Mental well-being nowadays is defined as a state of psychological, social, and physical prosperity, meaning that an individual is connected to all political, social, economic, and cultural structures due to their psychological coherence. Any disorder or turmoil in these structures also affects the individual.

The increase in suicide rates in a society is also derived from the turmoil and disorganization of structures and can include various factors. The main and central core of suicide is psychological pain, but this does not mean that individual and internal factors are the only threatening and influential factors in suicidal thoughts. Therefore, suicide is a multifactorial phenomenon in which different factors can play a role depending on the structures. Biological and psychological factors, cultural and social factors, economic and political factors can all play a role in increasing suicide rates in a society. However, if we consider the society of Iran today, one of the main factors is economic and social factors that have reached their most unstable level. For example, one of the underlying threatening factors in suicide is the development of poverty in a society, but can this factor be applied to all social groups? Therefore, recent and repeated suicides in the treatment sector are also an indication that we should not think of suicide as only related to a part of society or a specific group

Suicide is now a collective crisis and social harm that occurs in a contradictory process full of complexity and ambiguity. A person who has suicidal thoughts goes through a complex process; meaning that they need a high level of psychological help and support, they need to be understood and seen, and on the other hand, it is very difficult for them to join a group or seek help with such mental turmoil. Additionally, this person feels the need for change but lacks the psychological ability and capacity to make any changes within themselves.

Keep in mind that what has been said only shows a part of the individual’s mind and psychological processes that has suicidal thoughts. For this reason, the psychological model of suicidal thoughts and desire for death is not only superficial and temporary, but the individual may think about it for hours, days, or even months. Depending on the individual’s personality and social status, the distance between “suicidal thoughts” and “desire for death” to “suicide attempt” can be different, and these thoughts can even bring the individual closer to anxiety and depression disorders – which are among the most common disorders in individuals with suicidal thoughts.

But why in recent years has suicide increased significantly in society as a whole, especially among medical residents and healthcare professionals? Can we say that the society composed of healthcare professionals has reached a state of social despair or has suicide become widespread among healthcare professionals? Considering the structural disorganization in society – of which healthcare professionals are not exempt – it seems that they are carrying a heavy burden of mental stress, therefore requiring a more comprehensive evaluation and assessment. For this evaluation, we must examine the level of intensity and psychological pressure in the past few years.

In the past years, healthcare workers have not only faced suicide threats individually, but have also been directly involved in some social events. One of these cases was the COVID-19 epidemic. Throughout the epidemic and the problems that arose as a result, healthcare workers were directly involved with patients and mortality statistics. During this time, they may not have been able to receive enough psychological support or be with their families. They were often away from their families and children for long periods of time due to work shifts and COVID-related regulations.

“It is true that the conditions were critical and changing for the whole world, but for the medical staff who were faced with high rates of death and had to sacrifice their own well-being while also worrying about the health of their families who were far away, the mental burden was even heavier. It was expected that after the difficult and exhausting period of the coronavirus, the medical staff would receive some good psychological and financial support in order to help them cope with the psychological damages of that time. However, not only did this not happen, but they unfortunately had to continue their work with all the psychological wounds of that time. The experience of consecutive mourning without the opportunity to grieve, created widespread anxiety for them, leading to a loss of meaning in their lives.”

After the era of COVID, the level of economic and social inequalities has greatly increased. One of the psychological standards is stability and balance in life, which the treatment team was unable to achieve for the essential social and occupational stability they needed. This in turn led to complex disturbances for these individuals. When these disturbances occur, the individual feels a sense of emptiness and inadequacy in a large part of their social identity. The lack of personal and social worth also carries a heavy psychological burden for the individual, which can be the source of many feelings of hopelessness and despair, causing the individual to feel inadequate and unworthy.

On the other hand, future visualization is another aspect of mental and social health standards, and when we are unable to do it, it exposes us to various psychological damages. Disconnection and lack of trust in not visualizing the future play a major role and are considered as fundamental factors threatening suicide in this group. Lack of control and ability to create motivation and desire can create a sense of despair, which medical residents experience heavily these days. Even visualizing this group does not only not improve their personal and social needs, but it also does not provide a special social status for them by choosing this profession. Lack of hope for the future and lack of control and ability to construct personal and social life causes them to suffer from collective trauma that is beyond their psychological capacities. Alongside psychological factors, lack of benefits and appropriate rights, long working hours and consecutive shifts, cause them to experience mental fatigue and exhaustion. They also suffer from sleep disorders, eating disorders, memory disorders, lack of concentration, and so

In such unsafe and unsupported environments, perception and understanding of the surroundings undergo significant changes and fragmented social interactions result in true impairment of social functioning. The consequence of this dysfunction is the loss of all external assets for them. This is where a large part of their social identity collapses. The result of losing such assets creates a set of feelings of shame and guilt for them. The despair and hopelessness they experience can be closely related to the phenomenon of suicide.

Nowadays, the medical staff are under absolute pressure and in an environment full of ambiguity, contradictions, and neglect, which can limit their emotional and psychological well-being and affect their level of social participation. These issues create a deep gap between individual and social needs and can also affect their social credibility. Therefore, the devaluation of the individual and social identity of the medical staff not only leads to personal damages such as inability, lack of mental focus, and decline in job and daily performance, but can also result in social damages. With such damages and loss of all mental standards, they reach an internal collapse and thoughts of self-destruction form in their minds; this is certainly a warning not only for the medical staff but also for the physical and mental health of the society.

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At the end, some psychological solutions and recommendations for dealing with individuals who have a desire to die or have suicidal thoughts are mentioned. It should be noted that individuals with suicidal thoughts have many obvious warning signs, including feelings of extreme hopelessness, lack of motivation, and inability to concentrate. Therefore, it is recommended to:

Let’s take the warning signs of self-destruction, despair, hopelessness, and lack of motivation in individuals seriously.

Let’s try to keep the individual in a safe circle as an active listener without providing practical solutions.

Some similar phrases: “Don’t just think about yourself, think about what your family will do after you” or “Look at the lives of others, their circumstances are much worse than yours”, we should strongly refrain from being self-centered.

Let’s avoid any kind of joking and mocking of their thoughts.

One false belief is that we think people who have decided to commit suicide will definitely go through with it, so there is nothing we can do about it.

Another misconception is to assume that a person who has such thoughts is only seeking attention, so we should not pay attention to them.

In the end, if you or any of your loved ones have thoughts of suicide or a desire to die, or if your mental processes are filled with absolute despair and hopelessness, take these thoughts seriously and try to talk to a trusted person. Preferably, seek professional help from a therapist or psychologist.