Mental ill-health in doctors is a global phenomenon. Doctors experience more mental ill health and addiction than other professional groups.
The numbers in the UK are high. A recent survey of 600 doctors by the Medical Protection Society (MPS), reported high levels of stress (75%), anxiety (49%), depression (32%) and suicidal feelings (13%).
There are higher rates of suicide in doctors than other professionals, especially in young women, who are two and a half times more likely than other women to kill themselves.
The rising number of complaints, GMC enquiries, litigation and even criminal proceedings compounds the isolation and sense of paranoia perceived by so many.
General practice is under a lot of pressure in particular. This is due to an increasingly high workload, long working hours and a more complex patient demand. Recent statistics from the BMA revealed 68% of GPs describing their workload as unmanageable and GPs being more likely than other groups to report their workload as unmanageable or unsustainable.
The evidence shows that despite this immense pressure, doctors are unlikely to access mainstream NHS services when they need support, primarily due to issues of stigma and confidentiality.
The result of doctors becoming ill, leaving the profession, emigrating or retiring early has huge economic consequences. Sickness absence, for example, costs the NHS £1.7 billion each year and presenteeism has been estimated to cost at least £2.55 billion.
There is clearly an urgent need to tackle this crisis.
With this in mind, NHS England have commissioned a new, free and confidential NHS GP health service for all GPs and GP trainees working or looking to return to clinical practice in England who are suffering with mental health or addiction issues, including stress and burnout. This went live on 30 January and so far has had 88 self-referrals in its first 2 weeks.
Evidence shows that once doctors relinquish their medical self and become patients, the outcomes are good in terms of reduced distress, reduced impairment and global improvement. This could be linked to the characteristics that constitute a good doctor in the first place, such as perfectionism and drive.
Five year follow-up data from the Practitioner Health Programme (PHP) in London shows that health practitioners treated recover at a faster rate than patients who are not doctors or dentists, and that there are improvements in mental health, social functions and numbers returning to work or training, as well as a reduction in the involvement of the regulator. These improvements persist over time and are regardless of sex, diagnostic category, or age of patient .
This data is positive. It highlights the importance of having a specific health service for doctors in place; from both a compassionate and economic perspective.
What does the service offer?
It offers an easy access, confidential, nationally consistent service to all GPs across all 13 regions in England.
Confidentiality is key. No information will be disclosed to any third party, unless there is a legal, regulatory or public interest reason to do so. The practitioner’s consent will be sought prior to disclosure.
How can I access it?
Through self-referral using either:
What can I expect from the service?
All patients will be offered a telephone assessment within a couple of days to identify their needs.
This will be followed by an in-depth assessment where a care and treatment plan will be formulated or the doctor will be signposted to other services.
Each case will be discussed in a multidisciplinary team. In some instances, further specialist assessment may be necessary and a more intense treatment package put into place.
More clearly needs to be done at local and national level to address the systemic issues within the health service and so prevent us getting to this position in the first place. However, this new GP health service is a great leap in the right direction, acting as a safety net to catch those of us that are falling, and hopefully to catch us before it is too late.
If you know anyone who is struggling or you yourself are struggling, please do reach out and seek help. It could make all the difference.
Dr Kate Little MBChB MRCP MRCGP DRCOG DFFP Dip Teaching.
Clinical Champion for Physical Activity, Public Health England
Clinical Lead for NHS GP Health service
Founder of Physician Burnout UK
Founder of Horsley Hub