What are the barriers and facilitators to seeking help for mental health in NHS doctors: a systematic review and qualitative study

Abstract

Background The mental health of healthcare professionals is reaching a breaking point, and the COVID-19 pandemic has exacerbated current mental health issues to unprecedented levels. Whilst some research has been carried out on the barriers that doctors face when seeking mental health help, there is little research into factors which may facilitate seeking help. We aimed to expand the research base on factors which act as barriers to seeking help, as well as gain insight into facilitators of help-seeking behaviour for mental health in NHS doctors. Methods We conducted a systematic literature review which identified the barriers and facilitators to seeking help for mental health in healthcare professionals. Following this, we conducted semi-structured interviews with 31 NHS doctors about their experiences with mental health services. Finally, through thematic analysis, key themes were synthesised from the data. Results Our systematic literature review uncovered barriers and facilitators from pre-existing literature, of which the barriers were: preventing actions, self-stigma, perceived stigma, costs of seeking treatment, lack of awareness and availability of support, negative career implications, confidentiality concerns and a lack of time to seek help. Only two facilitators were found in the pre-existing literature, a positive work environment and availability of support services. Our qualitative study uncovered additional barriers and facilitators, of which the identified barriers include: a negative workplace culture, lack of openness, expectations of doctors and generational differences. The facilitators include positive views about mental health, external confidential service, better patient outcomes, protected time, greater awareness and accessibility, open culture and supportive supervisors. Conclusion Our study began by identifying barriers and facilitators to seeking mental health help in healthcare workers, through our systematic literature review. We contributed to these findings by identifying themes in qualitative data.. Our findings are crucial to identify factors preventing NHS doctors from seeking help for their mental health so that more can be done on a national, trust-wide and personal level to overcome these barriers. Likewise, further research into facilitators is key to encourage doctors to reach out and seek help for their mental health.

Factors associated with burnout among healthcare providers in a rural context, South Africa

“… 12 A systematic review by Zaman et al examined 16 studies from the United Kingdom, the United States, Australia, South Africa, Singapore and South Korea on the barriers and facilitators to seeking help for mental health in doctors. 23 Facilitators found to increase help-seeking behaviour included positive views about mental health, greater awareness and accessibility to mental health services and supportive supervisors. 23 …”

‘Who you gonna call?’ A qualitative study of psychiatrists accessing mental health services

“…This supports evidence that having a positive perception towards mental health is a facilitator to help-seeking. 19 Psychiatric training enabled identification of goals for intervention and tailoring of search for providers by specific therapeutic modality. Although there were reported concerns about the potential professional dynamics between the psychiatrist-as-a-patient and their healthcare provider, the relationship between perceived ‘peers’, with shared health literacy and mutual understanding, was fundamental in allowing participants to initiate discussion of their concerns in a safe environment.…”

Translation, Adaptation, and Validation of the Malay Version of the Barriers to Access to Care Questionnaire for Assessing the Barriers to Seeking Mental Health Care Among the Health Workforce in the East Coast Region of Peninsular Malaysia

“…However, despite the benefits of obtaining professional help for mental health problems, several barriers impede individuals from seeking such help, and this also occurs among people who work in the health sector, even though they work in the sector that provides mental health support services. Some of these barriers include stigma and fear of being judged or discriminated against by others, concerns about career progression, concerns about confidentiality and privacy, lack of time, and poor attitudes, such as the thought of being capable of managing their own mental health [6][7][8][9].…”