Mental Health of Doctors Across the Globe: Literature Review

This literature review explores the poor mental health of doctors across the globe due to the nature of their work, including burnout, stress, depression, and suicidal thoughts. It identifies various factors contributing to their vulnerability and suggests interventions to promote their mental well-being.

Mental health of Doctors
across the globe

Literature Review
Mental health of doctors has been shown to suffer across the globe due to the nature of their
work. The poor mental health of the doctors is depicted by increased cases of burnout, stress,
depression, and suicidal thoughts among health professionals. In particular, various reasons have
been identified for the vulnerability of Doctors to mental morbidity, which are busy schedules,
multiple role compulsions, emotional taxing, etc. The stress at the workplace can impact the
mental well-being of the health professionals by limiting their proficiency and having a negative
influence on their overall quality of life. One of the studies conducted in Nigeria found that there
was a prominent absence of workplace stress management strategies in a healthcare setting. It
was revealed that the doctors frequently remark a failure to show interest by the management
about their mental state. Study also identified certain important factors which assisted in
reducing workplace stress were need to promote and morally reward the workers and also give
them the opportunities for continuing their education (Koinis, et al., 2015).
Another study was conducted to understand the relation between empathy levels and burnout of
health professionals working in emergency departments. The study revealed a strong link
between the empathy and burnout of health professionals of ER. Therefore, the study concluded
that decreasing professional burnout may help keep health professionals' levels of empathy high,
which would subsequently ensure an improved quality of care (Yuguero, et al., 2017). Apart
from the Emergency department, other department which has a taxing effect on healthcare
professional’s health is the pediatric department. A study was conducted to investigate the effect
of frequent exposure to pediatric medical trauma on interdisciplinary teams in a pediatric
medical facility and the associations between mental distress, resilience and coping abilities. The

study indicated that pediatric health trauma can negatively influence a doctor’s health, especially
those professionals who are under the age of 25 years as they are unable to utilize positive
coping skills effectively. The study established a need for creation of useful interventions for
doctors working in pediatric healthcare facilities as per its findings (McGarry, et al., 2013).
It is further observed in practice as well as in literature that doctors don’t admit or report that
they have mental health issues in spite of its high prevalence. In addition, the health
professionals are not promptly given mental health assessment by their coworkers because of the
fear of labeling and stigma. An experiment was conducted in the UK to examine the attitudes of
doctors in revealing their mental illness and the barriers and enablers to gaining assistance. An
inconsistency was found between what doctors think they might do and what they really did
when they suffered from mental health issues. Trainees and doctors at young age were most
reluctant to admit or reveal the illness. Doctors revealed certain obstacles to disclosure such as
fear of being labelled, confidentiality issues and a lack of understanding the care support
structure. It is essential to remove these barriers while planning for interventions of mental health
professionals in future (Cohen, Winstanley, & Greene, 2016). The findings of this study is
confirmed by another study which revealed that the obstacles to gaining support by doctors
suffering from mental health problems are confidentiality, judgement and effect on career. In
addition, the study also found that the requirements mentally suffering doctor reflect the
requirements of patients in general, that is compassionate and non-judgmental attitude from
coworkers. The mentally unwell patients as well as doctors want to overcome the issues of
confidentiality and stigma (Brooks, Gerada, & Chalder, 2017).
Literature has also identified another factor which negatively influences the mental well-being of
health professionals which is receiving complains. One study conducted in Australia established

an association between complains and its adverse impact on doctor’s mental health. the study
suggested that the governing bodies of Australia must officially recognize the substantial
influence complaints process can have on professionals. They should further make efforts to
improve the complaint procedure to lower the negative effects. Doctors' health advisory services
as well as the members of the profession should support and encourage the other professionals
and build culture that induces health and wellbeing of the coworkers (Haysom, 2016). In spite of
encouraging colleagues to support the professionals experiencing mental health professionals, it
is essential to understand that supporting colleagues with depression and suicidal ideation is
more difficult than supporting those who are not from this profession. It is found that the existing
support structure of reporting and supporting the doctors experiencing mental health issues is not
effective and can make support seeking and accepting more difficult. Accessibility of efficient
psychiatric assistance privately and frequently is hard unless it is expected, enabled and resistant
to initial refusal. Suicide of the doctors suffering from mental health professionals is linked with
unhelpful generalizations on the value of psychiatric therapy among coworkers that makes others
less liable to pursue support or consider that the caregiver will care (Nunn, 2017).
It is observed that doctors start facing mental health issues during their studying period only. A
study was conducted in Brazil to give a detailed insight of mental health issues among medical
students by recording their prevalence and links with co-factors. The mental health issues that
were most prevalent among the students were depression, common mental disorders, burnout,
stress, low quality of sleep, increased daytime sleepiness and anxiety. Co-factors that were
related to the mental health issues were absence of motivation, emotional assistance, and
educational overload. The study also suggested that evidence-based therapies and psychosocial

assistance are required to encourage mental health among the medical students of Brazil
(Pacheco, et al., 2017).
A study was conducted in Hungary to find the gender-specific indicators of mental health and
burnout particularly among female doctors. Female health professionals in Hungary have
demonstrated worse signs of physical and mental health as compared to women from other
professions especially in terms of depression, suicidal thoughts, and sleep disorders during two
interval points that is 2003 and 2013. The study also reported that increased workload had an
evident adverse influence on sleep and the personal achievement aspect of burnout (Győrffy,
Dweik, & Girasek, 2016). Not only in female health professionals, is the prevalence of
depression and burnout high among doctors in Hungary. One study was conducted to assess the
mediating role of coping mechanisms for prevention of depression and burnout among healthcare
professionals. The study revealed the prevalence of severe depression and lack of personal
accomplishment among the doctors. The symptoms of burnout and depression was predicted by
workplace both directly and indirectly through the facilitation of coping mechanisms. One of the
useful coping strategies found in the study was cognitive restructuring, which highlights on the
accurate evaluation of difficult situations. This strategy lowered the chances of occurrence of
burnout and depression symptoms. Therefore, this study verified the significance of formulation
of cognitive interventions and accentuated the importance of these strategies in preventing
depression and burnout among doctors (Mészáros, Cserháti, Oláh, Forintos, & Adám, 2013).
After reviewing the literature of the mental health of healthcare professionals, it can be
concluded that various aspects needs to be conducted to develop interventions so that their health
can be promoted. A range of factors work at national, organizational and individual level such as
lack of support from management and coworkers, excessive workload, refusal to admit, etc.

which has contributed in high prevalence of mental health issues among the doctors. It is
essential to identify these factors at different levels and intervention should be planned.
References
Brooks, Gerada, & Chalder. (2017). The specific needs of doctors with mental health problems:
qualitative analysis of doctor-patients' experiences with the Practitioner Health
Programme. J Ment Health., 26(2), 161-66.
Cohen, Winstanley, & Greene. (2016). Understanding doctors' attitudes towards self-disclosure
of mental ill health. Occup Med (Lond)., 66(5), 383-9.
Győrffy, Dweik, & Girasek. (2016). Workload, mental health and burnout indicators among
female physicians. Hum Resour Health.
Haysom. (2016). The impact of complaints on doctors. Aust Fam Physician, 45(4), 242-4.
Koinis, A., Giannou, V., Drantaki, V., Angelaina, S., Stratou, E., & Saridi, M. (2015). The
Impact of Healthcare Workers Job Environment on Their Mental-emotional Health.
Coping Strategies: The Case of a Local General Hospital. Health Psychol Res., 13(1).
McGarry, Girdler, McDonald, Valentine, Lee, Blair, . . . Elliott. (2013). Paediatric health-care
professionals: relationships between psychological distress, resilience and coping skills. J
Paediatr Child Health, 49(9), 725-32.
Mészáros, Cserháti, Oláh, Forintos, P., & Adám. (2013). Coping with work-related stress in
health care professionals -- strategies for the prevention of burnout and depression. Orv
Hetil, 154(12), 449-54.
Nunn. (2017). Mental health of health professionals. J Paediatr Child Health, 53(8), 735-36.

Pacheco, Giacomin, Tam, Ribeiro, Arab, Bezerra, & Pinasco. (2017). Mental health problems
among medical students in Brazil: a systematic review and meta-analysis. Rev Bras
Psiquiatr., 39(4), 369-78.
Yuguero, Forné, Esquerda, Pifarré, Abadías, & Viñas. (2017). Empathy and burnout of
emergency professionals of a health region: A cross-sectional study. Medicine
(Baltimore), 96(37).