ABSTRACT
Mental health conditions are a significant part of the national burden of disease.1 Burnout, depression and anxiety are increasingly common diseases amongst doctors that impair their ability to perform at home and at work, as well as cope with life stressors.2'3 Burnout has been documented to affect 45% in a consultant survey in one New Zealand hospital prior to the COVID-19 pandemic, and this is likely to have increased with the present frustrating work environment.4 Overseas counties have found increased mental health issues amongst doctors in the present phase of the COVID-19 pandemic.5'6 Documentation of increased suicide risk among doctors dates back to the nineteenth century. The first published systematic review in 2004 estimated doctors relative risk at 1.41 (95% CI 1.21-1.65) for men and 2.27 (95% CI 1.90-2.73) for women compared with the general population.7 However, a second more recent systematic review and meta-analysis reported that male physicians had a lower rate compared with men in general (0.67;95% CI 0.55-0.79), and while female physicians still had a higher rate (1.46;95% CI 1.02-1.91), it was considerably less than that reported 15 years prior. Defences that are useful in surviving medical practices such as intellectualisation, dissociation and sublimation may make it harder to create attachments to others, or to recognise when the emotional burden of work becomes too much, therefore contributing to the spiralling of discontent and increased risk of suicide.11 In addition, doctors tend to neglect their own need for psychiatric, emotional, or medical help, and are more critical of themselves and others.7 They are more likely to blame themselves for their illnesses and feel they have failed by becoming mentally unwell. A survey of doctors, comparing those with recent or current complaints, found that they were more than twice as likely to report thoughts of self-harm or suicidal ideation and, of those referred to the General Medical Council in the UK, around one in four had moderate to severe depression and/or anxiety.13 In summary, suicide in doctors appears to be associated with multiple factors including: organisational and occupational stressors, such as long working hours, increasing administration, lack of support, and dealing with death;individual differences, such as personality, coping style, and skill set);and life stressors, such as relationship breakups and complaints and litigation.
ABSTRACT
The NZMJ is currently undergoing a review of all papers to assess the proportion of articles reporting on Hauora Maori outcomes, to determine a baseline for assessment of future publication trends. 3.Ensure the ongoing retention of themed issues in health equity. There was unanimous agreement that the NZMJ should reject publications promoting ethnic bias,3-6 thus taking an international lead in changing researcher and health practitioner culture in Aotearoa in a sustainable way. Consolidated criteria for strengthening reporting of health research involving indigenous peoples: the CONSIDER statement.