Article type: Opinion Piece/View Point


Author: Rajvi Chaudhary (Founder, GSNMH)





Everyone knows the arduous journey of getting admitted to medical school. It is so painful to hear about someone from your fraternity taking suicidal steps after crossing the wall of the long haul. We do research in many areas but did not do enough studies to discuss the emergence of mental health challenges we face. Being a health care professional (HCP) doesn’t necessarily grant them the privilege to seek early aid for their mental health issues; rather, they feel more stigma for seeking help.1

There was already a shortage of HCPs in India, and COVID-19 worsened it. After facing many deaths from COVID-19 during my internship, I contemplated how I could become a doctor if I couldn’t handle the stress in the field. Like me, many HCPs may have these thoughts, but many have shielded themselves very well. Can it be a downside or a silver lining for them? Would putting aside the shield for some time make them less of a warrior? Can’t they ask for help to heal their mental wounds? 

In India, the pandemic significantly affected HCPs’ mental health. For example, some landlords or society members prohibited HCPs from entering their homes to work in COVID-19 facilities. After working long hours, grounding themselves was essential; instead, they had to fight to enter their homes. Numerous had faced violence in the hospital itself. Many of the HCPs had thought: Did I choose the right profession?2 What an irony it is.

Lately, many medical students and residents have ended their lives by suicide. In an editorial in the Indian Journal of Psychiatry, the authors stated, “The time has come to take urgent steps to prevent the premature loss of young and productive lives.” Educational reforms like teaching medical students from the first year to handle the stress in the field can improve their resilience. For residents, sessions on managing stress would help them to cope with mental exhaustion. Psychiatry departments of medical colleges and university authorities need to get engaged to alleviate this issue.3

Chahal et al. 4 found that a total of 358 suicide deaths among medical students (125), residents (105), and physicians (128) were reported between 2010 and 2019 in India. Ragging, discrimination, nepotism, and marital discord were leading causes of suicides among them. Researchers in this study also recommended that this preventable domain should be further explored through focused research.

In a recent survey, Das et al. 2 reported that medical students and residents take suicidal steps due to academic and work-related stress, mental illness, and workplace harassment. Hectic long working hours for HCPs significantly impact their well-being. Supe and Burdick5 reported that most districts of India lack adequate hospital supplies, leading to considerable stress on HCPs to provide the best possible care.

In my undergraduate years, I used to think that don’t health care workers also need mental health assessments once in a while? Don’t we need a solid curriculum to teach students how to handle stress in the field the day they enter medical school? Teaching when and where to seek help when things become overwhelming shouldn’t be this hard.

I think that all levels of medical professionals and authorities are essential stakeholders and are equally responsible. We must be committed to improving mental health-related issues in our profession, thus decreasing and eliminating suicides.


References:

  1. Gerada C. Doctors, suicide and mental illness. BJPsych Bull. 2018;42(4):165-168. doi:10.1192/bjb.2018.11
  2. Das N, Khar P, Karia S, Shah N. Suicide among Health Care Professionals-An Indian Perspective. Healthcare (Basel). 2022;10(2):354. Published 2022 Feb 11. doi:10.3390/healthcare10020354
  3. Singh OP. Increasing suicides in trainee doctors: Time to stem the tide!. Indian J Psychiatry. 2022;64(3):223-224. doi:10.4103/indianjpsychiatry.indianjpsychiatry_355_22
  4. Chahal S, Nadda A, Govil N, et al. Suicide deaths among medical students, residents and physicians in India spanning a decade (2010-2019): An exploratory study using on line news portals and Google database. Int J Soc Psychiatry. 2022;68(4):718-728. doi:10.1177/00207640211011365
  5. Supe A, Burdick WP. Challenges and issues in medical education in India. Acad Med. 2006;81(12):1076-1080. doi:10.1097/01.ACM.0000246699.94234.ab