Rural GPs urged to look after mental health

Matt Woodley

11/05/2020 4:23:46 PM

Emerging research shows that while the pandemic is affecting everyone, those in rural and remote communities are particularly vulnerable.

Empty rural road
While mental health is a complex area with many underlying causes, the COVID-19 pandemic has placed extra strain on many people, including healthcare workers in rural and remote communities.

The RACGP is encouraging rural and remote members to utilise a new $3 million e-mental health hub that has been specifically designed to help healthcare workers deal with coronavirus-related issues.
Previous research into mental health care in rural and remote communities has found widespread problems related to accessing services, and recent data suggests the rate of access remains at just 20% of those who access equivalent services in metropolitan areas.
As such, RACGP Vice President and Chair of RACGP Rural Associate Professor Ayman Shenouda said it is vital for rural and remote healthcare workers, including GPs, to take advantage of the new resource.
‘If any healthcare worker has concerns about their mental health please reach out and use this mental health support unit right away,’ he said. ‘This is something the RACGP has been fighting strongly for and it will make a real difference.’
Associate Professor Shenouda said while mental health is a ‘complex area’ with many underlying causes, the COVID-19 pandemic has placed extra strain on many people, including healthcare workers.
‘Research is emerging from all over the world that healthcare workers treating people with COVID-19 are reporting substantially higher rates of psychological distress,’ he said.
‘There is of course the added stress of knowing that as a healthcare worker you are at higher risk of contracting COVID-19 yourself … I have [also] heard reports of some patients abusing and even spitting on general practice staff.
‘So if you are part of a small community where the pandemic hits, you can only imagine what it must feel like to be a healthcare worker on the frontline.’
Recent research into healthcare workers in China treating COVID-19 patients found a ‘considerable proportion’ had experienced symptoms of depression, anxiety, insomnia, and distress. These issues were especially prevalent in frontline healthcare workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19.
Meanwhile, a Lancet Psychiatry position paper published in April which identified research priorities for the coronavirus pandemic found there is ‘an urgent need’ for research into addressing how mental health consequences for vulnerable groups, including healthcare workers, can be mitigated under pandemic conditions. 
Likewise, new research tracking the impact of viral epidemic outbreaks on mental health of healthcare workers (which has not been peer-reviewed) concludes that the prevalence of anxiety, depression, acute and post-traumatic stress disorder, and burnout is high both during and after the event.
‘These problems not only have a long-lasting effect on the mental health of healthcare workers, but also hinder the urgent response to the current COVID-19 pandemic, by jeopardising attention and decision-making,’ the paper found.
‘Governments and healthcare authorities should take urgent actions to protect the mental health of healthcare workers.’
Associate Professor Shenouda said limited resources and workforce numbers, as well as distance from other specialists, only adds to the uncertainty and pressure felt by rural and regional GPs.
‘For example, if you work in a remote town that only has one small hospital you would constantly be thinking to yourself, can we handle an influx of people with COVID-19? What if some of them require ventilators and we just don’t have enough?’ he said
‘This can all add up and place a real strain on healthcare workers when we need them the most.’
The recently updated Beyond Blue National Mental Health Survey of Doctors and Medical Students found that doctors have substantially higher rates of psychological distress compared to both the Australian population and other Australian professionals, an issue exacerbated in regional areas by a comparative lack of access to mental health services.
As a result, Associate Professor Shenouda believes the new support unit will be especially valuable for healthcare workers based outside of major cities.
‘The scheme is set up so that it is all done over the phone and online so you don’t have to drive miles and miles to take advantage of it,’ he said.
‘Whilst it is important not to generalise too much, I think that in some rural communities there is great worth placed on stoicism and a belief that you can simply work through periods of depression or anxiety on your own without seeking help. There is a certain stigma attached to putting your hand up and saying that you need help.
‘But we must combat this attitude because we are all human beings and there is absolutely no shame in getting help for any mental health concerns. Many people, including all types of healthcare workers, have gone through what you are experiencing and with help have come out the other side.
‘So I say to the entire rural and remote healthcare workforce – if you need to talk to someone reach out because it could make all the difference.’
There are mental health resources for GPs available on the RACGP website.
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