4 Apr - Practitioner Health Matters Programme confirms it helped 47 practitioners in its first year
Doctors make up the vast majority of referrals to the service
Substance misuse was the most common standalone presenting problem followed by anxiety and depression
A new service, the Practitioner Health Matters Programme (PHMP), which supports health professionals who may have addiction or mental health issues, has confirmed it helped 47 practitioners in its first year of operation.
GPs, Non Consultant Hospital Doctors and Consultants made up 86% of referrals to the new confidential Programme which is open to doctors, dentists and pharmacists.
An independent charitable organisation, the PHMP has the support of the representative and training bodies for the medical, dental and pharmacy professions as well as the three professional regulatory bodies.
The issues
In its first annual report the PHMP said 30 practitioners presented with a single problem at registration while 17 had more than one problem.
Substance misuse was the most common standalone presenting problem (15) followed by anxiety (6) and depression (4). Where practitioners presented with a combination of issues, depression was the most common presentation (13) followed by anxiety (10) with substance misuse in combination with other symptoms being found in a further seven cases.
While women made up just under half of the total (23), they were the clear majority in both the youngest (24-29) and oldest (60-69) age groups. While there were eight women in the youngest age group, their highest representation, this was the group with the least number of men, with just three. Overall the largest number of registrations, 13, was represented in both the 30-39 and 50-59 age groups.
Almost half of all referrals were self-referrals (22) while eight referrals were made by a consultant psychiatrist and six were referred by a colleague.
The Outcomes
Over half of all practitioners patients registered on the programme have continued working in their professions and with the support provided by PHMP, did not require to take time off work. Six were required to stop working for a period of time but have now either returned or are returning to work in the near future.
Seven patients are not currently working; of these one has retired and the others are deemed unfit for practice and are under ongoing review. Seven others are attending the Health Committee of the Medical Council.
Clinical Lead Dr Íde Delargy
Dr Íde Delargy, the Clinical Lead for the new Programme said health professionals are very slow to come forward to declare that they may have a mental health or alcohol or drug related problems due to reputational/confidentiality issues. She said they also generally present when in crisis, often having tried to self manage and self medicate their problem.
“After our first year in operation the PHMP has offered almost 50 practitioners access to a high standard of care in a nonjudgmental atmosphere and with complete confidentiality assured. We want to get the message out there that health professionals in difficulty can come to us to have their health needs met” she said.
“Early intervention is key and while taking that first step can be extremely challenging, for the person involved or their friend or family, it can also be lifesaving. If practitioners come forward early and get the help they need the statistics show their chances of getting back to work are very good. Practitioners who access a service from a designated programme like this do extremely well and about 80% recover and return to working well” she said.
The future
Like the general public, it’s estimated that 1 in 4 practitioners may have mental health difficulties at some point in their lives. With alcohol or drug related problems the rates in the general population are between 10 -15%. It’s believed the rates amongst doctors, dentists and pharmacists are at the upper end of this spectrum and they are also considered to have higher suicide rates.
Mr Hugh Kane, the Chairperson of the PHMP said that with over 25,000 doctors, pharmacists and dentists in the country the PHMP would anticipate that in excess of 2,000 practitioners may require help on an annual basis.
“One of our main aims for 2017 will be to engage in an awareness raising campaign of this service amongst health professionals. The other is to establish a sustainable funding model for the Programme. “
“From the start we didn’t want the lack of funding to be a barrier to the service and we don’t believe it has. However as demand for the service grows we will require additional funding and resources and we will be looking to all the relevant bodies to support us in our endeavours to develop the service further in the year ahead”
For full details of the Programme go to www.practitionerhealth.ie
Notes to Editor
Case Study 1
A male practitioner presented at the request of his partner who is also a practitioner. The couple had been under considerable stress due to financial concerns, and a new baby within a couple of months. As a result of these pressures he had resorted to using alcohol to excess and was binge drinking at weekends in particular. This had become a feature of his coping mechanism and a mechanism for dealing with stress. He was not functioning well at work, not enjoying his work and procrastinating with a range of business related matters which were mounting up and adding to the stress. Following initial assessment and a mental health assessment, the practitioner demonstrated good insight and good motivation to reverse his situation. A random alcohol screening programme was put in place with regular reviews with the PHMP team. The practitioner has remained alcohol free for many months now, his mental health has improved significantly as well as his physical fitness and wellbeing. He states that he has not felt so well in years.
Case Study 2
A pharmacist with previous mental health problems in adolescence self-referred to the programme in significant distress. The practitioner had broken down at work and had been advised not to return to work until better. Due to his location of work he was unable to access the medical help required as he was now separated from his original mental health team and was isolated from family and friends. The practitioner was depressed, anxious and tearful. He was on medication from his own GP but compliance was erratic. Following assessment it became evident that a combination of long working hours, poor work life balance and binge drinking with friends at weekends were all contributing to his poor functioning. He was referred to a Consultant Psychiatrist who works closely with the programme. Medications were adjusted and although other recommendations were made the practitioner again did not comply with these recommendations. A number of further sessions with PHMP were required for the practitioner to develop insight and this remains an ongoing challenge. An alcohol management plan has also been introduced and the practitioner remains under close review.
Case Study 3
A young practitioner was referred to PHMP by her programme director. The doctor was the subject of a complaint to the medical council following an adverse event in the hospital. The doctor was feeling very anxious, dejected and worthless and while it appeared unlikely that the doctor would be found in any way at fault, she found herself ruminating about the event, could not sleep and was becoming increasingly stressed and distracted. A short period of time off work to rest and recover was recommended. A number of consultations were offered which provided a safe, confidential space for the practitioner to discuss the issues. PHMP supported the practitioner in getting the circumstances into perspective and to help her regain her confidence in her abilities. She is back working healthy and well but remains under review.