May is Mental Health Awareness Month. The stigma of mental health challenges have run deep throughout societies and across centuries. Having a mental health diagnosis is often seen as a weakness or something disgraceful to be ashamed of. Although we do not approach diabetes or hypertension in this manner, mental health continues to carry a stigma that is not ascribed to other health conditions.
Mental health challenges permeate every aspect of society, and healthcare is no exception.
Over the past several years, I have read, seen, and heard of physicians struggling with mental health conditions, several of whom went on to commit suicide. In some cases, organizations have gone through great lengths to hide suicide as the actual cause of death. Despite the seemingly good intention of such secrecy to preserve the individual’s privacy, the problem is that such secrecy often does a greater disservice by further worsening the stigma already associated with mental health diagnoses. After all, such levels of secrecy do not surround deaths from other conditions like heart attacks or strokes, so concealing deaths from suicide only serves to promote the silencing and stigmata. On the other hand, there are individuals and organizations working to shed light on suicide deaths. It is great to see such initiatives to bring awareness of mental health to the forefront for individuals, families, communities, and the society at large.
During this Mental Health Awareness Month, we reflect on how COVID-19 has impacted mental wellness. When you consider how concerns about mental health among the general population have come to the foreground – pressures of the disease, social isolation, shelter-in-place, mask-fatigue, dying from the disease, etc.– can you begin to understand the trauma healthcare professionals have been enduring for the past year and a half? In actuality, this has been going on long before COVID, but the past year’s pressures on healthcare workers have intensified far beyond the norm, thus bringing the issue to a more conscious and collective awareness.
The Sad Truth
According to a study conducted by The American Journal of Psychiatry, prior to COVID-19, one doctor commits suicide in the U.S. every day. This is one of the highest suicide rates across professions. And according to the study, the number of doctor suicides — 28 to 40 per 100,000 — is more than twice that of the general population. The rate in the general population is 12.3 per 100,000. https://www.forbes.com/sites/physiciansfoundation/2018/07/18/physicians-are-human-too/?sh=662736384a29
This is not new news. In fact, according to the National Institutes of Health (NIH), the increased rate of suicide among physicians has been known since 1858, yet physician suicide has remained a silent epidemic for the past 150 years. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436060/
It is also anticipated that due to COVID-19, these numbers are predicted to show a steep increase due to the increased work demands, social isolation, decreased self-care, and increased exposure to emotionally traumatic events at work and home. At the same time, COVID-19 may also be responsible for helping to break the silence and bringing more focused attention that cultivate mental and emotional stress among healthcare professionals.
Doctors Who Admit To Having Mental Health Issues Fear Professional Repercussions
The stresses of the medical profession begin early in medical school. Medical students and residents work long hours and take call for days on end. As a woman, a woman of color, and an immigrant, I am keenly aware of the extraordinary pressures that can strain the emotional, physical and psychological capacities of those wanting to become doctors. This is why it is so critical to guard one’s health and draw upon support systems.
Unfortunately, the climate has not always allowed trainees or doctors that need help to get it. In fact, many learn early on that it doesn’t pay to acknowledge any history that would include seeing a psychiatrist or seeking help for any condition that could be perceived as a mental health disorder. Several research articles have shown that doctors and physician-trainees historically experience a high degree of job-related mental distress, depression, and burnout. A mainstream article notes that most are reluctant to seek help for a variety of reasons, including the fear of professional repercussions. https://www.forbes.com/sites/physiciansfoundation/2018/07/18/physicians-are-human-too/?sh=662736384a29
Doctors Are Expected To Be Super Human And Immune To Mental Challenges
A recent Forbes.com article states, “A resident at UCSF, Dr. Justin Bullock, who has written about and openly discussed his own experiences with Bipolar Disorder, explained that even though people would write him, and many thanked him for his story, people always suggested he be careful disclosing his mental health history. He said, “There is a palpable stigma in medicine (and in society in general), and this false notion that physicians are supposed perhuman and not suffer from the same diseases as our patients.”
It is important to acknowledge that medical professionals are human beings too, which means they are subject to the same challenges caused by traumatic events, daily stressors, inherited tendencies, etc. As the article notes, it is time, and it is integral to the health of our society in general to begin a shift “in the toxic culture of medicine that dictates physicians bury their mental health needs and deal with things internally” https://www.forbes.com/sites/jessicagold/2020/07/13/it-is-time-to-stop-stigmatizing-mental-health-among-healthcare-workers/?sh=2dcc937a7709
May 6 – 12th is National Nurses Week
Let’s not forget our nurses as well, as we turn our attention to mental health issues. Without nurses, doctors could not do what they do best. Recent studies indicate that the burnout rate for nurses is skyrocketing and in some regions of the U.S., “nearly 30% of new graduates leave the profession within 2 years.” Like doctors, nurses also experience burnout, depression and suicide at higher rates than the normal populations. https://www.registerednursing.org/articles/nurse-suicides/
Our County Is In A Mental Health Crisis
According to a survey by the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report, “As of June 2020, nearly 41% of adults in the U.S. had reported they were struggling with mental health or substance use, with 31% reporting symptoms of anxiety or depression, and 26% reporting trauma or a stressor-related disorder related to the pandemic.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7440121/
Mental Health Awareness Month is an opportunity to engage in conversations and actions to educate and dispel the stigma associated with the inevitable consequences of being human. As I’ve witnessed the loss of colleagues in the healthcare community, and the sadness and devastation it brings to families, coworkers, friends, and communities, I feel it is important to bring renewed awareness, understanding and knowledge to mental health issues. It’s time to tend to this serious epidemic.
Given past and recent suicidal events that have rocked and impacted many of us, I hope that we speak up and use this month to reflect on the impact of mental health conditions in society in general, and the even worse statistics in healthcare in particular. Speak up today – you may just save a life!