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Doctors are suffering a mental health “tragedy,” according to physician-based news outlet Medscape.
The outlet surveyed more than 13,000 physicians across 29 specialties about the level of their mental health and their thoughts about death and suicide. They found not only that depression is widespread, but that many doctors don’t get help because they fear professional repercussions. The survey, A Tragedy of the Profession, encompasses 13,069 U.S. physicians across 29 specialties.
They found that about a fifth of doctors surveyed — 21 per cent — reported experiencing depression. Of that group, about a quarter said they had clinical depression, while well more than half — 64 per cent — had what the report defined as “colloquial” depression. Those doctors didn’t necessarily hit the threshold for a clinical diagnosis, but experienced several symptoms like hopelessness, despair or thoughts of suicide.
The extremely difficult working conditions that have been ongoing since the beginning of the pandemic are likely a major component of these high numbers, the survey suggests. Many doctors have now been face-to-face with mass death for more than two years and have put themselves at risk too — especially before vaccines were widely available. They’ve also been forced to work long hours, often without breaks or vacations, which has led to a significant exodus from what’s clearly a punishing career: three in 10 medical professionals are considering leaving, according to the Washington Post.
The survey points out that Penn State College of Medicine’s screenings for doctors’ depression rates pre-pandemic were around 10 per cent. Today, they’re between 30 and 33 per cent.
“When patients go on ventilators, it’s often true that they don’t come off them,” said Daniel Shapiro, the university’s vice-dean for faculty and administrative affairs. “So physicians are witnessing terrible tragedy, which is a painful way to practice.”
In Canada, there was a mental health crisis among doctors even before the pandemic started: according to a Canadian Medical Association report in 2019, one in three doctors experienced signs of depression. Burnout can be hard to recognize in doctors because “we can still maintain high levels of pay even though we may be burnt out,” Dr. Gigi Osler, then-president of the Canadian Medical Association (CMA), told Global News in 2019.
About 9 per cent of Medscape respondents said they had thoughts of suicide, down from 22 per cent in 2020. But it’s still an issue: other studies indicate that while the general public’s rate of suicidal thoughts is around four per cent, it is nearly double for doctors at 7.2 per cent. Around one per cent of doctors said they had attempted suicide.
Why many doctors don’t get help
But seeking help can be problematic for doctors, the survey suggests. Many fear that visiting an expert to attempt to improve their mental health could negatively impact their professional lives.
“I’m afraid that if I spoke to a therapist, I’d have to report receiving psychiatric treatment to credentialing or licensing boards,” one anonymous respondent said.
“Physicians cannot seek help for these issues because if we do that, these temporary issues will follow us for the rest of our careers,” another added.
Licensing boards sometimes ask questions about mental health. When that happens, even mental health treatment sought years ago can threaten a doctor’s ability to practice medicine, according to the Association of American Medical Colleges (AAMC). Some doctors also worry about having to share private medical records with boards. There are initiatives on the go to change some of these licensing practices, but they’re time-consuming and slow, the AAMC explains.
And while stigma prevents many members of the general public from seeking mental health treatment, it’s even more widespread among doctors: one 2020 study found 73 per cent of doctors expect to be judged negatively by their colleagues if they seek therapy or other mental health interventions.
Older doctors least likely to seek help, male doctors most at risk
The problem of depression among physicians is widespread, but it also has generational implications: younger doctors are more likely to open up about suicidal thoughts to a friend, family member, colleague, therapist or counsellor. Of the people who said they had had suicidal thoughts, 44 per cent of Baby Boomers — defined here as people between ages 57 and 75 — said they didn’t tell anyone. That was true of 38 per cent of generation X (42-56 years old), and 34 per cent of Millenials (27-41).
Male doctors were also more at risk: of the doctors who experienced suicidal thoughts, 61 per cent were men.
In terms of medical specialties, suicidal thoughts were most common among doctors whose specialty was pathology (13 per cent), general surgery and oncology (12 per cent each).