Implementation of Structured Suicide Risk Screening in a State Physician Health Monitoring Program

This study examined the implementation of structured suicide risk screening by a large state physician health monitoring program (PHP).

Physicians (n = 363; 87 women; 44.78 years-old, SD = 13.75) were screened for suicide risk with the Columbia Suicide Severity Rating Scale (C-SSRS) at PHP intake and at 2-weeks, 3-months, 1-year, 2-years, 3-years after initiating monitoring, and following any sentinel events. The PHP response was recorded at each timepoint.

At intake, female physicians reported higher current (p = .025, Cramer's V = .178) and lifetime suicide risk (p = .010, Cramer's V = .163) compared to male physicians. Physicians monitored for substance use disorders (SUD) were more likely to deny any lifetime suicide risk than those monitored for co-occurring SUD and psychiatric disorders (p = .017, Cramer's V = .171), and had lower rates of "moderate" lifetime suicide risk than those monitored for psychiatric disorders only (p = .017, Cramer's V = .171). The PHP offered behavioral health referrals for physicians reporting "low" risk (n = 2) plus safety measures for those with "moderate" (n = 2) and "high" risk (n = 1). One physician reporting "low" risk and four physicians reporting "high" risk were already in-treatment. At 2-weeks and 3-months into monitoring, suicide risk remained "very low" (99.4% and 98.8%) or "low." At 1-year, risk was "very low" for 99.3% of physicians, with two at "moderate" risk. At 2 and 3 years, 100% reported "very low" suicide risk. No suicides occurred among monitored physicians.

PHPs offer support to mitigate suicide risk among physicians. The observed decrease in suicide risk across monitoring may reflect the recovery processes that monitoring is intended to support.