While the country is still reeling from the loss of revered cardiologist Professor Bongani Mayosi, following his tragic suicide after battling depression for two years, his death has resulted in new concern and discussion around the mental health of medical practitioners.
A study recently published in the SA Journal of Psychiatry indicates that symptoms of mental wellness issues, such as burnout – which can be a forerunner to clinical depression – can start as early as a medical professional’s student years.
Burnout, according to the study, describes a process of mental exhaustion. It has been shown to “have a devastating impact on health professionals, such as declining mental and physical health as well as quality of life, which has serious repercussions for health professions as the career becomes less attractive”.
Compared with the general population, the researchers also noted how students and medical practitioners had a higher prevalence of burnout and stress-related mental disorders.
Researchers set out to determine the association between levels of burnout and quality of life among 121 fourth-year medical students at the University of the Free State who were in their first semester of the clinical phase.
“It is well established in research that burnout is the forerunner for clinical depression and that the two conditions share certain similarities. The mental exhaustion experienced in burnout is similar to that experienced in depression,” Edwin du Plessis, the study’s corresponding author, told City Press this week.
“From the middle of their third year, students are exposed to more practical work as the start of the clinical years. Students are expected to see patients under the supervision of more experienced clinical staff, attend clinical ward rounds and perform after-hours duties like being on call,” he said, adding that this could be extremely gruelling as the students still had to keep up with their theoretical work and also prepare for the following day.
The researchers used the internationally recognised Maslach Burnout Inventory and assessed the risk of burnout by exploring three components: emotional exhaustion, depersonalisation and personal achievement.
“The most surprising of the results was how common the occurrence of high levels of burnout among the fourth-year students was, with 46.1% experiencing it.
“We always expected to find the levels of burnout to be high, given the demands placed on these students, but we were still very surprised as to the extent of the problem,” Du Plessis said.
Psychiatrist Jan Chabalala said what was particularly surprising for him about Mayosi’s suicide and the discussions many people were having around depression, was the misconception that “successful and intelligent people don’t become depressed”.
“People think that because you supposedly have ‘everything’ in a material sense, and are intelligent, you won’t suffer from mental illness. But the bottom line is that Mayosi was a human being, and disease is everyone’s risk,” he said.
Chabalala conceded, however, that certain professions were predisposed to their employees suffering from depression.
“For instance, dentists, gynaecologists and anaesthesiologists all have high suicide rates because they deal with a lot of complaints and litigation if operations do not go well. That criticism is stressful and can knock one,” he said.
Du Plessis said people often underestimated the impact of stress on mental and physical health.
“Unfortunately, issues surrounding mental health still carry a lot of stigma in South Africa. This often prevents people from seeking help when it is clear they are not coping.
“Acknowledging you are not coping is not a sign of weakness, but rather a sign that you are looking after yourself,” he said.
Du Plessis advised medical students to focus on time management, adding that the effective use of time opened up more free time. See Voices