I want to offer support

Promoting health and wellbeing – whether in yourself and with a colleague or friend – is a skill that requires active and mindful attention. Helping a colleague or trainee may require you to gently and purposefully intervene when necessary.

Those at highest risk

Medical professionals are at a higher risk of mental health issues than other professionals, and within this group the most vulnerable are:

  • trainees
  • female doctors
  • rural and remote doctors
  • indigenous doctors
  • oversees doctors seeking local registration
  • doctors involved in medico-legal proceedings

Seeing the warning signs

High-functioning individuals are often very effective at concealing quite high levels of distress. These are warning signs you may see in yourself or others:

  • feeling the need to put on a brave face
  • struggling at work, or feeling overwhelmed
  • poor concentration
  • inability to make decisions
  • disappearing while on shift
  • increasing use of alcohol or drugs
  • poor attention to physical appearance
  • loss of energy
  • may lack insight
  • low moods, increased anxiety or irritability
  • withdrawing or feeling isolated
  • sleeping too much or too little
  • colleagues raising concerns

Five steps to helping a colleague or friend

The old saying that "the doctor who treats himself has a fool for a physician" is very true according to Dr Jill Gordon, an experienced medical psychotherapist and educator.

In a recent Pomegranate Health podcast, Dr Gordon offered these five tips to get a more positive outcome supporting a colleague.

Connecting with a struggling colleague

Talking to a colleague about self-care can be challenging. There are some conversation examples and ideas to help you have that difficult conversation with a colleague in need.

Approach Example
Before the person has agreed to the support conversation
First contact
(approach the person in a relaxed and private space)
"Every clinician I know has been in this position at some point in their career, and I have too…. We've found that most of us appreciate talking to a person because it's hard for other people to know how this feels.”
Once the person has agreed to the support conversation

Invitation/opening
(provide an opportunity for the person to talk openly)

"How are you going?”
Active listening "You mentioned your wife was missing her family back home, tell me more about that.”
Reflecting
(validating and normalising the person's emotions)

"It can be really tough managing work and home at the best of times, let alone when you have relocated and don't have the usual supports around you. It takes time to adjust to a new setting. The fact you and your wife can communicate openly with each other about how you feel is great. Everyone reacts differently to change, so I can't give you any advice, but I know how challenging it can be.”

Reframing
(giving perspective)

"The fact you are stressed and worried about how your wife and kids are coping shows how much you care. If you didn't love your family so much, there would be no challenge.”

Sense-making
(encourage the person to make positive changes)

"It is great you are conscious of the stress and fatigue you have been feeling. In many cases people are unaware and unable to help themselves before the problem escalates.”

Coping
(discuss coping strategies, support networks and the importance of self-care)
"It is really important you make self-care a priority. What have you done in the past that has helped you through difficult times?”
Closing "I really appreciate you sharing with me. It helps put some of my thoughts in perspective too. Remember how well you are doing and that challenges like these only make you a stronger physician.”
Resources/referrals "I am sure you will start feeling better soon, but if you're not coping and need some extra support, make sure you reach out. You are not alone. It gets rough sometimes and there are plenty of people who can help you.”

Supporting a trainee

A trainee discusses her progress with her supervisor

As a supervisor, there are a number of ways in which you can support your trainees and improve the workplace in order to reduce their risk of mental health issues. If you notice signs of distress or are concerned about one of your trainees:

  1. Meet with your trainee and assess the immediate risk.
  2. It is okay to ask about depression, suicidal thoughts, what support they have in place, if there are stressors outside training that they want to disclose, and if they have a GP or mental health professional who can help them.
  3. Address practical issues. If the trainee has identified training conditions that are contributing to their mental health issues, address practicalities that might alleviate some of the stress, such as rostering or taking leave. Speak with the Junior Medical Officer Manager or Director of Medical Services to find other practical responses that could help.
  4. Do not diagnose. Seek agreement with the trainee that they will visit their GP. Be aware of the difference between being a supervisor and being a treating doctor.
  5. Agree on internal and external support to be provided or accessed.
  6. Identify and encourage the trainee to access other support internal and external support such as mentors, employee assistance programs or other specialist services.
  7. Document your meeting and any agreed actions.
  8. Follow up with the trainee in one to two weeks, or as required.
Screenshot from the eLearning module Physician Self-Care and Wellbeing.

Other ways to support a trainee

Supervisors play a central role in setting the culture within healthcare settings. Available options that can improve your ability to support a trainee are:

  • Maintain a supportive and collegiate workplace.
  • Respond effectively to complaints of bullying or harassment.
  • Provide debriefings for critical incidents.
  • Have available the names and contact details of at least two GPs who are comfortable seeing doctors as patients.
  • Take a RACP eLearning course:

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