World Suicide Prevention Day – dentists: not just fillings, feelings too!

world suicide prevention dayToday is World Suicide Prevention Day. Melika Hedayat and Nikki Nabavi explore the pressures and mental strains currently facing dentists and dental students today.

The wellbeing, stress and burnout of doctors is highly researched.

Pressure on key workers risking their livelihoods in the COVID-19 global pandemic will only highlight this further.

But what are the facts and figures surrounding dentists and dental students facing the same stressors and why must we raise awareness towards it?

Dentistry stresses

The commitment to pursue a career in dentistry often starts during school.

An article from the British Dental Journal portrays the level of competition. With only a ‘15:1 ratio of applicants to places in most undergraduate dental schools in the UK’ (Youngson, 2016).

The stress induced to impress is rather overwhelming. It is not uncommon to hear people say that the hardest part of medicine or dentistry is getting in.

Whilst true in some respects, the workload doesn’t decrease.

With the same high standard of achievement throughout each peer group, this can lead to a sense of ‘imposter syndrome’.

Student challenges

Studying at university can in itself face students with a plethora of challenges. Such as working in a different manner, moving away from home, making new friends and adjusting to different surroundings, as well as having to cook and clean for themselves.

A study by the Education Policy Institute (2018) shows that:

  • A fifth of students spent all of their student loan within the first 100 days
  • Over 60% of students report their maintenance loan wasn’t enough
  • 46% report that financial difficulties have a negative impact on their mental health.

The academic demands for dental students is therefore a significant stressor.

Many of these factors make them more vulnerable to predisposed mental health conditions. Plus the added pressure on students with extra hours, commuting to placements and a heavier workload, can heighten this predisposition.

The latest statistics

The British Dental Association (BDA) ran an online survey in 2019, completed by 2,053 dentists.

It shows high levels of self-reported stress, burnout and psychological distress. Especially in GDPs working within the NHS, as opposed to those in other fields of dentistry.

The highest stressors were threats of litigation and dissatisfied patients.

Dentists also felt a lack of support from regulatory bodies, the government and their own practice management.

Most worryingly, an alarming proportion of dentists (17.6% of respondents) have seriously considered committing suicide. With 10% of the total respondents having these thoughts in the last 12 months (Collin et al, 2019).

Mental health stories

The above statistics raise questions on stigma around mental health and help-seeking behaviours; especially for people who deem themselves ‘capable’ and are ‘high achieving’.

Hiraa Jamil shares her experience with mental health through an article she wrote when in dental school.

She explains that the first step to recovery is admitting to having a problem in the first place. Probably the hardest part for individuals like dentists (Jamil, 2019).

Hiraa’s article shares a very personal journey, which to most dental students is shocking.

But for the first time we are seeing encouragement towards sharing these struggles, which in turn opens a whole new can of worms.

Along with Hiraa’s Instagram page (@drhiraajamil), there are now many more social media pages encouraging dentists and dental students to share their stories and experiences with mental health.

These pages also provide advice, relevant resources and reassurance through their posts.

Such Instagram pages include @positiviteeth, @mindovermolar and @bds.mentalhealth.

Individuals can also refer to the NHS Practitioner Health Programme, extended to all NHS dentists across England.

Additionally, the BDA offers an assistance programme called ‘health assured’. This programme is for members and includes online CBT and a 24-hour helpline.

Interventions such as these suggest we should integrate coping mechanisms into students’ curriculum as a preventative measure; an intervention the University of Portsmouth is already implementing (Colley et al, 2018).

Can mental health services keep up?

In light of the current pandemic, stress and anxiety is most definitely heightened in the general population and for dentists in particular.

Practices are closing and training ceasing, but then opening back up with almost no warning.

Dental practices now face the long-term consequences. This includes increased impending workload and new hygiene measures and standards.

The pressure is on dentists and medics alike, and our mental health services must deliver.

Dental students and foundation dentists, on the other hand, are left worrying about their future careers.

With limited face-to-face teaching and loss of valuable clinical experience, one cannot help but feel disadvantaged.

Institutions must make sure they have a clear and effective system. One that students can use and refer to if they ever feeling anxious, depressed or even have suicidal thoughts or ideation.

World Suicide Prevention Day

Today is World Suicide Prevention Day.

We’d like to encourage everyone to engage widely in conversations around mental health; sharing the important facts, advice, resources and even personal stories on the topic of suicide across social media platforms and also through word of mouth.

As statistics suggest, suicide is a prevalent issue within the dental community. But it is also important to recognise risks amongst our patients, family, friends as well as our colleagues.

Most importantly we recommend everyone completes the free, online, 20-minute suicide awareness course found here: www.zerosuicidealliance.com/training.

References

Colley J, Harris M, Hellyer P and Radford D (2018) Teaching stress management in undergraduate dental education: are we doing enough? Br Dent J 224: 405-7

Collin V, Toon M, O’Selmo E, Reynolds L and Whitehead P (2019) A survey of stress, burnout and well-being in UK dentists. Br Dent J 226: 40-9

Jamil H (2019) It’s okay to not be okay. Br Dent J Stud 26: 16-21

Youngson, C (2016) A highly competitive environment. Br Dent J 221: 150

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