Dr Sarah Norris
Health Technology Analysts Pty Ltd
Project completion year
The mental and physical health of medical students and health professionals is an area of concern to the medical profession and general community. This project undertook a systematic review of the literature on mental health-related issues in and affecting medical practitioners. The review included primary studies addressing pre-specified clinical questions.
Ten topic areas were selected: prevalence of anxiety and depression, prevalence of substance misuse and self-medication, suicide rates, risk factors for anxiety and depression, help-seeking rates for anxiety and depression, barriers to help-seeking, interventions for anxiety and depression, attitudes of medical colleagues, impact on patient care, and impact on work and family life.
The literature was searched using the Medline, EMBASE, Scopus and PsychInfo databases and the Cochrane Library. Bibliographies of included papers were also examined.
Following review of abstract and title, 402 full-text publications were retrieved and evaluated. Of these, 86 met the inclusion criteria.
Depression and anxiety were commonly identified in doctors and medical students, although there was no evidence that these rates were higher than in the general population or in other medical professions.
Risk factors associated with poorer well-being were positively correlated with depression, and risk factors associated with improved well-being were negatively correlated with depression.
Doctors had a higher rate of suicide compared with the general population, with suicide more common in female than male doctors. Alcohol consumption was lower in doctors and medical students when compared to the general population. However, distinct patterns of drug use were observed in the medical profession, with higher rates of prescription drug use, presumably related to the relative ease of access compared with “street drugs”. Self-medication was common in medical practitioners.
A significant proportion of doctors reported that they would not seek help for depression despite their awareness and understanding of the effects of depression. Barriers to help-seeking included concerns about stigma, career development, impact on colleagues, impact on patients, confidentiality, embarrassment and professional integrity.
There was insufficient data regarding the attitudes of medical colleagues, impact on patient care or impact on work and family life.
Implications for policy, practice and further research
The literature search identified only three studies conducted in Australia, and there were no studies of the prevalence of depression or anxiety in medical practitioners in the Australian setting. Similarly, there is a lack of data relating to indigenous doctors, or to other under-represented groups such as doctors working in regional and remote Australia.
It is likely that the Australian medical system is associated with unique risk factors. Further research into risk factors may help identify medical professionals most at risk of developing mental health conditions.
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