The recent suicide of a prominent physician in Brisbane, Australia sent reverberations of shock among the medical fraternity globally. Sadly, this has been seen time and time again. Suicide, especially in Asian societies is a taboo topic. Unfortunately, this is magnified when it involves doctors, who are considered the very pillars of a nations’ health and progress. It is high time to realise that doctors are not infallible, and in fact, more vulnerable to suicide and other mental illnesses than the very patients that they dedicate their lives caring for.
The question remains, who monitors the mental wellbeing of doctors?
The research has repeatedly concluded what we already know: that doctors, and in particular, female doctors, have a significantly higher rate of suicide than the general public.
It is ironic that while spending hours in hospitals each day, doctors neglect their own need for psychiatric or medical help. Doctors also have access to lethal drugs, and the knowledge of more effective methods of suicide which may contribute to the statistics. Female doctors are particularly vulnerable, as they are subjected to the added burden of balancing home life with their work responsibilities.
One glaring question remains to be answered: are we, in Malaysia, more critical of doctors who seek psychiatric help? This unfortunately is reported by doctor-patients, who are labelled as “problem doctors” among their colleagues and ridiculed at times. As doctors, we have a well of empathy for our patients and are compassionate beings. However, when our patient in question is a doctor, the well seems to dry up.
As a psychiatrist, one burgeoning aspect of my job is dealing with doctors who are undergoing psychological distress. This is a double edged sword for the doctor-patient, as they face unique barriers that other patients from the general population don’t. A doctor who seeks help has the right to be treated as any other patient would. However, there are ethical and legal aspects that need to be considered as well. The capacity of the doctor-patient has to be assessed, and their ability to fulfil their professional responsibilities with reasonable safety has to be determined. So how is this done without compromising the therapeutic alliance between a psychiatrist and their patient, and more importantly, confidentiality? Will a doctor in distress confide in their treating psychiatrist knowing that their superiors may be informed?
A step in the right direction was by the dissemination of guidelines by the Malaysian Ministry of Health on managing impaired doctors. This will lead to a more cohesive, standardised method of management between hospitals nationwide.
The real tides of change, however, lie in the hearts and minds of each doctor. After all, humanity is a prerequisite in medicine. Our colleagues are killing themselves, and we have the power to stem this tide. A kind word to colleagues who are struggling and superiors that encourage, not admonish, their doctors to seek help could make all the difference. It could even save a life.
Dr Sumeet Kaur (MBBS, M.Psych. Med. (UM)) is a Clinical Psychiatrist and Medical Lecturer at University Sains Islam Malaysia and Hospital Ampang.
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]