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Saturday, May 14, 2022

Suicides of Psychologists and Other Health Professionals: National Violent Death Reporting System Data, 2003–2018

Li, T., Petrik, M. L., Freese, R. L., & Robiner, W. N.
(2022). American Psychologist. 
Advance online publication.


Suicide is a prevalent problem among health professionals, with suicide rates often described as exceeding that of the general population. The literature addressing suicide of psychologists is limited, including its epidemiological estimates. This study explored suicide rates in psychologists by examining the National Violent Death Reporting System (NVDRS), the Centers for Disease Control and Prevention’s data set of U.S. violent deaths. Data were examined from participating states from 2003 to 2018. Trends in suicide deaths longitudinally were examined. Suicide decedents were characterized by examining demographics, region of residence, method of suicide, mental health, suicidal ideation, and suicidal behavior histories. Psychologists’ suicide rates are compared to those of other health professionals. Since its inception, the NVDRS identified 159 cases of psychologist suicide. Males comprised 64% of decedents. Average age was 56.3 years. Factors, circumstances, and trends related to psychologist suicides are presented. In 2018, psychologist suicide deaths were estimated to account for 4.9% of suicides among 10 selected health professions. As the NVDRS expands to include data from all 50 states, it will become increasingly valuable in delineating the epidemiology of suicide for psychologists and other health professionals and designing prevention strategies. 

From the Discussion

Between 2003 and 2018, 159 cases of psychologist death by suicide were identified in the NVDRS, providing a basis for examining the phenomenon rather than clarifying its true incidence. Suicide deaths spanned all U.S. regions, with the South accounting for the most (35.8%) cases, followed by the West (24.5%), Midwest (20.1%), and Northeast (19.5%). It is unclear whether this is due to the South and West actually having higher suicide rates among psychologists or if these regions have greater representation due to inclusion of more reporting states. It should also be noted that these regions make up different proportions of the population for the entire United States. According to the U.S. Census Bureau (n.d.), the proportion of each region’s population as compared to the entire U.S. population for the year 2019 was South (38.3%), West (23.9%), Midwest (20.8%), and Northeast (17.1%). This could have affected the number of cases seen within each region, as could other factors, such as the trend for gun ownership to be more than twice as common in the South than in the Northeast (Pew Research Center, 2017). The 2003–2018 psychologist suicide deaths were more than 13 times higher than NVDRS-identified psychologist homicide deaths (n = 12) for that same period (Robiner & Li, 2022).

The number of psychologist suicides identified in the NVDRS generally increased longitudinally. It is not clear whether this might signal an actual increasing incidence, and if so what factors may be contributing, or how much it is an artifact of the increasing number of NVDRS-reporting states. Starting in 2020, the data will more clearly reveal temporal patterns, with variation reflecting changes in suicide incidence rather than how many states reported. In the future, we anticipate longitudinal trends will not be confounded by variation in the number of reporting states.

Most psychologist suicide decedents were White (92.5%). Smaller percentages were Black, Indigenous, and People of Color (BIPOC): Black (2.5%), Asian or Pacific Islander (1.9%), and two or more races (3.1%). These proportions align largely with the racial/ethnic makeup of the psychologist workforce in APA’s Survey of Psychology Health Service Providers for White (87.8%), Black (2.6%), Asian (2.5%), and multiracial/multiethnic psychologists (1.7%; Hamp et al., 2016). The data are generally consistent with earlier findings of psychologist suicide (Phillips, 1999) that most psychologist suicide decedents are White and reveal slightly greater diversification within the field. CDC data from 2019 reveals rates in the general population of suicide per 100,000 are greatest in Whites (29.8 male, 8 female), followed by Blacks (12.4 male, 2.9 female), Asians (11.2 male, 4.0 female), and Hispanics (11.3 male, 3.0 female; NIMH, 2021). There were no cases of Hispanic psychologist suicide in this sample, which is generally consistent with the relatively lower numbers of suicides reported for Hispanics by the CDC. The relatively small numbers of suicides within subgroups limit the certainty of inferences that can be drawn about the association of ethnicity, and potentially other demographics, and suicide incidence. As the demographic composition of the field diversifies, the durability of the present findings for subgroups remains to be seen.