The danger when doctors don’t get mental health help


Staying mentally healthy is essential for everyone, and it’s vital for doctors. As healthcare professionals, you are continually exposed to overwork, burnout, stressful situations and difficult ethical decisions. Yet seeking help for mental health care may be last on your to-do list — or completely off your radar.

It’s sad and dangerous, since the American College of Emergency Physicians says 300-400 doctors die by suicide each year, and stigma prevents 69% of female doctors from seeking mental health care, according to a pre-pandemic study. .

In A Tragedy of the Profession: Medscape Report on Physician Suicide 2022, 11% of female physicians and 9% of male physicians reported having had suicidal thoughts, and 64% experienced familiar depression (feeling down, sad, or blue).

Additionally, doctors are generally seen as strong and capable and are often put on a pedestal by their loved ones, patients, and the public as superhuman. No wonder it’s not easy when you need time to decompress and heal your mental well-being.

“Doctors are really scared when it comes to getting mental health care,” says Emil Tsai, MD, PhD, MAS, professor in the Department of Psychiatry and Behavioral Sciences at the University of California, Los Angeles. Angeles (UCLA), and an internationally renowned scientist in the field of neuroscience and brain disorders.

The fear, Tsai says, comes from the stigma of mental health issues, potential job repercussions and the conceivable suspension or removal of the medical board.

Tsai tells medical landscape that to combat the “punishment” anxiety that many physicians fear when seeking care for their mental health, we must allow physicians to take time out of their daily patient care for respite and treatment without retaliation .

Since the medical profession is very stressful and has a high rate of depression and suicide, finding solutions is imperative. And doctors need to feel supported enough to seek treatment when needed. So how can we normalize mental health care-seeking among physicians?

Be honest about stress and burnout

The only way to normalize any behavior is to be open and candid, says Tsai medical landscape. The conversation about mental health needs to take place at all levels, not just within the medical profession.

“The best thing we can do to try to ease the burden we put on doctors is to be willing to talk and be honest about the stress that doctors face and the importance of everyone feeling free. to get treatment and rest to strengthen his mental health,” Tsai says.

The more we talk about mental health and its treatment, the more we reduce the stigma, says Tsai. This could be more employer-employee audits, advice within the framework of the well-being of doctors and programs structured in a way that does not interpret a penal system.

“Mental health in the medical profession is a major issue that must be treated with the same compassion and care as it should be for any patient. We have annual physical exams. Why don’t we offer annual mental health checkups for everyone, including doctors? asks Tsai.

Assess workload

Elizabeth Lombardo, PhD, psychologist, coach and international speaker, thinks healthcare employers should re-examine their doctors’ workloads to see if they’re contributing to mental health issues.

The conversation about mental health in the workplace shouldn’t be about a certain person’s ability to deal with stressors that are “normal” for healthcare settings. Instead, workplace managers in healthcare facilities should redefine workloads to ensure physicians are not overly burdened with responsibilities that can cause overwork, burnout and problems. mental health,” she said.

Reduce stigma

Even when doctors want to seek help for their psychological struggles, they can be weary of the reaction of their colleagues if they knew about it.

Raphael Antonino, MD, Clinical Director of Therapy Central in London, UK, says there can be several underlying fears at the heart of a doctor that prevent them from seeking treatment – ​​being seen as weak, deemed unfit to practice medicine and the notion that “something is wrong with them.”

Antonino says we need to understand that doctors face challenges of grief and trauma stemming from the loss of patients and the inability to save someone’s life. “These issues can easily turn into a buildup of difficult, unprocessed emotions, later manifesting in symptoms and signs of PTSD, anxiety, and depression,” he says.

Education is the best way to end this stigma, as it does all forms of prejudice and stereotypes. For example, we know that healthcare professionals are at risk of developing burnout. Thus, educating physicians about the symptoms and management of burnout and its consequences and prevention strategies is a must.

“Imagine what could happen if there were regular opportunities to work through the day’s events before leaving a shift. The idea that one-on-one weekly therapy is the only way to relieve mental distress is wrong,” says Lori McIsaac Bewsher, MSW, RSW, trauma therapist and owner of a trauma-focused mental health clinic in New Brunswick. , Canada.

“There are ways to integrate individual care into our medical practices and hospitals that can be brief, effective and confidential. The best way to introduce these interventions is early and collective; no one is immune to “Potential impact of exposure to trauma. The earlier these interventions are accessible, the better the outcomes for everyone,” she says.

Antonino suggests, perhaps in the future, that organizations could have “burnout checks” or mental health checks for doctors, as we also have rapid checkups for various physical ailments. What if physicians routinely completed a 10-question mental health survey as part of a burnout or injury prevention strategy?

“Their profession and their identity are often linked to a sense of strength, leadership and (benevolent) power: adjectives that, at first sight, might be perceived as incompatible with what, unfortunately and wrongly, can be associated with mentality. health issues,” says Antonino.

keep it private

When it comes to eliminating the stigma of mental health care and treatment for physicians, confidentiality is a priority. There must be some form of privacy protection for physicians seeking professional help for mental health reasons. Lombardo says physicians must have the choice to keep their mental health journeys private. “Ideally, normalization should mean an open conversation about mental health, but for doctors it can be a matter of life and death for their careers, so the choice to stay private is something they should be afforded,” she says.

Along these lines, the American Medical Association is pushing for system changes in the legislative and regulatory arenas to support the mental health of practicing physicians, residents, and medical students. The organization is also urging health systems and state medical licensing bodies to remove questions on their applications that ask about past treatment for mental health conditions.

Among many programs across the country, the Pennsylvania Medical Society Foundation has also created a Physician Health Program, which provides confidential assessment, counseling and referral services for physicians with mental health issues.

“All of these initiatives are important in helping to destigmatize mental health issues among physicians,” says Harold Hong, MD, a board-certified psychiatrist in Raleigh, North Carolina.

Celebrate the benefits of treatment

Hong says that to continue to destigmatize mental health among physicians and normalize its treatment, we need to not only emphasize how mental health has individual benefits, but also how it helps us help our patients.

“A key aspect that perhaps underlies this issue is the ever-present separation between mental and physical health, between mind and body,” Hong says. medical landscape. “Feeling sad, angry or anxious should become a fact of life, a characteristic of being human, just like catching a cold or breaking a leg.”

It’s a normalization that, perhaps more than anything else, can pave the way to improving mental health outcomes for physicians while improving them for the rest of society. When society can finally see a person’s health and well-being in both their psychological and physical state, some of the stigmas can dissipate and perhaps the lives of more doctors can be saved.

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