I want to start this piece by posing a few questions about mental health stigma in healthcare. Not with the intention of causing a divide or debate, but rather to provoke and stimulate a reflection of our own misconceptions and unconscious biases. Would you be happy to be treated by a Doctor who had schizophrenia or bipolar? Would you want to receive care from a Nurse who suffered from crippling anxiety and depression? Would you care if your Physiotherapist had a long-term diagnosis of anorexia or bulimia? I ask these questions with the intention of generating a more positive outlook amongst patients and healthcare providers on mental illness. This issue is complex, and one I know is a very sensitive topic to many people. Reader discretion is therefore advised. My subsequent response would be this: Does it matter? Does it affect their ability to work and treat you? Would it affect the relationship you have with your colleague?
Healthcare providers are held to very high standards not only by their governing bodies, but also by the public. They are rigorously and regularly assessed for competency and fitness to work. We no longer live in the Harold Shipman era, where trusted doctors can get away with overdosing patients on opioids. However, one thing that these organisations and the public forget, is that we are still human. We are fallible, we are prone to stress and at times can experience burnout. It is during these times when we are most mentally vulnerable. It isn’t uncommon for healthcare professionals to go on sick leave as a result of stress, in fact it’s on the rise. Because we are held to such high standards, it shouldn’t matter if the person treating you suffers from depression. If their mental health was suffering so much that they might make mistakes, they would not be at work.
Another issue that is commonplace amongst those with mental illnesses is that they’re just seen as a diagnosis. They often don’t see past that and ignore the real person in front of them. A diagnosis is commonly used as a label. Misconceptions surrounding the diagnosis stigmatises, discredits emotions and makes people feel less deserving of care. This can happen for colleagues as well. Imagine for a moment that a peer called in sick and took time off work with a broken leg. What would your reaction be? Would it be one of sympathy or would you feel frustrated and annoyed that they slipped on some ice at home? Imagine if a colleague called in sick as a result of stress, or because of a relapse in their mental health. Would your reaction be the same? We rarely stigmatise physical illnesses or injuries, so why should we do the same for mental illnesses? Who are we to judge if our colleague has to take time off work because they’re literally too burnt out to do their job properly. They are making a safe decision to not come into work and taking responsibility for their mental health. I know from personal experience how challenging this can be.
I’d like to think that the conversation surrounding mental illness in the healthcare profession is changing for the better. In general, people are becoming more aware of these issues. There is now a larger drive than ever encouraging people to be kind, to reach out and to talk about their feelings. Despite all this, however, the suicide rates among doctors and nurses are still shockingly high. As a doctor, I am not only representing myself in work, I am representing the profession as a whole as well as the NHS and my governing body. We are expected to maintain a positive and confident image, whilst showing adequate empathy to patients. There have been times in work where I have been near breaking point. I have been able to maintain a caring, compassionate and kind temperament at the bedside, only to slip into the store room to cry. This kind of emotional labour is rife within the field of healthcare. It’s no wonder why suicide rates are so high in my field of work.
A consultant once told me that mental illness should be used as a form of strength, rather than a weakness to dwell on. I reflected on this for a while, and simply had to agree with him. Considering how far I have come since my diagnosis, I am proud of what I have achieved. My mental health has had its ups and downs, but with the appropriate help, I have always come back fighting. Being a doctor, it is never easy to admit defeat and take time off work when ill, but this is so important. It’s important not only for self-preservation, but for the duty of care to my patients. I care for people for a living which is one of the toughest things to do. I do my job with as much love and compassion as I can give. I make big decisions at times, and these can be very difficult to make when I am stressed. However, I can do my job just as well as the next doctor, as can any healthcare professional with a mental illness in their field. I strive to do well in my career, in spite of my mental illness. I try not to dwell on the negatives, rather I reflect on the past and utilise what I’ve learnt to be a better, more positive doctor in the future.