The topic of suicide is indeed a difficult one, but when statistics show that the rates of suicide in nurses in England are estimated to be 23% higher than in the general population (ONS 2017), it’s important to try to understand why in order to provide the necessary support. In this blog, Dr Pauline Milne MBE, a Churchill Fellow who recently published the report ‘Protecting Nurses from Suicide,’ explains why data is crucial for intervention strategies.

She said, “One of the challenges for preventing this is gathering data. A recent review of the NMC undertaken by Rise Associates (2024) reported that over the last year six registrants, who were undergoing Fitness to Practice processes, died by suicide. The trouble is that data on nurse suicide rates in the UK is sparse and there are limitations with the datasets which do exist.

There are several possible reasons for the underreporting of nurses who die by suicide. This was an area explored in my Fellowship meetings and much of the feedback is based on anecdote and supposition. The reasons discussed included the stigma associated with death by suicide, this may be more prominent in some cultures whereby families are unwilling to acknowledge suicide as the cause of death, incomplete data for example lack of information on occupation or uncertainty regarding the cause of death. Improved data on suicides can inform better prevention strategies and interventions. Over time trends in the data can then be used to track the impact of these interventions.”

Problems that may be contributing to these statistics being higher for nurses compared to the general public

“Nurse suicide is a complex issue with a range of potential predisposing factors or stressors which may be personal,” Pauline explains, “for example, relationships issues, bereavement, financial worries, gambling, dependence of drugs or alcohol, poor mental health, isolation and loneliness or work-related factors including workload, burnout, management, disciplinary issues, perceptions of competence and quality of available supervision.”

“There is an urgent need to better understand the circumstances that result in nurses attempting to end their lives by suicide. This should be informed by the real-life experiences of nurses who have been in this position. More information would help with the development of best practice approaches to identify nurses at high risk of suicide and tailor interventions appropriately to support them.”

Support services like Cavell help nurses feel like they have somewhere to turn to in tough times  

Cavell is the charity supporting UK nurses, midwives and nursing associates, working and retired, when they’re suffering personal or financial hardship often due to illness, disability, older age, domestic abuse and the ongoing cost of living crisis.

Everyone’s circumstances are unique, and financial hardship can strike at any time, for example, when a nurse is a single mum of three and her fridge stops working, or a midwife needs to flee domestic violence but risks facing homelessness.

In June 2024, Cavell surveyed nurses and midwives and found that 69% were unprepared for a financial crisis, and 92% felt their financial situation negatively impacts their mental health. Turning to Cavell in a time of crisis can be a lifeline for nurses and midwives who see no way out of tough times.

Look out for colleagues

If you have concerns about a friend or colleague and think they might be struggling with their mental health or even suicidal, encourage them to seek help from a healthcare professional who specialises in mental health or to contact a emotional support organisation such as Samaritans on 116 123. More information about support from Samaritans can be found here

Never underestimate the importance of having that initial conversation with a friend or colleague and showing them that you care.

Pauline’s full report can be found here  

References

National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH).  Suicide by female nurses: a brief report (2020).   University of Manchester

Office for National Statistics (2017).  Suicide by occupation, England 2011-2015.  Analysis of deaths from suicide in different occupational groups for people aged 20-64 years, based on deaths registered in England between 2011 and 2015.

Rise Associates (2004).  The Nursing and Midwifery Council Independent Culture Review. Available at https://www.nmc.org.uk/about-us/independent-reviews/