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Mental Health ‘Self-Stigma’ in the GP surgery

In our last newsletter we featured a piece on mental health stigma and primary care which highlighted the ‘inward and outward facing’ nature of stigma. While much focus in recent years has been directed at tackling the ‘outward facing’ aspect of stigma - for example public anti-stigma campaigns - the ‘inward’ aspect - ‘self-stigma’ is arguably the more challenging to combat and perhaps even more so for health professionals.

Just as health professionals are not exempt from mental health difficulties, nor are we exempt from our own self-limiting experiences of mental health stigma. In fact, with regard to the medical profession in particular, rates of both mental health difficulties and associated stigma have been found to be significant[i]. The Doctors’ Support Network – a charity which provides peer support to doctors with mental health problems in the UK, carried out a 2014 survey-based study on the impact of stigma on doctors with mental health difficulties. While the sample was small (n=127), a high incidence of perceived stigma was apparent and of concern, and this was associated with decreased willingness to seek help[ii]. More than half of those surveyed (53%) reported that stigma affected how they felt about their mental health problems, and 55% reported that “stigma had affected their willingness to seek help, and that this had delayed accessing support”[iii].

Particular occupational risk factors and obstacles to seeking support for mental health difficulties have been highlighted as unique to the experiences of doctors, including the difficult and emotionally demanding nature of the job, concerns around the professional implications of mental health difficulties, and the ‘role reversal’ inherent in a doctor ‘becoming a patient’[iv]. For GPs, challenges including the impact of a pressured workload and the risk of burnout, and the practicalities of cancelling clinics have been identified in relation to the development of mental health difficulties and seeking timely support [v][vi]. Regardless of workplace or other challenges, it’s essential that all healthcare professionals recognise that mental health stigma is a barrier to getting help and support for our own healthcare needs, and can delay recovery needlessly.

Where you can find more information:

  • The Practitioner Health Matters Programme is an independent and confidential services for “any doctor, dentist or pharmacist in Ireland who has a concern about stress, burnout, mental health difficulties or who may have an alcohol or drug misuse problem” - practitionerhealth.ie
  • St Patrick’s GP portal – GP burnout film: Professor James Lucey discusses the nature of delivering a health service while taking your own mental health into account
  • A list of resources and information on where to go for help and support is available at rcpi.ie/physician-wellbeing/where-to-go-for-help-and-advice/
  • Information about different aspects of mental health and treatment options are available on our website at stpatricks.ie

References available on request; email communications@stpatsmail.com

[i] Brooks, S. K.; Gerada, C.; Chalder, T. (2011) Review of literature on the mental health of doctors: Are specialist services needed? Journal of Mental Health 1-11. DOI: 10.3109/10.3109/09638237.2010.541300

[ii] Freeman, L. J.; Sykes, R. (2014) Assessing the Impact of Stigma on Doctors with Mental Illness. Poster presentation – International Conference on Physician Health, London 2014.

[iii] Freeman, L. J.; Sykes, R. (2014) DSN Stigma Survey - Assessing the Impact of Stigma on Doctors with Mental Illness. [Accessed on 22 November, 2018 at https://www.dsn.org.uk/dsn-stigma-survey-2014.

[iv] Brooks, S. K.; Gerada, C.; Chalder, T. (2011) Review of literature on the mental health of doctors: Are specialist services needed? Journal of Mental Health 1-11. DOI: 10.3109/10.3109/09638237.2010.541300

[v] O'Dea B, O'Connor P, Lydon S, Murphy AW. (2016) Prevalence of burnout among Irish general practitioners: a cross-sectional study. Ir J Med Sci. 2017 May;186(2):447-453. doi: 10.1007/s11845-016-1407-9. Epub 2016 Jan 23.

[vi] Carpenter, L. Why doctors hide their own illnesses.  The Guardian Friday, 16 May, 2014.

[Accessed on 22 November, 2018 at https://www.theguardian.com/society/2014/may/16/why-doctors-hide-their-own-illnesses].

Author

Prof Jim Lucey

Prof. Jim Lucey is Medical Director of St Patrick’s Mental Health Services, Dublin, since 2008, and Clinical Professor of Psychiatry at Trinity College Dublin. He has been working for more than 30 years with patients suffering from mental health problems. In addition to medical management, he maintains his clinical practice at St Patrick`s, where he specialises in the assessment, diagnosis and management of Obsessive Compulsive Disorder (OCD) and other anxiety disorders. He gives public lectures and is a regular broadcaster on mental health matters on RTÉ radio, featuring on ‘Today with Sean O’Rourke’.

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