In health is worse amongst doctors. In addition,

In conclusion,
the mental health of doctors and primary care givers deserves a specific
treatment pathway, which is more specialised than that of the general population.
This is to allow the workers in medicine to be able to obtain treatment that
has been specifically designed to combat the stressful and extremely consuming
work environment that is present in medicine. Although the figures comparing
the occurrence of mental health disorders in doctors and the general population
vary, it can be determined by the vast majority of research that the conclusion
is that mental health is worse amongst doctors. In addition, researchers are in
agreement that treatment of doctors is vital as mental illness will affect the efficiency
of their work and, as a result, their patients. They also agree that doctors
are made aware of a limited amount of helpful resources in the event of a
mental health problem, and that there aren’t enough options which provide doctors
with specialised support. Due to this, the focus should be shifted away from the
rate of mental health illnesses in doctors, and should instead be on the treatment
of mental health in doctors, and how to minimize the occurrence of mental
health problems in medicine.

Unclear
information on where to find help is actually a major concern when it comes to
combating mental health disorders in primary care givers. Many young doctors
are unsure as to what the role of occupational health services are (Baldwin et
al-1997). This creates a barrier, as these doctors are unable to get help early
on, resulting in a deterioration in mental health over time. Therefore, early
detection is a vital part in combating mental health problems in medicine.
However, there are no reliable predictors of mental health problems, so early
detection may prove more difficult than anticipated (Tyssen and Vaglum-2002).
As a result, the medical profession must make an active effort to encourage the
use of mental health services by primary care workers.

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Currently, we
do not have good national data surrounding the services doctors actually use.
It is known that many junior doctors are not registered with a GP, which is
probably due to job mobility required by them. Regardless, doctors are shown to
prefer discussing their conditions informally with co-workers- known as
“corridor consultations.” This means that many doctors do not have documented
health documents regarding their physical, and mental, health. Doctors with
mental health problems can be referred to specialists on a case-by-case basis.
Doctors also have access to treatment specifically designed for them. The
British Medical Association created a telephone line specifically for doctors,
and is run by doctors (BMA-2006). Although there are these helplines available,
they are often not easy to find, and are not presented to doctors commonly.

The question
arises as to why doctors are not seeking help for mental health problems. The
first major reason is thought to be that doctors self-diagnose themselves and
self-prescribe (British Medical Association-1998). This is a concern as
self-diagnosis isn’t accurate, so the doctors can be affecting their health
negatively. There is also a reluctance to seek help due to the stigma
surrounding mental health in the medical profession. The general consensus
shows that doctors believe that good doctors do not make mistakes, and that
illness is considered to be weakness (McKevitt C and Morgan M 1997). There is
also the pressure that showing vulnerability will decrease respect amongst
peers, which is particularly concerning to junior doctors. These concerns lead
to doctors concealing any mental health problems due to concerns regarding the
future of their career, which they rely on for their livelihood.

One main
concern to be considered is how mental health disorders in our doctors is
affecting the care provided by them. Doctors themselves have reported that
stress impacts their ability to provide high quality care. The careers of
doctors can also be shortened due to mental health problems, which reduces the
number of doctors available to treat patients. In fact, 40% of doctors taking
early retirement are due to psychiatry problems (Pattani S, Constantinovici N
and Williams S-2001). However, poor performance and early retirement are not
inevitable consequences of mental health problems. It is estimated that three
quarters of doctors with alcohol problems could return to work if provided with
proper help (Lloyd G-2002).

Clearly, there
is a significant amount of research available which supports the fact that
mental health is a big problem amongst primary care givers in medicine.
However, most of the research conducted have low sample sizes, indicating that
they may not be entirely accurate and reliable. Additionally, although a lot of
the research have the same conclusion, they all differ in the fact that they
all focus on a specific group of professionals. Therefore, it isn’t possible to
determine figures for mental health in medicine as a whole. Another problem is
that the figures comparing doctors to the general republic vary from source to
source, meaning it isn’t entirely possible to determine the accuracy of any
statements made though these comparisons. Despite this, we can still be sure
that there is a problem surrounding the mental health of doctors, as proven by
the sheer amount of research which conclude the same statement. Therefore, it
seems that observing doctor’s mental health, and providing insight in their
vulnerability to it, may be the best cause of action to reduce the number of
mental health cases amongst primary care workers.

Young doctors
seem to have a significantly higher chance of mental disorders probably due to
the high workload, and the stress of the medical career. This is probably why
stress and fatigue rates are incredibly high amongst junior doctors (Rout U-1999).
In addition, research suggests that junior doctors are more likely to observe
addiction in their career if they had addiction problems during medical school
(Marshall-2008). This suggests that the stress related to medicine is highly
linked to the occurrence of addiction and/ or drug reliance (Marshall-2008). As
a result, it can be concluded that there is a need for observance and guidance
of mental health amongst medical professional from the start of their careers.
In addition, conducting medical training which emphasis the vulnerability
surrounding the mental health of doctors, and establishes clear protocols for
how to deal with mental health concerns, is vital in order to reduce the
occurrence of mental disorders amongst health care professionals (Hassan et
al-2009).

Depression is
another major mental concern surrounding doctors. It is estimated that between
10-20% of doctors in the United Kingdom will develop some form of depression
within their career as a doctor (Firth Cozens-2006). In addition, a survey sent
around NHS 16 NHS doctors found that 68% of the participants had a diagnosis of
depression (Miller- 2008). The survey also found reports of anxiety, burnout,
and eating disorders.

Although
figures do vary, doctors are shown to be at a higher risk of mental disorders
when compared to the rest of the population (Williams S, Michie S and Pattani
S-1998, Wall T D et
al-1997, Ghodse H-2000).
Doctors have been shown to be particularly prone to disorders such as anxiety (Kroenke
et al -2007), alcohol abuse and drugs. In fact, it is thought that up to 7% of
doctors will have a substance abuse problem within their lifetime (Brooke D,
Edwards G and Taylor C -1991, British
Medical Association-1998). Additionally, the doctors access to prescription
drugs may be a key factor in the elevated risk of suicide amongst doctors,
specifically in GPs and psychiatrists (Hawton K et al.-2001, Richings J C,
Khara G S and McDowell M-1986). Their access to prescription drugs also can
lead to doctors self-prescribing and self-medicating (British
Medical Association-1998).

The research
presented in this narrative review is based upon the epidemiology of mental
health in doctors (and in medicine in general) and will reveal the prevalence
and risk factors of mental disorders in doctors. Through research we will be
able to also consider the obstacles that doctors who suffer from mental health
illnesses face, and how or if they are prevented from seeking professional
health.