Data concerning women who died by suicide while employed as nurses over a 6-year period (2011-2016) determined that female registered nurses appear to be at significantly higher risk than the population generally. More than half of the nurses who died were not in contact with mental health services. There is a need to improve access to mental health care in nurses, just as there is a need in many groups (National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), 2020).
The Office for National Statistics (ONS) (2017) identified female nurses as having a risk of suicide 23% above the risk of women in other occupations. Currently, there have been no national studies undertaken to determine factors that are associated with suicide specifically in this population. The provision of robust and reliable data could enable the development of interventions and prevention measures. It should be noted that the available information does not include data collected during the COVID-19 pandemic – right now, these numbers are more likely to be even higher. Burnout among healthcare providers hit new levels during the peak of the COVID-19 pandemic and for some this will continue. The stress from long hours and the constant exposure to severely ill or deceased patients takes a massive toll on the mental health of some nurses.
Although deaths by suicide among doctors have reduced in recent years, in other professions, including female nurses, the figures are increasing. Suicide is complicated and needs further exploration – an examination of the specific effects of workplace, financial and personal problems. The various reports would suggest that there is a need to think more about whether there are specific risk factors that predispose female nurses to suicide. Furthermore, consideration should be given to developing a dedicated mental health service for women in the profession as well as the provision of high-quality wellness programmes that are meaningful, with specific aims and objectives. A one-size-fits-all approach is unacceptable in these circumstances. There are some indicators of suicide risk in female nurses that are important, for example, depression and substance misuse are common to most groups at risk. These raise the importance of comprehensive, needs-based clinical care in improving prevention.
Attempting to explain suicide by occupation is multifaceted and complex. Job-related features include low resources and high demands resulting in heightened risk. Predefined characteristics may attract people to certain types of work that increase their suicide risk. Occupations that increase the access to, or knowledge of, methods of suicide can result in an exacerbation of risk (ONS, 2017). High risk of suicide among health professionals in general may be explained by these occupations having significant knowledge of methods of suicide. Self-poisoning rates among female nurses were high in the NCISH (2020) study and this needs further unpicking to inform prevention measures.
Nursing staff are exposed to high levels of stress, an ongoing staff shortage and exceptionally long work hours leading to exhaustion and burnout. Healthy workplaces that promote better work environments and emphasise self-care have to be implemented by the NHS and other organisations. The extraordinary demands that COVID-19 imposed on women, from home schooling to finding child care, will further increase the stress on nurses and in particular female nurses. The number of female nurses completing suicide could suggest that there is insufficient attention and action being paid to the health and wellbeing of nursing staff. One nurse's death by suicide is one too many (Health Education England, 2019).