Who cares for the clinicians? The mental health crisis in the GP workforce

Spiers, Johanna; Buszewicz, Marta; Chew-Graham, Carolyn A; Gerada, Clare; Keßler, David; Leggett, Nick; Manning, Chris; Taylor, Anna; Thornton, Gail; Riley, Ruth

doi:10.3399/bjgp16x685765

Cited by 13 publications

(10 citation statements)

References 9 publications

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“…Factors contributing to distress and mental health conditions such as depression, anxiety and suicidality, or which compound stress or underlying mental ill health among doctors, have been identified through recent research exploring mental illness and help seeking among general practitioners (GPs). 13 Participants attributed sources of stress/distress to systemic factors relating to increasing workloads, bureaucracy, loss of autonomy and toxic work cultures, including dysfunctional relationships at work, bullying, lack of support and isolation.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Sources of work-related psychological distress experienced by UK-wide foundation and junior doctors: a qualitative study

et al. 2021

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ObjectivesThis paper reports findings exploring work cultures, contexts and conditions associated with psychological distress in foundation and junior doctors.DesignQualitative study using in-depth interviews with 21 junior doctor participants. The interviews were audio-recorded, transcribed, anonymised and imported into NVivo V.11 to facilitate data management. Data were analysed using a thematic analysis employing the constant comparative method.SettingNHS in England.ParticipantsA purposive sample of 16 female and five male junior doctor junior doctor participants who self-identified as having stress, distress, anxiety, depression and suicidal thoughts, or having attempted to kill themselves.ResultsAnalysis reported four key themes: (1) workload and working conditions; (2) toxic work cultures—including abuse and bullying, sexism and racism, culture of blaming and shaming; (3) lack of support; (4) stigma and a perceived need to appear invulnerable.ConclusionThis study highlights the need for future solutions and interventions targeted at improving work cultures and conditions. There needs to be greater recognition of the components and cumulative effects of potentially toxic workplaces and stressors intrinsic to the work of junior doctors, such as the stress of managing high workloads and lack of access to clinical and emotional support. A cultural shift is needed within medicine to more supportive and compassionate leadership and work environments, and a zero-tolerance approach to bullying, harassment and discrimination.

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Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Sources of work-related psychological distress experienced by UK-wide foundation and junior doctors: a qualitative study

et al. 2021

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“…Regarding forgoing sick leave, some research has been conducted on the specific domain of seeking treatment for psychological distress [ 17 , 18 , 29 , 30 ]. In this context, the embarrassment or discomfort of being a psychologist’s patient or the fear of the opinions of colleagues and patients were particularly highlighted.…”

Section: Discussionmentioning

confidence: 99%

“…How physicians neglect their health can be illustrated via several specific behaviours, known as illness behaviours, including forgoing care (defined as not seeking healthcare while presenting medical symptoms) [ 7 , 13 ], self-treatment [ 14 , 15 ], a reluctance to take sick leave [ 3 , 7 ] and not having their own GP [ 13 ]. Forgoing care has mainly been studied in the context of the psychological distress linked to physicians’ substantial exposure to occupational stress [ 16 ], particularly among GPs [ 17 , 18 ]. Yet, physicians’ difficulties accepting and dealing with their somatic ailments seem to be compounded when their ailments are psychological, and this could have significant consequences on the quality of care they provide to others [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Primary Care Physicians’ Personal and Professional Attributes Associated With Forgoing Own Care and Presenteeism: A Cross Sectional Study

Cohidon

Mahler

Broers

et al. 2022

Int J Public Health

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Objective: The aim of this study was to describe the prevalence of forgoing care and forgoing sick leave among primary care physicians (PCPs) in Switzerland and to investigate associated factors.Methods: A random sample of 1,000 PCPs in French-speaking regions of Switzerland (participation rate: 50%) was asked whether they had forgone care and sick leave during the last year. Sociodemographic, personal and occupational characteristics were recorded. Logistic regressions were performed to study these behaviours.Results: 37% of respondents reported at least one episode of forgoing care and 29% reported an episode of forgoing sick leave. No associations were found between individual characteristics and forgoing care. A heavy workload was the most common reason evoked for forgoing care. Coming to work when sick (presenteeism) was associated with female sex, younger age, having a chronic illness, working in a suburban area and working full-time.Conclusion: A high proportion of PCPs in Switzerland is forgoing own care and continues to work despite sickness. New generations of PCPs should require careful monitoring, and specific solutions should be sought to reduce these harmful behaviours.

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“…Residents may lack support20 but a main reason may be that they have internal barriers to help-seeking due to concerns about confidentiality, stigma around mental illness21 22 and fear of not being competent, leading, in many cases, to 23 ‘presenteeism’ (attendance at work despite ill health),21 and to long working hours 21 22. The impact of physicians’ mental health goes beyond their personal well-being and extends to the quality of care provided to patients,23–25 leading to increased difficulties in professional relationships, reduced learning ability, worse patient satisfaction and more medical errors 9 26–28.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of resident physicians accessing a specialised mental health service: a retrospective study

et al. 2021

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ObjectivesLittle is known about resident physicians being treated at physician health programmes around the world despite the fact that it is a highly demanding training period. This study aims to describe the profiles of resident physicians accessing a specialised mental health service in Spain over a 20-year period and to compare them to consultant-grade physicians.DesignRetrospective observational study.SettingMedical records of the Galatea Care Programme for Sick Physicians.Participants1846 physicians registered at the Barcelona Medical Council-Association and admitted to the programme from January 1998 to December 2018.Primary and secondary outcome measuresNumber of admissions, sociodemographic and clinical variables, including medical specialty, main diagnosis and need of hospitalisation.ResultsResidents accounted for 18.1% (n=335) of the sample and admissions increased over the years. Most residents (n=311; 94.5%) and consultant-grade physicians (n=1391; 92.8%) were self-referred. The most common specialty among residents was family medicine (n=107; 31.9%), followed by internal medicine (n=18; 5.4%), paediatrics (n=14; 4.2%), psychiatry (n=13; 3.9%) and anaesthesiology (n=13; 3.9%). Residents, regardless of year of training, mainly asked for help because of adjustment (n=131; 39.1%), affective (n=77; 23%), anxiety disorders (n=40; 18.8%) and addictions (n=19; 5.7%). There were no significant differences between groups in the main diagnosis and in the variables related to need of hospitalisation. The percentage of residents accessing the programme was higher than in the reference population registered at the Barcelona Medical Council-Association (18.1% vs 7.6%; z=7.2, p<0.001) as was the percentage of family medicine residents (31.9% vs 19.6%; z=5.7, p<0.001).ConclusionsResidents are more likely than consultant-grade physicians to seek help when suffering from mental disorders. Local primary prevention actions since the beginning of their training period and having access to a well-known highly reliable programme may partly explain these findings.

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Who cares for the clinicians? The mental health crisis in the GP workforce

Cited by 13 publications

References 9 publications

Sources of work-related psychological distress experienced by UK-wide foundation and junior doctors: a qualitative study

Sources of work-related psychological distress experienced by UK-wide foundation and junior doctors: a qualitative study

Primary Care Physicians’ Personal and Professional Attributes Associated With Forgoing Own Care and Presenteeism: A Cross Sectional Study

Characteristics of resident physicians accessing a specialised mental health service: a retrospective study

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