New book calls for compassionate approach to physician mental health
Leading GP Professor Dame Clare Gerada advocates for reform in treating healthcare workers’ mental illness, highlighting alarming suicide rates and systemic issues in the medical profession.
Healthcare workers face mental health crisis
A new book by Professor Dame Clare Gerada, past president of the Royal College of General Practitioners (RCGP), is set to shine a spotlight on the pressing issue of mental health among doctors and nurses. “The Handbook of Physician Mental Health”, due for publication next week, presents a comprehensive analysis of the factors contributing to mental illness in healthcare professionals and proposes a more compassionate approach to their treatment.
The book comes at a critical time, with Gerada noting that “general practice across the world is in crisis”. She points to substantially increased workloads in recent years that have not been matched by growth in funding or workforce. This imbalance is just one of the many factors contributing to the alarming rates of mental illness and suicide among medical professionals.
Alarming suicide rates among doctors
One of the most startling revelations in the book is the disproportionately high suicide rate among doctors. According to Gerada, physicians are up to four times more likely to die by suicide compared to other professional groups. The book identifies certain groups within the medical community as being at particularly high risk, including GPs, psychiatrists, and doctors trained overseas.
Female clinicians are also highlighted as a vulnerable group, facing what Gerada terms a “second shift” – caring for patients during the day and their families at night. This additional burden contributes to the increased risk of mental health issues among women in the medical profession.
Systemic issues and fear driving mental illness
The book delves into the numerous factors contributing to the development of depression, anxiety, and other mental health problems among clinicians. These include a global workforce crisis, increased workload, bullying, and racism within the healthcare system.
Gerada also points to what she describes as “the industrialisation of care” as a key risk factor. This refers to an overemphasis on meeting strict targets at the expense of providing personalised healthcare for patients, which can lead to increased stress and dissatisfaction among medical professionals.
Fear plays a central role in the mental health crisis among physicians. Gerada explains: “Fear is at the heart of the factors contributing to physician mental illness and suicide. Doctors fear losing their professional identity, being cast out of medicine, becoming a patient, being abused and excluded, making mistakes, upsetting seniors and failing to meet patient expectations.”
Call for compassionate treatment
A key message in Gerada’s book is the need for a more compassionate approach to treating healthcare workers who are struggling with mental illness. She criticises the current system, saying: “Sick health professionals want to be treated compassionately – with sensitivity, sympathy, empathy and non-judgmentally. However, trainers, employers and regulators often treat them as naughty schoolchildren or wrongdoers for crossing the boundary from practitioner to patient.”
Gerada argues that many in positions of authority over doctors wrongly conflate illness with performance issues, treating mental health problems as disciplinary matters rather than medical conditions requiring support and treatment.
Barriers to seeking help
The book also explores the various barriers that prevent healthcare workers from seeking the help they need. These include:
- Fear of losing confidentiality
- A public perception that doctors are immune to illness
- Medical training that emphasises placing patients’ needs above their own
These factors can lead doctors to hide their illnesses, exacerbating the problem and potentially leading to more severe outcomes.
A call for reform
Through “The Handbook of Physician Mental Health”, Gerada aims to provide evidence-based insights into why doctors become unwell, how to identify those at risk, and the best approaches to aid their recovery. By drawing on learning from NHS Practitioner Health, which supports around 6,500 health and care professionals annually, the book offers practical guidance for addressing this critical issue.
As the medical community grapples with ongoing challenges, including increased workloads and systemic pressures, Gerada’s call for a more compassionate and understanding approach to physician mental health could not be more timely. The book serves as both a wake-up call to the severity of the problem and a roadmap for much-needed reform in the care and support of healthcare professionals.
Handbook of Physician Mental Health
by Clare Gerada (Routledge, 2024)
ISBN: Paperback: 9781032479866 | Hardback 9781032489377 | eBook 9781003391500
doi: https://doi.org/10.1201/9781003391500
