Shame and Stigma; why doctors won’t seek help for their mental health

Ever since I can remember, I have been fascinated by people. At school I was quite good at science and since I also liked people and, well, mainly because I was 15 and thought the idea of working at a computer in an office sounded particularly dull and a spectacular waste of my life; I decided to become a doctor.

People fascinated me you see, because inside we are all the same. We are all human beings. We all have a heart and a brain and lungs and a liver and kidneys and blood and skin and muscle and bones and mostly the same number and arrangement of each. But being a person is not the same thing as being a human. Being a person requires some strange abstract concepts like consciousness or a soul or a conscience and having these means you do strange things like develop connections with other people and ponder the meaning of your existence or, you know, spend all day binge watching Netflix.

When I became a doctor I realised that I wasn’t so interested in the precise mechanisms and intricacies of anatomy and physiology as I was in the idea of understanding the person; their beliefs and attitudes and behaviours. Instead of focusing on the HbA1c and the level of sugar in the blood of a diabetic patient, I wanted to know what their beliefs were about their illness, how they viewed themselves and what was happening in their life that could be affecting their diabetic control.

You see, from a young age, I always knew I wanted to become not just a doctor, but a psychiatrist. A job where I could combine my scientific knowledge with psychology and sociology and ethics and law. A job where there aren’t flow charts and right answers but lots of unknowns and abstract concepts. In my opinion psychiatry is brilliantly challenging yet so important. In today’s society it feels like more and more mental health resources are needed, whether that’s because we are generally becoming unhappier or because we are finally seeking the help we always needed. My job is not to make everybody happy but to help everybody to make the most out of the precious time they have on this infuriatingly beautiful yet sometimes heartbreakingly cruel little planet we call home.

The thing is, that many other people don’t share my enthusiasm for psychiatry. In fact, within medicine it has a reputation for being a “soft specialty”. It’s been said that I’m “not a real doctor”. I’ve been asked if I practice psychiatry by choice, as if I might have accidentally stumbled into the wrong room one day and got stuck there or it was a punishment for not paying enough attention at medical school. There is an implication that it’s a specialty for bad doctors.

Now, I’m not that surprised when I hear this type of thing from the public because I think there’s a degree of misunderstanding and ignorance when it comes to mental health which I am hoping is changing. But I receive this type of courtesy stigma from my colleagues in other specialties. It is my belief that this is partly a product of the entrenched culture of medicine. It’s not something we talk about or that everybody experiences to the same degree but I think most of us are affected, be it subconsciously or consciously by antiquated, competitive, hierarchical values. Revered doctors are those that work above and beyond the hours they are paid for, that come in even when they are sick, that prioritise work over their families, over sleep and their own health. Doctors that are kind and compassionate but that don’t allow themselves to be affected by their experiences. Doctors that would go from one cardiac arrest to the next without letting their judgement cloud or their actions falter.

But doctors are people, not robots.

This way of thinking is not safe for them nor for their patients.

The Office of National Statistics showed that between 2011 and 2015, 430 doctors died by suicide. A survey by Medscape in 2018 which collected results from nearly 1,000 UK doctors, found that 22% of doctors from all specialties feel burned out, 4% feel depressed and 10% feel both burned out and depressed. Of these, only 1 in 10 said that they had got help or planned to get help. We have problems with recruitment and retention of doctors in almost all specialties. Many are moving abroad or pursuing other careers.

How can we expect to help others if we do not help ourselves? There’s a saying that “you cannot pour from an empty jug” and we need to do more to keep our own jugs full.

This is partly why I joined The Doctors’ Association UK. Doctors need their voices to be heard both within our workplaces and more widely, in politics and in the media. We need to work on creating a safer place to work with better resources and abilities to do our jobs but we also need to work on the culture within the healthcare system. We need to encourage our colleagues to treat each other with respect, kindness and compassion rather than to bully and belittle. Asking for help should not be seen as a sign of weakness and mental health should not be seen as inferior to physical health.

Saving doctors’ lives ultimately saves patients’ lives.

 

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