“It is a moment not to be squandered by territorialism, squabbling over funding allocations, or short-term thinking. In every part of our country, and for the sake of our society and economy, we need to continue to stress that maintaining good mental health and preventing suicide is a social, economic and political imperative.”
— Julia Gillard, Beyond Blue Chair; 2019 Diego De Leo Address, 23 July 2019
JULIA Gillard’s words have never been more relevant. The coronavirus disease 2019 (COVID-19) pandemic’s effect on the mental health of our health care workers requires action now.
I was privileged to attend the launch a few years ago of a workplace document called Developing a workplace mental health strategy, which was developed by Beyond Blue with significant input from many key stakeholders. The launch was attended by leaders in all health services and medical colleges.
On that occasion it was Ms Gillard’s wish and hope that the document would be well thumbed and not destined to be filed on the bookshelf, only to be rediscovered when moving or cleaning one’s office. My feeling from my years of speaking on this issue is that sadly the document largely has been filed away, propping up a shelf somewhere.
That’s somewhat sad and disheartening, as much work was put into this document and it was filled with great resource material.
More recently I was asked by another senior person in the mental health area how in medicine one achieves some agreement on a proposal. I replied, somewhat cynically I suppose, that it was a riddle, like how many electricians does it take to change a light bulb. I wish it was a joke, but sadly it is not.
Why do I raise this? Because we are at a significant moment in mental health reform, heightened by the COVID-19 pandemic, in which health care workers are at great risk.
Data from health workers overseas show a high rate of mental health distress, and indeed there have been some tragedies. Of course, many issues involving the mental health of health care workers pre-date COVID-19, but there is no doubt that the far-reaching consequences of the pandemic are still to be felt.
In Victoria, a Royal Commission into Victoria’s Mental Health System was established and the initial findings have been made public. Advisors directly to the Prime Minister in suicide prevention and targeting zero deaths by suicide have been appointed. A COVID-19 mental health plan has been developed by the Mental Health Commission.
Awareness appears to be at an all-time high, thanks to our COVID-19 frontline workers who are going public with their concerns (and here, from the US and Canada). More stories are shared. But awareness will only go so far; the individuals who share their stories, which are indeed powerful, only go so far; action and change are required.
It has to be said that unless we listen to and hear Julia Gillard’s words it might all be for nothing.
Medicine in many ways typifies the territoriality and egos that can get in the way of positive action. Each stakeholder, for want of a better word, needs to put their own spin on a document or resource, delaying the implementation. This is a response to the ever-increasing need to prove that they have ticked the box.
Responsibility is often “handballed” back and forth between various entities. Examples include guidance on work rosters, overtime hours, training requirements, and adherence to awards. Sadly, sometimes, no one takes responsibility. Look at the cases of Dr Chloe Abbott, and Dr Yumiko Kadota as examples.
We must bring all stakeholders together. This used to be hard – assembling all in a room at the same time was close to impossible – but now virtual meetings allow us to interact far more easily.
There are no excuses any more for failing to come to a consensus on how we can help our health workers keep their mental health strong.
The time for action is now. There has been much research and data collection often again finding the same results such as long hours, excessive overtime, cultural issues of bullying and sexual harassment, but as the late John Kennedy, legendary coach of the Hawthorn Football Club, at half-time in 1985 Grand Final said to his players:
“At least DO SOMETHING! DO! Don’t think, don’t hope, DO! At least you can come off and say. ‘I did this, I shepherded, I played on. At least I did something’.”
The time is now to use much more energy in action and synergy, all working together with no self-interest. We can keep thinking, but we must do far more doing, at every level, with a unified approach.
We have seen in the COVID-19 response that a unified, bipartisan approach can be effective. Where it starts to fall down is at the level of interparty sniping, interstate rivalries and media baiting.
The federal Health Minister is targeting zero COVID-19 deaths in health care workers.
We, the health professionals, must also target zero deaths from self-harm in those same workers.
If we can come home at the end of the working day saying “I have tried to do something to improve our mental wellbeing, our rosters, our workplace environment”, then we will be doing something right.
Dr Geoffrey Toogood is a cardiologist and a long-time advocate for mental health. He has swum the English Channel. He came up with the idea of crazysocks4docs day. He was the 2019 Australian Medical Association President’s Award recipient.
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The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.