The news of a Medical student recently committing suicide in Mumbai, has indeed touched the hearts, and brought tears to many medical professionals, who not only sympathise, but also empathise and understand the plight which medical students undergo today. Medical education in the country, today, comes with a degree of pressure that young mind cannot anticipate in advance, often breaking down when coming face to face with the harsh conditions inherent in the medical education.
The statistics of suicide among doctors and Medical students is frightening and on an average about 400 doctors commit suicide every year. The cause of suicide is cited to be increasing incidence of depression in medical professionals and according to an estimate 12 per cent of males and 18 per cent of females suffer from depression. Medical students and residents are even more vulnerable as 15-30 per cent of them are screened positive for depressive symptoms.
Its important that as fellow medical professionals, we must lookout for our friends, fellows and colleagues, screen them for depression and offer help at every point. Some of the possible causes of Stress & Depression which may lead to suicide in various groups may be
• Among students– Many students who were toppers in their school are shocked to find themselves in the middle or even at the bottom of the class in the medical college. Sense of lack of competence, frustration develops leading depression because of poor performance and repeated failure in the examinations. Man students also encounter problems with English language as study medium, have inability to cope with work related stress and resort to use of drugs/alcohol.
• Among residents– Stress and strain of long working hours during residency, harassment and ridicule in public by seniors, failure to get speciality of choice, use of drugs/painkillers/alcohol, ear
• Among senior doctors– Many Senior doctors have also become victim of depression and suicidal thoughts. Failure to reach expected economic goals ,Continuous long exposure to professional stress and strain, loss of reputation, Marital discord due to competition with doctor spouse, failure to recognise depression and resorting to self-medication, , overindulgence with drugs/alcohol are some of the possible causes for the same.
Following measures may be taken for Preventing Suicide among Medical Professionals
1. Competence Assessment at admission:There should be a system of assessing the academic, emotional as well as psychological suitability of the student at the time of admission to prevent a mismatch between the student’s competence and the requisite competence.
2. Provision of adequate Physical/Mental Rest and Recreation: One reason for undue stress and burnout is overwork in long 12 to 24 hour shifts. The authorities must ensure that the hospitals employ adequate manpower as per the norms so that no resident is grossly overworked.
3. Faculty Members and Seniors may be asked to be consciously respectful to students and Juniors especially in Public.
4. Faculty Members should form a support group for providing social psychological support and guidance. On weekends free interactions between juniors, seniors and the faculty members over a cup of tea would provide an excellent opportunity to mix around, enjoy and take a break from work fatigue. Students and residents should be made to realistically understand the level of their competence and the pace at which they can progress. Unnecessary competition with the better ones only leads to tension, disappointments and depression and may best be avoided.
5. Prevention of Burn out by organizing Stress Busting Activities like Physical exercises, sports, recreational activities, meditation, yoga, relaxation techniques, and hobbies.
6. Engaging faculty to monitor use of Non prescription drugs including painkillers and tranquilizers by the students/residents.
7. Resolution of Grief: In case some individual has known cause of grief, she/he must be looked after with extra rest, nutritious eating, and opportunities of participation in extracurricular activities may be provided to him.
8. Counselling Services and. Suicide Hotline: Opportunity of availability of timely help/counselling from Support Centres can be created in collaboration with department of Psychiatry and a Suicide Prevention hotline can also be provided and publicized.
9. Starting Websites that allow students to screen themselves anonymously for depression and taking help of counselors who may encourage them to come in for evaluation/treatment, observing full confidentiality. Special efforts should be made for removing the stigma and other barriers to reporting and treating depression and encourage the students to come forward and seek timely counselling and help.
What else can be done to put a stop on increasing tendency of suicides among doctors? Please share-