A postal survey of doctor's attitudes to becoming mentally ill

Editor – I read with great interest Hassan et al's excellent paper (Clin Med August 2009 pp 327–32). There is much research and publicity, for example a recent Department of Health review,¹ which finds that there are higher rates of psychological illnesses in doctors than the general population, so it is surprising to find in this study that the majority of doctors, especially psychiatrists, were not aware of this fact. Overall it seems to me that as a profession we are having the same ‘conversation’ about this issue. The debate on how to provide services for sick doctors has continued in a similar way for years. One of the factors that bothers doctor-patients most, indeed many patients, is the stigma of illness and sickness absence, as is borne out in this study. It is interesting that in reality most doctors do not lose their jobs, or have any long-term problem resulting from the fact of a particular diagnosis or sickness absence. It is true that long-term sickness absence requires a multidisciplinary approach and that the earlier a problem is dealt with the better. Many of a doctor's problems with illness arise from a denial of them. Confidentiality, which is different, and as borne out in this study, is the key to managing these situations. Many services for doctors do exist, can be accessed via their general practitioners or occupational health departments, and can be off-site from the workplaces.

I am surprised that most respondents say they would talk to family and friends because in many cases, in my experience as an occupational physician, once doctors and other people are ill, they find that admitting illness to family is difficult. Those answers smack of denial as well and may be a source of information bias in the study.

Most interesting is that the authors say that these attitudes and perceptions about doctors’ health should be tackled and changed at medical school level as I am currently carrying out this kind of work with students. I have found, sadly, that the attitudes written about in this paper are well-entrenched by mid-third-year stage.

• © 2010 Royal College of Physicians