Abstract
Objective: The burden of suicidal behavior is anticipated to increase as a sequela of the COVID-19 pandemic. However, there is limited evidence on suicidal behavior among healthcare workers, an at-risk population. Our study aimed to investigate suicidal ideation in terms of the rate and associated factors in a sample of Malaysian healthcare workers during the early-phase of the COVID-19 pandemic.Methods: A subpopulation analysis (N = 171) was conducted within a larger, nation-wide cross-sectional study of Malaysian healthcare worker psychological distress from March 18–21, 2020. Current suicidal ideation was measured with item 9 of the Patient Health Questionnaire-9 (PHQ-9). The following independent variables were assessed: socio-demographic profile, occupation and service-related factors, health-anxiety (Health Anxiety Inventory, HAI), lifetime anxiety disorder and severity of depression (PHQ-9).Results: The proportion of healthcare workers with current suicidal ideation (19/171) and clinical depression (17/171) were 11.1 and 9.9%, respectively. Multivariable analysis showed that clinical depression was the most significant factor associated with current suicidal ideation (p < 0.001, OR = 55.983, 95% CI = 9.015–347.671) followed by mild (subthreshold) depression (p = 0.001, OR = 115.984, 95% CI = 2.977–85.804). Service duration of more than 10 years was associated with significantly less suicidal ideation (p = 0.049, OR = 0.072, 95% CI = 0.005–0.993).Conclusions: Depression (subthreshold and especially within the clinical range) and early-career status (<10 years in service) may be target areas of early intervention for reduction of suicidal ideation amongst healthcare workers who have served during the COVID-19 pandemic. Further research is warranted to elucidate specific occupational stressors related to COVID-19 work conditions to tailor appropriate suicide preventive strategies in this population.
Highlights
Suicidal behavior has been projected to increase globally [1] as a sequela of the anticipated mental health crisis stemming for the COVID-19 pandemic
A meta-analysis showed that the mental health impact of the COVID-19 pandemic on healthcare workers was more severe compared to the general population [4]
Our present study showed that 11.1% of healthcare workers in Malaysia reported current suicidal ideation during the early phase of the COVID-19 pandemic and lockdown
Summary
Suicidal behavior has been projected to increase globally [1] as a sequela of the anticipated mental health crisis stemming for the COVID-19 pandemic. The mental health needs of frontline healthcare workers (HCWs) have been highlighted as a global priority [2]. A pre-pandemic meta-analysis showed that physicians who are female, United States-based, and in disciplines such as anesthesia, psychiatry, general practice, and general surgery may have higher suicide risk compared to the general population [3]. A meta-analysis showed that the mental health impact of the COVID-19 pandemic on healthcare workers was more severe compared to the general population [4]. Spanish and American healthcare workers’ high levels of psychological distress were significantly correlated with fears of being infected or infecting others, especially family and friends, and clinical challenges i.e., perceived uncertainty/lack of control and inadequacy of PPE [5, 6]
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