#JamesDonaldson on #MentalHealth – Fears Mandatory Reporting Of #Doctors With #MentalHealthIssues Leading To #Suicides

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By Lucy Shannon

Two men stand on the sidelines of the Tour De France

John Bryant never planned on becoming a #mentalhealth advocate but fell into the role when his father, Andrew Bryant, took his own life.

Key points:

  • Mandatory reporting requires health professionals to report colleagues they believe pose a risk to the public
  • Doctors can be reported due to a #mentalhealthissue
  • Some feel the laws deter clinicians from seeking help

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

The 54-year-old respected Brisbane gastroenterologist went to work one day in 2017 and did not come home, leaving his wife Susan and four adult children in complete shock.

“At the time, me and my family weren’t aware that he was struggling with #depression, he managed to hide that very well,” John Bryant said.

Since his father’s death, John has delved into the problem of #mentalillness in the medical profession and found his father was by no means a random case.

“Doctors are one of the most at-risk professions in terms of #mentalillness … there’s a very high rate of #anxiety and #depression and #suicide in doctors,” he said.

John believes one of the reasons his father felt he couldn’t seek help for his #mentalhealth problems was because of concerns over mandatory reporting.

Family of doctor, Andrew Bryant, who took his own life in 2017

#Doctors blame #suicides on mandatory reporting

Mandatory reporting laws, adopted nationally in 2010, require health practitioners to report fellow clinicians they believe have an impairment that could place the public at risk.

As well protecting the public, the laws are aimed at reducing #suicides amongst clinicians.

However, doctors’ groups such as the Australian Medical Association and the Royal Australian College of General Practitioners blame mandatory reporting for making health professionals too scared to seek help for a #mentalillness.

“We have already lost too many talented, brilliant and dedicated colleagues who felt they could not seek help because they would be reported,” AMA president Dr Tony Bartone said.

A surgeon and team performs an operation at St Vincent's Hospital

After years of steady lobbying, amendments to the laws will come into effect in all states and territories except Western Australia, which has decided to scrap the requirement altogether, early next year.

Currently a report must be made if a health professional thinks a clinician could pose a risk to the public.

Under the changes, the threshold will be raised to ‘substantial’ risk.

Notifiable conduct by registered health practitioners is defined as:

  • Practising while intoxicated by alcohol or drugs
  • Sexual misconduct in the practice of the profession
  • Placing the public at risk of substantial harm because of an impairment (health issue)
  • Placing the public at risk because of a significant departure from accepted professional standards

This week, the body responsible for regulating #healthprofessionals, AHPRA, released an information campaign about mandatory reporting in the lead-up to next year’s changes.

“We want to work together to address any confusion and create the culture and leadership needed to support practitioners and make mandatory notifications easier to understand,” AHPRA chief executive Martin Fletcher said.

The organisation said the new “very high threshold” would result in reporting becoming “rare”.

Psychiatrist Dr Kym Jenkins features in Aphra’s campaign and described a doctor who had #depression, sought treatment and was not reported.

“He started on some anti-depressant medication and embarked on a course of psychotherapy and had a few more weeks off work to get better, there was no question at all about putting in a mandatory report for this #doctor” she said.

“Fear of mandatory reporting should not be one of the factors that delays you in getting help for yourself” she added.

#Doctors still in doubt

#Doctors’ groups are not convinced the changes will eliminate the fear of being reported.

“We still firmly believe that even with all this advertising … #doctors are still going to be faced with that dilemma when they’re unwell, should they be going to see someone,” RACGP President Dr Harry Nespolon said.

The RACGP said it had no problem with clinicians being reported for serious misconduct, but believed #mentalhealth reporting should be scrapped.

Harry Nespolon from the Royal Australian College of General Practitioners

“What we would like to see is go back to the West Australian model where there is no requirement of mandatory reporting,” Dr Nespolon said.

“As far as we’re aware there’s been no issue with regards to patient safety.”

The Medical Journal of Australia has reported that doctors and other medical professionals are more likely to die by suicide than the general population.

#Male #doctors reportedly take their own lives at 1.4 times the general rate and #female #doctors 2.2 times.

Dr Nespolon said there was a cultural issue.

“#Doctors believe they’re bulletproof, which they’re not, and we’ve spent a lot of time within the profession telling #doctors to take care of themselves, get their own GP, see your doctor regularly for routine checks,” he said.

“A healthy doctor means a healthy patient.”

#Female #doctors under extra pressure

A woman wearing a stethoscope sits on a couch

Darwin-based junior doctor Josephine de Costa sees first hand the complex pressures facing #women in the medical profession and at home.

“Issues like sexual harassment … and difficulties in terms of career progression,” she said.

“They perform a lot higher proportion of things like emotional labour and work around the home.”

However, Dr de Costa believes young #doctors are, to a certain extent, becoming more open to discussing #mentalhealth.

“But I do think certainly issues like #depression and #anxiety are really common among members of my professions and particularly the younger ones,” she said.

Mr Bryant does not blame mandatory reporting alone for his father’s death, calling for changes to long working hours and better support systems.

“[My Dad] was doing a lot of on-call night shifts, being called away at nights … I think that lack of sleep contributed to things,” he said.

“He didn’t let any one know he was struggling … if we’d known we could have helped him find the help he needed.”

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