SPECIAL FEATURE
DOCTORS’ MENTAL HEALTH RESOURCES
Emergency numbers
Lifeline: 13 11 14 This is a 24-hour national hotline for people experiencing suicidal ideation, anxiety, depression, abuse, trauma or personal crisis.
Suicide Call Back Service: 1300 659 456
This 24-hour, 7-day-a-week service provides free counselling for anyone affected by suicide.
Beyondblue Support Service: 1300 22 4636
A 24 / 7 support service offered by mental health professionals.
Confidential advice
Doctors’ Health Advisory Service
All state and territory services have a special helpline for calls relating to stress, mental illness, drug and alcohol problems, or personal and financial difficulties. The service guarantees privacy and confidentiality. The Medical Board of Australia funds these services, but the AMA administers the programs through its subsidiary company, Doctors’ Health Services, to keep them at arms length from regulators.
The services also offer GPs training for treating colleagues. Workshops can be found at the website: www. drs4drs. com. au
NSW: 02 9437 6552
ACT: 02 9437 6552
NT: 08 8366 0250 Queensland: 07 3833 4352
SA: 08 8366 0250
Tasmania: 03 9495 6011
Victoria: 03 9495 6011 WA: 08 9321 3098
Awareness campaigns
Doctors Are Humans
This new blog is run by doctors in training. It wants to encourage doctors and medical students to share their struggles and triumphs in medicine to reduce the stigma surrounding mental health. The blog also aims to come up with ideas to improve workplace culture and safe hours. doctorsarehuman. wordpress. com
BPT-OK Program
The pilot program is being run at the Royal Prince Alfred Hospital in Sydney. It aims to teach doctor-trainees to recognise, prevent and manage stress. The program will include mentorship and workshops covering stress management, meditation and healthy exam preparation. http:// bit. ly / 2rP5FvY
Doctors’ Mental Health Program
The mental health charity Beyondblue’ s program aims to raise awareness of the issues affecting the mental health of doctors and medical students. It is currently working on a blueprint for change to help healthcare providers identify and reduce the barriers to help-seeking and to better protect the mental health of their employees. http:// bit. ly / 2dvmN7m
‘ Bullying, exam stress, burn-out. I still struggle to get up every day’
THE FIGHTER
Dr Kate Johnson is a senior registrar in Sydney, NSW. In response to a recent spate of physician suicides, she set up the‘ Doctors Are Human’ website with three other doctors. It offers doctors a public space to share their experiences, and gain support and inspiration.
IT is hard for me to tell this story. A voice in me says,‘ no one cares’,‘ what would you know anyway?’ and‘ you have no right to enter this discussion.’
I’ m afraid of inciting personal criticism for my flaws and mistakes, of people recognising me, of being exposed as a failure and blacklisted by potential employers.
However, I have decided to share my story because I think this is important.
I want to open up the dialogue to people who are struggling in silence, because arguably, these are the people we need to listen to if things are to change.
To introduce myself, I am a female doctor, who works in Sydney, but did not grow up here. As a result, my current social network consists entirely of associates and a few friends, who I see infrequently.
There is no one to whom I tell my secrets, except my psychologist. Through my psychologist, I have become conscious of how my negative cognitive style and negative core beliefs influence my experiences.
I am also socially anxious and introverted. I struggle with confidence and am not a natural leader. So, stepping up to work as a registrar presented a challenge in itself, and these factors certainly coloured the experiences that follow.
I started as a registrar in 2015, as a green and optimistic PGY3. My first term was in a tertiary centre and went well. I hadn’ t a clue what I was doing, but I felt supported.
In the second term, however, I was seconded to a rural centre and the story was very different.
Three days into the term, one of the trainees had to take time off due to family illness, throwing the roster into chaos.
It changed five times during the 13 weeks and I ended up with a disproportionate number of nights and a run of 11 long days, with little support from the consultants.
Needless to say, I remember reaching shift 8 or 9 in an emotionally labile state. My response to a question about a catheter was to burst into tears!
More serious incidents took place, too. Midway through the term, I tried to advance a nasogastric tube and perforated a patient’ s diaphragm.
Another weekend, a patient died on my shift due to delayed identification of hypoglycaemia. Then, being tired after a night shift, I chose an unsatisfactory article for journal club.
All in all, I really wasn’ t a favourite. A particular consultant felt so anyway when he decided to call the intern for all communications, not me. Then, when the intern broke down, I made the mistake of confronting him about it. This led to various meetings, discussing my lack of competence.
The final straw— with a 30-patient list— was that I was struggling to teach my JMO prioritisation skills and because of a delayed consult, another consultant started complaining about my competence.
My end-of-term feedback was; if you don’ t improve dramatically, you should seek a new career.
Shift-work meant I barely saw the other registrars. I remember feeling very isolated out there, and experienced none of those fables where friendly consultants invite you to their homes for dinner or take you to see their farm.
I coped, as always, by exercising, listening to audiobooks, retail therapy and ranting at my friends over text.
But I felt overwhelmed, hopeless and trapped.
I didn’ t see any future worth having, yet I didn’ t want to burden my hard-working parents with grief should I die.
‘ I WANT TO OPEN UP THE DIALOGUE TO PEOPLE WHO ARE STRUGGLING IN SILENCE.’
Instead I took several promethazine so I could sleep for a while, and forget.
When I confided in my more senior registrar friends, they nodded knowingly; at least one term like this was to be expected.
I didn’ t seek help from the program director till quite late in the term. I didn’ t trust them and I was ashamed. And when I did, I received no substantive support.
To be fair, the supervisors at my home hospital were kind people, who were more overworked, burnt out and exhausted than me, and that is probably a large part of the problem.
Further challenges awaited me in the following year. Bullying. Exam stress. Burn out. I still struggle to get up everyday, to see a future, but I am learning to question my pervasive negativity and to seek opportunities, despite potential failure.
I hope by sharing this story I am able to help others who feel alone and unsupported. I also hope that by inspiring others to do the same, we might encourage those in power to embrace the multiplicity of reasons why suicide happens( both individual and systematic) instead of looking to a list of two or three tick-box solutions before moving on.
Getting rid of mandatory reporting and putting an exercise program in place is not enough.
Perhaps this way, THIS time, we will achieve change.
PHOTO: Steve Christo
4 | Australian Doctor | 2 June 2017 www. australiandoctor. com. au