Suicides among pharmacists exceed the general public
According to a longitudinal analysis, suicide rates among pharmacists are higher than those of the general population.
Using data from the CDC’s National Violent Death Reporting System (NVDRS) for the years 2003 through 2018, 316 pharmacist suicides were identified compared to 213,146 non-pharmacist suicides, reported Kelly Lee, PharmD, of the Skaggs University of California San Diego School of Pharmacy and Pharmaceutical Sciences, and colleagues.
The age-adjusted rates for pharmacist suicides were 19.6, 20.1 and 18.2 per 100,000 in 2004, 2009 and 2014, respectively, they noted in the Journal of the American Pharmacists Association. By comparison, the 2017 age-adjusted suicide rate in the general public was 14 per 100,000 people, the authors noted.
“There really hasn’t been any published data regarding pharmacist suicides in the United States” so far, Lee said. MedPage today.
“We know that burnout is a result of caregiver burden,” she said. Nurses, doctors and pharmacists give a part of themselves when caring for patients, and “I don’t think we realize the price it takes to provide that care every day.”
Stigma often discourages pharmacists and other healthcare professionals from reporting mental health issues.
“There are … huge implications for a medical professional to admit they have mental health issues, substance abuse [challenges] …because we’re not supposed to have that. I mean, the public doesn’t want to hear that her doctor is considering suicide. The public does not want to hear that the person dispensing their medication has depression. … But we’re not immune to mental health issues,” Lee noted.
Of the 316 pharmacists who died by suicide, firearms were the most common method, accounting for 134 deaths, followed by poisoning, which was used in 79 deaths, and hanging, strangulation or suffocation , which was the method used in 35 deaths.
Use of firearms was similar among pharmacists and non-pharmacists, but poisoning was a more common method among pharmacists (29.4% versus 16.7%, respectively, P P=0.007).
Lee said she and her colleagues were surprised that guns were the most common method of suicide compared to poisoning, given pharmacists’ access to drugs, but noted that drugs don’t “often not necessarily guarantee a death”.
Compared to non-pharmacists, suicide among pharmacists was more often associated with professional problems (OR 1.77, 95% CI 1.32-2.37, P=0.011) and current treatment for mental illness (OR 1.56, 95% CI 1.24-1.96P=0.008).
Of the 316 pharmacists, the average age was 53.5 years, 75% were male and 85% were Caucasian.
Men in this group were significantly less likely than women to have attempted suicide in the past (OR 0.34, 95% CI 0.18-0.62, P= 0.018), and less likely to have a ‘recorded mental health problem’, current or past history of treatment for mental illness, or history of suicidal thoughts. However, they were more likely to have a physical health problem associated with suicide (OR 2.81, 95% CI 1.28-6.19, P=0.238).
In a accompanying editorial, Delesha Carpenter, PhD, MSPH, of the University of North Carolina at Chapel Hill, drew attention to the fact that employment problems and current mental health treatment were both associated with pharmacist suicide. . “Given the recent attention pharmacist stress and burnout have received in the literature, these findings are of particular concern,” she wrote.
Carpenter recommended formally training “suicide prevention gatekeepers,” people who can identify those at risk, validate their feelings, and expedite referrals. Institutions and workplaces can require suicide prevention training or mental health first aid training, she suggested, and professional societies can promote such offerings.
Additionally, professional societies should work together “to collectively lobby for improved suicide prevention resources at the local, state, and national levels,” Carpenter wrote.
Lee also said more widespread preventive measures need to be put in place in workplaces and also argued that institutions and workplaces should “promote well-being” through policies such as limiting mailings during work hours, protecting time for lunch, and providing adequate spacing between exams for students.
She and her co-authors are currently studying what nursing boards, medical licensing boards, and pharmacy boards are doing to help those struggling with mental and behavioral health issues.
Currently among pharmacy boards, “there’s no room for mistakes…and that’s a shame,” Lee added. “We punish or penalize people for having a disorder.”
NVDRS is a CDC surveillance system that aggregates suicide data collected from death certificates, medical examiner and law enforcement reports, and toxicology results into an anonymized database by state. .
A total of 13 states reported to NVDRS in 2004, 16 in 2009, and 18 in 2014. In total, the 2003-2018 dataset included suicides reported in 39 states, Washington, DC, and Puerto Rico.
An important limitation to the study was the small sample size. Also, Lee and colleagues were only able to calculate age-adjusted rates for some years.
If you or someone you know is struggling with a mental health issue or is having suicidal thoughts, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
The authors have reported no relevant conflicts of interest or financial relationships.