Working conditions, psychological distress and suicidal ideation: cross-sectional survey study of UK junior doctors

Rui-Han Teoh, Kevin; Dunning, Alice; Kathryn Taylor, Anna; Gopfert, Anya; Chew-Graham, Carolyn A.; Spiers, Johanna; Appleby, Louis; Van Hove, Maria; Buszewicz, Marta; Riley, Ruth

Abstract

Background
Evidence attests a link between junior doctors’ working conditions and psychological distress. Despite increasing concerns around suicidality among junior doctors, little is known about its relationship to their working conditions.

Aims
To (a) establish the prevalence of suicidal ideation among junior doctors in the National Health Service; (b) examine the relationships between perceived working conditions and suicidal ideation; and (c) explore whether psychological distress (e.g. symptoms of depression and anxiety) mediates these relationships.

Method
Junior doctors were recruited between March 2020 and January 2021, for a cross-sectional online survey. We used the Health and Safety Executive's Management Standards Tool; Depression, Anxiety and Stress Scale 21; and Paykel Suicidality Scale to assess working conditions, psychological distress and suicidality, respectively.

Results
Of the 424 participants, 50.2% reported suicidal ideation, including 6.1% who had made an attempt on their own life. Participants who identified as LGBTQ+ (odds ratio 2.18, 95% CI 1.15–4.12) or reported depression symptoms (odds ratio 1.10, 95% CI 1.07–1.14) were more likely to report suicidal ideation. No direct relationships were reported between working conditions (i.e. control, support, role clarity, strained relationships, demand and change) and suicidal ideation. However, depression symptoms mediated all six relationships.

Conclusions
This sample of junior doctors reported alarming levels of suicidal ideation. There may be an indirect relationship between working conditions and suicidal ideation via depressive symptoms. Clearer research exploring the experience of suicidality in junior doctors is needed, including those who identify as LGBTQ+. Systematic interventions addressing working environment are needed to support junior doctors’ mental health.

Citation

Rui-Han Teoh, K., Dunning, A., Kathryn Taylor, A., Gopfert, A., Chew-Graham, C. A., Spiers, J., Appleby, L., Van Hove, M., Buszewicz, M., & Riley, R. (2024). Working conditions, psychological distress and suicidal ideation: cross-sectional survey study of UK junior doctors. BJPsych Open, 10(1), Article e14. https://doi.org/10.1192/bjo.2023.619

• Journal Article Type: Article
• Acceptance Date: Dec 15, 2023
• Online Publication Date: Dec 15, 2023
• Publication Date: 2024-01
• Deposit Date: Jan 31, 2024
• Journal: BJPsych Open
• Print ISSN: 2056-4724
• Electronic ISSN: 2056-4724
• Publisher: Cambridge University Press
• Peer Reviewed: Peer Reviewed
• Volume: 10
• Issue: 1
• Article Number: e14
• DOI: https://doi.org/10.1192/bjo.2023.619
• Public URL: https://keele-repository.worktribe.com/output/719915
• Publisher URL: https://www.cambridge.org/core/journals/bjpsych-open/article/working-conditions-psychological-distress-and-suicidal-ideation-crosssectional-survey-study-of-uk-junior-doctors/04CEA70282365EFB6E798726DC6DBEAF