The Mental Health Crisis Among Doctors Is a Problem for Patients

Keren Landman

vox.com

Originally posted 25 OCT 23

Here is an excerpt:

What’s causing such high levels of mental distress among doctors?

Physicians have high rates of mental distress — and they’re only getting higher. One 2023 survey found six out of 10 doctors often had feelings of burnout, compared to four out of 10 pre-pandemic. In a separate 2023 study, nearly a quarter of doctors said they were depressed.

Physicians die by suicide at rates higher than the general population, with women’s risk twice as high as men’s. In a 2022 survey, one in 10 doctors said they’d thought about or attempted suicide.

Not all doctors are at equal risk: Primary care providers — like emergency medicine, internal medicine, and pediatrics practitioners — are most likely to say they’re burned out, and female physicians experience burnout at higher rates than male physicians.

(It’s worth noting that other health care professionals — perhaps most prominently nurses — also face high levels of mental distress. But because nurses are more frequently unionized than doctors and because their professional culture isn’t the same as doctor culture, the causes and solutions are also somewhat different.)

The info is here.

Here is my summary:

The article discusses the mental health crisis among doctors and its implications for patients. It notes that doctors are at a higher risk of suicide than any other profession, and that they also experience high rates of burnout and depression.

The mental health crisis among doctors is a problem for patients because it can lead to impaired judgment, medical errors, and reduced quality of care. Additionally, the stigma associated with mental illness can prevent doctors from seeking the help they need, which can further exacerbate the problem.

The article concludes by calling for more attention to the mental health of doctors and for more resources to be made available to help them.

I treat a number of physicians in my practice.

Should Doctors Be Tested for Competence at Age 65?

By Leigh Page
MedScape
Originally published October 28, 2015

Should older physicians be forced to stop practicing once they begin to slow down? Some experts in competency testing are calling for doctors to be evaluated as early as age 65, arguing that that's when physical and mental disabilities start to become apparent.

A few hospitals have already started evaluating physicians in their 70s for competency. When results show significant impairment, these physicians are required to get remediation, submit to limitations of their privileges, or retire completely, depending on the severity of the impairment.

Some experts argue that the cutoff age for these exams should be 65 years, which would have a huge impact on America's doctors. Owing to the baby boom, 240,000 doctors are now in that age group—a fourfold increase since 1975, according to the American Medical Association (AMA).

In June 2015, delegates to the AMA decided to bring together stakeholders to create guidelines for such testing. But other physician groups are still on the fence, and the issue divides the medical community.

The entire article is here.

Practicing School Psychology While Impaired: Ethical, Professional, and Legal Issues

Emery B. Mahoney, Richard J. Morris
Journal of Applied School Psychology 
Vol. 28, Iss. 4, 2012
DOI:10.1080/15377903.2012.722180

Abstract

Studies on impairment in psychologists and other mental health practitioners began appearing in the literature 30–35 years ago. Since then, research and related scholarly writings have continued to be published to more fully understand this concept and its components. In school psychology, however, little has been written regarding school psychologists’ delivery of psychological services while they are impaired. This is true even though the provision of such services violates numerous ethical principles and standards of professional conduct in the ethics code of the National Association of School Psychologists and the American Psychological Association. In this article, the authors review the prevalence and incidence data regarding impairment, as well as definitional issues regarding what constitutes impairment. Ethical and legal issues associated with practicing while impaired are also discussed, followed by a discussion of assessing risk for impairment in school psychologists and the presentation of a self-administered risk assessment scale on the basis of empirical and other literature in the area of ethics and professional standards in the practice of psychology. Future directions for developing an agreed-upon definition of impairment within the field of school psychology and future directions for research on assessing and predicting impairment in school psychologists are discussed.

(cut)

It is unfortunate that there is a paucity of research investigating impairment issues as applied specifically to school psychologists. As a result, on the basis of empirical research and risk assessment models developed with psychologists practicing in mental health clinics, private practice, and hospital settings, we have presented in Figure 1 the Instrument for Monitoring Psychologists’ Awareness of Impaired Responding (IMPAIR).

The entire article is here.

Colleague Assistance

A recent article in the Monitor on Psychology by Rebecca Clay highlights several important points about colleague assistance and your ethical responsibilities as a psychologist.  The article features our own Sam Knapp.

The article, When A Colleague is Impaired, can be found here.  A portion of it is reproduced below.

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A psychologist friend of yours is undergoing a divorce so wrenching, you sense she can barely get up in the morning, let alone provide effective therapy.

A colleague in your building stumbles as he walks down the hall, and you smell alcohol on his breath.

You’ve heard that an older colleague has become forgetful, sometimes seems confused and has even fallen asleep during a session.

How do you ethically handle such scenarios?

APA’s Code of Ethics requires psychologists to recognize when their own personal problems might interfere with their effectiveness and take action. But when it’s someone else who has the problem, knowing what to do can be difficult.

“On the one hand, people want to do something; on the other, they don’t want to get someone in trouble where they might lose their license,” says Michael O. Ranney, executive director of the Ohio Psychological Association. “For many people, it’s a difficult ethical dilemma — what to do and how to do it.”

The approach Ranney and other experts recommend? Step in early and take advantage of a colleague assistance program or other forms of help offered by your state, provincial or territorial psychological association (SPTA). Reporting someone to the state licensing board should be a last resort, they emphasize.

Preventing problems

Getting other psychologists the help they need is an ethical duty just like getting help for yourself, says Stephen Behnke, JD, PhD, director of APA’s Ethics Office.

“All of our training, all of our experience is to promote health and well-being, and that should begin in our own community of psychologists,” he says. “It absolutely should be an ethical responsibility that we take on as psychologists to be that supportive community to our colleagues in distress.”

Stopping problems before they escalate is key, Behnke and others agree.

One way to do that is to develop and maintain a network of social relations with other psychologists, says Sam Knapp, EdD, director of professional affairs at the Pennsylvania Psychological Association. Work on meeting your colleagues and reach out to them in good times and bad.

“If you find out that a colleague has just had a death in the family or a divorce or some kind of event like that, send them a card or call them up and express condolences,” says Knapp. “Ninety-nine percent of the time they’re not going to slip into impairment, but they’re going to appreciate it and feel that they can confide in you about other things.”

It’s not just personal issues that can cause problems, he adds. A patient’s suicide, for example, could plunge a psychologist into depression.

Once other psychologists become comfortable with you, says Knapp, they might ask for a referral for therapy or substance abuse treatment. They might seek consultation on a case they’re having trouble with. Or they might just want someone to talk to.