Doctors' mental health

In 2013, beyondblue conducted a world-first survey of more than 12,000 doctors and around 1,800 medical students to get a clearer picture of their mental health and the support they may require^[1].

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Distress and suicidal ideation

The survey confirmed doctors have substantially higher rates of psychological distress and suicide attempts than other professions and the general public ^[1]. Around 10% of doctors reported suicidal ideation in the previous year and one in four reported suicidal thoughts prior to the previous year. Young doctors and female doctors reported higher levels of general and specific mental health problems and they also reported greater work stress.

Mood and anxiety disorders

Around 21% of doctors reported that they had been diagnosed or treated for depression with 6% indicating they had a current diagnosis. While these rates seem high they are in line with figures for the general public but higher than for other professions. Around 9% of doctors reported having been diagnosed and or treated for an anxiety disorder and only 3.7% reported a current diagnosis, a slightly higher rate than the general public (2.7%).

Stressful and demanding work

Respondents to the survey rated the experience of work-related stressors high but this became less of an issue with increasing age. Maintaining work-life balance was ranked as the most common source of work stress by 26.8% of respondents.

Stigma and resilience

The beyondblue survey identified concerning and persistent stigmatisation in the profession about the competence of doctors with mental health problems. This fact is reflected in the 40% of doctors who felt that colleagues with such conditions were seen as less competent than their peers. Almost 60% of doctors felt that being a patient was embarrassing.

More likely to seek treatment

The good news is that doctors appear to have a greater resilience and are able to minimise the impact of mental health issues on their work. Another positive finding from the research was that in spite of barriers including fears about confidentiality (52.5%), fears about risking their medical registration and limited time for treatment, doctors reported higher rates of treatment and medication use for mental health issues than the general public

“These findings suggest that despite having high levels of general and specific distress, doctors are more likely to seek treatment than the Australian population and are able to manage some of the negative effects of poor mental health,” the report says.

Clearly more work is needed to destigmatise mental health issues among the medical profession and to catch up with the general public and business community where destigamtisation, early identification, support and intervention efforts are now receiving the attention they require.

“The aim is to normalise mental health issues for doctors, to learn how to support them and to enhance the care of the profession,” Dr Kay says.

Case Study

No-one is invulnerable

beyondblue’s recent survey of Australian doctors confirmed that doctors have substantially higher rates of psychological distress and suicide attempts than other professions and the general public. But it was not until anxiety and depression affected one of our members that it really hit home.

A story of cumulative pressures

My experience with this illness started in a fairly mundane way. I was exposed to a gradual buildup of stressors that eventually came to overwhelm me, much like the frog placed in the slowly heated water that eventually boils to death. Fortunately I was able to extricate myself in time.

I was a junior consultant anesthetist working as a VMO in both public and private practice. I was busy trying to establish myself professionally while trying to raise a young family with a partner who also worked full time. As I picked up work, I was required to participate in more on-call rosters.

We took on a large mortgage so there was more pressure on me to increase my income. I started to feel my life was out of control and I had no idea how to fix the situation. Add a family tragedy and some extremely stressful clinical incidents at work into the mix and I clearly wasn’t coping.

Reaching a crisis point

I found it increasingly difficult to sleep, I was unpleasant to be around and I cut myself off from those who were most concerned about me. It was very difficult for me to ask for help. I felt I should be coping and was ashamed I wasn’t and I turned to self-medication to try to deal with my problems.

I reached a crisis point and I had to get help. Through my GP I found a supportive psychiatrist who got me on the right antidepressant after some trial and error. I also saw a psychologist who helped me work through some of my perfectionist tendencies and negative thinking and I took time off to re-evaluate my life.

Reappraised values and goals

A few years down the track I am much happier. I may not be quite as well off financially as I would have been if I had kept going down the old path, but I am far richer in friendship, health and enjoyment of life. And I believe I am a much better doctor and person as a result.

I know I am still vulnerable to another episode of anxiety or depression but I have developed strategies to recognise the warning signs and seek help earlier. I learnt that no one is indispensable and there will always be great demands on your time. You need to be wise about what you take on.

Many of my colleagues commented to me afterwards that they were surprised this could have happened to me. I guess the lesson is that no one is invulnerable.

Tips

Maintaining your emotional health

• Have a good General Practitioner
• Take regular leave – plan it annually
• Have a life outside medicine
• Find a mentor you trust and respect
• Ensure you have a support network
• Make an effort to ensure you have regular sleep, exercise and a healthy diet
• Look after your colleagues
• Debrief after significant events
• Focus on having good time management
• Know there is help out there if you need it