A colleague's death is hard to contemplate. But the suicides of two psychologists in 2008 — as well as those of noted psychologists Michael J. Mahoney, PhD, in 2006, and Lawrence Kohlberg, PhD, in 1987 — prompted an ad hoc APA committee to look closely at what is known about this hazard and what the profession can do about it.
The group – led by Phillip M. Kleespies, PhD, of the VA Boston Healthcare System and made up of members of APA's Advisory Committee on Colleague Assistance, the APA Practice Directorate and the APA Div. 12 (Clinical) Section on Clinical Emergencies and Crises — examined research in four critical areas: suicide rates, risk factors, impact on others and how colleagues support psychologists in distress. They also examined the current state of prevention and intervention, and suggested ways to enhance training in this vital area.
In terms of rates, research is mixed and sparse about whether psychologists are more likely to commit suicide than other professions, write the working group members in the June issue of Professional Psychology: Research and Practice (Vol. 42, No. 3). Some studies show elevated rates among white female psychologists, for example, but not among white male psychologists or black psychologists, and there are no studies looking at psychologists of other ethnicities.
However, several studies support the idea that psychologists may have an elevated risk for suicidal ideation and behavior compared to general population, the team also found. A 2009 APA survey, for instance, found that 40 percent to 60 percent of psychological practitioners reported some disruption in professional functioning due to burnout, anxiety or depression. Moreover, case studies suggest that a therapist's suicide can profoundly and negatively affect clients, while other studies indicate that psychologists are often insufficiently educated on the best ways to intervene with a distressed colleague.
Given these factors, the authors recommend the following actions:
A more concerted and formal effort to build education on suicide risk and prevention into graduate training.
Better training of professionals on possible signs of suicidality and ways to intervene with struggling colleagues, for example through continuing education and state psychological association mechanisms.
More emphasis normalizing the challenges of being a practicing psychologist, an approach increasingly taken by many state psychological associations' colleague assistance programs. One aspect of this strategy is fostering the use of regular self-care strategies for all psychologists.
Better education on "post-ventions," or what to do in the event of a colleague's suicide. This includes having immediate support and mechanisms in place for all affected individuals, and longer-term supports for those who may need them. In general for the profession, having a professional will in place can greatly facilitate how patient records and issues are handled in the event of death from any cause.
More research on whether psychologists are at unique risk for suicide given possible self-selection factors and factors specific to the therapy profession, such as the intense and isolated nature of the work.
Whether or not research ends up showing an elevated risk among psychologists, it's vital the profession tackle all aspects of prevention and post-vention given the potentially profound effect of suicide on clients and others, they write.
"Suicide by psychologists, individuals with special expertise in human behavior, seems to be particularly fraught with challenges and raises concerns specific to psychology such as doubt in the value of therapy," they write. "Identifying risks, reducing the stigma associated with acknowledging hopelessness or despair, and overcoming other barriers to intervention are critical to reducing the incidence of suicide."
Tori DeAngelis is a writer in Syracuse, N.Y.
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