Pulse May 2019 issue - Page 30

30 Opinion Let’s demand support to stop GP suicide Dr Lucy Henshall gave a moving speech at the LMCs Conference in Belfast this year about the suicide of a friend. She says GPs need to start prioritising their own wellbeing Pulse May 2019 leads to individuals becoming martyrs, obsessively workaholic, unnecessarily self-critical and disheartened if they stumble or struggle. The expectation on GPs to uncomplainingly sustain perennially excessive and often unsafe workloads, simply heightens the sense of isolation and despair for anyone who struggles to stay afloat. GPs expect each other to ‘keep going’ in ways they would never expect of their patients. Harsh, but again true.  Breakdown can be triggered by any event – a tense encounter with a patient or colleague, or an illness in the family. A complaint, even if not a serious one, can hit an already vulnerable GP very hard. Most GPs are sailing close to the wind most of the time. Burnout lurking, anxiety and depression knocking at the door. What is needed now is a deliberate and very visible resetting of the balance to enable all GPs to apply their own oxygen masks, before turning to care for patients. This means reinstatement of designated time for meaningful peer support and debrief within the workplace. This could be a 15-minute face-to-face coffee break with all GPs together on a daily basis (with no interruptions), or a weekly meeting with no business agenda beyond time to check in with each other. It could be an external Balint or facilitated peer-support group on a less frequent basis. We should now be demanding the right to close our practice doors so such activities can take place within routine working hours. Locking the door and switching off phones for perhaps one hour a week is not much to ask. Appropriate access to emergency cover is entirely possible to create across the landscape, using technology for support where necessary. This will entail a small investment centrally, with a potentially huge return For too long psychological support for GPs has been wholly inadequate ONLINE You can fi nd a longer version of this piece at pulsetoday.co.uk/ henshall if GPs then remain well, fit and at work, instead of taking long-term sick leave, early retirement or, in the very worst cases, suicide.  My speech clearly resonated with colleagues at the Waterfront Hall in Belfast, who rose to their feet as one, and then paid their respects to our many peers lost by suicide, with a powerful one- minute standing silence after the debate.  It was deliberately a starting point, not an endpoint. There is much to be done to embed in our working lives the support we deserve as the norm, not an afterthought. I am proud to have played a part in triggering thoughts, reflections, conversations and noise. As a profession we now need action. Each of us can start in our workplaces, by reinstating meaningful peer support and prioritising clinician mental wellbeing. Collectively, we can continue to campaign for funding and access to other support, such as coaching and mentoring. Our representatives at the BMA and RCGP have key roles in pushing ahead with this agenda. But the first task is perhaps the most important: persuading all GPs to value and prioritise their own psychological wellbeing, and that of their colleagues; reinstating humanity and mutual respect and displaying kindness and compassion to each other, especially to those who are struggling. We each and all deserve love and care, not criticism. Reach out to a colleague today, make them a cup of tea, offer them your ear and your time. Show kindness. Doing so may just save a career, or even a life. Dr Lucy Henshall is a portfolio GP, vice-chair of Suffolk LMC, East of England clinical lead for GP Health Service and founder of Suffolk GP Welcome Back to Work Service. S peaking about the suicide of our dear friend, my husband’s former GP partner Dr Rich Bennett, was an easy decision. I knew real stories would be the best way to convey meaning to the audience – and to have lasting impact. Figures are forgettable, stories travel. Suicide among doctors is an unsavoury reality that is still largely unseen, and is generally spoken of in hushed voices behind closed doors. It’s almost an embarrassment to the NHS – 157 doctors have died by suicide in the past 10 years, according to the Government’s adviser on suicide prevention Professor Louis Appleby. The tragic reality is that we continue to lose some of our best doctors to suicide, because the toxic system in which they do their extraordinary work, and to which they have dedicated their lives, has failed them as human beings. This is a scandal. For too long provision of psychological support for GPs has been wholly inadequate. Instead of protected time, space and opportunity to process the emotional burden of caring, and embedded coaching and mentoring within our career structures, we are expected to self-manage and largely ‘just cope’ with all that is thrown at us. Possibly with a one-off mindfulness course, or occasional CPD activity that touches on wellbeing and self-care for an hour or so. Shameful. But true. Our work – our vocation – is demanding of our energies, emotions and intellect in equal measure. Excellence is expected across the board. For many in medicine, the first experience of ‘failing’ is a devastating experience, compounded by the attendant criticism and pressure to ‘do better’. In combination with common traits in medics such as perfectionism, altruism and keen attention to detail, this