07 August 2009

A majority of doctors would avoid seeking professional advice for mental health issues in an outpatient setting, according to a new survey published by the Royal College of Physicians in the journal Clinical Medicine. Nearly three quarters of respondents said they would rather discuss mental health problems with family or friends, than seek formal or informal advice, citing reasons such as career implications, professional integrity, and perceived stigma of mental health problems.

The survey of over 3,500 doctors in Birmingham is the first of its kind of this scale looking at (non-psychiatric) doctors' preferences for disclosure and treatment in the event of becoming mentally ill. Key among the findings is that only 13% of respondents would choose to disclose their illness to a GP or another health professional and that when it comes to inpatient treatment, 79% would opt for treatment in either a private or distant facility, rather than be treated by local NHS services. In both cases the decision appears most often to be based around concerns that personal information would not be kept confidential and that this may compromise career and/or reputation.

The findings include:

  • - 73% of respondents to the study would be most likely to disclose mental health problems to family or friends, rather than seek formal or informal advice.
  • - The most important reasons affecting that decision were issues such as career implications (33%), professional integrity (30%), and stigma (20%).
  • - 41% of respondents would seek informal advice for outpatient treatment, but 8% would either self-medicate or opt for no treatment at all.
  • - 79% of respondents would opt for inpatient treatment in either a private or distant facility, rather than be treated by local NHS services. (Only 25% make this decision based on quality of care.)
  • - 55% would make the decision about inpatient care based on confidentiality or stigma issues.

The study had a response rate of over 70%, indicating that this is an important issue for doctors.

Commenting on behalf of the research team, Dr Alfred White, said:

"Doctors who are reluctant to seek professional advice for mental health issues may be putting themselves, and possibly also their patients, at risk and we are concerned that there are a lack of options for doctors who feel they are mentally unwell.

"Doctors suffer higher levels for depression and substance misuse, as well as higher rates of suicide than the general population. The apparent lack of confidence in the current system protecting doctors' confidentiality may exacerbate these trends.

"Greater emphasis is needed to educate doctors on mental health and to improve and extend the options open to them for accessing mental health support."

Notes:

1. The article published in Clinical Medicine is titled ‘A postal survey of doctors' attitudes to becoming mentally ill'. The authors are Dr Tariq M. Hassan, Dr Syed O. Ahmed, Dr Alfred C. White and Niall Galbraith.

2. For press information, please contact Zoë Horwich, Communications Officer, Royal College of Physicians on 020 7935 1174 ext. 354 or email zoe.horwich@rcplondon.ac.uk.