Nursing is a profession built on compassion and resilience, yet beneath its caring façade lies a growing mental health crisis. Many don’t know that nurses face one of the highest rates of suicide risk among healthcare workers, a silent epidemic rarely acknowledged in national headlines. Research shows that registered nurses have a significantly elevated suicide risk compared to the general population, and among female nurses, the risk nearly doubles.

Why does nurse suicide remain so overshadowed and unresolved? For starters, it’s largely invisible: suicides are rarely disaggregated by occupation in public statistics, leading to systemic underreporting of nurse-specific risks. While burnout and mental health among physicians have gained more attention (thankfully due to physician advocacy), the conversation about nurses’ emotional distress seldom breaks into mainstream discourse. Furthermore, nursing is predominantly female — yet occupational stress, compassion fatigue and trauma are frequently minimized when they afflict women, reinforcing silence surrounding mental health struggles in caring professions.

Nurses shoulder an emotional burden that few outside the profession can truly comprehend. Day after day, they bear witness to suffering, death and unimaginable trauma — experiences that leave deep, often invisible scars. Compassion fatigue, the emotional and physical exhaustion that comes from unrelenting caregiving, is alarmingly common, with some studies showing that 60% to 80% of emergency nurses meet criteria for this condition. The toll is compounded by burnout and moral injury, a painful disconnect between the care nurses strive to provide and the constraints imposed by their work environment. For many, the workplace itself becomes another source of harm: between 60% and 90% of nurses report experiencing verbal or physical abuse on the job, an unending assault on their dignity and psychological well-being. Layer onto this the grinding reality of chronic understaffing, mandatory overtime and crushing workloads — pressures that slowly strip away emotional resilience. And even when the weight becomes unbearable, stigma and fear keep many silent. Worries about confidentiality, professional repercussions, or being labeled “unfit to practice” stop nurses from reaching out for help, leaving them to endure their pain in isolation.

To confront this hidden crisis and protect both the nursing workforce and the patients they serve, bold policy action is urgently needed. First, healthcare organizations must mandate suicide prevention training for all nursing staff, ensuring that every nurse can recognize warning signs, know how to respond, and feel empowered to care for themselves and their colleagues. Embedding this training into orientation and continuing education would make mental health awareness a cornerstone of professional practice. Globally, some countries have already identified this need. For example, the United Kingdom’s National Health Service has introduced mandatory suicide prevention training across its health workforce as part of its broader mental health strategy. This initiative equips clinical staff with practical skills to identify signs that a peer needs support, initiate supportive conversations and connect colleagues to appropriate help — serving as a model for how such training can be normalized and embedded into healthcare culture. Second, policy reform must target the root causes of distress: enforce safe staffing ratios, eliminate mandatory overtime, invest in workplace violence prevention and ensure timely debriefs after traumatic events. Finally, a national registry tracking healthcare worker suicides could reveal patterns unique to nursing, helping to guide prevention efforts with precision. Nurses dedicate their lives to caring for others; it is time for our systems, policies and culture to show that same care to them.

Research on nurse suicide must also go beyond describing prevalence and risk factors to explore the underlying biological mechanisms that contribute to vulnerability. Investigating both physiological and epigenetic pathways that link adverse occupational exposures — such as chronic stress, moral injury and compassion fatigue — to suicide risk could offer groundbreaking insight into prevention. At Columbia University School of Nursing, my team is actively pursuing evidence on how stress-related biological changes, such as alterations in stress hormone regulation and DNA methylation patterns, may interact with workplace experiences to heighten suicide risk among nurses. This integrative approach, which examines the interplay between a nurse’s work environment, professional experiences and biological responses, has the potential to reveal biomarkers of distress and resilience among nurses. Such findings could inform precision-based interventions and guide policy reforms aimed at reducing harmful workplace exposures, ultimately protecting the mental health and lives of the nursing workforce.

Nurses are the backbone of healthcare — and when their wellness falters, the entire system is at risk. The data is unwavering: suicide rates for nurses remain higher than for the general population, and in some comparisons, even exceed physician rates. It is not guilt or duty that should motivate reform — but care. Care for a profession that gives unceasingly to others, and in turn deserves protection, support and respect.

The time to act is now. There is a critical need to establish meaningful policies that prioritize mental health, cultivate peer-to-peer empathy, and invest in prevention and research infrastructure. Let us break the silence and honor the humanity of nurses — not only in health policy, but in every ward, shift and heart they touch.

If you or someone you know is struggling, dial 988. You are not alone.

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