Mental illness and suicide among physicians
Open accessAbstract
The COVID-19 pandemic has heightened interest in how physician mental health can be protected and optimised, but uncertainty and misinformation remain about some key issues. In this Review, we discuss the current literature, which shows that despite what might be inferred during training, physicians are not immune to mental illness, with between a quarter and a third reporting increased symptoms of mental ill health. Physicians, particularly female physicians, are at an increased risk of suicide. An emerging consensus exists that some aspects of physician training, working conditions, and organisational support are unacceptable. Changes in medical training and health systems, and the additional strain of working through a pandemic, might have amplified these problems. A new evidence-informed framework for how individual and organisational interventions can be used in an integrated manner in medical schools, in health-care settings, and by professional colleagues is proposed. New initiatives are required at each of these levels, with an urgent need for organisational-level interventions, to better protect the mental health and wellbeing of physicians.
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As medical students use smartphones frequently, stand-alone app-delivered interventions have potential for cost-effective scalability and can offset accessibility barriers by providing anonymous and private access to medical students concerned about mental health stigma.
“As medical students use smartphones frequently [63], stand-alone app–delivered interventions have the potential for cost-effective scalability [39,64] and can offset known accessibility barriers by providing anonymous and private access to medical students concerned about mental health stigma [11,32,64].”
From Evaluation of an App-Delivered Psychological Flexibility Skill Training Intervention for Medical Student Burnout and Well-being: Randomized Controlled Trial (2023) · cites this paper as [39]
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Experimental — accuracy not yet measuredApp-delivered approaches offer stakeholders a cost-effective scalable intervention option that could reach a large number of students while maintaining relevance to individual needs.
“They also offer stakeholders a cost-effective scalable intervention option that could reach a large number of students [39,64] while maintaining relevance to individual needs [75].”
From Evaluation of an App-Delivered Psychological Flexibility Skill Training Intervention for Medical Student Burnout and Well-being: Randomized Controlled Trial (2023) · cites this paper as [39]
In “Potential solutions > The individual physician” (page unavailable), the review identifies eHealth and mobile apps as a potential way to scale interventions and says they are more feasible than face-to-face delivery in other occupational groups. It does not establish cost-effectiveness or that apps can reach large numbers of students; its discussion of app interventions concerns physicians and medical interns. (LLM, conf=0.86)
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References 121 · Cited by 307
Research works printed but not linked: 9
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- [116]National Academies of Sciences, Engineering, and Medicine National Academy of Medicine Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being Taking action against clinician burnout: a systems approach to professional well-being 2019 The National Academies Press Washington, DC 332 31940160
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- Authors
- Harvey, S. B., Epstein, R. M., Glozier, N., Petrie, K., Strudwick, J., Gayed, A., Dean, K., & Henderson, M.
- Affiliations
- Black Dog Institute (AU)
- University of Rochester Medicine (US)
- UNSW Sydney (AU)
- University of Leeds (GB)
- Corresponding author
- Harvey, Samuel B
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2021-09
- Volume
- 398
- Issue
- 10303
- Pages
- 920-930
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC9618683
- OpenAlex
- W3197660118
- Cited by
- 307
- References
- 121
- Citations by year
- 2026: 54 · 2025: 88 · 2024: 76 · 2023: 52 · 2022: 30 · 2021: 7
- FWCI
- 8.49
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- The Lancet (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- The Sydney eScholarship Repository (The University of Sydney) (submittedVersion)
- Funders
- National Health and Medical Research Council
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
- Keywords
- physician mental health, suicide, mental illness, female physicians, medical training, working conditions, organizational support, COVID-19 pandemic, well-being interventions, medical schools, health care organization
- MeSH terms
- COVID-19, SARS-CoV-2, Suicide Prevention, Mental Disorders, Burnout, Professional, Female, Humans, Male, Physicians, Physicians, Women, Risk Factors, Suicide, Work Schedule Tolerance, Substance-Related Disorders, Pandemics
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