This definitive textbook on practitioner health mixes academic rigour with practitioner and patient experiences. It is a unique book covering care relevant to any regulated health professional, focusing on the care of doctors and nurses with mental illness. The book builds on themes introduced in the award-winning publication Beneath the White Coat: Doctors Their Minds and Mental Health from the same author. It provides an invaluable ‘how to manage’ companion to supplement and enhance the broader issues relating to doctors and mental illness addressed in that first book.
Key Features
- Creates a thorough framework on how to assess a health professional with mental illness
- Includes evidence-based guidance on the diagnosis and management of common mental health problems in health professionals
- Supports an understanding of how the workplace affects mental health and how mental health affects work in the context of doctors working in a variety of settings
- Provides an understanding of the regulatory framework governing different health professionals
- Offers practical advice and guidance on primary prevention measures, including ‘how to spot doctors in distress’, ‘how to approach a doctor colleague to express concern’ and ‘how time and space can be developed within a department to address stress and burnout’
Drawing together 15 years of expertise in caring for more than 17,000 doctors with mental illness, the book is relevant to any health professional working in clinical practice. It will be essential reading for those who regulate, appraise, train, and support health practitioners across various disciplines.
Introduction, Acknowledgements and About the Authors.
Chapter 1 Setting the Scene.
Practitioner Health. Competences. Practitioner Health (UK) vs. Physician Health (North America).
Chapter 2 The Wounded Healer.
Chapter 3 Doctors and Mental Illness.
Burnout. Compassion Fatigue. Depression. Anxiety. Post-traumatic stress disorder (PTSD) Addictions. Barriers To Seeking Help for Doctors Who Have an Addiction Disorder. Problems Linked to Addiction. Why Do Doctors Develop an Addiction Disorder? Changes In Presentations to Practitioner Health (2008-2022). Personality Disorder. Autism. Attention Deficit Hyperactivity Disorder (ADHD). Bipolar Affective Disorder (BPAD). Suicide
Chapter 4. Why Doctors Become Mentally Unwell.
Personality. Psychological ‘Ego-defences’. Cognitive Distortions. Organisational Defences. Choosing Medicine Wrongly.
Chapter 5 Risk of Mental Illness.
Socio-Political Factors. Culture And Practice. Blame And Fear. Stigma. Shame. Bullying And Racism. Industrialisation Of Care. The Workplace. Sleep Disturbance. Workload and Intensity of Work. Organisation, Resilience and Working Practices.
Chapter 6 The Doctor and Their Speciality.
Speciality.
General practitioners. Psychiatrists. Surgeons. Anaesthetists. Paediatricians.
Vulnerable Groups.
International Medical Graduates (IMGs). Support of IMGs. Female Doctors.
Chapter 7 Factors Influencing Seeking Help.
Fear of Lack of Confidentiality. Adapting to the patient role. Doctors Treating Their Own. Tips for treating doctors with mental illness. Patients, the public and their views of sick doctors.
Chapter 8 Engagement, Assessment, and Formulation.
Making Contact. The Consulting Room. Understanding Dual Responsibilities. Setting And Maintaining Boundaries. Initial Assessment. Formulation.
Chapter 9 Suicide Risk and Management.
Assessing Risk. Eight Truths About Suicide.
Suicide Risk Factors in Doctors.
Life events. Isolation and Loneliness. Access to drugs. Self-harm versus suicidality.
Managing The Suicidal Patient.
Chapter 10 Impact of Complaints.
Complaints. Relationship Between Mental Illness in Doctors and Complaints. Dealing With Complaints.
Chapter 11 Mental Illness and Professionalism.
Receiving a Complaint. Professional Behaviour. Involving The Regulator? Refer Or Not Refer? GMC Health Procedures. Outcome Of GMC Investigations. Medical Practitioners Tribunal Service (MPTS). Reasons For Sanctions by The Regulator. Report Writing.
Chapter 12 Confidentiality and Information Sharing.
Information Sharing. The Caldicott principles.
Chapter 13 Management of Mental Illness.
Management of Burnout, Depression and Anxiety. Management of Addiction. Stages Of Recovery. Overcoming Ambivalence to Change. Motivational Interviewing. Making The Diagnosis of Addiction. The Aim of The Assessment. Detoxification. When to refer doctors with substance misuse disorder to the regulator (GMC or GDC). Doctors With Substance Misuse and Regulatory Involvement. Abstinence vs. Substitute Treatment and Controlled Drinking. Supporting Recovery. Relapse.
Mutual Groups Supporting Addiction.
The Sick Doctors’ Trust (SDT). The British Doctors’ and Dentists’ Group (BDDG). The Dentists’ Health Support Trust (DHST). Other mutual support groups.
Return To Work. Outcome. Management Of Bipolar Disorder.
Chapter 14 Presenteeism.
Chapter 15 Returning to Work.
Timing Of Return to Work. Planning Ones Return to Work. Fitness To Work Related to Performance Issues.
Chapter 16 The Role of Occupational Health.
Chapter 17 Talking Therapies.
Psychodynamic Psychotherapy. Cognitive Behavioural Therapy (CBT).
Counselling.
Mentalisation-based therapy (MBT). Dialectical Behavioural Therapy.
Group Therapy. Schwartz Round. Balint group.
Chapter 18 Reflections.
From a Cognitive Behavioural Therapist (CBT) working at PH.
On running a group for doctors unable to work due to regulatory sanctions. On running reflective groups for doctors. A Personal Tale.
Chapter 19 Self-Care.
Tea & Empathy. Dealing with stress. Exercise. Nutrition. Sleep.
Chapter 20 And finally.
The ‘Restored Healer’.
Index.
Biography
Dame Professor Clare Gerada is an international leader in practitioner health and, until recently, has led the largest physician health programme in the world. She is a Co-Chair of the NHS Assembly and Past President of the Royal College of General Practitioners, UK.
