Physician – look after yourself
Following World Mental Health day earlier this month, Dr Richard Stacey from our GP support team looks at how clinicians can take better care of their own mental health.
10 October 2019 marked the World Mental Health Day, this year’s theme being suicide prevention – any initiatives that raise awareness about and de-stigmatise mental health issues are of course welcome, however given that a 2018 survey of GPs by MIND suggested that 40% of GP consultations have a mental health component, GPs have to be mental health-aware every working day.
The concept of transference (which in brief terms in the general practice setting means the unconscious projection of a patient’s emotions and feelings onto the doctor) was first described by Sigmund Freud and the cumulative impact of transference on a GP’s mental health is often overlooked (this is of course amplified by all the other pressures that modern-day general practice brings).
Assorted studies have demonstrated that doctors (and particularly GPs) are significantly vulnerable to burnout, mental health issues and, particularly worryingly an increased risk of suicide - so what should GPs do to look after themselves and their colleagues?
The first step is to be alive to the signs of burnout and mental health issues both in yourself and your colleagues - some of the common symptoms are a loss of empathy, irritability, anxiety, low mood, exhaustion, a fall in performance and sleep disturbance.
The second step is to promptly seek appropriate help (or if you recognise the symptoms in a colleague support them to do so), fortunately there are numerous sources of help available, which includes your own GP. The General Practice Forward View has followed-up the promise to promote and wellbeing and combat burnout by setting-up the NHS GP Health Service, in addition, the Doctors' support network provides peer-support and their website provides helpful links to other sources of help and support.
A important personal consideration if you do develop a mental health problem is as to whether it impacts on your ability to care for patients, the GMC state at paragraph 28 of Good Medical Practice that if you have a concern that a medical condition may impair your judgement and performance, then you must not rely on your own assessment of any risk to patients, rather you should consult a suitably qualified colleague and follow their advice.
In a wider sense the General Practice Forward View has workload issues at the centre of its recommendations, which includes assorted funded strategies aimed at reducing the burden on GPs. This recognises that workload issues have been the single most common concern for most GPs and that importantly that the mental health of GPs needs to be safeguarded in order that they can deliver high quality healthcare.
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