Suicide attempts among Swedish healthcare workers – a population-based cohort study

BACKGROUND: While there are abundant studies on healthcare workers’ (HCWs’) suicide risk, studies on HCWs’ suicide attempts are rarer. Most previous studies on HCWs’ suicide attempts were based on cross-sectional self-reported information among selected occupations, i.e., physicians, and did not consider potential multiple attempts. This study aimed to determine the risk of suicide attempts among a wide range of healthcare professions using information from Swedish nationwide population registers. METHODS: This population-based cohort study included 4.9 million Swedish workers aged 20 years and above residing in Sweden in 2005 who were followed until their death, emigration, age 65, or 31 December 2020. The suicide attempts rates (number of secondary care visits with ICD-10 codes X60-84 and Y10-34 during follow-up) among HCWs were identified and compared with the general working population. The following occupations were included: physicians, nurses, dentists and dental hygienists, psychologists, psychotherapists, counsellors, pharmacists and prescriptionists, therapists and other allied health professionals, assistant nurses, and healthcare administrators. Adjusted rate ratios (aRRs) were estimated using Poisson regression controlling for demographics, socioeconomic, and health status. RESULTS: Most HCWs have an increased risk of suicide attempts compared to other workers. The highest risk was observed among nurses (aRR 1.48, 95% CI 1.42-1.56) and assistant nurses (aRR 1.33, 95% CI 1.30-1.35). The association was stronger in males (aRR nurses 1.56, 95% CI 1.35-1.81) than in females (aRR nurses 1.41, 95% CI 1.34-1.48). The risks were similar over the age at follow-up and calendar year. CONCLUSIONS: Many HCWs were at increased risk of suicide attempts. Unlike patterns observed in the general population, male HCWs might have a higher increase in suicide attempt risk. Preventive efforts for suicide attempts within the healthcare system might need to be improved. KEY MESSAGES: • Healthcare workers were at increased risk for suicide attempts, and the risk might be stronger in male than female HCWs. • The risk for suicide attempts among healthcare workers was similar throughout age and calendar year.