One in four doctors, dentists and pharmacists – just like everyone else – will have mental-health problems at some stage. About 10 to 15 per cent of them will have a problem related to alcohol or drugs, which is again similar to the general population, according to figures from the new Practitioner Health Matters Programme (PHMP).
“Doctors are one of the most resilient groups in the healthcare system. They have low absenteeism, and sometimes they stay at work when they shouldn’t be there. The reason a specific programme was needed for doctors, dentists and pharmacists is because it’s much more difficult for them to access help. With this free programme, we want doctors to feel safe in coming forward to have their needs addressed in a non-judgemental and confidential way,” says Dr Íde DeLargy, the GP who leads the programme with a senior nurse who specialises in mental health and addiction.
Drug or alcohol abuse accounts for about half of the issues doctors need help with. Mental-health problems make up about 40 per cent and a small per centage of medical professionals abuse alcohol and drugs, according to Irish figures.
Access to prescription medicines is one factor that results in health professionals with mental-health difficulties being more likely to abuse prescription drugs than illegal drugs.
One key aspect of the programme is that it is an independent charity funded by the representative, training and regulatory bodies for the medical, dental and pharmacy professions. It replaces the Sick Doctor scheme.
“We won’t refer anyone to the regulators unless they are not willing to comply with the treatment programme and/or are putting patients at risk,” says Delargy.
The stigma of having any type of psychiatric problem is the greatest barrier to doctors seeking help. “Doctors have no problem seeking help for physical health problems but they are slow to reach out to their peers for help with mental-health or substance-abuse problems,” says Delargy.
Acceptance of alcoholism
Dr Hugh Gallagher, a GP with experience of the addiction services, is on the steering committee of the PHMP. “There is a cultural acceptance of alcoholism, and doctors – just like everyone else – have to be mindful of alcoholism creeping up on them if they drink to deal with the stresses and strains of work pressures and lack of resources.”
Gallagher says that a professional peer-to-peer support group might also benefit those in recovery.
Getting treatment early is crucial for both patient safety and doctors’ own health, Delargy says. She urges practitioners to take the lead in seeking help for themselves or their colleagues.
“The key is to present early and for us to intervene early. The longer the delay, the more entrenched the problem becomes and the person is out of work for longer,” says Delargy. “Internationally, these programmes have very high success rates and 80 per cent of practitioners recover to full health and get back to work. Some even continue to work while being supported and monitored.”
Middle-aged, mid-career male doctors and young wom en doctors with young families seek help in the greatest numbers. Dentists – particularly those working in isolated single-dentist practices, both urban and rural – are also vulnerable to mental-health problems.
Dr Hugh Kane, chairman of the PHMP, says, “Often the person in difficulty is the last person to realise they need help. We encourage colleagues, family and friends to watch out for everything from subtle warming signs to the more obvious ones. Discussing these issues with someone in difficulty can be extremely challenging, but they can also be lifesaving. Ignoring problems, as we often did in the past, benefits no one.”
The Practitioner Health Matters Programme is run from the Dean Clinic, Sandyford, Co Dublin, on Monday afternoons and Thursday mornings: practitionerhealth.ie
