The missing discourse on mental health of psychiatrists during COVID-19

To the Editor

Researchers have often highlighted the higher-than-expected rates of physical illnesses, psycho-social morbidities and completed suicide among psychiatrists (Firth-Cozens, 2007), likely stemming from lack of self-care. Among 59 abstracts available on PubMed using keywords ‘(“COVID” [TiAB] OR “CORONA*” [TiAB]) AND (“Psychiatrist” [TiAB])’ (accessed 4 July 2020: 1600), there was a conspicuous absence of scientific discourse on the mental health (MH) needs of psychiatrists themselves during the ongoing COVID-19 pandemic. It is concerning when contrasted against 14,855 abstracts available for ‘COVID [TiAB]’ (PubMed, accessed 4 July 2020: 1600), perhaps reflective of a practiced attitude of putting our patients before ourselves. Various professional bodies have warned against the detrimental effects of this mind-set.

With the ongoing pandemic, psychiatrists are facing unprecedented challenges. Davies (2020) has highlighted the very complex adaptations we are making in these times, and Singh (2020) has brought out the increased challenges being faced by us in terms of looking after our patients and their manifold needs. He made an astute observation regarding the need for MH support to ‘front-line medical staff’ and pitched for a reduction in burnout among this group. However, there was no emphasis on a similar need for psychiatrists themselves.

Some of us are possibly facing similar stresses as our patients—of being exposed to the risks of infection, unfiltered information and anxiety around our families’ well-being. At the professional front, virtual cessation of face-to-face peer interactions is likely adding to the sense of isolation, and enforced adaptations to newer frameworks as telehealth are uncomfortable for many, however.

Australia is also served by a large number of overseas-trained medical graduates in psychiatry, who are additionally facing uncertainties in their home countries and of international border closures.

The Royal Australian and New Zealand College of Psychiatrists recognized very early that the demands on psychiatric services were likely to increase and has advocated for focus on MH services (https://www.ranzcp.org/news-policy/media-center, last accessed 4 July 2020: 1600). It has also started ‘Emergency response register COVID-19’ to link psychiatrists with frontline healthcare workers and address their needs. However, an explicit focus on psychiatrists themselves seems lacking.

Why are we, as a responsible group of professionals, so reluctant to advocate for our own MH? Above-mentioned personal and professional demands are bound to overwhelm our capabilities, and it is imperative that we address the elephant in the room. As doctors, it is not only our ethical responsibility to look after ourselves, but we also owe it to our patients.