Reflexive thematic analysis of job-related problems associated with pharmacist suicide, 2003-2019

Marcus A Groner-Richardson; Shannon A Cotton; Sarah Ali; Judy E Davidson; Gordon Y Ye; Sidney Zisook; Kelly C Lee

doi:10.1016/j.sapharm.2023.02.001

Reflexive thematic analysis of job-related problems associated with pharmacist suicide, 2003-2019

Res Social Adm Pharm. 2023 May;19(5):728-737. doi: 10.1016/j.sapharm.2023.02.001. Epub 2023 Feb 10.

Authors

Marcus A Groner-Richardson¹, Shannon A Cotton², Sarah Ali³, Judy E Davidson⁴, Gordon Y Ye⁵, Sidney Zisook⁵, Kelly C Lee⁶

Affiliations

¹ University of California San Diego Health, Surgical Oncology, USA; Azusa Pacific University, School of Nursing, USA. Electronic address: marichardson@health.ucsd.edu.
² University of California San Diego Health, Intensive Care Unit, USA; University of California, Irvine, USA.
³ University of California San Diego, Global Health, USA.
⁴ University of California San Diego Health, USA; University of California San Diego School of Medicine, Department of Psychiatry, USA.
⁵ University of California San Diego School of Medicine, Department of Psychiatry, USA.
⁶ Clinical Pharmacy, University of California San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences, USA.

PMID: 36781370
DOI: 10.1016/j.sapharm.2023.02.001

Abstract

Background: Few qualitative studies have focused on suicide and specific job-related problems associated with suicide in pharmacists. Greater knowledge of specific work-related stressors amongst pharmacists could inform suicide prevention strategies.

Objective: To identify job-related stressors associated with pharmacist suicides and compare stressors to those previously reported in physicians and nurses.

Methods: Free-text law enforcement and medical examiner data for pharmacist suicides were extracted from the National Violent Death Registry (NVDRS) for 2003-2019. Reflexive thematic analysis was deployed via a deductive approach utilizing codes and themes found in previous research on nurse and physician suicides. New codes were also identified through inductive coding.

Results: A total of 291,872 suicides occurred between 2003 and 2019, of which 392 were pharmacist deaths. Of these, 62 pharmacist suicides were coded with job-related problems. Almost all deductive themes/codes extracted from nurses and physicians were present in pharmacists. Common codes found in the pharmacist dataset that were also found previously in physicians and nurses were: history of mental health, substance use disorder, hopelessness impending or proceeding job loss, and access to lethal weapons and/or drugs. Novel codes were added through inductive content analysis. Codes novel to pharmacists were: verbalized suicidal ideation (SI) or intent, diversion for the purpose of suicide, and the fear of job loss. Disciplinary action at the institutional level was associated with the fear of job loss and cited as the event triggering suicide completion.

Conclusion: Pharmacists have similar job-related stressors associated with suicide as physicians and nurses. Evaluating the process of disciplinary action is warranted. Future research is indicated to evaluate causal relationship between work-related stressors and mental health outcomes leading to suicide in pharmacists.

Keywords: Depression; Fear of job loss; Occupational stress; Pharmacist; Qualitative research; Substance use disorder; Suicide.

MeSH terms

Cause of Death
Homicide
Humans
Pharmacists
Suicide* / psychology
Violence