On October 30, a female resident doctor from the Neurosurgery Department at Sawai Man Singh Medical College, Rajasthan was admitted to the ICU. The resident was said to have consumed sleeping pills and was admitted to the ICU in a serious condition on a ventilator.
This happened exactly a few days after the death of a resident of the same college who also committed suicide.
On October 28th, Dr. Sana Khan, Paediatric Department, SMS Medical College, took her life by injecting herself with anesthesia. The hospital administration admitted her to the ICU, but she passed away the next day.
The rate of suicide among doctors is approximately 2.5 times higher than in the general population. In a study conducted between March 2016 and March 2019, it was found that 30 suicides were committed, out of which 18 were females and 12 were males. A systematic review and meta-analysis in 2019 showed a mortality rate of 1·44 for suicides among physicians, with female physicians more at risk. [1]
Dr. Sugirtha Sivakumar, a postgraduate student at the Sree Mookambika Institute of Medical Sciences (SMIMS) in Tamil Nadu, took her life in her hostel accommodation on October 6th by injecting herself with a muscle relaxant. A suicide note was found, attributing her actions to sexual harassment and abuse.
Dr. Preethi, a first-year MD (anesthesia) student at the Kakatiya Medical College, Telangana, Attempts Suicide After Alleged Harassment from a Senior Doctor
Not only the postgraduate doctors but also the medical students are at a higher risk of suicide.
A third-year MBBS student at Kuppam Medical College was found hanging in his room. The student was said to be undergoing mental stress.
Another 20-year-old, Aruna Awase, a second-year MBBS student at the Atal Bihari Vajpayee Government Medical College, allegedly hanged herself from a fan in her hostel room.
The suicidal tendency among medical students is high and ranges from 1.8% to 53.6%.[2] Ragging, excessive working hours, study, and examinations can be considered a risk factor for suicide among medical students.
Few studies found that a few of the issues that increase the risk for doctors are substance use, poor coping skills, burnout, financial debts, workload, and mental health issues. [3,4] Knowledge and access to lethal means are two of the most important reasons for the increased risk of suicide among physicians.[5]
Professional bodies in different countries have demanded a greater focus on physician mental health within training programs, workplaces, and the health service.
On October 24, the Centers for Disease Control and Prevention (CDC) launched the program 'Impact Wellbeing' to address the issue of Mental Health Crisis among healthcare workers.
According to a report by Mental Health America, 93% of healthcare workers reported feeling stressed, 86% of them reported feeling anxious, and 76% of them reported the issue of burnout.
The data published in JAMA reported a rise in the suicide rate among healthcare workers and highlighted that healthcare workers have been fighting mental health issues for years.
The CDC reported that, compared with other workers surveyed between 2018 and 2022, healthcare workers had a major decline in mental health.
In India, associations like the Indian Medical Association have taken some steps to ensure doctors are mentally healthy through their Doctors for Doctors, or D4D program.
In 2017, Suhas Chandran and Kishor M. from the J.S.S. Medical College and Hospital, Mysuru, wrote "Depression in Doctors: “Unsaid, Untold, Unexplored" that too many doctors suffered depression in silence, afraid to seek help because they feared penalties at work and, in some cases, being judged. They further wrote that it’s high time for the medical fraternity to consider that mental health is our collective responsibility, and doctors who spend so much of their lives caring for patients are often suffering in silence.
The field of health of health care workers remains a neglected sector in the Indian health care setup. With rising discordance between the expectations and the infrastructure of the health care system these incidents are bound to rise. Only an immediate intervention in the present can prevent the collapse of the healthcare system in the near future.Dr. Anurag, MBBS, MD (Internal Medicine), Assam
People have forgotten somewhere that health care professionals are people too. People may compare us to deities but that’s not what we really want, we just want compassion from our patients, we have hard days too, we are just like any other human being walking on the face of this earth; who’re working day and night without a break just to provide strangers with the care that we unfortunately can’t give to our own selves and our families. This emotional gap between the patient and healthcare provider is the reason that so many of us suffer from mental health issues and take such dire steps.Dr. Shakun Sonkhle, MBBS, Medical Officer, Himachal Pradesh
References
1. Hawton K, Clements A, Simkin S, Malmberg A. Doctors who kill themselves: a study of the methods used for suicide. QJM. 2000 Jun;93(6):351-7
2. Coentre R, Góis C. Suicidal ideation in medical students: Recent insights Adv Med Educ Pract. 2018;9:873–80
3. Gabbard GO. The role of compulsiveness in the normal physician JAMA. 1985;254:2926–9
4. Krakowski AJ. Stress and the practice of Medicine: The myth and reality J Psychosom Res. 1982;26:91–8
5. Fahrenkopf AM, Sectish TC, Barger LK, et al. Rates of medication errors among depressed and burnt out residents: prospective cohort study BMJ. 2008 Mar 1;336(7642):488-91.
(By Dr. Shelja Chauhan)