31 May The stigma surrounding mental health has to change
Hi. I am a GP and I have a recurring mental illness. And I know that I’m not alone. There is a vast number of research projects addressing mental health in healthcare professionals and we know that doctors are more likely (than the general population) to suffer burnout, anxiety, depression and addictions. Despite this common knowledge, as a group we are shockingly poor at self care. Many doctors are not even registered with a GP and when help is required we are stuck and uncertain where to go next.
We are naturally born strivers. We hate to fail. We perceive being mentally ill as somehow not coping with the demands and rigours of the job and as a result we avoid seeking help. The cycle of negativity begins and continues. Meanwhile we turn to maladaptive coping strategies: alcohol, drugs, self medicating.
My own story is of a recurrent psychotic depression which first occurred 20 years ago, during the psychiatric phase of my GP training in Scotland. It recurred 8 years ago during my first year as a GP Partner in Norfolk, and again fifteen months ago when I was actually off sick with a milder depressive illness and burnout following a particularly difficult year at work.
I feel I have been particularly lucky. My first hand experience of treatment in the NHS has been fantastic. The most recent episode of psychosis was diagnosed by an excellent private therapist I was seeing who made a direct referral to the crisis team in my local area. The team consultant visited me at home the next morning and I was given intensive support for the next six weeks. I am now under the care of the CMHT (Community Mental Health Team) and my key worker is an insightful and incredibly helpful Consultant Psychologist. Medication seems to be key for me to get well, but I’ve also been able to access psychological treatment reasonably easily.
Successful outcome? Currently for me it is. That’s not to say that over the years I haven’t experienced stigma. Prior to my last episode I have seen my return to work as “the goal” and the proof that I was better. Once achieved I could put depression behind me and forget about it. The illness was my failure, my inability to cope.
As another episode started to creep in, I did my very best to push it away and keep going. I’ve sought solace in a bottle at the end of the day. I’ve experienced a shocking lack of support from my colleagues, which only reinforced my internal struggle with failure and acknowledging my illness. I also know of other colleagues who have similar experiences as well. When we find ourselves without hope and with nowhere to turn to, we are at risk of the ultimate act of desperation.
The stigma surrounding mental health particularly amongst medical professionals has to change. It underpins the reluctance to seek help when it is most appropriate, hinders recovery and a return to wellbeing.
It has only been during my last episode of depression that I have learned the value of reaching out to others who are in a similar position. I read blogs, articles and books. I would recommend following the story of Linda Gask in her excellent book “The other side of silence-a psychiatrist’s memoir of depression”.
My research has now lead me to the Doctors’ Support Network (DSN). A charitable organisation set up in 1996 by Dr Liz Miller a neurosurgeon who was diagnosed with Bipolar Disorder. Doctors’ Support Network offers peer support for any doctor with mental illness or addiction. It is run on an entirely voluntary basis and all members have themselves experienced mental ill health. The network offers a confidential forum where members exchange vital help and support, signposts doctors to relevant sources of help, and it also has a crucial role as an advocacy group highlighting the importance of recognising and treating mental illness in medical professionals.
In recent times DSN has spearheaded the &me anti stigma campaign, which encouraged senior healthcare professionals who have recovered from mental illness or addictions to speak out in order to reduce the stigma.
Accessing help will be easier too. This year sees the national roll out of the NHS GP Health Service. This service, which began in London as the Practitioner Health Programme offers free and confidential support to doctors who are unable to access help through the normal channels.
Stigma can be addressed and challenged but this work needs recognition, involvement and reinforcement. We all have to take part. For my part “My name is Susan, I am a senior GP and I have a history of depression”.
Dr Susan Atcheson is a Clinical Lead GP in a small rural practice in Norfolk with special interests in palliative care and education. She graduated from Aberdeen and worked there for a few years before moving south in 2003. She has also undertaken additional work for the Norfolk Out of Hours Service and as a Medico-legal Reports Doctor for the Charity Freedom from Torture in London. Susan is a committee member for the Doctors’ Support Network and hopes to continue to undertake work for this supportive and vital community.