When you visit your doctor, and run through your list of symptoms, you’re not likely to be thinking about how they are feeling – so why is doctor mental health something we need to think about?
As a society who relies on our doctors, their mental health is something that should be getting more attention. We rely on doctors to diagnose our illnesses, to help our children to get better, and to help us to manage chronic health conditions. And it seems many doctors are pretty good at looking after their physical health … yet what about their mental health?
A 2013 report from Beyond Blue found that Doctors reported significantly higher rates of psychological distress and higher rates of suicide attempts than the Australian population in general and higher than other Australian professionals. In discussions with both junior and senior doctors over the last few years they share similar stories of the pressures they experience. Working in high care roles, with long hours, and managing crises with limited resources, can lead to high levels of ongoing stress for medical professionals. Many report their workplaces not only don’t support them at times of mental health issues, but in many cases they feel stigmatised and even blatantly discriminated against. Some report that the understanding and compassion that is shown to patients is not offered to colleagues and that instead the workplace culture is to “get over it” and to ignore or bully people into more acceptable behaviour. Health professionals often report that they are not confident in responding to the functional impacts of a colleague’s mental illness and not comfortable having conversations about mental health concerns with colleagues that they habitually have with patients. Despite years of training and dedication to excellence, Doctors are after still humans working in a field that is incredibly pressured. This pressure can be a strong breeding ground for emotional distress.
Doctor Sarah Newman is a General Practitioner and a board member of The Doctors’ Health Advisory Service Western Australia (DHAS WA) and the AMA Doctors in Training Committee (Co-Chair of Welfare Sub-Committe). Dr Newman says “It is known in medicine that we have a risk around practitioner mental health and tragedies like the recent suicide death of junior doctors in Sydney, and the fact that we’ve lost 20 junior doctors to suicide in the last 10 years is distressing to our profession, however is anything changing to minimise the risk? Not quickly enough.”
“There is a lot of focus on getting medical practitioners to increase our insight into the emotional toll in what we do, to build our resilience and coping strategies, but the systems are still lagging behind. We can train our doctors to be resilient but they can only be as resilient as what their environment allows.”
When considering the risks to medical practitioner’s mental health Dr Newman states that it is a combination of factors such as the vicarious trauma experienced in treating sick and dying patients; the demands of modern medicine being that our society requires a high level of care 24 hours per day which often leads to Doctors working long shifts; the personality type often attracted to medicine being someone who is driven and intelligent and used to pushing themselves; the ever present umbrella of medico-legal risks of practice; the urgency of care and low cost pressures; and the stigma within the profession, which all contribute to the effect.
Often the management staff in medical practices, like in many professions, are promoted because of their clinical skills. However, they may not have the necessary skills to manage the human side of their role – managing people. A focus simply on patient needs and administrative requirements is not enough. Managers, as in all workplaces, must know their roles and responsibilities in recognising and responding to mental health issues in the workplace. They need to know what is legally required to ensure that they are not discriminating against staff because of mental illness. They need strategies to approach and address staff with mental health issues, know how to have the conversations with staff and how to develop reasonable workplace accommodations or adjustments for mental illness.
From a systemic level, medical institutions who want to improve their mental health culture, the wellbeing of their practitioners and ultimately safeguard patient care, should consider an audit of their own processes and systems. Do they promote a culture of positive mental health and wellbeing through leadership awareness, commitment and accountability around employee mental health? Do they have preventative structures in place such as appropriate rostering to minimise onerous fatigue, access to leave entitlements and programs to nurture the skills of leaders to appropriately manage mental health risks that arise?
If we rely on our doctors to help make us well. Don’t we want and need them to be well also?