Mental health in doctors
Mental health problems are common within the medical profession, including depression, anxiety, alcohol or drug addiction and burnout1. Suicide is higher than in the general population2, particularly in female doctors3-4. A BMA survey of over 4,300 doctors and medical students revealed that 80% of doctors were at high/very high risk of burnout (characterised by exhaustion, depersonalisation and reduced personal efficacy), 27% had a diagnosed mental health condition and 40% were suffering from other psychological and emotional conditions5. Female and younger doctors are at higher risk of mental health conditions and burnout3.
The risk factors for mental health difficulties within the medical profession include occupational and individual risk factors1. Structural occupational risk factors include heavy workloads and long working hours, conflicts with colleagues, workplace bullying and lack of teamwork. Lack of sleep is also a contributory factor6. Doctors frequently have to deal with breaking bad news, high patient expectations and occasionally patient aggression, all of which constitute clinical occupational risk factors. Many of the personal characteristics that make a good doctor can also increase the risk of mental health problems, for example perfectionism, self-criticism, a desire to please, self-doubt, obsessive-compulsive traits and unhelpful coping strategies, such as emotional distancing.
Doctors often delay or avoid seeking medical help for themselves1. Reasons for this include a sense of responsibility for “not letting the team down” by taking time off work, concerns about being seen as “weak”, the perceived stigma attached to having a mental health diagnosis, or to avoid disciplinary action.
Poor mental health in doctors has a negative impact on patient care7-8, though knowledge of how to seek help and support is often poor4. It is only by increasing the awareness of mental health in doctors that we can begin to break down the stigma, offer help and support to those suffering and keep our doctors and their patients safe.
- Brooks SK et al. Review of literature on the mental health of doctors: Are specialist services needed? Journal of Mental Health 2001; 1-11, iFirst
- Firth-Cozens J (2006). A perspective on stress and depression. In J Cox et al (Eds.), Understanding doctors’ performance (PP. 22-25). Oxford; Radcliffe Publishing.
- Hawton K et al. Suicide in doctors: a study of risk according to gender, seniority and specialty in medical practitioners in England and Wales, 1979-1995. Journal of Epidemiology and Community Health 2001;55(5):296-300.
- Schernhammer ES et al. Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). American Journal of Psychiatry 161;12:2295-2302.
- British Medical Association. Caring for the mental health of the medical workforce. Bma.org.uk. Accessed 7th October 2019.
- Firth-Cozens. Individual and organizational predictors of depression in general practitioners. British Journal of General Practitioners 1998;48:1647-1651.
- Sauerteig So et al. Doctors’ health and wellbeing: at the hearth of the NHS’ mission or still a secondary consideration? Interval Review of Psychiatry 2019;14:1-7.doi: 10.1080/09540261.2019.1586165.
- McCray et al. Resident physician burnout: is there hope? Family Medicine 2008;40(9):626-32.