It is well known that doctors are at higher risk of depression, anxiety and suicide than almost any other profession.
Now, a global review led by UNSW Sydney and Black Dog Institute has revealed which intervention approaches could help – and where research is still needed.
Approaches that built doctors’ skills, like mindfulness and face-to-face interventions, showed the biggest promise in the review published recently in Nature Mental Health.
The study analysed 24 international studies involving 2336 practicing doctors.
Lead author Dr Katherine Petrie, a postdoctoral research Fellow at UNSW Sydney and Black Dog Institute, said the review found certain mental health interventions could improve outcomes for doctors, and that these positive effects appear to hold up over time.
“Skills-based approaches – such as mindfulness and mind-body techniques like meditation – had a moderate positive effect on reducing symptoms like anxiety and depression,” she said.
“Other skills-based programs such as cognitive behavioural therapy, stress management, and peer support had an even stronger positive effect.”
The study found programs that only provided educational information about mental health, without teaching practical skills, did not show a meaningful benefit.
The review also uncovered a concerning absence of high-quality research into organisational-level interventions designed to improve physician mental health.
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Dr Mark Deady, workplace mental health research lead at Black Dog Institute, pointed out that despite clear evidence that poor working conditions contribute to psychological distress among doctors, no controlled studies had evaluated interventions that target workplace factors at the organisational level.
“We know that working conditions have a major impact on physicians’ mental health – yet not one study examined organisational-level interventions that aimed to improve physician mental health through modifications to the work environment, such as modifying working hours or rescheduling rosters,” he said.
“This gap is now too wide to ignore. Workplaces have real potential to be part of the solution. The evidence shows that multi-level approaches are essential for creating mentally healthy workplaces.”
Dr Deady said without more research into these interventions, opportunities to implement solutions that meet doctors where they are, within the environments that are contributing to their distress, would continue to be missed.
“If organisations do not address the stressors and hazards present in the working environment, it is unlikely that skills-based interventions alone will have a meaningful or sustained effect.”
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Dr Petrie said the review also highlighted a stark gap in suicide prevention research.
Just two studies examined interventions that targeted suicidal ideation among doctors, despite their elevated suicide risk.
“The lack of suicide-focused research is particularly alarming given the increased suicide risk among physicians compared to all other professional groups and the general population,” Dr Petrie said.
“This must be treated as a critical research priority.”
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Dr Deady said while further research was needed to confirm the most effective delivery formats and strategies, the findings provided guidance for integrating mental health support into broader organisational programs.
“Given the mental health morbidity among physicians, our results provide important guidance for workplaces as to some promising interventions that could improve the mental health of this workforce,” he said.
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