Compassion Over Blame: Tackling Mental Health Crisis Among Doctors

Healthcare professionals experiencing burnout should be met with compassion rather than blame, according to a prominent GP. Clare Gerada emphasizes that employers often treat physicians like "naughty school children" when they fall ill or face mental health challenges. Professor Dame Gerada, former president of the Royal College of General Practitioners (RCGP), advocates for comprehensive guidance centered on "kindness" and "sensitivity" (1^✔ ✔Trusted Source
Breaking the burnout cycle

Go to source). As a co-founder of the mental health charity Doctors in Distress, she underscores the urgent need for significant reforms in a new book aimed at improving care for doctors and nurses with mental health issues.

"The Handbook of Physician Mental Health," set to be published next week, reveals that doctors’ suicide rates are up to four times higher than those of other professionals. It highlights that GPs, psychiatrists, and internationally trained doctors are particularly vulnerable.

So are female clinicians who face the burden of a ‘second shift’ – caring for patients during the day and their families at night.

Physician Mental Health with Compassion and Reform

A global workforce crisis fuelled by increased workload and bullying and racism are among numerous factors identified in the book for clinicians developing depression, anxiety and other mental health problems.

Another key risk factor is what Professor Gerada describes as ‘the industrialisation of care’ where too much focus is placed on meeting strict targets at the expense of providing personalized healthcare for patients.

The Handbook of Physician Mental Health references high-profile cases where doctors have died by suicide including junior doctor Rose Polge in 2016 and psychiatrist Daksha Emson who took her life and that of her daughter in 2000.

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Professor Gerada says: “General practice across the world is in crisis. Workload has increased substantially in recent years and has yet to be matched by growth in either funding or workforce.

“Fear is at the heart of the factors contributing to physician mental illness and suicide. Doctors fear losing their professional identity, being cast out of medicine, becoming a patient, being abused and excluded, making mistakes, upsetting seniors and failing to meet patient expectations.

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“Sick health professionals want to be treated compassionately – with sensitivity, sympathy, empathy and non-judgmentally. However, trainers, employers and regulators often treat them as naughty school children or wrongdoers for crossing the boundary from practitioner to patient.

Conflating Illness with Performance: A Flawed Approach to Physician Mental Health

“Many in authority over doctors wrongly conflate illness with a performance issue, like a disciplinary issue that needs to be addressed”.

This evidence-based handbook provides comprehensive insights into why doctors become unwell, how to identify those at risk, and the best approach to aid their recovery. It draws on learning from NHS Practitioner Health, a mental health service which supports around 6,500 health and care professionals a year.

Among patient case histories featured in the book is a first-hand account by Sarinda Wijetunge, a junior doctor who was admitted to a mental health unit. Dr Wijetunge says doctors are ‘pushed to their limits by the job’s demands’.

The General Medical Council and British Medical Association does provide guidance on how doctors should behave when unwell or consulting with a sick colleague. But Professor Gerada says the advice is couched in ‘the language of blame, harm and avoiding problems – not focused on compassion’.

Patient complaints are a significant factor in suicide among doctors who derive self-worth from their jobs. The book explains that allegations of wrongdoing or unsatisfactory treatment can challenge the self-perception of healthcare workers as unsocial hours, working night shifts and moving frequently for career progression put doctors at risk of loneliness and increases their odds of developing mental health issues. The author says: “Doctors can find themselves surrounded by people and yet very much alone”.

Professor Gerada also outlines the barriers that exist to healthcare workers getting the help they need.

Fear of losing confidentiality, a belief among the public that doctors are immune to illness, and their training which requires them to place their patient’s needs above their own are among the reasons why they may hide their illness.

Reference:

1. Breaking the burnout cycle - (https://www.medicalprotection.org/docs/medicalprotectioninternationallibraries/pdf2/media-centre/1907310561-ire-mp-burnout-policy-paper.pdf?)

Source-Eurekalert