Donna Hall shares recent statistics about anxiety and stress in dentistry and speaks to Rory O’Connor from the Dental Health Support Trust about how to cope with anxiety and mental health issues.
According to the recent Dentistry Confidence Monitor survey, 90% of NHS dentists are anxious about the risk of complaints. That compares with 59% of private dentists.
The survey, run by Practice Plan and closed in June 2019, also showed that 86% of NHS and 48% of private dentists are anxious about their ability to meet the standards set by the General Dental Council (GDC). Also, 92% of NHS dentists and 21% of private dentists are unhappy about their ability to carry out their work without feeling overly stressed.
Mental health is becoming a much-discussed topic within the profession; however, these types of statistics suggest not much is actually changing. Fortunately, more organisations are setting up to help struggling dentists.
The Dental Health Support Trust (DHST) is one of those. I spoke to Rory O’Connor, clinical lead with the trust, to find out more about the work they do. And to find out how those with mental health issues are supported.
What do you say to dentists and professionals when they ask how to cope with anxiety, stress and suicidal thoughts?
Rory O’Connor (RO): When it comes to how to cope with anxiety, stress or burnout at work, something to think about is your own self-care. A good place to start is sleep hygiene. Such as whether you’re going to bed at a reasonable time, and doing so consistently. Also, look at how healthy your diet is, and how much exercise and relaxation you get. Involve yourself with other groups that enjoy the things you like doing, whether that’s dancing, singing or exercising.
Be mindful of how much you’re drinking. Alcohol, as well as other substances such as cocaine or cannabis, can be a way of self-medicating.
If you do have a sense things aren’t right, have the courage to talk to somebody and seek help. Look at things such as mindfulness and relaxation apps, and online cognitive behavioural therapy. The single most important thing is the recognition there’s a problem, acceptance there’s a problem, and then exploring the solution.
Ultimately, one of the reasons why this programme exists is to help explore the solution and provide ease of access to appropriate services to individuals who are in difficulty with mental health and addictive disorders.
A BDA survey showed that almost a fifth of dentists had seriously thought about suicide. What advice is there for anyone having suicidal thoughts?
RO: Suicide is one of the highest causes of death in men under 40. There’s some evidence there’s a slightly higher percentage of dentists who take their life by suicide compared to the general population.
The main thing about how to cope with anxiety, stress and suicidal thoughts is to find someone to talk to. When someone speaks to somebody about these thoughts, often they say: ‘I’m just so relieved to be able to say it’. Just speaking the words out loud can give them a sense of hope that things can be different.
Often, there is a sense of shame and guilt associated with these thoughts. But it’s important to remember that with some conditions – such as depression or bipolar disorder – it’s actually not abnormal to have suicidal thoughts and ideation.
That is also important for people to remember if they are the one on the other end of the conversation, listening to someone say they have considered suicide.
The key is not to react in a panicked or overly dramatic way. Just gently explore the nature of these thoughts with them. Explore the content of them, the severity, how intrusive they are and what the plan is. Then ask them about whether they have a contingency plan that will help them not to take that action. If they have any protective factors, such as family relationships, pets, their willingness to talk to someone such as their family, GP, Samaritans, a faith leader, etc.
A lot of people considering suicide say the thing that makes a difference is they spoke to somebody that understands.
Is that the main role of the DHST, to be someone for dentists to talk to?
RO: We have a phone, funded by the BDA. Anyone needing help on how to cope with anxiety, stress and suicidal thoughts can call between 7.30am and 10.30pm 365 days a year. Sometimes it can just be a relatively straightforward enquiry that needs advice.
Other times more action is needed, which can involve an assessment and a treatment plan. Then, post-treatment we would monitor the individual and support them in whatever way they need. For example back into work or if their condition has led them to the attention of the GDC and they need a report from us to return to work/continue working, we can produce those documents.
We have a memorandum of understanding with the GDC. This allows us to intervene and look after dentists without that information being passed to the regulator. It is developing further, which may lead to less challenging fitness to practise experiences for dentists in difficulty.
Sometimes dentists worry about talking to their GP about this. If they live and work locally, the GP may be a patient of theirs and may not want to disclose a mental health issue or drug/alcohol dependency to them.
That can be an obstacle in the gateway to treatment. So one of the things we do is manage around that. We can encourage them that actually the GP will understand and will be discrete. Or we may be able to find a way to move forward without involving the GP.