Suicide in Costa Rican Health Personnel: A Retrospective Look

In the world, mortality by suicide in health personnel is higher than in the general population and it is even higher in physicians and nurses. Several risk factors are mentioned, among them long shifts, difficulties to fit family life with professional performance, burnout and others. Working conditions for health personnel are not the same in different parts of the world, thus not all the aspects of suicide in health personnel are comparable as is shown in several meta-analysis. In our country the subject of suicide has been researched, but not the details of suicide in health personnel.

Methods: A retrospective country-wide study was undertaken from 01/01/2012 to 12/31/2021 to determine the epidemiological characteristics of deaths by suicide in this population. From all autopsies performed at the Forensic Pathology Department of persons dead by suicide during the time of the study, those of the ones dully recognized as members of health personnel were chosen for this investigation. The epidemiological and demographic information was taken from the charts filed at the Department of Legal Medicine. Data was then analyzed with descriptive statistics and then compared with suicide rates in the general public as published by the INEC (National Statistics Office)

Results: Along the ten years of the study period, there was a 48,4% increase in general mortality rate for the country and the suicide rate grew 16,31%. The numbers for suicide in health personnel were very small and it was not possible to obtain a specific rate for comparison.

There were 44 suicides in health personnel, 26/44 were males, age average was in the 30-39 decade. Female health personnel showed a higher incidence of suicides than women of the general public. The main mechanisms of death were asphyxia (hanging) and poisoning. Half of all the suicides occurred in Nurses and Physicians.

Conclusions: It is necessary to implement steps to discover features in individuals that may warrant close professional follow up, mainly in those with psychiatric disorders.

In the other hand it is important to improve the way the information of suicides is obtained, particularly that of health personnel. Forensic technicians should be instructed and their questionnaires modified, in order to allow a deeper analysis to be able to develop efficient preventive strategies.