'Doctors as Patients'

‘Doctors as Patients’ : Exploring the barriers and facilitators to help seeking for mental health problems by GPs and improving access to support 

Written by Marta Buszewicz, originally posted on the UCL Primary Care blogsite

The primary care mental health research project which I’m going to describe in this blog is an NIHR School of Primary Care (SPCR) funded study which is still underway.

There has been a great deal written in the press about the considerable and increasing work pressures which general practitioners (GPs) in the UK are currently under, along with  significant financial constraints and difficulties recruiting sufficient new GPs to replace those who are leaving or retiring. Something which has been explored less are the emotional and mental health difficulties experienced by many GPs, which they are often reluctant to disclose or may feel unable to seek appropriate help for. There is evidence that doctors, including GPs, are more likely than the general population to experience mental health symptoms such as anxiety, depression, stress and burnout.

This qualitative study involved 47 interviews with a wide range of GPs recruited from a variety of locations and including the following groups: those currently living with anxiety, depression, stress and/or burnout; those returning to work following treatment for such conditions; those off sick or retired early due to mental health problems and those who have not personally experienced mental health problems but were interested in the project. The study proved quite easy to recruit to, with so many GPs approaching us wanting to take part that we had to turn quite a few away after interviewing more than the initial recruitment target of 40 participants. I think this indicates how many practitioners are likely to be suffering in silence, and who welcomed the opportunity to speak in confidence to an empathic researcher about the problems which they were experiencing.

The research team were struck by the very high levels of stress, depression and anxiety experienced by many of those interviewed. It was also clear that many felt quite isolated, and that it was difficult for participants to acknowledge their difficulties within the practices they work in for fear of burdening the other doctors working there. It is also very difficult for many GPs to seek professional help for their psychological problems, as they often have concerns about confidentiality if the GP they are registered with is someone who they know locally in a professional context. Many GPs are reluctant to take time off sick because of the impact this is likely to have on their colleagues’ workload, as well as difficulty getting appropriately qualified locums in the current climate.    

We have now finished interviewing all the participants and the analysis is underway. Preliminary results were outlined in a recent British Journal of General Practice (BJGP) editorial.       http://bjgp.org/content/66/648/344

 An innovative component of our research project is that it has also informed two performances in November at an Arts Festival in Bristol -

http://www.bristol.ac.uk/blackwell/public-engagement/feel-it/

This is further described in a recent BJGP blog

http://bjgpblog.com/2016/10/18/performance-informed-by-research-into-gp-wellbeing/

In writing up the final results from this project and describing and discussing the various issues involved, we aim to highlight the emotional component of most GPs’ workload and encourage the primary care community to openly recognise this and be more supportive of each other. We also plan to make recommendations which can inform the provision of appropriate services for distressed GPs and which they can access without necessarily going through their GP if confidentiality is an issue.

I will give further details when the results of the study have been published.  It is being led from Bristol – further details of the project and the study team are available via this link

http://www.bristol.ac.uk/primaryhealthcare/researchthemes/improving-support/

This blog describes independent research funded by the National Institute for Health Research School for Primary Care Research (NIHR SPCR). The views expressed are those of the author(s) and not necessarily those of the NIHR, the NHS or the Department of Health.