Healthcare Occupations, Suicides, and Suicide Attempts: A Cohort Study Based on the Working Population in Sweden

Many studies have examined physicians' risk of suicide, but studies of other healthcare occupations have been fewer. Suicide attempts have also rarely been studied. We aimed to determine the risks of suicide and suicide attempts among healthcare workers in comparison with non-healthcare workers, according to occupational qualification level.

This population-based cohort study linking Swedish national registers included 243,183 healthcare workers in high-qualified occupations (e.g., physicians); 1,789,076 workers in other high-qualified occupations; 514,726 healthcare workers in low-qualified occupations (e.g., assistant nurses); and 2,026,890 workers in low-qualified occupations residing in Sweden in 2005 and followed them until the latest December 31, 2020. We estimated adjusted hazard ratios (aHR) for suicide and first suicide attempt.

Compared to non-healthcare workers, higher risks for suicide were observed for several healthcare occupations, primarily those working with patient care (e.g., aHR physicians 1.57, 95% CI: 1.23-2.00, registered nurses 1.61, 95% CI: 1.37-1.88, assistant nurses 1.25, 95% CI: 1.17-1.34), rather than those in administrative roles (aHR high-qualified healthcare administrators 1.01 95% CI: 0.76-1.35). Among physicians, the risk was most apparent for psychiatrists (aHR 2.70, 95% CI: 1.21-6.03). For suicide attempts, the risks were primarily observed among registered nurses (aHR 1.22, 95% CI: 1.15-1.29) and assistant nurses (aHR 1.15, 95% CI: 1.12-1.18). Among healthcare workers, assistant nurses had the highest incidence rates for suicide (18.7/100,000 person-years) and suicide attempts (175.1/100,000 person-years).

Workers in several healthcare occupations showed a higher risk of suicide relative to non-healthcare workers with a similar occupational qualification level. Interventions may need to be developed to reduce the risk of suicidal behavior in these groups.