Not the Only Way Out! (1) – Suicide: The Hidden Crisis 

This is the Opening Post of a 3-part Blog Series on Suicide and Prevention among Healthcare Workers titled "Not the Only Way Out!"

Content Warning: This article discusses suicide, mental health challenges, burnout, and emotional distress among healthcare workers. Some readers may find these topics difficult or triggering. Please read with care and take breaks if needed. Help is available, please find the helplines mentioned at the end of this blog.  

The crisis is not coming.

It is already here.

By Shilpa Sadanand, Psychologist & Program Manager, The George Institute of Global Health

Every morning, as I scroll through my news feed, I come across another heartbreaking story of suicide. The faces and names change, but the tragedy remains the same. Sometimes it is a young person with their whole life ahead of them. Sometimes it is an older adult carrying years of silent pain. And increasingly, it is someone from the healthcare profession, a person who spends their life caring for others.

Recently, the news of a psychiatrist dying by suicide sparked shock and disbelief online. Many people responded with comments such as, "How could this happen? They should have known better." Beneath those reactions lies a dangerous assumption: that healthcare workers are somehow immune to suffering because they understand it professionally. 

But knowledge does not make us invincible. 

As a psychologist, I often encounter similar expectations. People assume that because I understand human behaviour and emotional well-being, I must always have the perfect answers, manage every challenge effortlessly, and navigate life's difficulties without struggle. The reality, however, is very different. 

Before we are nurses, doctors, midwives, psychologists or therapists, we are human beings. We are someone's mother, father, spouse, child, sibling, or friend. We experience loss, loneliness, disappointment, exhaustion, and emotional pain just like everyone else. Professional training may give us tools, but it does not shield us from being human. 

As we observe World Suicide Prevention Day on 10th September, it is important that we talk more openly about suicide, mental health and the role we all play in supporting one another and healthcare workers. The need for these conversations has never been more urgent. 

Suicide is a major public health concern with far reaching consequences, each year more than 720,000 people worldwide die by suicide¹, and every loss profoundly impacts families and communities. Growing evidence shows that physicians and nurses and other healthcare professionals have a greater risk of suicide² compared to general population, making this a global public health concern. There is substantial body of research on suicide risk among physicians and nurses, far less is known about many other healthcare workers. Allied healthcare professionals, support staff and frontline and community health workers often face similar workplace pressures yet underrepresented in the literature. More robust research is needed to better understand the mental health challenges and suicide risk factors affecting the broader healthcare workforce².  

Why are healthcare workers at greater risk of suicide?  

When healthcare workers die by suicide, the immediate response is often to look for individual explanations: vulnerability, personal struggles, or a lack of resilience. While individual factors are important, evidence suggests that the problem is far larger and is frequently rooted in systemic issues. Research increasingly points out- burnout, moral injury, excessive workloads, long working hours, chronic stress, emotional exhaustion, depression, and the persistent stigma surrounding mental health support can all contribute to suicidal thoughts and behaviours among healthcare workers^3,4. Research has consistently identified depression as one of the strongest predictors of suicidal ideation⁵ 

Recent discussions on physician suicides have emphasized that understanding the underlying drivers of depression and suicide is critical.  Two major contributors are burnout and moral injury⁶. Approximately 60% of health workers have experienced burnout -

Burnout⁷ is physical, emotional, or mental exhaustion accompanied by decreased motivation, lowered performance, and negative attitudes toward oneself and others. Moral injury ⁸ involves a sense of betrayal by those in positions of authority and a violation of deeply held moral values and beliefs. For healthcare workers, moral challenges often arise when they are unable to act in a patient's best interest, forcing them to compromise their professional ethics^6,9.  Over time, this conflict between professional values and workplace realities can lead to profound psychological distress, contributing to depression, burnout, and suicidal ideation^10,11.  

These risks become even more pronounced during crises such as pandemics, disasters, armed conflicts, and humanitarian emergencies. Repeated exposure to trauma, death, suffering, ethical dilemmas, and resource scarcity can significantly increase the likelihood of anxiety, depression, post-traumatic stress, moral injury, and suicidal thoughts. Healthcare workers operating in these environments are often asked to carry enormous emotional burdens while continuing to provide care under extraordinary circumstances.   

The crisis is not coming. It is already here. The COVID-19 pandemic exposed many of the vulnerabilities within our healthcare systems, including the immense psychological toll borne by healthcare workers. For a brief moment, their struggles were visible to the world. Conversations about burnout, moral injury, mental health, and workforce wellbeing moved to the forefront. Yet only a few years later, many of those hard - earned lessons risk being forgotten.  

Must we wait for the next pandemic or disaster, before we once again acknowledge the emotional burden carried by healthcare workers? Or can we act now?  Reducing suicide among healthcare workers requires more than awareness. It requires investment in research, implementation of evidence-based interventions, and the creation of supportive work environments.  

If healthcare workers are expected to care for everyone else, who is responsible for caring for them when they need help the most?   

The next time you come across a news headline or social media post about a suicide, pause before making assumptions. Instead, ask: What support was missing? What barriers prevented this person from seeking help? What could have been done differently by their workplace, community, or the systems around them? 

Ultimately, the true measure of a healthcare system is not only how well it cares for its patients, but how well it cares for the people who dedicate their lives to caring for others. 

Crisis Support Resources 

If you or someone you know is experiencing thoughts of suicide, severe emotional distress, or feels unable to stay safe, please seek support immediately. You do not have to go through this alone. Reaching out is a courageous first step. 

The International Association for Suicide Prevention (IASP): https://iasp.findahelpline.com/ 

South Asia 

India 

• Tele-MANAS (Government of India): 14416 or 1-800-891-4416 (24/7)  

• Lifeline India: 1800-121-3667 (24/7) 

• AASRA: +91 22 2754 6669 (24/7) 

Sri Lanka 

• Sri Lanka Sumithrayo: +94 70 730 8308  

• Colombo Sumithrayo: 011 269 6666 / 011 269 2909 / 011 268 3555 

Bangladesh 

• Kaan Pete Roi (Emotional Support & Suicide Prevention Helpline): 09612 119911 

Pakistan 

• Umang Mental Health Helpline: 0311 7786264  

• Emergency Services: 1122  

Africa 

South Africa 

• SADAG Suicide Crisis Helpline: 0800 567 567 (24/7 

• SADAG Mental Health Line: 0800 456 789  

Global Resources 

• Befrienders Worldwide: https://www.befrienders.org 

• FindAHelpline: https://findahelpline.com 

• LifeLine International: https://lifeline-international.com 

References 

1. WSPD. IASP https://www.iasp.info/wspd/.
2. Dutheil, F. et al. Suicide among physicians and health-care workers: A systematic review and meta-analysis. PLoS One 14, e0226361 (2019). 
3. Jain, L. et al. Suicide in Healthcare Workers: An Umbrella Review of Prevalence, Causes, and Preventive Strategies. J Prim Care Community Health 15, 21501319241273242 (2024). 
4. Chahal, S. et al. Suicide deaths among medical students, residents and physicians in India spanning a decade (2010-2019): An exploratory study using on line news portals and Google database. Int J Soc Psychiatry 68, 718–728 (2022). 
5. Nguyen, N. et al. The Relationship Between Depression, Burnout, and Suicide Among Healthcare Professionals: A Scoping Review. Worldviews Evid Based Nurs 22, e70037 (2025). 
6. Blanchard, J. C., Munoz, L., Ziemann, M. & Pittman, P. Tackle burnout and moral injury to prevent doctor suicide. BMJ 387, q2284 (2024). 
7. APA Dictionary of Psychology. https://dictionary.apa.org/. 
8. Shay, J. Moral injury. Psychoanalytic Psychology 31, 182–191 (2014). 
9. Williamson, V., Murphy, D., Phelps, A., Forbes, D. & Greenberg, N. Moral injury: the effect on mental health and implications for treatment. The Lancet Psychiatry 8, 453–455 (2021). 
10. Griffin, B. J. et al. Moral injury is independently associated with suicidal ideation and suicide attempt in high-stress, service-oriented occupations. Npj Ment Health Res 4, 32 (2025). 
11. Anastasi, G. et al. Moral injury and mental health outcomes in nurses: A systematic review. Nurs Ethics 32, 698–723 (2025). 

About the Author

Shilpa is the Program Manager for The Resilience Collaborative initiative at The George Institute for Global Health. She leads initiatives to promote mental health and wellbeing among Healthcare Workers through stakeholder engagement, knowledge exchange and collaborative action. With over 15 years of experience in the field of mental health, she has worked across diverse settings including hospitals, NGOs, academic and research organizations contributing to projects on ageing, dementia, public health, and disability. She holds a doctorate from the National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore. Prior to her current role, Shilpa held both faculty and research positions, working in the areas of NCDs, mental health, and disability. Shilpa is passionate about creating spaces where lived experiences in mental health help shape support systems and foster meaningful connections.