Embracing Mental Health Issues in Healthcare Practitioners
Doctors with mental health problems and addictions face the stigma of being considered “weak.”
The mental health of physicians has been neglected for so long that it has become a national epidemic, cautions Adam Hill, MD, Associate Director of the Pediatric Residency Program at Indiana University School of Medicine in Indianapolis.
Doctors with mental health problems and addictions face both the stigma of being considered “weak” and a system that prevents them from getting the help they need, he says.
The result is that not only do their mental health issues go unaddressed, but they also often deal with additional feelings of brokenness, guilt, and shame that can lead to suicide. “When you live with such a condition, you're made to feel afraid, ashamed, different and guilty. Those feelings remove us further from human connection and empathy,” says Dr Hill.
Like 2 of his colleagues who had mental health conditions and recently committed suicide, Dr Hill himself has had suicidal ideation and has a history of depression and alcohol addiction. However, he stories his journey as one of recovery, and wants to make sure that other physicians with similar problems do not feel alone.
Last year, Dr Hill shared his story at a 200-person grand-rounds lecture at his hospital.
“I had been living in fear, ashamed of my own mental health history. When I embraced my own vulnerability, I found that many others also want to be heard — enough of us to start a cultural revolution,” said Dr Hill.
His recovery process has taught him several important lessons, including the importance of self-care and of creating a plan to deal with struggles. Part of this plan involves setting boundaries between personal life and work. In Dr Hill's case, it meant establishing priorities that reflect his identity first as a human being, husband, and father — and only then, as a physician.
“I learned that I must take care of myself before I can care for anyone else,” Dr Hill said.
Another lesson his experience with alcohol addiction taught him is that stereotypes — for example, that alcoholics are “bums” who live under bridges — often are not true, and that mental health “has no prejudice.” This understanding helped him to see each person's unique story, he says.
Stereotypes not only help keep providers with mental health issues in the closet, they also place patients at risk, Dr Hill wrote.
“The professionals who pose a risk to patient safety are those with active, untreated medical conditions who don't seek help out of fear and shame,” he said.
Finally, Dr Hill said that being open about his story and allowing himself to be vulnerable has led to personal growth, compassion, and connection. He now seeks employment only in supportive workplaces, and said that he finds that the benefits of authenticity outweigh the risks.
“When a colleague dies from suicide, we become angry, we mourn, we search for understanding and try to process the death… then we go on doing the same things,” he writes. “It's way past time for a change.”
- Hill AB. Breaking the Stigma — A Physician's Perspective on Self-Care and Recovery. New England Journal of Medicine. 2017; 376: 1103-1105. doi: 10.1056/NEJMp1615974