Suicide by health professionals: a retrospective mortality study in Australia, 2001–2012

Allison J Milner, Humaira Maheen, Marie M Bismark and Matthew J Spittal
Med J Aust 2016; 205 (6): 260-265. || doi: 10.5694/mja15.01044


Objectives: To report age-standardised rates and methods of suicide by health professionals, and to compare these with suicide rates for other occupations.

Study design: Retrospective mortality study.

Setting, participants: All intentional self-harm cases recorded by the National Coronial Information System during the period 2001–2012 were initially included. Cases were excluded if the person was unemployed at the time of death, if their employment status was unknown or occupational information was missing, or if they were under 20 years of age at the time of death. Suicide rates were calculated using Australian Bureau of Statistics population-level data from the 2006 census.

Main outcome measures: Suicide rates and method of suicide by occupational group.

Results: Suicide rates for female health professionals were higher than for women in other occupations (medical practitioners: incidence rate ratio [IRR], 2.52; 95% CI, 1.55–4.09; P < 0.001; nurses and midwives: IRR, 2.65; 95% CI, 2.22–3.15; P < 0.001). Suicide rates for male medical practitioners were not significantly higher than for other occupations, but the suicide rate for male nurses and midwives was significantly higher than for men working outside the health professions (IRR, 1.50; 95% CI 1.12–2.01; P = 0.006). The suicide rate for health professionals with ready access to prescription medications was higher than for those in health professions without such access or in non-health professional occupations. The most frequent method of suicide used by health professionals was self-poisoning.

Conclusion: Our results indicate the need for targeted prevention of suicide by health professionals.

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  • Allison J Milner1,2
  • Humaira Maheen1
  • Marie M Bismark3
  • Matthew J Spittal4

  • 1 Centre for Population Health Research, Deakin University, Melbourne, VIC
  • 2 Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC
  • 3 Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC
  • 4 Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC


This work was supported by the American Foundation for Suicide Prevention (SRG-1-091-13), the Society for Mental Health Research, and Deakin University. The funding sources had no involvement in the study design or in the collection, analysis and interpretation of the data, the writing of the manuscript, or the decision to submit the manuscript for publication.

Competing interests:

Allison Milner receives financial support from the Society for Mental Health Research, Deakin University, and the American Foundation for Suicide Prevention.

  • 1. Frank E, Biola H, Burnett CA. Mortality rates and causes among US physicians. Am J Prev Med 2000; 19: 155-159.
  • 2. Hawton K, Agerbo E, Simkin S, et al. Risk of suicide in medical and related occupational groups: a national study based on Danish case population-based registers. J Affect Disord 2011; 134: 320-326.
  • 3. Schernhammer ES, Colditz GA. Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). Am J Psychiatry 2004; 161: 2295-2302.
  • 4. Lindeman S, Laara E, Hakko H, Lonnqvist J. A systematic review on gender-specific suicide mortality in medical doctors. Br J Psychiatry 1996; 168: 274-279.
  • 5. Alderson M, Parent-Rocheleau X, Mishara B. Critical review on suicide among nurses. Crisis 2015; 36: 91-101.
  • 6. Kolves K, De Leo D. Suicide in medical doctors and nurses: an analysis of the Queensland Suicide Register. J Nerv Ment Dis 2013; 201: 987-990.
  • 7. Skegg K, Firth H, Gray A, Cox B. Suicide by occupation: does access to means increase the risk? Aust N Z J Psychiatry 2010; 44: 429-434.
  • 8. Australian Bureau of Statistics. 3303.0. Causes of death, Australia, 2013 [website]. Mar 2015.∼2013∼Main%20Features∼Suicides∼10004 (accessed Jan 2016).
  • 9. Escribà-Agüir V, Martin-Baena D, Pérez-Hoyos S. Psychosocial work environment and burnout among emergency medical and nursing staff. Int Arch Occup Environ Health 2006; 80: 127-133.
  • 10. De Leo D, Dudley MJ, Aebersold CJ, et al. Achieving standardised reporting of suicide in Australia: rationale and program for change. Med J Aust 2010; 192: 452-456. <MJA full text>
  • 11. World Health Organization. Intentional self-harm (X60–X84). International statistical classification of diseases and related health problems 10th revision (ICD-10) — WHO version for 2015 [website]. (accessed Dec 2015).
  • 12. Australian Bureau of Statistics. 1220.0. ANZSCO: Australian and New Zealand standard classification of occupations, 2013, version 1.2 [website]. June 2013.,%20Version%201.2?OpenDocument (accessed Dec 2015).
  • 13. Australian Bureau of Statistics. Standard population for use in age-standardisation. June 2013. (accessed Dec 2015).
  • 14. Hawton K, Clements A, Sakarovitch C, et al. Suicide in doctors: a study of risk according to gender, seniority and specialty in medical practitioners in England and Wales, 1979–1995. Epidemiol Community Health 2001; 55: 296-300.
  • 15. Boulis AK, Jacobs JA. The changing face of medicine: women doctors and the evolution of health care in America. Ithaca, NY: Cornell University Press, 2008.
  • 16. Riska E. Towards gender balance: but will women physicians have an impact on medicine? Soc Sci Med 2001; 52: 179-187.
  • 17. Alexandros-Stamatios GA, Marilyn JD, Cary LC. Occupational stress, job satisfaction and health state in male and female junior hospital doctors in Greece. J Manage Psychol 2003; 18: 592-621.
  • 18. Simpson R. Masculinity at work: the experiences of men in female dominated occupations. Work Employ Soc 2004; 18: 349-368.
  • 19. Goehring C, Bouvier Gallacchi M, Künzi B, Bovier P. Psychosocial and professional characteristics of burnout in Swiss primary care practitioners: a cross-sectional survey. Swiss Med Wkly 2005; 135: 101-108.
  • 20. beyondblue. National mental health survey of doctors and medical students. Oct 2013. (accessed Aug 2015).
  • 21. Nieuwenhuijsen K, Bruinvels D, Frings-Dresen M. Psychosocial work environment and stress-related disorders, a systematic review. Occup Med 2010; 60: 277-286.
  • 22. Cocker F, Martin A, Scott J, et al. Psychological distress, related work attendance, and productivity loss in small-to-medium enterprise owner/managers. Int J Environ Res Public Health 2013; 10: 5062-5082.
  • 23. Milner A, Niven H, LaMontagne AD. Occupational class differences in suicide: evidence of changes over time and during the global financial crisis in Australia. BMC Psychiatry 2015; 15: 223.


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