Self-care for psychiatrists
Whether you are a consultant psychiatrist or a trainee, self-care is a vital component of your professional practice. In fact, the RANZCP Code of Ethics states 'Psychiatrists shall ensure that their physical and mental health allows them to act responsibly and competently'.
Psychiatry is a challenging specialty and, like all medical professionals, you can give a lot of yourself through your work. However, by doing so, you can put your own health at risk.
The self-care advice on this page may seem simplistic – any doctor would give the same advice to their patients – but consider taking the challenge to genuinely reflect on which of these areas you are doing well in, and in which areas you could do more.
Need help now? Visit the Support for psychiatrists page.
Looking after yourself: the basics
1. Have your own GP and have regular check-ups
||Psychiatrists everywhere are not immune to problems like depression, anxiety, substance abuse, and other types of psychological distress.
Prof. Malcolm Hopwood
You probably agree in theory that all doctors should have their own GP, but do you have one yourself? If you only take one step towards better self-care, make finding a GP your top priority. There are many reasons doctors give for not visiting a GP: shortage of time, confidentiality concerns, discomfort with the situation, or not knowing a suitable GP. However, many of these possible barriers can be overcome by finding a GP who has expertise in treating doctors.
To find a GP in your area who has training and experience in treating doctors, phone your local doctors' health and advisory service. Also, some locations have clinical services specifically for doctors.
Your GP can offer objective assessment and appropriate management of your health situation, which is not possible via self-diagnosis or in 'corridor consultations' with colleagues. Seeing a GP also ensures you will have a documented clinical record of your health and health care. Having regular check-ups will ensure you undergo all recommended preventative screening and monitoring.
A key issue in doctors' wellbeing is known to be seeking help too late. To avoid this pitfall, find a GP you like and trust now, before you need them, and set up ongoing annual check-ups.
2. Avoid self-prescribing
It is important that you are aware of the risks of self-diagnosis and self-treatment. You owe it to yourself to seek an objective opinion from a GP or a specialist when you need medical care. The RANZCP strongly recommends that psychiatrists avoid self-prescribing, and that psychotropic drugs, sedatives, analgesics, and other drugs of addiction are never self-prescribed. You must also abide by the guidelines of your relevant medical board, being the Medical Board of Australia or Medical Council of New Zealand, as well as the legislation that applies to where you work and live.
3. Recognise when you're feeling stressed or burnt out
In jobs involving prolonged stress, as is the case for many psychiatrists, the risk of ‘burnout’ is high. In fact, burnout seems to be more common than depression among doctors.
Burnout is a syndrome involving high levels of emotional exhaustion, depersonalisation and low levels of personal accomplishment. People feeling burned out may feel cynical, extremely reluctant to go to work, a lack of satisfaction in their job, guilty that they are unable to get on top of their workload, or irritable with colleagues or patients.
The British Medical Association publishes an online Burnout Questionnaire for Doctors, based on the Oldenburg Burnout Inventory. Take the questionnaire to see how you score.
If you are experiencing symptoms of burnout or feel you are facing more stress than is compatible with your health and happiness, don't hesitate to seek help. The evidence shows that tackling stress and burnout is more effective if done earlier: it is not a professional failing to prioritise your own health.
4. Build effective coping mechanisms
||When a psychiatrist experiences mental illness, the 'them and us' divide suddenly changes. That can be very challenging, but you are not alone. With the challenges, and over time, can also come new partnerships and opportunities.
||RANZCP Fellow with a lived experience of mental illness
Take the advice you would give any patient about dealing with stress: build strategies to deal with it, or attempt to change the practicalities of your situation.
In terms of building strategies to deal with the stress, many psychiatrists who have faced difficulty will attest that it was objective psychological assistance that helped them turn the corner. Speak to your local doctors' health and advisory service about your needs – they will be able to refer you to appropriate services. Alternatively, some useful links to e-health psychotherapy programs and other resources on stress management are below.
In terms of practicalities, can you seek help in your personal life – perhaps from a financial planner, cleaner, housekeeper or child-care worker? In your professional life, can you say no to new referrals, be stringent in building in break times, review your personal life/work life boundaries, or speak to your practice staff about ways to ensure you get the breaks you need? There's no question that these things are easier said than done, but even small changes might give you the space you need.
5. Maintain an effective support network
Many psychiatrists experience considerable health and wellbeing benefits in having a peer support network of doctors facing similar challenges. Support networks outside the workplace are also important, whether family, social, sporting, or religious.
Evaluate your support networks by thinking through the question of who you'd look to for help if you experienced a major crisis tomorrow. Who would you turn to for professional advice on medical matters? What about legal advice? To debrief with after the event? To cover your work? To provide help with home and family arrangements? If there are gaps in your support system, try to take a tactical approach to fill them before you need the help. Some suggestions for building your network are on the Support for psychiatrists page.
Would you like to better understand your health and wellbeing?
Visit the new RANZCP self-care e-learning modules. These three 20-minute modules provide an interactive learning experience, and are endorsed for CPD credits (when all three modules are completed).
General wellbeing for doctors
Keeping the doctor alive – a self-care guidebook for medical practitioners: From the Royal Australian College of General Practitioners, a comprehensive resource on strategies for self-care as an essential element of a doctor’s professional life. Includes sections on stress management.
Australasian Doctors’ Health Network: Resources on self-care for doctors, their families and their colleagues.
Understanding and managing stress
The myCompass interactive self-help program aims to help people gain control of stress or anxiety. Developed by the Black Dog Institute.
Avoiding burn-out in remote areas: Surviving the day to day hassles is a guide for all remote health practitioners produced by the Council of Remote Area Nurses.
Video: Kelly McGonigal – How to make stress your friend (TED talk)
Video: Guy Winch: Why we all need to practice emotional first aid (TED talk)
Mood Gym is a cognitive behaviour therapy program for preventing and coping with depression (developed by the National Institute for Mental Health Research at the Australian National University).
Find other evidence-based programs to help with a range of health issues by using the Beacon e-health application directory. The directory is a comprehensive listing of e-health websites and mobile apps, with evidence level ratings provided by the National Institute for Mental Health Research. Also lists online support groups.
Creating a mentally healthy workplace
The Heads Up website provides resources and advice for health services wishing to develop a strategy for ensuring a mentally healthy work environment. Also provided is a detailed case study of how Monash Health supports the mental health and wellbeing of doctors.
This page and some of the associated resources were made possible through Australian Government funding.