Anaesthetist suicide linked to fatigue and stress says coroner
NEW YORK: The “tragic” suicide of an anaesthetist has highlighted the struggle of those in high-stress environments where “life and death decisions are part-and-parcel of their working days”.
Dr Richard Harding, 47, died at home in Whangārei on October 23, 2017, having moved from the United Kingdom with GP wife Kate and their two teenage children the year prior.
In a recent finding, Coroner Katherine Greig ruled Harding’s death a suicide, highlighting a “constellation” of factors in his death, “many of which were associated with his work”.
Long hours, sleep disruption and stress are common for medical professionals, but evidence suggests New Zealand has a “somewhat fragmented response” to dealing with factors that impact doctors’ wellbeing, the coroner said.
Harding was suffering from depression triggered by the first complaint against him in the UK – of which he was later cleared – and the stress of moving countries, the report said.
In August 2016, he started on anti-depressants.
A GP recorded he had thoughts of self-harm, but no plans to hurt himself. However, he was considered high risk because of his work.
He came off medication in March 2017 as his mood improved, but his depression returned, the report said.
He had insomnia, worsened by frequent night-time call-outs – despite “enjoying” his work as an anaesthetist and intensivist – and started taking medication again five weeks before he died.
Harding saw a psychologist on October 10, who considered his risk of self-harm was “low” and “prognosis was good”.
Harding showed no signs of improving, and he was due to see a psychiatrist a few days after he died.
Coroner Greig said Harding died “whilst overwhelmed with the effects of anxiety and depression”.
Greig’s inquiry found several stressors in the months before Harding’s death.
International evidence shows doctors undergoing complaints are more likely to be depressed and have suicidal ideation, the report said.
Harding was also sleeping poorly, doing more on-call work than he was used to.
Intensivists, who care for critically ill patients, work “very long hours [and] are often unable to go home safely – or even go home at all – the next day”, the report said.
That Harding’s work was a likely factor in his death was “no criticism of his new role at Whangārei Hospital… rather it is a comment on the systemic environment”, the report said.
Issues raised in the inquiry suggest “further deliberation is required” into the “complex” factors which may increase the vulnerability of intensivists and anaesthetists to suicide, and how these can be addressed to reduce the chances of further deaths, Greig said.
Australian and New Zealand College of Anaesthetists president Dr Vanessa Beavis said anaesthetists deal with life and death day in and day out.
“You can’t help but be touched [by that].”
Beavis said the medical college is “very mindful and concerned” about distress among anaesthetists.
While there is no robust data on psychological distress among anaesthetists, it is an issue the medical college has been aware of for more than two decades, establishing groups and resources to aid awareness and access to support, Beavis said.
These include a counselling service specific to the needs of anaesthetists, available 24/7.
It also facilitates peer support groups and runs wellbeing sessions at all major meetings, as “you can’t soldier on by yourself”.