By Dr. Nidhi Rawal, Consultant, Dept of Pediatric Gastroenterology, Hepatology and Nutrition, Madhukar Rainbow Children's Hospital, Delhi
Being a doctor has long been considered one of the most rewarding and sought-after occupations. However, this profession also comes with stress---some unique to the medical profession, others typical of high-pressure and highly skilled occupations. Doctors are not immune to mental illness, with between a quarter and a third reporting increased symptoms of mental ill health, which has been heightened after Covid-19 Pandemic.
It is estimated that more than 1 million doctors are in India. Every year more than 80,000 medical students graduate as doctors from 529 medical colleges in India.
Doctors have 2.5 times the risk of dying by suicide as compared to the general population. We have been listening cases of medicos dying by suicide because of one reason or another. It is appalling given that doctors are there to protect the community. But, the fact is they also succumb to various mental health conditions and don’t have the framework to seek timely help.
Two important studies published in 2021 found the rates of mental health illness including suicides in Indian medical students, residents and doctors. A total of 358 suicide deaths were reported among doctors between 2010 and 2019.
Female doctors are at the highest risk, with highest suicide rates were from South India excluding Kerala. Anesthesiologists and obstetricians/gynecologists had the highest rates of suicide. Hanging was the most common method used. Although multiple factors have found to contribute to mental illnesses amongst doctors, such as poor training environment, perfectionism, taboo associated with seeking help, high demand work profiles, lack of sleep and unregulated working hours, academic stress was found to be the most common reason amongst medical students and residents, whereas marital discord was the most common reason amongst doctors. 1 in 4 doctors (26%) exhibited suicide warning signs but only 13% sought any help.
We have known for almost 150 years that there is an increased risk of mental health illness amongst doctors. It’s time that we acknowledge this risk to our medical community and encourage changes in our training system as well as workplace environment and policies. New initiatives are required at all levels, especially at the organisational level, in both public and private sectors, to provide a healthy and positive work atmosphere, include mental health awareness and reduce the taboo associated with seeking help. Having a healthy, functional workforce of physicians is one of the most important parts of any country's health system.