New research documents high levels of psychiatric problems among physician trainees, concluding that a change of culture around mental health is needed to get them to seek help.

Published against the background of a “cluster of recent suicides among NSW physician trainees” the report aimed to evaluate the extent of alcohol use, burnout, psychiatric problems and lack of job satisfaction among RACP physicians trainees completing training in NSW hospitals.

“The level of distress is high and requires system changes to support both individual health measures and structural change to work and study programs,” it said.

Roughly half of those questioned met the researchers’ screening criteria for depression (53%), stress (51%) and anxiety (46%).

Those questioned said the main reasons they weren’t getting help for depression or anxiety were;

• lack of time – 81%
• fear of lack of confidentiality – 41%
• embarrassment – 39%
• potential effect on registration – 27%

Mirroring stigmatising attitudes towards mental health within the profession shown in other studies, 58% of respondents believed experiencing depression or anxiety “was a sign of personal weakness”.

The study, published in the Australian Health Review,  catalogued a range of problematic behaviour.

While 88% of respondents said they felt doctors should portray an image of health, 46% didn’t get regular exercise and 76% slept less than six hours per day.

Some 20% showed risky alcohol consumption, with higher levels among the female cohort, and 76% experienced high burnout, again with a higher female skew.

Secondary traumatic stress (STS) was also exceptionally high throughout the group with higher scores among females.

The study authors said these findings were consistent with those from other local and international surveys citing an inquiry submission to a later inquiry documenting showing full-time junior doctors putting in an average of 57 hours with 16% working up to 70 hours per week.

The study cohort worked a mean of 53 hours per week, with 25% working over 65 hours per week, it noted, “indicating that little has changed”.

The researchers concluded that a change of culture is needed to remove stigma around mental health and make it easier for trainees to seek help.

AMA Council of Doctors in Training (AMACDT) chair Dr Tessa Kennedy told the limbic that acknowledging mental health in the profession as a problem was “a necessary precursor for cultural change”.

But while there had been some initiatives in workplaces to increase resilience these were often little more than “symbolic gestures” such as free massages and yoga classes, she said.

“While the intentions are good, they’d be better off… hiring enough so people can take leave…[and] not penalise people for taking sick leave when they’re sick. But that all needs to come from the top,” said Dr Kennedy.

The Royal Australasian C0llege of Surgeons had been the most proactive in changing its culture although this was at least partly a response to considerable media attention on bullying, she said

“But all power to them for actually taking it on board”, she said, noting other groups, including physicians, had lagged behind in establishing similar programs,  happy to let the public believe the weight of the problem is with surgery.