Mental matters: Doctors’ mental health needs more attention

Mental health for doctors is a serious issue that does not get enough attention. Like Covid-19, it is close to being a pandemic. As an anaesthetic registrar working at Mthatha General Hospital in the Eastern Cape, Dr Yakheka Dyasi is alarmed by how many of her peers struggle with burnout, depression, substance abuse and suicidal ideations. 

“In SA, burnout syndrome in anaesthetic registrars was reported to be about 27% in 2013,” she says. “In 2020, it was at 36%. That’s almost a 10% increase.”

In 2021, the 33-year-old doctor received a Discovery Foundation Rural Individual Award for her study on the prevalence and risk factors of burnout syndrome in anaesthetic registrars in eight medical schools in SA.

“I work in a disadvantaged province, the Eastern Cape, where burnout in anaesthetic registrars is a big problem. I needed help to expand this study so the message can reach the relevant bodies to make a real change in this group of scarce, critically needed specialists in SA,” she says.

Dyasi says though burnout in doctors is a popular topic in literature worldwide, the prevalence, risk factors and impact is not well studied. 

“It is worse for us in a resource-limited setting such as SA. In the past eight months, two anaesthetic registrars have committed suicide. We don’t know why they did it, but I believe burnout syndrome is definitely one of the contributing factors,” she says. 

Why anaesthetists suffer from burnout

“In our country, especially in the public sector, the shortage of doctors and limited resources play a big role in burning out the few doctors we have,” says Dyasi. 

“The main stress with anaesthesia is that the life of the patient is literally in your hands. The type of work we do requires extreme concentration, because even a small mistake could cost the patient their life or impact their quality of life.

“On top of that, you’re going through the many requirements to be a specialist. There’s unfortunately limited psychological support when you’re a registrar; you’re expected to just handle it all. When you admit to burnout, people think you’re weak. Then there’s also a culture of professional bullying of registrars by seniors.” 

“It’s important to highlight that registrars from different medical schools may have different reasons for experiencing burnout, depending on their environment. So, our approach should be different in how we address it.”

Finding solutions together

With her mixed-research study, Dyasi aims to understand the risk factors of burnout in anaesthetic registrars in different provinces and universities, and with different historical backgrounds. She plans to extract themes from interviewing registrars on what they think should be done to mitigate the problem.

“The aim is to draft evidence-based recommendations to present to all the: medical schools and anaesthetic heads of department, the Colleges of Medicine of SA, the SA Society of Anaesthesiologists and Health Professions Council of SA on how to deal with this problem we are facing,” she says. 

Why this is a timely and relevant project

“SA has an overburdened health system, with a shortage of anaesthetists. We need more specialists that are registrars. We are sadly running a risk of losing more of these doctors yearly. The mental health of a doctor has an enormous impact on our public health system,” she says. “This problem is so much bigger than I thought at first; registrars are suffering so much that most even regret getting into the programme.”

Discovery Foundation alumna guides the way

Dyasi’s research supervisor is none other than Professor Busisiwe Mrara, a former recipient of a Discovery Foundation Academic Fellowship Award, who in 2020 made history as the first super-specialist at Nelson Mandela Academic Hospital. As president of the College of Anaesthetists, Mrara became the first black woman to hold the position in the Colleges of Medicine of SA.

“She is dynamite,” says Dyasi. “She’s so academically driven and always aiming to improve and empower those around her. I had no interest in research before working with her, but she really showed me the importance of evidence-based medicine when you want to effect change.”   

Mrara is not the first woman to motivate Dyasi. Born in the Eastern Cape as an only child, and raised by her grandmother along with four of her cousins, Dyasi knew she wanted to be a doctor from an early age. “I was inspired as a young girl by a woman named Dr Mbambisa. This lady is a humble, stylish woman, but still a doctor, and in those days it was inspiring and beautiful to see that. I wanted to be just like her.”

This article was paid for by Discovery Central Services.