Doctors seek help for mental ill-health

Depression, anxiety, stress and burnout were recurring mental health issues among the 48 doctors, dentists and pharmacists supported by a confidential programme last year, it has emerged.

Non-consultant hospital doctors, consultants and GPs made up 75% of referrals to the Practitioner Health Matters Programme (PHMP) last year.

However, there was a noticeable increase in the number of pharmacists and consultants using the service — nine in both cases.

It also emerged that all nine pharmacists presented with substance abuse issues, indicating that access to prescription drugs is a key issue.

One doctor was also attending the Medical Council’s health committee and two pharmacists had been referred to the Pharmaceutical Society of Ireland.

The PHMP is supported by the three regulatory bodies for the medical, dental and pharmacy professions, as well as the representative and training bodies.

The 48 health professionals helped last year is a 53% increase on the 47 treated by the programme in the first 18 months of operation during 2015 and 2016.

The independent charitable organisation said that last year 28 practitioners presented with mental health issues, 14 with substance misuse issues while six had both.

More women than men, 27 as against 21, availed of the service. The highest number of health professionals availing of the programme last year were in the 25 to 34 (18) and 35 to 44 (15) age groups.

Abuse of prescription drugs was the main issue for 57% of those with substance issues, while alcohol abuse was a problem for 29%.

More than half of all referrals were self-referrals (26) while eight were made by a colleague and five by a psychiatrist.

The remainder of referrals were made by the practitioner’s GP (3), an occupational health service (2), an addiction treatment centre (2), an employer (1) or a training facility (1).

The PHMP’s clinical lead, Dr Íde Delargy, said the programme is effective with over 80% of those supported back working safely again and the significant increase in overall numbers last year showed awareness of the programme was growing.

Our experience and international experience shows that health professionals are very slow to come forward with health or addiction issues due to shame, stigma or fears of reputational damage.

"Practitioners often resort to self-managing and self-medicating their problems which in turn results in them presenting late and often in crisis when their problems are worse. That is why it is heartening to see an increase in the numbers.”

Dr Delargy said it is a “concern” that many young female doctors are seeking help for mental health issues shortly after qualifying.

“They are often thrown in at the deep end and expected to get on with it, but, clearly, many find it difficult to navigate through what are often life or death situations.”

Many young women doctors are suffering from depression and burnout. Some had even developed post-traumatic stress disorder.

“This would indicate that the pressures of the job may need to be more clearly demonstrated to graduate doctors during training,” she said.

It is estimated that up to 15% of practitioners may experience problems with mental health or substance use issues at some stage in their career and that over 2,000 may need help annually.

The Royal College of Surgeons in Ireland’s first chair and professor of medical professionalism, Dubhfeasa Slattery, addressed the complex problem of burnout among healthcare professionals at a conference in Dublin yesterday.

“Self-care is one of the skills we aim to equip our students with so they have the resilience and insight to manage their well-being in a challenging work environment,” said Prof Slattery.

Case studies

  • A doctor wrote in a self-referral by email about “not coming back to myself” after the Medical Council found nothing wrong in how the practitioner managed a patient. “I think I have major depression, anxiety and post-traumatic stress syndrome — this is all self-diagnosis and I have been treating myself with anti-depressants and benzos and in bad times using sleeping tablets,” the doctor wrote. “I stay alone for many days at home pretending I am working or am abroad to cover my disappearance.”

  • A male non-consultant doctor attended the programme with his partner, who is also a healthcare worker, because he had been drinking heavily since medical school and occasionally used cannabis. Because he qualified under a graduate entry programme, he had multiple financial pressures. After being assessed, he stepped down from work and began dealing with his alcohol addiction. He is now back at work.

  • A pharmacist who took prescription medication to help with depression and anxiety sparked by a family bereavement was reported to the Pharmaceutical Society of Ireland and advised to seek help through the PHMP. The pharmacist is back at work.

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