Volume 206 - Issue 11
Suicide by health professionals: a retrospective mortality study in Australia, 2001–2012
Authors: Allison J Milner, Matthew J Spittal and Marie M Bismark
Med J Aust 2017; 206 (11): 506. || doi: 10.5694/mja16.01372
Published online: 19 June 2017
Published online: 19 June 2017
In reply:
In their comment on our article,1 Adler and Adler are correct in noting that sexual harassment is a significant issue facing female doctors, as it is for women in many occupations.2 Those who experience sexual harassment are also more likely to experience bullying and other forms of workplace incivility.3 Workplace bullying has also been found to be related to higher risk of suicidality.4 In view of this, we agree that these would be worthwhile targets for prevention initiatives.
But the question remains as to whether sexual harassment and the problems regarding gender role stress discussed in our article1 all stem from the same set of causes.
A meta-analysis3 noted two systematic sources of sexual harassment: (i) organisational context, including a climate that permits sexual harassment, and policies that do not support the reporting of and action against perpetrators; and (ii) the context of gender in the workplace — for example, the extent to which traditional gender roles are able to be maintained, such as through gender differences in the organisation of work, and the overall proportion of women employed in the job. In our article, we specifically highlighted the maintenance of gender-normative behaviour in medicine as potential stressors for suicide.
While we agree that sexual harassment is a significant issue that needs to be addressed, we suggest that this be incorporated into a wider and overall strategy to overcome gender inequality in medicine. This strategy should target the negative personal and organisational (eg, organisation commitment, work withdrawal, job satisfaction) outcomes of harassment,3 and include measures to allow both male and female doctors to care for their families. In addition, to align with best practice in workplace suicide prevention,5 we would also support a stigma reduction campaign, access to treatment for health practitioners who experience poor mental health and suicidal ideation, and support for colleagues and families following bereavement from suicide within the medical profession.
Competing interests
Allison Milner receives financial support from the Society for Mental Health Research, Deakin University, and the American Foundation for Suicide Prevention.
References
- Milner AJ, Maheen H, Bismark MM, Spittal MJ. Suicide by health professionals: a retrospective mortality study in Australia, 2001–2012. Med J Aust 2016; 205: 260-265.
- Lamontagne AD, Smith PM, Louie AM, Quinlan M, et al. Unwanted sexual advances at work: variations by employment arrangement in a sample of working Australians. Aust N Z J Public Health 2009; 33: 173-179.
- Willness CR, Steel P, Lee K. A meta-analysis of the antecedents and consequences of workplace sexual harrassment. Personnel Psychology 2007; 60: 127.
- Leach LS, Poyser C, Butterworth P. Workplace bullying and the association with suicidal ideation/thoughts and behaviour: a systematic review. Occup Environ Med 2016. doi: 10.1136/oemed-2016-103726.
- Milner A, Page K, Spencer-Thomas S, Lamotagne AD. Workplace suicide prevention: a systematic review of published and unpublished activities. Health Promot Int 2015; 30: 29-37.