The Stigma Healthcare Still Has to Break

To reduce suicide in the healthcare workforce, hospitals and health systems must create an environment where workers feel safe asking for help.

By Susan Szulewski, M.D., President and Chief Operating Officer, McLean Hospital; Vice President, Mass General Brigham Behavioral and Mental Health

For all the progress we have made in talking more openly about mental health, “suicide” remains a word many of us are still afraid to say.

That discomfort matters. It can keep someone experiencing suicidal thoughts from telling another person what they are going through — and it can leave the rest of us worried that asking the wrong question might make things worse.

We cannot allow that discomfort to become silence; there should be no shame in experiencing suicidal thoughts or in asking for help. And yet, for too many people, there is.

As a psychiatrist, I have cared for people during some of the most painful and vulnerable moments of their lives. I have seen how stigma can keep people silent and stand between someone who needs help and the care they deserve.

In 2024, nearly 49,000 people in the United States died by suicide, and an estimated 2.2 million adults reported attempting suicide. Behind every number is a person, a family and a story that cannot be captured by a statistic.

Breaking down stigma starts with being willing to talk about suicide. Directly asking someone if they are considering suicide does not increase suicidal thoughts or behavior. In fact, it can make it easier for someone to tell you what they are experiencing and, ideally, to get help.

This is where those of us who lead hospitals and health systems have a particular responsibility. We must ask whether we are creating environments where patients, families and our workforce feel safe saying, “I need help.”

As a hospital leader, I have learned that creating safety is about more than encouraging people to speak up. What happens after they speak up matters just as much. Asking for help should be met with compassion, timely access to care and a clear path forward.

I think about Leonard, a physician who shared his experience with depression and suicidal thoughts through McLean Hospital’s Deconstructing Stigma campaign. When he needed care, he hesitated, worried about what treatment might mean for his family, reputation and career. He ultimately sought help and now shares his experience so others in medicine may find it easier to do the same.

His story should both challenge and inspire us.

We cannot tell our patients there is no shame in seeking mental healthcare while allowing those who care for them to believe a different standard applies. Physicians, nurses and other caregivers deserve the same compassion we ask them to extend to others.

That requires more than wellness programs or encouraging self-care. Healthcare leaders should examine the barriers within our own institutions, including concerns about confidentiality, access to treatment and processes that may unintentionally discourage people from seeking care. The message our workforce hears should be the same one our patients hear: Asking for help should never be a source of shame.

I have seen people emerge from extraordinary despair and rediscover connection, meaning and joy. That is one of the reasons I remain hopeful. Hope can be difficult to see amid suffering, but it is there, and it can return.

We may not always have the perfect words. We do not need them. We need the courage to ask, the compassion to listen and the commitment to make sure that when someone asks for help, we are ready to respond.