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Federal money announced for doctors’ mental health

Health Minister Greg Hunt will work directly with doctors to develop a mental health care package for the medical profession.

Addressing the AMA National Conference on May 26, Mr Hunt (pictured) said a recent spate of young doctor suicides – including that of Deputy Chair of the AMA Doctors-in-Training Council Dr Chloe Abbott – has been a cause for great concern.

The Minister said that after speaking with AMA President Dr Michael Gannon and former President Dr Mukesh Haikerwal, he was determined to develop a mental health package targeting doctors.

“One of the main things we introduced in the Budget was prioritising mental health. For the first time, this has been raised to the top level as one of the four pillars of the long-term national health Plan,” Mr Hunt said.

“And we were able to invest significantly in mental health, both in the election, but in particular, in the Budget as well. There’s a very strong focus on suicide prevention with support for suicide prevention hotspots and an $11 million initiative, but also complementing that with the rural telehealth initiative for psychological services.

“Much of this is deeply important preventive health work on the mental health side and it goes with what has to happen in, I think, the medical work force. The case of Chloe Abbott was outlined and I’m aware that many people have been affected by Chloe’s loss, as well as others.

“And Michael and I have been speaking this week, and also been speaking in recent weeks with Mukesh Haikerwal, and I am determined to offer a partnership with the Government and the AMA for us to provide new investment directly into caring for carers.

“And so I want to announce that we will offer a partnership going forward and we will develop the suicide prevention, mental health programs with the AMA and the broader medical work force for suicide prevention and mental health support, specifically for doctors and other medical work force professionals.

“One of the critical roles that you have is psycho-social services. There’s the clinical work with those with mental health issues, but then there is the support services.”

The Minister offered few details of the partnership, stressing that it was still in its conception stage.

But he was determined to take action.

Following his address to the conference, he spoke more to the media about the plan.

“There have been some terrible tragedies in the sector. Michael Gannon and other doctors, Mukesh Haikerwal, have talked to me about that,” he said.

“What we’ll be doing is developing a caring for carers package which will be assisting with specialist channels, because sometimes, and this is what’s been explained to me, those who are doctors or nurses (a) will feel that they shouldn’t be seeking help even though they’re just the same as everybody, and (b) they might feel professionally uncomfortable. Even though they might be in the depths of despair they’ll still feel that professional discomfort at reaching out.

“And so if they have some specialised services for them then they will feel more comfortable, we hope, and that’s what’s been proposed by the profession.”

He did not know if the plan would address the mandatory reporting lines, where doctors might fear they would be reported to the Medical Board when they seek help.

He also promised funds to the partnership, but could not say how much at this stage.

“There’s been no proposal put to me yet, but as I’ve said, in designing of this, what I really want to do is work with the AMA and the GPs,” he said.

“What we’re doing is we’re designing together, and from that we’ll have the outcome.”

This article was originally published in Australian Medicine. Read the original piece here.

Doctorportal hosts a dedicated doctors’ health service providing support in the medical community.

Why don’t we speak openly about doctor suicides?

Why don’t we speak openly about doctor suicides?

 

Just over a week ago, I read an obituary in a medical publication about a young talented and clearly lovely junior doctor. Her life and achievements were celebrated, but no mention was made of the cause of her untimely death. Some colleagues and I surmised it was suicide, but then we wondered why it was it was not mentioned in the obituary.  Subsequently, suicide was confirmed, but at the time it felt as though there was an embargo on talking about doctor suicide. There is a shame about discussing it in public, and if this is the case, how can we possibly learn about the things that lead to suicide in our colleagues? We discuss medical cases openly so that we might learn, but why not of our colleagues who reach a point of no return?

It is well known that doctors do have a higher rate of suicide than the general public. These results have been reported as being up to 5.7 times higher than the general public. Female doctors are at the greatest risk with rates 2.27 – 5.7 times higher.

These results are staggering, but the fact that we have suicide at all in the profession is indicative of a deep dis-ease in our profession.

How is it that we can have people who are caring by nature, who choose to do medicine to care for people, but ending up so despairing that they take their own life?

And worse, that their colleagues and medical friends do not notice their decline to that point and are often completely surprised to hear of the death of a colleague in such a fashion?

These suicide statistics have been known for some time, yet until now, no true action has been undertaken.

In response to recent matters, last month the NSW Health Minister Brad Hazzard, instructed his staff that they have one month to come up with a plan for the doctor suicide crisis. It is great to see urgency brought to this matter, but is one month really enough and will it really get to the root of the cause?

What we are looking at here are ingrained issues, where for so long suicide has been accepted as a “sad yet inevitable”, or an “occupational hazard”. I was taught the statistics as though it was an inevitability that could not be altered. But is this really the case, and is this the way we would or ought to approach other health issues?

As doctors, we care about the health of people in medicine, yet we do not appear to be taking the same care and attention to the health of people in our own medical community.

Doctor suicide occurs within the context of the health care system and culture

Increasingly the culture of medicine is being revealed as replete with bullying and harassment. Far from caring for health care professionals, the culture of medicine is that of judgement, critique, condemnation, blaming and shaming. There is no true care and attention brought to the health and well-being of doctors and we are not trained in any suitable way how to deal with the emotional demands of the job, nor are we taught how to look after our own health and well-being.

Medicine is not a culture of peer support, but rather of peer competition and judgement. Any sign of human vulnerability and feelings is seen as a sign of failure. Medicine teaches you to be a “doctor” and not who you are as a human being. You are taught to “toughen up”. You learn that only the tough survive. There is stigma for those with mental health issues. People become isolated, hiding what they are going through. There are definitely some cultural factors that need addressing.

I have heard it said more than once that medicine is more stressful than being in the army or in a war zone, and that there is more compassion for your well-being when you are a soldier. In such a harsh environment, does it really surprise us that people do not survive?

As health care experts, why are doctors ‘surviving’ and not thriving?

Doctor suicide is the end of a long line of health issues for doctors, who are well known to have worse mental health than the general population on a number of counts. For every doctor who actually dies by suicide there are many who make an attempt but survive. Statistics show that  40-55% of the profession are burnt out with all of the personal health issues that entails such as higher rates of cardiovascular disease, anxiety, depression, diabetes, musculoskeletal disorders and suicidal thoughts. 25% of the profession have thought about killing themselves.

Doctor suicide exists in a longstanding culture that is well established to be uncaring and, at times, frankly abusive towards its own professionals. Suicide is an absolute tragedy but the day-to-day ill health of the medical profession is also a serious issue that needs to be recognised.

If we are serious about dealing with doctor suicide, we need to address the entire medical culture and system including the educational, medico-legal and regulatory aspects as well as personal factors at play. We need to be willing to make the needed changes. But we cannot do that until we are completely open about it and willing to examine the issue in absolute fullness.

Given the long association of suicide with the medical profession, there is clearly something amiss and thus something that can potentially be rectified. Let’s not look for short term solutions. Let’s aim to truly address the situation in full and get to the roots of the matter. Lives depend on it.

Dr Maxine Szramka is a Sydney-based rheumatologist and Clinical Senior Lecturer at the University of Wollongong. She blogs regularly at Dr Maxine Speaks.

Doctorportal hosts a dedicated doctors’ health service providing support and information about suicide prevention in the medical community.

For support and information about suicide prevention, call Lifeline on 13 11 14