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‘Deeply confronting’ findings show acute distress of AHPRA notifications
The regulator has released study findings showing there were 16 suicides over four years among practitioners facing regulatory scrutiny.
The study tracked those subject to notifications from January 2018 to December 2021.
Warning: This article contains reference to suicide and self-harm.
AHPRA has promised ‘major regulatory reforms’ in the management of notifications, following the ‘confronting’ results of a study into instances of suicide and self-harm by practitioners under investigation.
The regulator has disclosed top-level findings of research carried out by independent experts, members of health practitioner National Boards as well as AHPRA, which looked at instances of suicide and self-harm by practitioners facing regulatory scrutiny.
It found 16 practitioners took their own lives during the study period, which tracked those subject to notifications from January 2018 through to December 2021, while there were four attempted suicides or instances of self-harm.
The study findings were first reported in News Corp publications at the weekend. While AHPRA said it could not release the full report due to an ongoing peer review process for the study’s publication in a medical journal, it did send a detailed press release on the results.
It said the research followed similar studies in the UK, citing one carried out by that jurisdiction’s General Medical Council (GMC).
The latest GMC figures confirmed five suicides among doctors over a three-year period from 2018–20 in the UK, from 5370 investigations. During the study period of the AHPRA research, there was a total of 36,997 notifications.
The RACGP has consistently flagged the impact of notifications on GPs and advocated for systemic reform.
An AHPRA spokesperson said the research has already prompted changes, including the introduction of a ‘Health Management Team’ last year ‘to better support unwell practitioners’.
They also highlighted that the research period included the COVID pandemic, with ‘practitioners and the wider public … under increased stresses that exacerbated mental health issues for many people’.
AHPRA said in-depth reviews identified that practitioners who took their own lives often faced ‘significant life and health challenges’, including pre-existing mental health conditions or a history of substance misuse, or a combination of both.
‘The findings of this research are deeply confronting – but we commissioned it to learn and do better,’ AHPRA CEO Martin Fletcher said.
‘We want to clearly understand the pressure points in our processes that cause the greatest distress and change them.
‘We want to ensure that mental health safety is a thread that runs through all our essential regulatory work.
‘We are trying to increase the sensitivity of our approach, to strike a better balance between effective regulation that protects the public, and due care and respect for the practitioners involved in our regulatory processes who are often facing complex health and life challenges.’
The Medical Board of Australia Chair Dr Anne Tonkin said that patient safety remains a priority.
‘At the same time, we must do all we can to ensure our processes don’t make it harder for practitioners than the fact of regulatory scrutiny already makes it,’ she said.
The research was conducted by an expert advisory group brought together in September 2021, AHPRA said.
Associate Professor Manaan Kar Ray, a psychiatrist at Princess Alexandra Hospital, is part of that group.
‘The statistics show that health professionals are at a higher risk of taking their lives through suicide, and then you add a notification process to it, so you are in dangerous territory,’ Associate Professor Kar Ray said.
‘Most notifications actually don’t result in regulatory action, but the practitioners feel under threat, they feel their identity is under threat.
‘They worry that they can’t work, that they can’t provide, that they won’t be able to do the roles they have been doing for the rest of their lives.’
Another member of the group, the Chair of the Psychology Board of Australia Rachel Phillips, said the findings have led to changes.
‘The research has helped us see things from the point of view of the hardworking, often perfectionist and committed health practitioners,’ she said.
‘Their experience has been key to reforming our regulatory approach and the changes we are making aim to better align our processes with their needs, while keeping the public safe.’
AHPRA said that the average time to finalise a notification in instances where a health assessment is required has reduced from 265 days to 125 days since the establishment of the Health Management Team.
The college in the meantime has also highlighted the burden of trivial complaints, with the RACGP Vice President Dr Bruce Willett recently revealing how it took 10 months for a trivial complaint against him to be resolved.
Dr Tonkin has said that a triage process for such complaints has been set up to reduce the impact on clinicians.
AHPRA also stated the number of health assessments ordered has gone down by two-thirds, with more emphasis now placed on reports by the doctor’s treating practitioner when appropriate.
Further ‘wide-ranging reforms’ will be put in place in response to the research findings, the regulator has said.
As well as focusing on the management of health concerns, openness and transparency, and increasing support for at-risk practitioners, the regulator said it is committed to continue research into the impact of investigations.
These would include reviews of all serious incidents, with details on lessons learned and improvements to be published each year.
Mental health support for GPs
For immediate support, you can call Lifeline 13 11 14, or Beyond Blue 1300 22 46 36.
The RACGP also has self-care and mental health resources for GPs published on its website.
There are free, confidential doctor-to-doctor telephone services available across Australia.
ACT 1300 374 377
NSW 02 9437 6552
NT 08 8366 0250
Qld 07 3833 4352
SA 08 8366 0250
Tas 1800 991 997
Vic 03 9280 8712
WA 08 9321 3098
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