Suicide and utilisation of health-care services for depressive disorders among health-care professionals and clerics in Norway 2008–2021: a case-control study

Suicide risk was not significantly elevated among physicians, veterinarians, dentists, psychologists, pharmacists, physiotherapists, nurses, or clerics in Norway between 2008 and 2021 as compared to controls with higher and lower education.

Abstract
Background
There is a lack of research on suicide and depression among health-care professionals, and most studies on depression are based on self-report. Thus, we conducted a register-based study to examine suicide risk and health-care utilisation for depressive disorders, both in the primary and specialist health-care services, among physicians, veterinarians, dentists, psychologists, pharmacists, physiotherapists, and nurses, as well as among clerics, compared to controls with higher and lower education.

Methods
The study is a case-control analysis based on Norwegian nationwide registers from 2008 to 2021. Occupations were included according to the Classification of Occupations provided by Statistics Norway. Information on occupations were linked to the Norwegian Cause of Death Registry, the Norwegian Patient Registry, and the Norwegian Registry for Primary Care.

Results
Suicide risk was not significantly elevated in any of the professions investigated. Physicians, psychologists, physiotherapists, and nurses had significantly lower rates as compared to controls with lower education. Psychologists and clerics had a higher likelihood of utilising specialist health-care services for depression as compared to controls with both higher and lower education. Clerics also utilised primary health-care services for depression to a larger extent as compared to both groups.

Limitations
Occupational exposure is only one of many factors contributing to depression and suicide risk. Other risk factors such as working conditions or mental illnesses other than depression were not accounted for in the present study.

Conclusions
Preventive mental health measures and timely treatment of depression among health-care professionals in need is important and may contribute to suicide prevention.