BY DR SANDRA HIROWATARI, CHAIR, AMA COUNCIL OF RURAL DOCTORS
September 13 – R U OK? Day. R U OK? Day is a national day that encourages all of us to take the time to talk and to listen to each other to prevent suicide. It is held mid-September each year. This Day stems from one suicide, one grieving son, Gavin Larkin*, who felt there ought to be something that can be done to prevent suicide. He championed a movement to encourage people Australia wide to ask one question: are you okay? This is a national movement, 80 per cent of Australians are aware of this day of action and one in four have participated in an R U OK? Day activity.
It is more than a question, it is an act of taking away stigma – to make it OK to ask. Simply asking the question opens a door for both of you to talk about your mental health. It makes you talk about the steps to make sure you are both okay.
We doctors ask this questions to our patients every day. It is now time to take this question out of therapeutic relationships and just ask someone different, reach out where you do not usually go. Ask a Rural Doctor.
We all know a doctor who has suicided. There was another one in Far North Queensland a few months ago. Internationally, one doctor dies by suicide per day. In the United States, Dr Pamela Wible, (author of Physician Suicide Letters—Answered) says that is roughly equivalent to one medical school per year.
Doctors in training lists some of the causes: “…brutal expectations …the work eats you alive … hours expected to work, the conditions we work under, family sees less and less of us. How difficult this job is, the expectations…” There is an element of bullying and a culture that discourages getting help.
Dr Michael Myers, a New York University psychiatrist who studies doctor suicides states there are obvious occupational factors: access to lethal drugs, the knowledge to use them, learned fearlessness, exposure to vicarious trauma. Then there is the practice of medicine itself: an epidemic of burnout fueled by everything from long shifts and huge, complex caseloads to what many doctors say is a punitive and unsupportive regulatory culture.
Rural doctors, RU OK?
Most of you are okay. You have chosen a fulfilling profession in a challenging location, you have empowered yourself with generalist skills, you have a work-life balance. You love rural.
Some of you are not OK.
You are the “us” we worry about.