Very often neglected, it is extremely crucial to look into the mental health scenario of those who look after us. The medical profession has proven to have one of the highest risks of death by suicide among professions.
An estimated 12% of males and 19.5% of females in the medical profession suffer from depression, and it is even more common among medical students. About 15-30% of students and residents screen positive for depression. Studies also show that 1 in 16 trainees report suicidal ideation.
The most common mental illnesses among doctors happen to be affective disorders like depression and bipolar disorder, alcoholism and substance abuse and the most common method of suicide is the use of firearm or lethal medication overdose.
In India, a study conducted by the Indian Journal of Critical Care Medicine revealed that 21% of doctors consume alcohol in higher volumes, 18% are dependent on antidepressants, 14% are heavy smokers and doctors as well as nurses who work in the ICU routinely report auditory hallucinations.
There are multiple causes that explain the above findings:
1. Burnout: An early burnout among young doctors is highly prevalent due to very long working hours without necessary breaks. At the same time, senior doctors are consistently exposed to professional stress over the years. Both cases cause an overall emotional exhaustion leading to depression.
2. Medical School: Even before they become doctors, medical training can cause high levels of stress in students who become vulnerable to unhealthy coping mechanisms which they take forward later in life as well. Medical college demands a level of competence and aptitude that many students find difficult to meet in spite of being brilliant in school. This leads to a battered self-confidence and anxieties over the future and is worsened by lack of sleep, intense study hours, pressure from family and friends and the resulting mental fatigue.
3. Barriers to seeking mental health care: Ironically, the stigma associated with mental health is magnified in the medical profession. Doctors are less likely to seek out mental health services than the general population. The reasons are many – reluctance in expressing their issues to colleagues, fear that insurance forms may expose their identities, concerns about confidentiality and the belief that they can treat themselves.
4. Time constraints: Due to a hectic career and lifestyle, doctors feel that their own health and well being can take a back seat and they continue to live with conditions that need immediate care. This lifestyle often affects their marriage and family relations – causing more stress.
Preventing suicides among doctors:
1. Assessment of students: When students are admitted into medical schools, their psychological suitability should be assessed. Accordingly, there should be stress management programs which students can access as well as a well-qualified counsellor on campus.
2. Breaks: Hospital authorities must ensure that doctors are provided with the appropriate amount of physical and mental breaks from work. Overworked doctors sometimes have to work 24 to 32-hour shifts without breaks which ultimately leads to burnout.
3. Activities: Recreational activities can be organised to deal with stress effectively. Doctors should also be encouraged to practice yoga, meditation and other relaxation techniques as well as physical exercises to maintain a healthy, stress-free lifestyle.
4. Access to drugs: Easy access to lethal drugs is a major cause of suicide among doctors, students and residents. There should be a strict system that monitors usage of these drugs to prevent their misuse.
5. Recruitment: Lack of manpower leads to the few available doctors having to work for long hours and do jobs that are not their responsibility – which leads to frustration. There should be an adequate number of interns and doctors to ensure that work is divided equally and the staff is not overworked.
Most of the times, doctors fail to recognize depression and other mental health problems that they may be suffering from. It is necessary for them to understand that they must reach out for assistance as self-treatment is not always the answer. The medical profession is one of the most pivotal ones in the world, with doctors saving the lives of millions each day. Their mental health should be treated with utmost importance.
(Written by Shruti Venkatesh, The MINDS Foundation (Vadodara, Gujarat))