Clare Gerada: Preventing suicide in medical staff

I recently experienced a first in my career: while presenting at a conference, I shed tears.

To put things in context, I was talking at a session on preventing suicide in the NHS. Before mine, we heard brilliant talks from two paramedics, an ambulance controller, and a nurse, talking from their respective fields. As they gave their presentations I found myself reflecting on the group I had run that week—one I’ve written about before in BMJ Opinion.1 It’s a group no one wants to belong to, but it’s one that’s vital for the survival of its members. This is a group for people bereaved after the suicide or sudden accidental death of a doctor.

My thoughts kept replaying some of the themes that had come up that week. One father talked about how no one cares about the suicide of a doctor (or indeed of any NHS staff). He said that, while five deaths from listeria were leading to a fundamental review of all catering in the NHS and two deaths of reality TV contestants led to a parliamentary debate, the death of a doctor every three weeks barely registers on the radar of any media platform, parliamentary body, or NHS manager.

A wife, barely able to get her words out because of her grief, talked about her husband’s death, which she attributed entirely to an overworked, uncaring, and bullying work environment in his hospital. All life is precious, but it seems that the lives of NHS staff are disposable as long as targets are being met. This has to change.

Suicide prevention means tackling the pain in the whole system, not just in individuals. Systemic change won’t come about just through compulsory mindfulness, yoga, or suicide prevention training (although these might help in bringing people together), nor indeed through creating metrics for “kindness” or “compassion.” What we need is to tackle the policies that go to the heart of the cause of distress—bullying, complaints, a culture of shaming, workload, targets, and inspection.

We know what to do. Stop the name, blame, and shame culture that’s now institutionalised within the NHS; create spaces for staff to come together, to learn and reflect together in their teams—not in sterile spaces online but in real, protected places; and maybe create, at board level, a lead role solely to tackle the wellbeing of all staff in an organisation.

Let’s really put into practice efforts to make zero suicide a reality for those who care for us all. My tears were for the dead and for the living members of my group, struggling with their grief. I hope that my group gets no new members. Sadly, if the problem remains unchecked, I suspect that it will.