Program helps doctors discuss mental health
Speaking with others in the medical field supplies empathy amid stress: volunteer
Warning: This article discusses suicide and suicidal ideation.
Vancouver anesthesiologist Dr. Asim Iqbal often thinks of two former colleagues who died by suicide while they worked together at a hospital in the U.K.
Their deaths seemed to “come out of the blue,” said Iqbal, who has become a volunteer with a program run by Vancouver Coastal Health to provide peer support to doctors.
“I can't help but wonder if this kind of program was there for them, could they have accessed it? Could it have helped?”
Iqbal, who took a job at Vancouver General Hospital at the tail end of COVID-19, agreed to share his story to raise awareness about national Mental Health Week, which runs May 6 to 12.
Studies have shown that about 90 per cent of doctors turn to other doctors when they need to talk to someone about an event at work.
The VCH program aims to provide a simple, confidential way for doctors to discuss the stress they're facing with other doctors who can refer them to help if needed.
“It's about listening with empathy,” said Iqbal.
The anesthesiologist was forced to take a hard look at how his job was affecting his health when he lost partial vision in his left eye in 2017. The vision loss was related to elevated levels of cortisol, a stress hormone. He recovered when he made some adjustments to his usual attitude of “put your head down and carry on.” He also began to research peer support.
“When you're busy, it's easy to pretend nothing is going on,” he said. “People forget to do the things that bring them joy. Often it's about reminding people to look after themselves and to do the things that make them happy.”
The deaths of two of his colleagues, who took their own lives while they were working together at a hospital in England, also deeply affected him.
While one may have been traumatized after volunteering to work with COVID-19 patients at the height of the pandemic, the other didn't reach out to anyone and appeared totally normal, even on the day he died.
Iqbal said doctors are often critical of themselves when unexpected challenges arise.
“We always strive to be the best for our patients, but you can end up being a little critical of yourself,” he said.
COVID-19 also brought added stress, with “a lot of unknowns and uncertainty.”
Iqbal is one of about 40 physician peer supporters across the Vancouver Coastal Health region, which includes doctors from various specialties including emergency, surgical and family medicine.
The volunteers are trained by experts from Harvard Medical School and the Schulich School of Medicine and Dentistry. Doctors seeking peer support can reach out any time by email and a co-ordinator will match them with a doctor to speak to — not as a patient, but as a peer. Conversations, which are confidential, usually happen within about 48 hours.
Iqbal said it's important to reduce the stigma around mental health so people can feel comfortable seeking support. Speaking to a peer — a fellow doctor who understands the demands of the job, but isn't a direct colleague — can often help people feel better or see a way forward.
Vancouver Coastal Health is hoping to raise awareness of the program, which could be expanded to other hospitals.
In 2017, a study by the Canadian Medical Association (CMA) on physician health found that one in three doctors had screened positive for symptoms of depression — and eight per cent had thought of taking their own lives — within the previous year.
While U.S. studies have found doctors have a higher rate of suicide than the public, a 2022 study that looked at suicide rates among doctors in Ontario found the risk about the same.
A CMA article on mental health said doctors might not seek help because a culture of “self-sufficiency and stoicism” encourages them to push through their own distress to care for patients. Some also fear being seen as weak and unable to manage the responsibilities of a career in medicine.
“The medical culture and health systems that glorify self-neglect and sanction self-abuse must be transformed,” said the CMA article, which called for better data on suicides, safer workplaces and peer support.
“Understanding what your colleagues are going through, relating it to your own experiences and sharing coping strategies can provide insight, hope and recovery,” the article concluded.