A third of South African doctors surveyed by MPS, the international medical defence organisation, have experienced a decline in mental wellbeing as the COVID-19 pandemic progresses and will need specialist support to avoid "huge swathes" of doctors either leaving the profession or suffering in silence.
"The South African government and private healthcare providers must plan now for the mental wellbeing support doctors will need due to the COVID-19 pandemic, if we are to avoid huge swathes either leaving the profession or suffering in silence," the Medical Protection Society said.
MPS said plans must include specialist psychiatric and psychological support for those struggling with depression and PTSD, alongside measures to ensure the system has capacity so those needing treatment or time to recuperate are supported without adding to staff shortages or detracting from patient care.
The organisation said plans should be supported by all role players – including central government – to maintain local initiatives such as counselling services, while taking steps to increase awareness and research into mental health and provide more practitioner wellbeing support services.
The call comes as a survey of MPS members (conducted by Research By Design) showed that a third of doctors (32%) feel their mental wellbeing is worse compared to two weeks previously. Concern about the health of family and friends (60%), finances (54%), their own health (42%), and the health of patients (40%) were cited as having the most impact on healthcare professionals’ mental wellbeing.
Dr Volker Hitzeroth, medicolegal consultant at MPS, said: “Adrenaline will be carrying many healthcare workers through this pandemic and helping them to cope despite the exhaustion and tragedy they experience daily. It is when the crisis recedes and there is time to reflect that the accumulated stress and trauma may surface – this is the time healthcare professionals will be most at risk and need support.
“The government and private healthcare providers should be actively planning for this time now. A range of support will be needed; some will experience grief or moral injury, some may have unresolved anger over issues such as PPE supply, or distress and fear of reprisal at being unable to treat patients with non-COVID-19 conditions. Others may suffer with depression and PTSD, and many are at risk of burnout set against a backdrop of an already burnt out workforce. Possible regulatory or prosecutorial repercussions are an underlying threat faced by all who treat COVID-19 patients, compounding the mental strain of healthcare professionals.
“Mental wellbeing is not just a challenge to be met by the government; hospitals and professional societies have a part to play. Many professional societies have stepped up with dedicated colleagues looking after the wellbeing of their members. A nationwide campaign to raise awareness and provide additional support would help join up these efforts and ensure those healthcare professionals who need specialist support can access it when they need it most.
“But any plan must also build capacity and support into the system. Many doctors will not take time off to seek help if they are worrying about the extra workload for colleagues, or that they will be viewed as weak.
“If we don’t act now many doctors will become burnt out and disillusioned or continue with chronic mental health conditions – both of which put the safety of themselves, their families and their patients at risk. Many others may sadly choose to leave the profession.
“Even after the worst has passed, COVID-19 will continue to bring pressures and complications, compounded by a significant clinical backlog to deal with. The last thing we want is huge swathes of healthcare practitioners leaving the profession after COVID-19. This must be avoided – it is time to care for healthcare professionals just as they are caring for us.”