29 Mar 2019

Why doesn’t Australia have a national helpline for doctors?

29/03/2019 4:27:05 PM

Prominent doctors’ mental health advocates have called for a single helpline to make the current system easier to use.

Doctor's helpline
Would a national helpline make it easier for doctors to seek help?

But insiders have told newsGP that confidentiality and logistics issues mean the idea has never got traction. Efforts to introduce a national helpline in 2015 were abandoned due to cost and technical challenges.
Emergency physician Dr Andy Tagg and CrazySocks4Docs founder, cardiologist Dr Geoff Toogood, have called for a simplified way for doctors to get help, given that doctor suicides have been markedly increasing.  
Dr Tagg, a suicide survivor and long-time advocate for doctor mental health, told newsGP that none of his junior doctors knew where to turn if they needed help.
‘As a doctor with personal experience of being in distress, I just want a number like 13 DR DR that I can tell my juniors, so that any hospital I go to, anyone you speak to, you can say this is the number you call,’ he said.
‘I’ve spoken to many residents who really have no idea how to seek help – and it should be easy. Doctors’ health is clearly a national problem. Why doesn’t it have a national focus and better branding?’
Dr Toogood agreed that having a single number would be a ‘good start.’
‘It makes a lot of sense. [Callers] can then be diverted to the correct state,’ he told newsGP.  
One issue is that there are multiple websites with similar information.
The Australasian Doctors’ Health Network (ADHN) has a national website, but lists individual helplines for each state. There is also the Drs4Drs website, run by the Australian Medical Association’s subsidiary company, Doctors’ Health Services, which also lists state phone numbers.
Similarly, the Doctors’ Health Advisory Service (DHAS) in NSW has a national website listing state helpline numbers.
State and territory helplines are staffed by doctors – mainly GPs – who volunteer their time to help colleagues in distress.
Dr Margaret Kay, Chair of the Expert Advisory Committee for Doctors’ Health Services, said that while everyone acknowledged a single national helpline was a good idea in theory, issues around confidentiality and logistics meant this was unviable. 

‘My feeling is that most calls we get relate very much to local issues in states and territories. My deep concern is that if we were to arrange a single nationwide helpline that there might be a breakdown in the confidentiality currently provided by independent services,’ she said. 

‘As soon as there’s another layer on top, the questions of how you ensure anonymity, confidentiality and independence for each of the doctors who’s calling have to be considered very carefully.’

‘This idea has been discussed for decades and thrashed out in multiple rooms. Clearly the idealistic concept of one number is very attractive. But it has always been problematic when you look at how to action it. I understand people say it’s confusing, but with a single website, I find it hard to think that doctors can’t access the numbers relevant to them locally.’

Chair of the ADHN, Dr Jill Gordon, told newsGP she thought a single helpline was a good idea.
‘I think it’s an excellent idea as long as there is seamless transfer to the caller’s state or territory DHAS,’ she said.
newsGP understands that the concept of a single national helpline was examined in detail by the Doctors’ Health Service Board and Expert Advisory Council when the company was established in 2015 in a partnership between the AMA and the Medical Board of Australia, which provided $2 million in funding.
The partnership was intended to even the field in doctors’ health, given that Victoria and South Australia have traditionally had state-funded programs, while other states and territories had volunteer-run operations.
An AMA spokesperson said there were a number of reasons a national helpline was not introduced. 
‘[Most notable was] the technical challenges of guaranteeing a seamless connection from the caller on the helpline to the different helpline facilities operated by the various state services,’ the AMA spokesperson said.
‘It was felt at the time that a national helpline would only work if the number was directed to the appropriate state service by trained staff, but funds are not available for a 24-hour call centre-style facility. Further, AHPRA’s guidance was that the national website,, should be the principal resource for connecting to the services.
‘The key feature of the website is to provide a portal to the services via their helplines. The state services also advised that many clients, DiTs [doctors in training] in particular, use the internet to find and access doctors’ health services.’
A Medical Board of Australia spokesperson referred requests for comment to Doctors’ Health Services.
Dr Tagg said it is well known that doctors and medical students have disproportionately higher levels of mental distress.
A 2013 beyondblue study of more than 12,000 doctors found that levels of very high psychological distress were significantly greater amongst doctors (3.4%) than the general population (0.7%).
‘Most medicos are perfectionists. For a lot of us, your postgraduate exams are the first you ever fail.  You’ve gone through school and med school in the highflying 10%, and then you get to work, you flunk, you become decidedly average, relatively unsupported and often working in isolation,’ Dr Tagg said.
‘Things start to compound – whether it’s bullying or failing exams, it builds up and people find it hard to cope. Students start med school relatively happy, and when they leave, 25–30% have depression.’
Dr Tagg said a good model for a prospective national helpline was the Poisons Information Hotline, which is based in NSW but handles after-hours calls about poisons from across the entire country.
He said that awareness and branding of the existing resources could also be improved.

Depression and anxiety Doctors’ health Mental health Suicide

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Ian Truscott   2/04/2019 3:09:00 PM

One appropriate preventative strategy might to be to steer AHPRA toward achieving its legitimate goals, rather than whatever it is doing at the moment.