BMA: Supporting the mental health of doctors and medical students

BMA |April 2019 | Supporting the mental health of doctors and medical students

The BMA has now published its report: Supporting the mental health of doctors and medical students– which provides a summary of its findings from its survey (open to both BMA members and non-members) into doctors’ and medical students’ mental health, the survey received over 4300 responses. The report provides a summary of the BMA’s findings which include: 80 per cent of doctors are at high risk of burnout with junior doctors most at risk; nine-tenths of respondents said that current working, training or studying environment had contributed to their condition either to a significant or partial extent. Almost one-tenth (9%) of those completing the survey had also asked for but were not provided with support from their employer or medical school. 

bma.org.uk
Image source: bma.org.uk

Key points from the report’s findings:

  • Doctors can be vulnerable too
  • The working environment has an impact on doctors
  • Doctors should have access to support when they need it
  • The mental health of the workforce needs further support

Principles to improving mental health among doctors and medical students:

  • Building a supportive culture
  • Enhancing access to support
  • Encouraging self-care and peer support

 

An additional paper- ‘Personal stories of doctors in training with experience of mental illness’ – gives unique insights into what it is like to experience mental illness during a doctor’s trainee years by drawing on a review of the literature and  interviews with stakeholders and trainee doctors.

Key points

  • Doctors work when they know they are unwell and are reluctant to take sick leave
  • Doctors are concerned that their illness will be disclosed
  • Doctors can struggle to access support
  • Going back to work can be difficult

See also:  Personal stories of doctors in training with experience of mental illness

Further information about both publications is available from the BMA 

In the news:

OnMedica News Survey reveals ‘alarming’ mental health crisis among doctors

 

Out of Area Placements in mental health services

Latest statistics show that mentally ill patients are still being sent outside of their local areas for treatment | NHS Digital | via OnMedica

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The government has set a national ambition to eliminate inappropriate Out of Area Placements (OAPs) in mental health services for adults in acute inpatient care by 2020-21. However, OnMedica reports that the latest data suggests the government is not on track to achieve this ambition.

National statistics for January 2019, reveal there were 675 OAPs active at the end of January, 785 at the start, and that 40 OAPs were for a distance of 300km or greater, with a further 115 at distances greater than 200km, and 325 at distances greater than 100km.

Full story at OnMedica

Latest data: Out of Area Placements in Mental Health Services January 2019 | NHS Digital, April 2019.

Early access to mental health support: Over a third of local areas in England reduce real terms spending on low level children’s mental health services

Children’s Commissioner | April 2019 |Over a third of local areas in England reduce real terms spending on low level children’s mental health services

The Children’s Commissioner has published a report today (Wednesday 10 April) that looks at the amount spent on “low-level” mental health support. These are preventative and early intervention services for treating problems like anxiety and depression or eating disorders, for example services provided by school nurses or counsellors, drop-in centres or online counselling services.

The report highlights variations between between areas in how much funding is available: the top quarter of local areas spent at least £1.1 million or more, while the bottom 25 % spent £180,000 or less. The overall total spending figure of £226 million
includes a small number of very high spending areas masking a larger proportion of low spending areas.

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The report identifies a regional variation on low level mental health spend:

In the financial year 2018/19, reported per child spend on low-level mental health services was higher in London and the North East, and lower in the East Midlands, the East and the South East. In London, local authority spending per child was £17.88 per child, compared to only £5.32 per child in the East of England. CCG spend per child is highest in the North of England (£12.76 per child) and lowest in the Midlands & East (£5.83 per child). Spend per child in predominantly urban areas was slightly higher than in more rural areas.

Although the total spend on low-level mental health services across all areas in England increased by 22% between 2016/17 and 2018/19 in cash terms, and by 17% in real terms, over a third of areas around the country still saw a real-terms fall in spending – with nearly 60% of local authorities seeing a real-terms fall. Given the focus on improving access to children’s mental health, these reductions are concerning.

The report recommends that the government increase its focus on local spending on early access support for children with mental health problems, and that it repeat this data gathering exercise to monitor what progress has been made.
There should also be more pressure on LAs and the NHS to work together to ensure that each area has a joined-up plan to support children who do not require specialist care, and those areas which are reducing funding must be held to account (Source: Children’s Commissioner).

Press release: Over a third of local areas in England reduce real terms spending on low level children’s mental health services

Report: Early access to mental health support

Early access to mental health support technical report 

In the news:

BBC News Children’s mental health services ‘postcode lottery’

The Guardian Children who need help with mental health face postcode lottery – study

Specialist mental health support for new mums available in every part of England

NHS England | April 2019 | Specialist mental health support for new mums available in every part of England

New and expectant mothers across the country can now access specialist mental health care in the area where they live, NHS England announced this week.

The landmark rollout of specialist perinatal community services across the whole of England, means that mums and mums-to-be who are experiencing anxiety, depression or other forms of mental ill health should be able to access high quality care much closer to home (Source: NHS England).

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Full details from NHS England 

BBC News Bringing new mums back from crisis [Video]

More prescriptions issued in 2018

NHS Digital | March 2019 |Prescription Cost Analysis – England, 2018 [PAS]

Prescription Cost Analysis (PCA), analyis conducted by Office for National Statistics shows that in the calendar year 2018, the cost of prescriptions dispensed in the community was £8.8 billion an increase of 2.9 million prescription items dispensed in the community. This shows a decrease of 3.7% (£336.6 million) from £9.2 billion in 2017 (Source: NHS Digital). 

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Responding to an increase in the numbers of antidepressants prescribed, Professor Helen Stokes-Lampard, Chair of the Royal College of GPs said:

“Antidepressants are no different, and it’s really important that increasing numbers of antidepressant prescriptions are not automatically seen as a bad thing, as research has shown they can be very effective drugs when used appropriately.

“It can be difficult to determine why prescribing rates fluctuate, these figures could indicate rising awareness of mental health conditions in society, and that more patients are feeling able to seek medical care for them – as well as demonstrating an improvement in the identification and diagnosis of mental health conditions (Source: RCGP).

NHS Digital Prescription Cost Analysis- England 2018, [PAS] 

Rising prescription numbers not ‘automatically a bad thing’, says RCGP

Prescription Cost Analysis 2018- Report

Prescription Cost Analysis 2018- Factsheet 

In the news:

BBC News Jump in antidepressant prescriptions in England

The Guardian Antidepressant prescriptions in England double in a decade

Children living in emotional distress

Public Health England | March 2019 | Children living in emotional distress

Parental emotional distress can lead to mental health problems including anxiety or depression. It is associated with an increased risk of later behavioural and emotional difficulties in children.  

Public Health England’s (PHE) statistical commentary presents data on the proportion of children living with parents reporting symptoms of emotional distress in England for the period 2016 to 2017.

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This update includes new data on:

  • the proportion of children living with either 1 or both parents reporting symptoms of emotional distress overall
  • the proportion of children where at least 1 parent reports symptoms of emotional distress by family type and work status
Key points:
  • around 1 in 3 children lived with at least 1 parent reporting symptoms of emotional distress
  • over 1 in 5 children lived with a mother reporting symptoms of emotional distress
  • around 1 in 8 children lived with a father reporting symptoms of emotional distress
  • 1 in 28 children lived with both a mother and father reporting symptoms of emotional distress
  • there was an increase in the proportion of children living with parents in emotional distress for all indicators compared to data reported between 2015 and 2016
  • children were more likely to live with a parent reporting symptoms of emotional distress if both parents are out of work (Source: PHE)

The document is available from PHE 

In the news:

Daily Mail A third of children live with a parent suffering emotional distress – the highest proportion on record, official data shows