Mental health: Who doctors the doctors?

The mental health topic is such a diverse one and remains one that is yet to be fully captured and adequately addressed.

Three years ago, the world was ravaged by a global pandemic of epic proportions and countless lives were lost as we stood by watching helplessly and with fear.

Lockdowns helped many of us stay a little safer but also saw medical practitioners see and feel the brunt of the pandemic harder than anyone else on the planet.

We called them frontline workers and yes, they were our real life heroes but the burden and weight placed on medical practitioners is not one we can take lightly.

Even though the pandemic brought intensified mental agony, the reality is doctors still go through gruelling experiences every day.

To many of us, they are obliged to take care of us because that is what they signed up for and as a patient, when a medic delays attending to you, more often than not, blame and complaints of incompetency and lack of dedication to patients go around.

During the pandemic, we saw nurses and medics post and share videos of how challenging it is to work during that period and how isolated they were as they cared for patients.

Many of these nurses talked about the toll that the situation has had on their mental health and quite a number had shared that they did experience suicidal thoughts just to escape the gruesomeness of it all.

Yet they still committed to continue taking care of their patients.

However, I have learnt the very important lesson that should you walk a mile in a doctor’s shoe, many wouldn’t last a minute.

From seeing sick babies, still born babies, youths with promising futures struggle with things we take for granted, cancer patients or even losing patients in the emergency room while the waiting corridors are ever swamped with moaning or patients wailing in pain, medical practitioners see, hear and experience things many of us can’t even begin to imagine possible.

These people play the role of caretakers, healers, counsellors and even psychologists all at once in an effort to help a patient feel their best much quicker.

Their empathic ability calls on to them to wake up the next day and see more patients or spend 72-hour shifts working to save lives.

Questions arise

The questions that arise then are where do they get that resilience to keep moving forward and who helps them unpack all the trauma they see on the daily?

Why aren’t we talking and taking proactive measures for the mental health of the very people to whom we expect expert care from? When are we going to step out of our way to do for medical practitioners the very thing we demand of them?

I have met medics who resort to alcoholism, among others, as a coping mechanism and listening to their stories is enough to send chills up the back of any compassionate human being. The saddening part is how vehemently some of them deny their need to speak with therapists.

For those of us who kept up with social media feeds during the height of the Covid-19 pandemic, the posts and videos of health workers narrating how gruesome their work environments were or how taxing it has been for them mentally, the questions on our minds should have been who do they turn to unpack all these stressors and in the case of Tanzania, should there be a mandatory wellness program for medical practitioners?

“Before anyone can attain the privilege of being titled a doctor or engineer or lawyer, they are first and foremost human beings and as such, they already carry with them the trauma and experiences that life has had on them,” says Doctor Hussein Mebu from the Doctor’s Plaza Heart Clinic in Dar.

“When they come to treat you [psychologically], it doesn’t mean they are necessarily okay; It depends on how they also are and that’s why sometimes you might experience a doctor or nurse breaking off to their own issue while you are in the process of explaining yours. This may be a reflection of what they are dealing with [mentally],” he explains.

As such, Mebu explains that just it is human nature to need to be heard, without judgement, a fact that stretches out to every individual, doctors included.

However, another concern is the ego that many medics operate with. The notion that they are the practitioners and therefore have all health related issues under control is one that in the long run, is misleading.

This is also cemented into them by the acceptance that they are trained to do the job and that somehow supersedes their human need to address that they do grapple with horrific scenes of disease and suffering that their patients go through.

Health and well-being

Health and wellbeing is often just considered to be in reference to the physical state of being disease or ailment free. Having spoken to a few citizen, Your Health observed that when asked the question “What is health and wellbeing,” many responded with reference to eating healthy, keeping active and fit and being free of disease. A few more mentioned the aspect of being in the right mental state.

However, health and wellbeing covers every aspect of life. This means your physical health, psychological and emotional stability as well as social life.

It may seem odd to some that social life is considered part and parcel of health and well-being but human beings are social creatures and therefore, a healthy social life plays a big role in balancing emotions and the psychological state as it affords one their need to be heard.

Doctors and medical care practitioners on the other hand are acutely clear on all that encompasses health and well-being.

Doctors have the knowledge but rarely practice what they preach. “You would find a doctor who tells you to exercise and avoid sugar but they do the exact opposite. They have the knowledge but do not use it for their benefit and tend to get defensive when you call them out on it,” says Mebu.

Doctors and mental well being

“Doctors do not generally have a habit of doing health check-ups proactively. Many do so as a reaction after seeing certain symptoms when in reality, for you to see the symptoms, chances are the illness has been around for a long time,” he says.

He further explains that it takes a doctor who is self-aware to acknowledge that they need to go for a check-up because all these life issues have a way of trickling into other areas and creating unintended ripple effects.

Mental health is an integral and essential component of health. The World Health Organisation (WHO) constitution states that: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” An important implication of this definition is that mental health is more than just the absence of mental disorders or disabilities.

Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.

On this basis, the promotion, protection and restoration of mental health can be regarded as a vital concern of individuals, communities and societies throughout the world.

The National Institute for Occupational Safety and Health, which is part of the Center for Disease Control (CDC), recently sought comment in the Federal Register about supporting the mental health of health care workers, noting that the pandemic had exacerbated health workers’ existing demands at work and “contributed to new and worsening mental health concerns, including burnout, compassion fatigue, depression, anxiety, substance use disorders, and suicidal ideation.”

Physicians face a significant barrier to seeking mental treatment because of the need to report any psychiatric treatment, past or present, to certain state licensing boards and on institutional credentialing forms. Much like having a criminal record, medical healthcare workers may also be hesitant to seek help because of the stigma that surrounds mental health, and they’re afraid of how others may perceive them, especially when their struggles are documented.

In Tanzania, doctors and nurses alike aren’t particularly very forthcoming where their mental health is concerned.

This was very apparent even during interviews held for Your Health where both the nurses and doctors would rather skate around the topic and struggle to find an answer for whether they think they need an avenue to unpack mental stressors.

However, the doctors and nurses who did speak to Your Health at Doctors Plaza Heart Clinic did show optimism for the need to avail services for mental health care for medical personnel in the country.

As doctor Mebu put it, you are human before you are a doctor or a nurse and as such, your mental health care should be as proactively taken care of as any other aspect of your life, if there is any hope for you to be the best version of yourself.