Episode 16: Mental health for health professionals

Voiceover:

Welcome to the NPS MedicineWise podcast, helping health professionals stay up to date with the latest news and evidence about medicines and medical tests.

Anna Samecki:

Hello, and welcome to the NPS MedicineWise podcast. I'm Anna, a Sydney-based GP and medical adviser at NPS MedicineWise, and today's topic will focus on the mental health of healthcare workers during the pandemic. I'm joined today by Melissa Black, a clinical psychologist from the Black Dog Institute. Hi, Melissa.

Melissa Black:

Hi, Anna. Nice to be here.

Anna Samecki:

Thanks so much for your time today. Would you mind telling our listeners a little bit more about yourself and what you do?

Melissa Black:

Sure. I'm a clinical psychologist and clinical research fellow at the Black Dog Institute, and we work across research in clinical services and education programs. And what we're working on at the moment, one of our projects is The Essential Network or TEN, which is an e-health hub for healthcare workers, and it’s an evolving project. And so we're really trying to update things as the pandemic unfolds, but also respond to the longer term needs of healthcare workers and hopefully put something in place that's quite sustainable for healthcare workers managing their mental health going forward.

Anna Samecki:

Fantastic. Thanks so much for that introduction. I look forward to unpacking more about this new initiative. Now, we all know that working as a health professional can be stressful at the best of times, but the pandemic has certainly presented a whole new set of challenges to those on the frontline, but also those working to support those on the frontline and in other capacities across the health sector. Mental Health Australia actually polled over 200 healthcare professionals this October and according to a recent article on that in Australian Doctor, almost 80% of GPs that responded, reported feeling overwhelmed and anxious. 83% reported their work stress had increased. And between 60 to 70% also felt fatigued and experienced mood swings. However, only one in five of those GPs reported that they had sought help from a psychologist or psychiatrist during the pandemic. So Melissa this means a majority of those GPs struggling are not seeking help. Why do you think that is?

Melissa Black:

Yes, those are quite worrying, but unfortunately unsurprising statistics. And I think as you said, the COVID-19 pandemic has actually just exacerbated stresses that GPs and other healthcare workers are experiencing anyway. I think one thing that's unique about the COVID-19 pandemic is that health professionals are experiencing very similar stresses to the rest of the population in terms of lockdowns and economic fallout and so on, but then have the additional stresses of being a healthcare worker and having to adapt to new ways of working, having to respond to different types of concerns in their patients, and also needing to put coping strategies in place that might be new for them, that they might not be able to, or previously in the year, not be able to use their regular coping strategies when we weren't able to go out and see our friends and unwind from work in the same way.

So I think there are a number of different things that mean that healthcare workers are experiencing a lot more stress, but some of the things that we also hear, particularly from doctors, but from other healthcare workers as well, is the stigma associated with seeking help for your mental health. A lot of healthcare workers, they're used to caring for people and they're used to putting others' needs above their own. And so this has only been exacerbated this year and we really need to break down some of those barriers for people seeking help, because we want people to be at their best for both their patients, but also for their loved ones. So there are lots of things we can do, but there is a hurdle in helping doctors and healthcare workers seek help for their mental health.

Anna Samecki:

I think you've hit the nail on the head right there. I think for me, there's at least two elements. There's the time element. So obviously healthcare workers are worked to the bone at the moment, but also seeking help has always been somewhat of almost like a taboo subject. And I feel this is somewhat driven by a fear of even being reported, for example. And we obviously don't have time to delve into all the details of that today, but I guess the fact remains that help is available and we all know it is extremely important to stay on top of our mental health. I for one, am happy to admit I reached out to a psychologist for the first time in my life earlier this year, and it certainly helped me come to terms with becoming a new mum and juggling professional roles in this challenging time. But I also understand that others may not be as forthcoming in seeking help, but there is help available. So Melissa, can you talk us through some of the things that are available for health professionals.

Melissa Black:

That's right. There are a number of different routes by which people can seek help for their mental health. I guess I can talk about it in the context of The Essential Network, because we've tried to pull it all into a centralised e-health hub. So I think the first port of call is being able to recognise when you are experiencing mental health that's getting in the way of your everyday life. We know that there are fluctuations in stress and low mood and anxiety over time, but if those things are getting in the way of your work, or your family life, your relationships, coping day-to-day, then it's probably time to seek help. So, first of all, recognising when there might be a problem, and we have some self-assessment tools available through the Black Dog Institute for people to check in on mood, anxiety, post-traumatic stress, things like alcohol and drug use as well.

There are also a number of self-support resources. So evidence-based tools that people can use to develop self-care plans, undertake mindfulness activities or meditations, put exercise plans in place, manage finances, or how to talk to children about the pandemic. We know there are lots of different stresses. And then of course, the one that you're talking about Anna is reaching out for professional supports and there are a range of ways to do that. So seeking help through your own GP and I think that's something really important to recognise. We've heard from lots of health professionals, particularly doctors that they like to self-diagnose, but having your own GP is really important. Someone you can go and check in with.

And from there, there are a number of psychiatrists and through The Royal Australian and New Zealand College of Psychiatry, they've actually flagged a number of psychiatrists who are available and willing to see healthcare workers. So that's one port of call, and then there's also the Australian Psychological Society and the Australian Clinical Psychology Association that have databases of psychologists so that people can access help.

One of the other really important things that we're hearing from healthcare workers is the importance of peer support. And Hand in Hand is an organisation that's come up this year. They're a great group of doctors in Queensland, but they're working nationally to develop peer support networks because one really important thing for healthcare workers is that people get it. They want other people who understand their experiences to check in with, to provide some reassurance, and also to prompt them if they are potentially entering burnout or a crisis or something. So being able to check in with a peer at that first port of call to access support as well.

Anna Samecki:

Those are all really fantastic tips. Thanks, Melissa. As mentioned, we don't have a lot of time to get into mandatory reporting, but Melissa, can you tell us a bit more about why doctors shouldn't fear seeking help?

Melissa Black:

Sure. I mean, it is a really common concern. We hear from doctors all the time that they're worried that there might be implications if they do admit to experiencing mental health problems, but really as clinicians, what we're worried about is can someone do their job and can they do it safely? So we're interested in any patient or colleague safety concerns as well as concerns for the individual, but really seeking help is such a positive step. If someone is getting support for their mental health problems, if they're checking in with their own GP or a doctor or clinician regularly, and there are supports in place in the workplace, then people can continue to practice with those supports and there aren't concerns in terms of patient safety. So we would really encourage people to seek help because that's actually demonstrating that you're able to recognise there are difficulties and put supports in place so that things don't get worse and things don't escalate into a crisis.

Anna Samecki:

Thanks for that, Melissa. I think that's really important for our listeners to hear today.

I guess the last thing I wanted to quickly touch on is we've spoken a little bit about the professional formal things that healthcare workers can do. But I mean, as health professionals, we do know about how to stay healthy, but sometimes we don't really practice what we preach. So what are just some simple ways that health professionals can help manage their stress during this time and look after their mental health?

Melissa Black:

Yeah, great question. It's really going back to some of the basics in terms of make sure you're getting enough sleep and also putting things in like a wind down routine before sleep. We know lots of people work right up until bedtime or they're on the phone or engaging with social media. So having that wind down routine is really important. Also, getting enough exercise and that doesn't need to be lots of vigorous exercise, but getting out, getting some fresh air, moving your body. If you can combine that with communing with some nature, that's really helpful as well. Connecting with loved ones and friends is really important. Of course, in this time, it's a little bit trickier. And particularly for our colleagues in Melbourne, it's really challenging, but scheduling in some times. And it doesn't necessarily need to be a formal check-in. It might be things like connecting with someone and watching a Netflix sequel together or something like that or doing a quiz.

And then the other thing is setting aside some time to engage in pleasant and achievement-based activities. Lots of people enjoy things like mindfulness or meditation, but that also doesn't work for lots of people. A great doctor who's a part of our project, Dr Tracy Smart, who was previously the surgeon general of the ADF. And she described, she didn't like mindfulness and meditation, but she loves working with Lego. And for her, that's a form of mindfulness because she's really engaged with it. She's working with her hands, she's working towards something, and it's about being creative about what can you engage with outside of work to really switch off, but also get that sense of pleasure and achievement in your activities.

Anna Samecki:

Thank you so much, Melissa. I think that's been wonderful and thanks for all the great tips and thank you to our audience for listening. If this podcast has raised any concerns for you or a loved one, please contact Lifeline on 13 11 14. You can also find more information about The Essential Network on the Black Dog Institute's website, and you'll be able to find a link below this podcast. Thanks again.

Melissa Black:

Thanks Anna.

Voiceover:

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