaustion, high levels of depersonalization, burnout, or depressive symptoms were significantly more likely to have had suicidal ideation in the past year, compared with nurses without these characteristics,” Dr. Kelsey and colleagues write. After adjustment for other factors, nurses with burnout symptoms were twice as likely to have suicidal thoughts. Those with symptoms of depression were 11 times more likely to report suicidal ideation.
Eighty-four percent of nurses said they would “probably” or “definitely” seek professional help if they had a serious emotional problem. However, for nurses with suicidal ideation, this rate decreased to 73 percent. “In other words, those most in need of professional help were also more reluctant to seek it,” according to the authors.
Previous reports have suggested that nurses are at high risk for depression and death by suicide. Studies of physicians and medical students have linked depression and burnout to suicidal ideation. The new study is one of the first to examine these associations among nurses.
“Collectively, this evidence convincingly builds the case that health care organizations must address systems-level causes of burnout, for the good of both patients and health care workers,” Dr. Kelsey and coauthors conclude. “Given the increased stress nurses are experiencing during the Covid-19 pandemic, the need to act has never been more acute.” The researchers discuss the implications for nursing practice, education, and policy, including steps to build psychological safety in the workplace and reduce stigma around mental health issues.
“As has been demonstrated by media reports, the stressors and mental health impact of providing nursing care have been exacerbated by the Covid-19 pandemic,” comments Maureen Shawn Kennedy, MA, RN, FAAN, Editor in Chief of AJN. “This research was done prior to the pandemic and will serve as a baseline for studies of Covid-19’s effects on mental health, burnout, and suicidality among nurses.”
The study was funded by the Mayo Clinic Program on Physician Well-Being and the ANA and was based on work partially supported by a National Science Foundation (NSF) grant (No. 2041339).
Read “Suicidal Ideation and Attitudes Toward Help Seeking in U.S. Nurses Relative to the General Working Population” (doi: 10.1097/01.NAJ.0000798056.73563.fa)
About American Journal of Nursing
American Journal of Nursing is the most honored broad-based nursing journal in the world. Peer reviewed and evidence-based, it is considered the profession’s premier journal. AJN’s mission is to promote excellence in nursing and health care through the dissemination of evidence-based, peer-reviewed clinical information and original research, discussion of relevant and controversial professional issues, adherence to the standards of journalistic integrity and excellence, and promotion of nursing perspectives to the health care community and the public.
