The numbers are staggering. Americans made 139.8 million emergency department visits in 2024, that is 42.7 visits per 100 people, with behavioral health issues driving an unprecedented surge. Behind these statistics lies a harsh reality: depression, a leading cause of ill health and disability worldwide, is overwhelming our emergency departments with cases they were never designed to handle. This tsunami of mental health crises creates a vicious cycle. More behavioral health presentations mean longer wait times, over-taxed staff, and physicians working beyond their limits. Emergency physicians now spend increasing hours managing psychiatric emergencies without adequate resources or support systems, leading to exhaustion, burnout, and moral injury. The relentless pressure of stabilizing crisis after crisis, knowing you’re applying bandages to wounds that need surgery, takes an inevitable toll.

But there’s another, quieter cycle we rarely discuss, the one where physicians themselves become patients in a mental health system we know is broken. With 300-400 physicians dying by suicide annually in the U.S., and female physicians experiencing suicide rates 250-400 percent higher than women in other professions, we’re witnessing the catastrophic convergence of two crises: a mental health system in collapse and a physician workforce pushed beyond breaking point.

The irony is devastating. Physicians treat the depression that leads to disability in patients; they also treat the disabilities and chronic illnesses caused by depression and other mental illnesses in their patients, while ignoring the warning signs of overexhaustion and depression in themselves, driven by empathy and the resilience ingrained in their training. While this reality persists, the emergency room has become a core revolving door for mental health crises, crushing those who work there under its weight.

The parallel pandemics

The statistics paint a devastating picture. But these numbers don’t exist in isolation. They reflect a health care system where mental health has been relegated to crisis management rather than preventive care. When we see patients returning to the emergency room in a mental health crisis, we’re witnessing system failure. When physicians who have every advantage of medical knowledge and access still die by suicide at rates two to three times the general population, we’re seeing that same system failure magnified.

The factors are interconnected: burnout from treating an endless stream of crises, moral injury from practicing in a system that prioritizes throughput over therapeutic connection, and the crushing weight of knowing that both our patients and physicians deserve better.

The cost of the cycle

Consider what happens in a typical emergency room mental health encounter. A patient arrives in crisis, waits hours in an environment designed for medical emergencies, not emotional ones. Physicians stabilize immediate safety concerns, perhaps adjust medications, and discharge with a referral to outpatient services that may have months-long waitlists. The patient returns weeks later, often in worse condition. Each cycle deepens hopelessness, theirs and the physicians’. When illnesses like depression affect physicians, the ripple effects multiply, impacting patient care, increasing medical errors, and perpetuating a cycle of inadequate mental health care. While they might recognize their own depression or anxiety, they may face barriers unique to their profession: fear of license implications, concern about colleague judgment, and the deeply ingrained belief of high achievers that seeking help is weakness. So they, too, wait until crisis, contributing to that devastating completion-to-attempt ratio that makes physician suicide particularly lethal.

Breaking free: a systems approach

The solution is a fundamental system reform that addresses both societal and physician mental health simultaneously. We need to transform mental health care from a crisis-response model to a preventive, continuous care approach.

• First: We must create true alternatives to emergency room mental health care. Crisis stabilization units, peer support programs, and same-day psychiatric access can divert non-emergency cases from the emergency room while providing more appropriate care. Telepsychiatry and digital therapeutics, when properly validated and integrated, can bridge gaps in care continuity. These aren’t just services for patients; they are services physicians need access to without stigma or professional consequence.
• Second: We need to address physician mental health as the public health crisis it is. This means confidential, non-punitive mental health services specifically designed for health care workers. It means reforming licensing questions that discourage seeking help. It means acknowledging that physician suicide isn’t about individual weakness but systemic failure.
• Third: We must integrate mental health screening and intervention into routine care for both patients and providers. Annual depression screening should be as standard as blood pressure checks. Early intervention programs should catch mental health concerns before they become crises. For physicians, this might mean mandatory wellness checks that are truly confidential and supportive, not punitive.

The path forward: healing the healers to heal the system

The most promising models recognize that physician well-being and patient care are inseparable. Health care systems that have invested in comprehensive physician wellness programs report not only reduced burnout and turnover but also improved patient satisfaction and outcomes.

Some institutions are pioneering change. The University of California, San Diego’s Healer Education Assessment and Referral (HEAR) program provides confidential mental health services for health care workers. Mount Sinai’s COPE program offers rapid access to mental health support for frontline workers. These programs recognize that supporting physician mental health isn’t self-indulgent; it’s essential for sustaining our health care system. Technology, thoughtfully applied, can help. AI-assisted triage could reduce the burden on emergency physicians while identifying patients who need immediate intervention versus those who could be managed through alternative pathways.

A call for courage

Breaking the emergency room cycle demands courage: courage to admit the system is failing both patients and providers, courage for clinicians to seek help, and courage to push for fundamental reform over superficial fixes.

This requires speaking openly about physician suicide, not in whispers, but in medical schools and conferences. Institutions must provide real, trusted mental health support, moving beyond underused EAPs. Clinicians must advocate for their patients and themselves simultaneously, recognizing that their well-being is essential to healing. The path isn’t easy, but it’s necessary. As technologists and system builders, we must help create a system that truly supports mental health “from prevention through crisis” for patients and providers alike. Only then can we break the cycle and build a health care system worthy of those who dedicate their lives to healing.

Ronke Lawal is the founder of Wolfe, a neuroadaptive AI platform engineering resilience at the synaptic level. From Bain & Company’s social impact and private equity practices to leading finance at tech startups, her three-year journey revealed a $20 billion blind spot in digital mental health: cultural incompetence at scale. Now both building and coding Wolfe’s AI architecture, Ronke combines her business acumen with self-taught engineering skills to tackle what she calls “algorithmic malpractice” in mental health care. Her work focuses on computational neuroscience applications that predict crises seventy-two hours before symptoms emerge and reverse trauma through precision-timed interventions. Currently an MBA candidate at the University of Notre Dame’s Mendoza College of Business, Ronke writes on AI, neuroscience, and health care equity. Her insights on cultural intelligence in digital health have been featured in KevinMD and discussed on major health care platforms. Connect with her on LinkedIn. Her most recent publication is “The End of the Unmeasured Mind: How AI-Driven Outcome Tracking is Eradicating the Data Desert in Mental Healthcare.”