Mental Health Matters: How CNOs Can Help Prevent Nurse Suicides

By G Hatfield

Nursing is an incredibly difficult profession.

Nurses face new challenges, including high stress emergency situations, workplace violence incidents, and death, on a daily basis with patients and families. All of those events can take a major toll on a nurse’s mental health, which can lead to more serious problems.

September is Suicide Prevention Month, and CNOs need to be aware of the risks and warning signs among their workforce and provide mental health resources and programs.

Nurses are at risk

According to a 2023 study from JAMA Network, from 2008 to 2019, the risk of suicide was higher for healthcare workers, specifically registered nurses, healthcare support workers, and health technicians, compared to non-healthcare workers.

Another 2021 article published in the Journal of Psychosocial Nursing reported that the available data from the CDC’s National Violent Death Reporting System showed nurses were 18% more likely to die from suicide than the general population between 2007 and 2018. The risk of death by suicide for female nurses was twice as high than the general population, and 70% more than female physicians.

According to the American Association of Critical-Care Nurses (AACN), the suicide risks are higher for nurses because of several different reasons, including high levels of stress, hectic schedules, exposure to trauma, workplace violence, and a lack of healthy work environments. Other factors include feeling a lack of support and preparation for the job, leadership concerns, depression, and financial issues.

How CNOs can help

While the numbers are startling, nurse leaders can make an impact. It’s critical that CNOs take steps to address the underlying issues that contribute to suicide risks to improve the work environment to keep their nurses safe and healthy.

According to Betty Jo Rocchio, senior vice president and chief nurse executive at Mercy, the CNOs at the health system support the whole person by offering flexible work hours so that nurses can choose how and when they work.

“Mental health and well-being are important for both an individual’s personal life and work life,” Rocchio said. “Flexible hours and environments support the needs of our nurses and ultimately provide the space for our nurses to deliver compassionate, quality patient care.”

Additionally, Mercy has programs in place that support whole health, Rocchio explained, including a robust employee assistance program with an abundance of mental health resources.

“People flourish when we support them as a whole person,” Rocchio said, “by tending to their physical, mental, emotional, and social well-being.”

According to Deana Sievert, chief nursing officer at Ohio State Wexner University and Ross Heart Hospitals, and HealthLeaders Exchange member, there are two areas that CNOs should focus on: staff support structures and nursing workflows.

Sievert also recommended implementing an employee assistance program and a strong-structured shared governance model, but Sievert also emphasized the need for a more proactive approach.

“There are some in the nursing community that I have heard are doing a simple screening of the nursing team, through very brief individual surveys,” Sievert said, “to help identify those subtle red flags that could lead to reactions such as depression, anxiety, or even suicide.

Sievert is hopeful that this strategy will become more widely used throughout the nursing industry.

“I applaud those organizations and CNOs that have moved here,” Sievert said, “and I am hopeful that this becomes a best practice that many of us adopt.”

Advice for nurses and leaders

Rocchio also emphasized the important role that CNOs and other nurse leaders play in creating a sustainable work environment where nurses feel supported.

“It’s of the utmost importance for our nursing leaders and teams to have a close professional relationship so they can help and support each other,” Rocchio said. “Changing the care delivery model to meet workforce needs, designed and supported by nurse leaders, is the key to a healthy workforce, healthy work environment, and a workflow that supports the best patient care possible.”

“Mental health is critical. As nurses, we tend to set aside our own needs and take care of others first. We must remember that before we can take care of others, we must first take care of ourselves. It’s imperative because our families, friends and patients need caregivers who are mentally, physically and emotionally healthy. Supporting our team and paying attention to their needs supports a healthy workforce and environment. Healthcare and nursing put patients and caregivers at the center of our care model because people matter!”

Sievert also had some words of encouragement for nurses.

“First and most importantly, ask for help. We are all here and hope that there is comfort in being able to reach out. Then I would encourage reaching out to your nursing leaders. I assure you we do care about you. We want to help, and we want to support you. Please do not let the stigma that often still exists stop you from asking for help. You are too important to us!”

The 988 Suicide and Crisis Lifeline is a hotline for individuals in crisis or for those looking to help someone else. To speak with a trained listener, call 988. Visit 988lifeline.org for crisis chat services or for more information.

G Hatfield is the nursing editor for HealthLeaders.