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Top GP issues mental health warning as 400 doctors die by suicide

Professor Clare Gerada has called on the Government to improve support available to doctors, amid data showing over 400 doctors died by suicide in just four years.

According to the BBC, the leader of the national GP mental health support service believes that the rate of suicide within the medical profession may be rising, and she called for the NHS Practitioner Health Programme (PHP) to be expanded to help more people.

The Victoria Derbyshire programme, due to air this morning, will focus on Office for National Statistics data showing that between 2011 and 2015, 430 doctors died by suicide.

Professor Gerada warned that doctors, especially female doctors, are at a higher risk of suicide than the rest of the population, and she linked this in part to the pressure related to receiving patient complaints.

Former RCGP chair Professor Gerada is medical director of PHP, which has offered mental health support to doctors since 2008. But she told the BBC that the programme should be expanded, as currently only London-based practitioners can anonymously self-refer to the service.

PHP is also the provider of the more far-ranging GP mental health service, which was launched in January 2017, and to which GPs from all over the country are free to self refer, anonymously and free of charge.

According to NHS England, some 1,500 GPs have now gone through the programme, but Professor Gerada will say on the BBC programme that doctors with mental health problems remain ‘the last taboo in the NHS’.

She will say: ‘Doctors are at an incredibly high risk for mental illness. Female doctors have up to four times the risk of suicide in comparison to people in the [general] population.’

She will add that of the 5,000 doctors the service has seen over the last decade over two-thirds were women, with the average age dropping from 51.6 years to 38.9 over the course of 10 years.

Complaints from the public have the biggest impact on doctor mental health, Dr Gerada will add, as they can 'shatter their sense of self'.

In 2015, it was revealed that 13 doctors had died while under investigation by the GMC.

Since then, the doctors’ regulator has moved to improve its process, and it revealed in May this year that it had since halted seven fitness-to-practise investigations to spare doctors with mental health concerns.

The GMC’s assistant director of fitness to practice Anna Rowland said: ‘We're committed to continuing this work, and we're also keen to influence the way wellbeing is approached by other healthcare leaders through independent research… Health organisations must come together to tackle these important issues.’

Asked about her comments to the BBC, Professor Gerada told Pulse: 'I am not sure we know whether the rate of suicides is increasing. We do know that the rate of mental illness is - which is of course a risk for suicide.

'I think PHP should expand across England for all doctors, not just GPs. Other doctors are in desperate straights and have very poor access to effective care.'

An NHS England spokesperson said: ‘We launched the NHS GP Health service in 2017, a world-first, nationally funded confidential service which specialises in supporting GPs and trainee GPs experiencing mental ill health and which has already helped more than 1,500 GPs.

‘NHS Trusts and clinical commissioning groups may offer additional support for professionals in their area, for example CCGs in London have commissioned the NHS practitioner health programme for their staff.’

The state of GP mental health

The news comes after a recent survey revealed that two in five GPs have experienced mental health problems, including conditions like depression, anxiety, bipolar disorder and post-traumatic stress disorder.

The launch of the GP mental health service followed lobbying from the profession - and Pulse’s Battling Burnout campaign - for a comprehensive support service for GPs struggling with mental health concerns related to stress and burnout.

The RCGP reported this year that one in four GPs in the UK's devolved nations are so stressed that they feel unable to cope at least once a week. 

And last year Pulse revealed that one in nine GPs has turned to alcohol because of work pressures, while 6% have turned to prescription drugs.

Readers' comments (42)

  • How about just improving working conditions? No, I thought not. So take the sensible option. RLE

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  • Will you please stop talking about 'top GP's. It sounds like tabloid journalism!

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  • Agree with decorumest. Instead of putting money in to support programs instead improve the inhumane conditions were under. Start by ending bull@&&@ complaints before they even get to the poor doctor. Unfortunately lots of money to be made by doctors misery.

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  • ditch appraisal, GMC and CQC. That will save a few lives

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  • I agree with all the above. The Daily Mail referred to me as "a senior GP". That just means I'm over 50. I slept 1 -2 hours last night as I was dreading coming in to work so much today. At 4 in the morning I went for a drive and then a walk. I feel a bit better today.

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  • This is so sad. I am crying in my surgery right now as I type this.
    I have stop responding to silly time wasting complaints as I have decided to fight for myself , my life , my family and my hard earned career. I trained to be a doctor , a saver of lives and not to be bogged down by silly time wasting complaints of the NHS.
    I have made this clear to all my patients, my practice and they know I am dead serious! . The good I do outweighs the so called bad as perceived by patients leading to the useless complaints.
    Is my life and there is no duplicate .As long as there is nothing criminal, whoever wants to destroy my life and my career spanning over 26 years will definitely go down with me,GMC or no GMC.

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  • And who exactly takes responsibility for what has been happening where doctors reach the end of the line? The politicians will merely say ‘we didn’t force you to do that job’ which is probably why there is a relative exodus from NHS medicine.
    When expectations and demands become more appropriate rather than exponentially increasing then that may be a good start.
    I’m glad that I got out after 42 years working for the NHS before it finished me off!

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  • We will continue to have this problem until and unless each doctor is given the absolute right in law to sue for exemplary damages any patient making a false, inappropriate or malicious accusation against them.

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  • we get 10 minutes per patient--- any wonder we can frequently trip up--- a complaint ensues against said dr who took 10 years to train,but realises he/she works in dysfunctional systems--- cannot reconcile his training with unreasonable system constraints-- harms self, especially when we are mostly perfectionists.

    Not rocket science, but then we all knew that!

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  • This is ultimately about deregulation. The DOH have been allowed to cut budgets in an unsustainable way. Hospital management are encouraged to cut staffing and other resources to balance the books but are not accountable to the people they serve or their staff. Front-line staff are then hung out to dry whilst those with real influence get off Scott free. It happens time and time again. Meanwhile a pretty unregulated bunch of quangos CQC/GMC/NHSE/Ombudsman ring the till for every complaint they process. The whole thing is so corrupt it beggars belief.

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  • Is the suicide rate higher than in other occupations?I'll be curious to know.

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  • Medical profession suicide rate is approximately double the average rate in the UK.

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  • Abolishing Appraisal and Revalidation would remove a significant source of stress for GPs. It does not work to improve standards or protect patients. It does waste the equivalent of 500-1,000 full time GPs annually, and wastes of pounds. There ia already a huge amount of data available to identify outliers that could be used to direct focused interventions where there might be problems. The continuing support by the College for this failed system undermines any claims of concern fot the welfare of GPs.

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  • The corrupt colossus, that is the GMC, has engorged itself on the vitality of U.K. medical establishment and has left it an empty shell. Our guardian angel has turned on us and viciously smitten us with appraisal and litigiousness. The leaders of this unprovoked internal assault have consistently been amoral scallywags with a profound ignorance of their social duty. They will devour us all if ...

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  • My doctor friends in other countries have long been shaking their heads in disbelief over the complaints culture here and how GMC/NHS England/indemnity insurances/CQC etc respond and collude to make us the scapegoats for a dying system. Now this: although on one side glad it is not just me this is getting to I am fuming that patients' complaints are allowed to endanger our sanity to that degree. I have equally started - out of sheer desperation - to turn selfdoubt back into the appropriate reaction which should be anger and challenging the maliciousness, lack of respect and willingness to bite my hand off with which a lot of patients think they can treat me. Certainly the preferred option to suicide.

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  • AlanAlmond

    Nobody outside medicine gets this. I was at my mothers funeral last week, a close(ish) family friend who I’d not seen since I was about 10 strolled up to me and with a big smile on his face said, “ you're the one who became a GP arent you..how many days a week do you work... 3 and a half?”

    This guy is old but not old enough to know a country without a free health care system. He hasn’t got a clue ...none of them do.

    Without a seismic change in public perception (which isn’t going to happen) the only thing to do is go part time, wait for your moment and then leave.

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  • Vinci Ho

    The problem is that will always be somebody in our profession , higher up in an establishment or hierarchy, saying that , ‘stop being a crybaby and get on with it . We had no problem 20 years ago’.
    That is exactly the mentality when the Chair of GMC ( retiring this year ) said that doctors needed ‘emotional resilience’ like soldiers in Afghanistan. That was so out of touch and prejudiced .
    We have seen no evidence of real soul-searching from GMC after their own internal review revealed the death of 114 doctors during the FTP processes between 2005 and 2013 .
    This latest figure :
    ‘Figures from the Office for National Statistics, covering England, showed that between 2011 and 2015, 430 health professionals took their own lives.’

    How many more have to die ??

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  • "Since then, the doctors’ regulator has moved to improve its process, and it revealed in May this year that it had since halted seven fitness-to-practise investigations to spare doctors with mental health concerns."

    SEVEN, really?
    100 suicides per year, and the GMC takes steps to help in just the 7 highest risk cases?

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  • I wonder whether a single one of them was a CCG or LMC member or an NHSE official. A breakdown by ethnicity would be helpful - it's a tragedy when lives are lost irrespective of colour or creed but there are human factors inside NHS that cause most tragedies.

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  • I'm now feeling a lot worse. Totally overwhelmed with visits,Docman,scripts,lab results,phone calls,coroner wants to speak to me,reports and assessments requested.

    It is so overwhelming that I don't know where to begin. Knock on the door as Trainee wants helps with Docman.

    This is not why I became a GP

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  • Patient seen 2 days earlier writes to the MP - 'I called the Surgery 67 times today and could not get an appointment. I want an explanation'.
    records show, she was seen on a same day appointment next morning again with no problem.
    However, the zealous MP who has to show she is doing something has written a lengthy leter asking for a stupid explanation and elaboration of how my appointment system works. My answer should be p** off as I have no time, but no - I will sit down and waste patient time by blocking 5 patient visits tomorrow to answer her so another 5 patients can have a reason to complain - and the cartwheel goes round and round.
    When you have imbecile and infantile politicians who don't tell the patient to first raise concerns with the Surgery, this is what you get.

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  • CENSORSHIP?

    I prescribe
    REM SONG ..
    EVERYBODY CRIES ..
    HOLD ON..
    HOLD ON..

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  • CENSORSHIP?

    @unscepted ...
    hopefully in your reply to the mp
    you can throw in there something related to the current drive for
    doctor in hand
    babylon health type services
    and the currnet health secretaries drive for no physical gp's

    I would add an interest in the MP'S appointment list as we have a lot of issues to discuss aswell

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  • AlanAlmond

    Merlin. You sound exhausted. Please sort out a holiday for yourself. I hope you are ok

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  • Unscepted

    Please use the letter to tell it like it is in General Practice. Enlighten the MP on how close to collapse general Practice is.

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  • @4:45and 5:30 - sure intend to give a piece of my mind:)

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  • yes , interesting that this problem has now been given a face but in fact has been a long term problem over the last 3-4 years across the NHS...and may well be a severely growing issue !

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  • The establishment have absolutely no idea what is coming their way!

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  • This is an appalling situation which needs proper evaluation and treatment
    We must stop accepting high stress working conditions where we can not do our job properly and the bullying culture of our commissioners
    who think more and more can be piled on us
    Help...!!’

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  • Unscepted why answer the letter at all? None of the MPs business or expertise.
    Don’t waste your time.

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  • Guess what everyone. The demand and stress will only worsen:

    "The impact of an aging population on palliative care."

    https://www.ncbi.nlm.nih.gov/pubmed/24303834

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  • Thanks Alan. I am exhausted. But oh joy of joys today. Started batting my way through the open surgery when there was the usual ominous knock on my door.

    "Dr Merlin a locum has just turned up that we weren't expecting"

    Marvellous! Give her my patients so that I can make a start on the Admin. OK 800 quid out the window--but I honestly don't care. Today I can breath.

    OK folks--I'm off to put the kettle on.

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  • @10:12 - I have now gone through the letter written by this seemingly grossly disturbed teenager a couple of times which batters not only the GP but also mentions '' bums, alcoholics and junkies in the Parliament''

    Bit of a shock, maybe the MP also needs some sympathy. I'll temper my response so the MP doesn't need counselling:)

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  • I blame the culture of enforced reflection induced by Revalidation and Appraisal , which is now blatantly a formative assessment . Doctors are naturally reflective and introspective . Now we are forced to constantly self immolate due to the pressure induced by appraisal .This constant searching for negative aspects of practice and relentless self questioning cannot be good for ones mental health , especially considering the baseline pressures of the job .

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  • Most doctors do not need or want the support. Just improve the working conditions. Scrap the CQC, GMC and the manslaughter laws. I am looking forward to retirement. If I am younger the best decision is to move abroad for better working conditions. There are no CCG meetings, PPGs, patient surveys,child protection etc.You can actually practice medicine.

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  • @Merlin, I think we've all been there. Difficult patients, too many scripts, time draining complaints, safeguarding letters to write, coroner on the phone, lots of extras, Docman inbox bursting at the seams,very sick patients whose ambulance hasn't turned up, late visit requests etc etc

    We try our best in a broken system. I've been there late into the evening - thinking, "what am I doing here"?

    I think most of us can be proud that we try our hardest, we make a big difference to our patients lives and we work hard - for the right reasons.

    At the end of the day it's a job. It sounds like you need a break. I'm inferring that you're a partner in a single handed practice. Do you need to think about handing in your contract?

    Seriously, we all see in our job that life is short. You don't owe other people anything. It sounds like you have done more than your fair share of good for humanity.

    You can always come back, but have a serious think about a long extended break. Your patients will still be there, but you sanity might return.

    Sending you positive thoughts and love.

    PS - I'm currently loving being a GP - I sooke to our practice manager and made some changes. I've got a much better work life balance now and I think I'm more effective when I'm at work. There can be light at the end of the tunnel, but you have to look after yourself too.

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  • Qato.D.M. Ozenburger. M.S. Olfson.M.

    Jama: Original Investigation. 2018.

    "Medications with depression, depressive disorder, suicide, suicidal thoughts,suicidal thoughts,suicidal ideation, or suicidal behaviour listed as common or serious adverse effects were defined as having a potential for depression as an adverse effect".

    "Suicide and suicidal thoughts and suicidal ideation, and suicidal behaviour were further sub-classified as having suicidal symptoms as adverse effect".

    Several classes of prescription drugs cause akathisia which is the common denominator underlying medication induced suicide.

    The increasing and overwhelming agitation, writhing restlessness and emotional blunting which are the dominant features of SSRI/SNRI induced akathisia are vulnerable to misdiagnosis as worsening or "emergent" serious mental Illness/illnesses.

    The prevalence of clinically significant akathisia in those taking these drugs has been reported as 20%.

    We are told that these drugs are used (apparently?)
    prophylactically in some doctors where adverse professional circumstances have caused vulnerability to depression.
    (R.S.M. Podcast).

    As far as I am aware, no meticulous prescription drug history, record of changes of (akathisia inducing) psychotropic medication, dose increase, decrease, or additional psychotropic drug augmentation is routinely made available as a component of the inquest reports on our colleagues who have died by alleged suicide.

    Surely a greater awareness of akathisia, the risk of misdiagnosis and the associated risk of induced suicidality justifies detailed, unbiased, objective investigation.

    If denial, and unwillingness to address the most serious ADR of SSRIs and SNRis predominates, how can it be known whether or not these tragic deaths in our colleagues, are being mis-classified as "suicide"?

    The life-long devastation of their families becoming even more unbearable as a result of a potentially incorrect verdict.


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  • Great pitch. The current contract is only worth 19.5 million pounds.

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  • Clare Gerada is correct to highlight issues and pressures. ReValidation is unhelpful and resources are inadequate and demands escalating.Workforce limitations will force model of care to change.Government must accept resposibility for current demands.As GP turnover and workforce diminishes their will be political accountability.

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  • "Most doctors do not need or want the support. Just improve the working conditions"

    An recently unemployed depressed patient doesn't need anti-depressants, they need a job. A depressed doctor doesn't need support they need a better job.

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  • CG was responsible for excessive stress to GP trainees as chair. I am glad that I have left the system and hope not to return because nothing is going to change.

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  • Hi this is helping me feel I am . not the only one neither is Merlin.got packed off on sick by occ health for m h reasons 3 days ago and colleagues also at breaking point Would’ve been better to have actually planned a sabbatical before this point bu who’s got the spare money?

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