Physician Mental Health: An Evidence-Based Approach to Change

Abstract

Awareness of high rates of physician burnout, depression and suicide is leading to changes within the medical profession at all levels. Most mental health problems can be effectively managed, but real and perceived barriers — such as confidentiality concerns and fear of negative ramifications on one's reputation, licensure, or hospital privileging — keep many physicians from addressing their mental health needs. Unattended distress has ramifications for physicians as well as the health care industry and patient safety. A number of factors contribute: in addition to individual risk factors and stress load, institutional culture plays a critical role in leading physicians to rationalize and internalize distress as part of their professional identity. There are several initiatives with demonstrated effectiveness in medical settings that can be scaled up for greatest impact: education and stigma reduction efforts, policies and procedures that treat mental health on par with physical health, and efforts that promote an overarching culture of respect. Further strides can be made by addressing hospital and state licensing forms' questions related to mental health — ensuring that questions pertain to competence rather than illness — or replacing questions altogether with a statement encouraging proactive actions to protect physician mental health and safe practice.

Protecting providers and patients: results of an Internet survey of health care workers’ risk perceptions and ethical concerns during the COVID-19 pandemic

“…In December 2019, the first cases of Coronavirus Disease 2019 (COVID- 19) were reported in Wuhan, China. The disease was initially characterized by severe respiratory symptoms caused by a highly infectious, novel, humaninfecting coronavirus [1].…”

“…Though the challenges faced by health care workers in the COVID-19 pandemic are not inherently new, relevant previous studies on mental health and burnout [19][20][21][22], occupational risks [23], and ethical decisionmaking [24,25] are limited in this context because they were not all being experienced simultaneously, as was the case with the unprecedented nature of this global crisis. The synergism of all these issues is unique.…”

Innovative and Timely Approaches to Suicide Prevention in Medical Education

“…These twin topics—suicide prevention for patients and suicide prevention for health care providers—are indeed intertwined. Shedding stigma and caring for the mental health and suicide risk of health care providers can facilitate better care for the mental health and suicide risk of patients [ 23 ]. The American Medical Association, Accreditation Council for Graduate Medical Education, National Academy of Medicine, and nearly every other national health care association have made clinician wellbeing and suicide prevention a priority over the past 5 years [ 24 , 25 ].…”

Physician Suicide Prevention and the Ethics and Role of a Healing Community: an American College of Physicians Policy Paper

“… 46 Facilitating physicians’ access to care and treatment may result in better care of their patients; for instance, improving physician mental health self-care can help physicians’ ability to detect risk, empathize with and effectively address suicide prevention for their patients. 47 , 48 Physicians should care for themselves, 19 , 20 and this may help support caring for others, but can only be fully realized by looking beyond the individual to the community of medicine.…”