Junior doctors' mental health and coronavirus disease safety concerns

Objective This article aims to assess whether caring for COVID‐19 patients impacted junior doctors' COVID‐19‐related anxieties, general anxiety and depression, and the relative impact of depression, general anxiety and specific COVID‐19 anxiety on work and social functioning during the COVID‐19 pandemic in 2020. Methods Recruitment occurred between June and August 2020 in New South Wales, Australia. Demographic information, symptoms of depression (PHQ‐9), generalised anxiety (GAD‐7), and COVID‐19‐related anxieties around infections, help‐seeking behaviours, and work and social functioning (WSAS) were collected. Results About one third (n=73, 33%) had cared for a patient with overt or covert COVID‐19 in the previous month. However, the extent of COVID‐19‐related anxiety symptoms was largely unrelated to caring for COVID‐19 patients. Instead, the presence of other COVID‐19 concerns and gender predicted variations in COVID‐19 concerns for one's own safety and the safety of loved ones. Conclusion COVID‐19 anxiety symptoms were largely unrelated to caring for COVID‐19 patients, while COVID‐19‐related anxiety around the safety of family and friends added to impaired functioning in addition to the established impact of depression and general anxiety. Implications for public health: Provided the replicability of these findings, this research highlights the importance of addressing pandemic‐related anxieties in junior doctor populations.

Exploring the lived experience of mental health and coping during unemployment.

BACKGROUND: Unemployment is known to involve various psychosocial challenges that can negatively impact mental health. However, the intricacies of how individuals experience these challenges and strive to cope within the context of varied sociocultural and individuating factors, remain comparatively understudied. The present qualitative study used an interpretative phenomenological approach to explore the lived experiences of mental health and coping during unemployment. METHODS: Fifteen Australian adults who had recently experienced unemployment (for ≥3 months in the last 2 years), despite being available for and able to work, participated in semi-structured interviews from August to September 2021. Maximum variation sampling ensured participants represented diverse sociodemographic backgrounds. Interviews were audio-recorded, transcribed verbatim and analysed using reflexive thematic analysis within NVivo12 software. RESULTS: Four major themes were identified: 1) disrupted identity and direction in life; 2) navigating conflicting views of contribution and progress; 3) knowing how to cope is not enough; and 4) unemployment as a catalyst for new understandings. Unemployment disrupted participants' sense of purpose, identity and visions for the future. It signified a perceived failure to meet societal standards of value based upon the economic functions of work, which participants struggled to reconcile with their own priorities for work that satisfied psychosocial needs. Participants were aware of effective coping strategies, although these had mixed positive and negative effects on mental health, or were difficult to mobilise during unemployment. The COVID-19 pandemic, while normalising unemployment to some degree, exacerbated future uncertainty and prevented engagement with known coping strategies (e.g., social interaction). However, unemployment could also instigate growth through re-defining markers of achievement, re-aligning goals with one's core values, and developing greater compassion. CONCLUSIONS: Experiences of mental health and coping during unemployment share complex relationships both with each other and with broader personal and sociocultural contexts. Service providers may better meet the mental health needs of those experiencing unemployment by balancing the economic and psychosocial functions of work, understanding that coping is a wholistic issue that goes beyond knowledge of effective strategies, and being aware of the opportunities for self-development that unemployment can create.

Junior doctors' mental health and coronavirus disease safety concerns.

OBJECTIVE: This article aims to assess whether caring for COVID-19 patients impacted junior doctors' COVID-19-related anxieties, general anxiety and depression, and the relative impact of depression, general anxiety and specific COVID-19 anxiety on work and social functioning during the COVID-19 pandemic in 2020. METHODS: Recruitment occurred between June and August 2020 in New South Wales, Australia. Demographic information, symptoms of depression (PHQ-9), generalised anxiety (GAD-7), and COVID-19-related anxieties around infections, help-seeking behaviours, and work and social functioning (WSAS) were collected. RESULTS: About one third (n=73, 33%) had cared for a patient with overt or covert COVID-19 in the previous month. However, the extent of COVID-19-related anxiety symptoms was largely unrelated to caring for COVID-19 patients. Instead, the presence of other COVID-19 concerns and gender predicted variations in COVID-19 concerns for one's own safety and the safety of loved ones. CONCLUSION: COVID-19 anxiety symptoms were largely unrelated to caring for COVID-19 patients, while COVID-19-related anxiety around the safety of family and friends added to impaired functioning in addition to the established impact of depression and general anxiety. IMPLICATIONS FOR PUBLIC HEALTH: Provided the replicability of these findings, this research highlights the importance of addressing pandemic-related anxieties in junior doctor populations.

Mental illness and suicide among physicians.

The COVID-19 pandemic has heightened interest in how physician mental health can be protected and optimised, but uncertainty and misinformation remain about some key issues. In this Review, we discuss the current literature, which shows that despite what might be inferred during training, physicians are not immune to mental illness, with between a quarter and a third reporting increased symptoms of mental ill health. Physicians, particularly female physicians, are at an increased risk of suicide. An emerging consensus exists that some aspects of physician training, working conditions, and organisational support are unacceptable. Changes in medical training and health systems, and the additional strain of working through a pandemic, might have amplified these problems. A new evidence-informed framework for how individual and organisational interventions can be used in an integrated manner in medical schools, in health-care settings, and by professional colleagues is proposed. New initiatives are required at each of these levels, with an urgent need for organisational-level interventions, to better protect the mental health and wellbeing of physicians.

The voice of mental health practice in Australia: a mixed-method cross-sectional study of gaps and areas of need.

OBJECTIVES: To examine the perceptions of health professionals regarding the gaps in mental health service provision in Australia and their need for assistance in managing patients with mental illness. METHOD: A total of 570 health professionals participated in an anonymous online survey in January 2018 that assessed: i) health professionals' current levels of need for assistance in the management of patients with mental health conditions; and ii) perceived gaps in the mental health care system, and how these can be addressed. Data were analysed using a mixed-methods approach. RESULTS: Of those surveyed, 71.2% of health professionals and 77.3% of general practitioners reported that they required assistance in managing their patients with at least one stage of care for at least one type of mental disorder. Qualitative analyses revealed eight major themes in health professionals' perceptions of gaps in mental health service provision, including affordability and accessibility, the problems with crisis-driven care and the 'missing middle'. CONCLUSION: Overall, the results of this study provide a concerning insight into the substantial gaps in mental health care within the Australian system. Implications for public health: The results of this study add weight to ongoing calls for reform of and increased investment in the Australian mental health care system.