‘I felt burnt out, rubbish at my job and was worried I was going to be struck off’
Mental health problems and suicide rates are higher among doctors than in any other profession. So why is the caring sector failing to look after its own?
the day before Sophie Spooner took her own life last October, she suffered a panic attack while on duty as a junior doctor. She returned to work the next day, but was later found dead by her sister in the flat she shared with her fiancé, Jonny Miller. Sophie had received a complaint at work 18 months earlier. ‘She started catastrophising,’ Jonny, 30, tells Grazia. ‘She came home in a state. She mentioned suicidal thoughts, but I never thought she’d try anything.’
Sophie, 26, had bipolar disorder and was being treated for anxiety and depression. Jonny says thinking about work – the night shifts, long hours and fear of complaints – often triggered her anxiety. The pair had been engaged for a year when she died. They had postponed the wedding while Sophie considered whether to stay in medicine. ‘She spent five years training so it wasn’t easy to walk away,’ Jonny says. ‘She cared deeply about her patients. It is such an understaffed environment, she felt she couldn’t give them what they deserved.’
We rely on doctors to look after us, but how often do we consider their wellbeing? Doctors’ working conditions are more punishing than anything an office worker has to deal with, and they are more prone to mental health issues than any other profession. Yet many say they don’t feel supported. ‘Female doctors have up to four times the risk of suicide of people in the general population,’ says Dr Clare Gerada, medical director of the NHS Practitioner Health Programme (PHP). Figures from the ONS show that between 2011 and 2015, 430 health professionals took their own lives in England. PHP is the only confidential service that offers doctors treatment for all mental illness – but at the moment only those who work in London can self-refer anonymously. ( There are plans to roll this out nationally in the next six months.)
In 2016, the body of junior doctor Rose Polge was found after she walked into the sea in Devon. Her death was at the height of a junior doctors’ strike over new contracts. Rose, 25, expressed concern about pressures in the NHS and mentioned the then Health Secretary, Jeremy Hunt, in her suicide note.
Writing on Rose’s Just Giving page, her mother said, ‘Exhaustion because of long hours, work-related anxiety, despair at her future in medicine and the news of the imposition of the new contract on junior doctors [announced the day before Rose disappeared] were definite contributors to this awful and final decision.’
It was during the search for Rose’s body that Phyllida Roe – a psychiatrist at the same hospital – set up a Facebook group, Tea and Empathy, to support struggling medics. Overnight, 600 joined – nearly all of them junior doctors. Now it has almost 7,000 members. ‘I was shocked how many people joined so quickly,’ Phyllida tells Grazia. ‘But we’re in a profession where people are very good at disguising their own uncertainties. Until now, there hasn’t been a safe space to talk about it because not being “strong enough” is very stigmatised in healthcare.’
Phyllida, who has been a junior doctor for seven years, says there’s been a breakdown in support networks after the system changed to shift work a few years ago. This means some junior doctors now rarely work with the same consultant twice, which leaves many feeling they don’t have anyone to turn to when they have questions.
‘ The other thing is that you must pass “professionalism” as part of your portfolio. So if you’re having a bad day and you get upset, you’re afraid to talk about it,’ Phyllida adds. ‘Losing professionalism would mean the end of your training.’
Before taking her life, Sophie posted on Tea and Empathy a couple of times. Jonny says, ‘Many could relate to what she was going through. This shows the scale of the problem. Junior doctors are under so much pressure, particularly in the UK where a lot of hospitals are understaffed and don’t have proper resources for mental health support.’
Lack of support comes up again and again. Janine*, 32, a junior doctor in Leeds, thought about suicide last year. She was struggling with a huge workload, had exams to prepare for and was on crutches with an ankle injury. ‘I often feel unsupported, and it got to me,’ she tells Grazia. Of two junior doctor friends she graduated with, one took their own life while the other tried and, thankfully, failed.
Dr Louise Freeman, 50, co-chair of the Doctors’ Support Network, says she left the NHS after feeling unsupported during an episode of depression while working as a consultant in emergency medicine. ‘ When it’s happening to you, you feel so alone,’ she says. ‘Struggling doctors are basically told, “If you can’t take the heat, get out of the kitchen.” It’s brutal. It’s generally, “Oh well, you’ve got depression, so medicine isn’t for you.”’
Dr Caroline Elton is an occupational psychologist. She’s heard hundreds of medics describe the challenges they face while researching her book, Also Human. ‘More than half of medical students in the UK are now female, but the system has failed to adjust for this: training lasts for many years and they’re often moved around every six months while having to work nights and weekends, which can make managing a young family difficult,’ she says.
Does she think the psychological wellbeing of doctors is being overlooked? ‘ That’s one of the major conclusions of my book,’ she says. ‘ The psychological needs of the doctor have been surgically excised. This underpins the selection of medical students, where psychological suitability is not given the attention it deserves; progress through medical school, where doctors who are not suited to the profession are allowed to stay; and the lack of support after a traumatic incident at work, or if a doctor becomes ill.’
She thinks more funding and a cultural change is needed: ‘So that asking for help is seen as a sign of personal insight rather than weakness.’ Dr Caroline Walker, a psychiatrist and therapist who launched The Joyful Doctor, offering mentoring, psychotherapy and reflective spaces for struggling doctors, agrees. She says, ‘ When I was a junior doctor everything looked fine to everyone else. But on the inside, I thought I was rubbish, an imposter... bound to get struck off. I burnt out and got depressed very quickly.’ She personally sees around two new doctors a week with mental health problems and says common themes include anxiety, workrelated stress, trauma and low self-esteem.
In October, NHS England chief executive Simon Stevens announced new funding that will expand the currently available mental health support to an additional 110,000 doctors. ‘ This will help all NHS doctors by providing a safe, confidential service to turn to when they need help,’ he said. ‘Ultimately, patients, not just their doctors, will benefit.’
The NHS is one of the UK’S most cherished institutions, but it seems something has gone wrong when its beating heart – the medics – is at breaking point. ‘It makes me angry that this profession takes enthusiastic, gifted people and is so destructive that they don’t want to live any more,’ says Phyllida. ‘ We’re the caring profession, but we’re not really caring for each other.’