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Why doctors’ mental health matters

DR YANSIE ROLSTON Monday, March 20 2017

MEDICAL doctors are great people because they help the sick to get better and reduce mortality rates; their proud families can be heard bragging and boasting about their substantial earning power. But the stark reality is that they are also susceptible to individual and occupational situations which affect their mental and physical well-being.

The World Health Organisation states that one in four people will experience an episode of mental illness during their life time, whether we choose to believe it or not, doctors are included in that statistic.

The image of a doctor is that of a lifesaving hero, but the job is incredibly challenging. The burden of responsibility placed on doctors to care for and preserve life, and the knowledge that one mistake could be fatal is extremely onerous.

Doctors are faced with sickness, suffering and death on a daily basis, often working in stressful environments; juggling increased clinical demands, pacifying anxious and aggressive patients and/ or families, using outdated or malfunctioning equipment, and struggling with a health service beset with drug shortages.

It shouldn’t come as a surprise that they are also vulnerable to the personal circumstances to which everyone is exposed. They too undergo the psychological and emotional impacts of relationship breakdowns and family dysfunction, death of close relatives, self-doubt and criticism, financial burdens, and lifestyle behaviours such as drink and drug misuse and abuse.

All of which have the potential to cause or exacerbate mental health struggles.

There is a connection between the pressures of the job and emotional resilience, it is therefore no surprise that mental illness is common amongst doctors, and their rates are higher than other professional groups (Journal of Mental Health). Societal pressures force them to appear healthy, so they mask their mental health struggles such as depression, anxiety and addiction.

Consequently, they are reluctant to seek help, even if it adversely affects the quality of the care they provide.

Dr Naresh (not his real name) was diagnosed with cancer while going through an acrimonious divorce and seeking custody of his children. He admitted to having days when his personal issues, compounded with work-related pressures led to bouts of depressive anxiety, and lapses in concentration. He suspected that his peers were aware his personal problems were affecting his clinical performance, but he was hesitant to discuss his psychological distress to them for fear of being ridiculed and ostracised. His biggest anxiety was the implications the stigma and discrimination of mental health could have on his professional future.

Social stratification means that as a doctor he was always afforded a high level of autonomy, power and prestige. So accepting that he was unable to cope, made him feel a failure, exacerbating his depressive anxiety. For a while he self-medicated with alcohol, cigarettes, promiscuity, and misused opiate prescription drugs which were easy for him to access.

Until one day, after a serious lapse in clinical judgment which endangered the life of a patient, he had to acknowledge the gravity of his mental state, and that his impaired performance could no longer be ignored. He finally accepted that in spite of his reluctance he had to get help, so he took holidays and sought medical treatment abroad.

Doctors are fallible human beings and should not have to silently endure feelings of shame, embarrassment and guilt because they are struggling mentally. Stigma, discrimination and misperceptions of mental health affects everyone and needs to be continually challenged.

Remember, the very doctors we rely upon to keep us safe and well, work in highly-pressured, emotionally demanding environments, and like all of us they also endure challenges which affect their well-being. Consequently, if we expect them to provide first class patient care, and save lives, it is vital that they are able to seek mental health support and treatment when they need it.

The mental health of our doctors and health care providers, is important to us all and matters to everyone.

Dr Yansie Rolston FRSA is a UK-based disability and mental health specialist advisor. She is a social change trainer and facilitator who works internationally, at various levels of government, business, and civil society. Contact her at yr@efficacyeva.com

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