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Doctors, nurses and other health practitioners need better mental health support

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The suicide rate for health professionals, those charged with caring for our community, should concern us all. This week a study revealed that the suicide rate of female health professionals is double those in other occupations, an added impetus for policy change.

The study, which is based on data from the period between 2001 and 2012 and is by the University of Melbourne and Deakin University, is an unprecedented analysis of suicide by healthcare professionals.

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Researchers say female health practitioners have extra sources of ”gender role stress”. Photo: Peter Braig

The overall number of people who die by suicide is twice the number killed on our roads, so the study is an important contribution to the debate on how to reduce this tragic, preventable toll. But its most striking element is the gender difference, particularly the gap between female healthcare professionals and other female professionals.

While male doctors and nurses have a higher rate of death by suicide than female doctors, the men are in line with other occupations.

The suicide rate of male doctors is 14.8 per 100,000 person years, while male nurses have a rate of 22.7. Those compare with 14.9 per 100,000 person years in other jobs. For women the corresponding figures are 6.4 and 8.6 per 100,000 person years, as against 2.8.

The study’s authors postulate that female doctors face a “toxic cocktail” – occupational stress, home/life pressures and ready access to prescription drugs. They say medical professionals have higher rates of stress than other occupations – reflecting long working hours, work-family conflict and anxiety about making mistakes.

Female health professionals, the authors argue, have extra sources of “gender role stress”, particularly pressures to perform childcare and household roles. They also say female doctors in male-dominated fields – surgery, for example – suffer because of barriers to career advancement, including bullying and harassment.

Perhaps surprisingly, the report also suggests that doctors feel there is a still lot of stigma about mental illness within the medical profession, and that there are barriers to getting help, including denial, fear of prejudice and being seen as weak. This is further evidence that policymakers need to intensify the efforts of recent years to raise community awareness about mental health and where to get help. There is a profoundly important link between mental illness and death by suicide.

So, what might be done? One practical measure would be to provide far better cover for doctors who need to take sick leave. It is the norm in many medical jobs that when someone takes sick leave their colleagues have to shoulder the extra burden or patients get cancelled. These are both a significant deterrent to conscientious people taking necessary leave.

Access to lethal prescription medicines is clearly a risk factor. It should not be beyond the wit of policymakers to design safeguards against undue access.

Then there are the less clinical aspects. Dr Kym Jenkins at the Doctors’ Health Advisory Service advocates human connection as a protective factor. She says encouraging health professionals to nurture friendships and community belonging outside of their clinical work – and allowing them the time to do so – would be of great benefit.

Some good internal changes are under way. The Doctors’ Health Advisory Service is expanding support to doctors and medical students in NSW, South Australia, the ACT and the Northern Territory. And the Royal Australian College of Surgeons is moving to reduce the bullying and harassment of women that has been revealed by research.

Health practitioners provide crucial support, understanding and services to the community. It has become evident they need and deserve to get the same in return.

For help contact Lifeline on 131 114 or beyondblue on 1300 224 636.

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Peter King
Peter is the CEO of the Centre for Mental Health Education specialising in educating mental health professionals in effective approaches when managing extreme emotion dysregulation, borderline personality disorder and PTSD using approaches such as Dialectical Behaviour Therapy and Somatic Trauma Therapy.
http://www.cmhe.com.au

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