Doctors’ health and wellbeing: talking about our mental health
Ward rounds, clinics, family discussions, studying for exams, sitting exams and failing exams, all comprise some of the potential strains on our time as junior doctors. The workload and type of work can create significant stress and, among the day-to-day work, the preparation for, and outcome of exams adds further strain on a stressful situation.
In October 2013, beyondblue showed through the National Mental Health Survey of Doctors and Medical Students that, as a profession we have a higher rate of severe psychological distress and attempted suicide compared to the Australian population and other professionals. The rate of suicidal ideation among health practitioners was a staggering 28.5 per cent in females and 22.3 per cent in males compared to the 15.0 per cent and 11.5 per cent respectively in the Australian population. Young training doctors appear to be a more vulnerable group with higher levels of burnout than their older colleagues as measured by rates of emotional exhaustion 47.5 per cent (compared to less than 35 per cent for over 30 years of age), cynicism 45.8 per cent (compared to 36.5 per cent or less for over 30), and lower professional efficacy 17.6 per cent (compared to 16.3 per cent in the 31-40 age group).
While many questions can be asked of the profession as a whole, why in particular are doctors in training more vulnerable? Previous articles have cited the nature of junior doctors work, studying for exams and the difficulties maintaining work-life balance. Mental Health services for practitioners exist such as the Victorian Doctors Health Program (VDHP), but often they are consulted by practitioners late when high stress has already had a significant impact on the wellbeing of an individual. When surveyed, junior doctors have cited fear of stigma, concerns regarding anonymity when seeking help and the prospect of being reported to the Medical Board. Among junior doctors, in particular the feeling of “letting the side down” and concerns regarding the negative connotations of not coping with the workload on the overall assessment of their training performance.
In response to the concerning figures raised in the National Mental Health Survey of Doctors, beyondblue, together with the AMA, has created a forum involving major stakeholders in medical training and doctor wellbeing. The roundtable discussion is aimed to generate models for addressing workplace stress – not just at the individual level, but also at an institutional and training college level. Ideally, prevention is the goal and we applaud the work of medical schools including personal development and stress management as teaching modules within training. At the institutional level, hospitals such as the Royal Melbourne have implemented additional programs that help identify at-risk individuals but also to review rostering practices and ensure safe hours and adequate work-life balance. More can still be done to address the problem and ensure the right balance of safe, enjoyable practice with adequate training exposure that produces trainees with the skills to cope with a wide variety of workplace stress.
The Council of Doctors in Training hopes to generate further discussion regarding the area of reducing the risk of trainee suicide and stress management at our upcoming Trainee Forum on the 15th of March.