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Doctors: Your Mental Welfare

J Yeung 20/11/17; excerpts adapted from 'Bendigo Health Junior Doctor Welfare: Support Services; Scope : All doctors in training'; excerpts adapted from the organisations listed

Looking after yourself | Looking out for your colleagues

'I don't think I should be feeling this.

I walk the hospital corridors in shame. I don't wear my name-badge (with "doctor" written on it), and I don't wear my stethoscope. I don't feel worthy of them, I don't feel worthy of the title of doctor, I don't want people to recognise me, I don't want them to know think that I'm the one who asked for help.

I don't think I should be feeling this.' 

- Austin Intern - HMO Panellist at Austin Health/Beyond Blue Grand Round presentation 2017

Feelings of being overwhelmed, stressed, down or anxious can affect anyone - medical student to consultant.  If you are experiencing this, or know/suspect someone who is, there is help available.  Below is a list of useful resources, including the Austin Health/Beyond Blue June 2017 presentation on this critical area of doctor's mental health.  This list is by no means exhaustive, but hopefully will help give you some options if you need them.

Family & friends
​We acknowledge that friends and family are where many people go to for support.  Sometimes people feel they don’t have anyone to turn to or can’t talk to those closest to them.  Sometimes they need to talk to a supportive person in the work place or someone removed from the situation.  Below are further options.

General practitioner
All JMOs and Registrars are encouraged to have their own trusted GP who can help manage their health.  If you are in Bendigo longer term (years) then we suggest you ask around for a good GP in addition to your GP at home.  For shorter term support or emergency GP help,  Bendigo Health has an arrangement with Bendigo Primary Care Centre.   Dr Ray Moore and his colleagues are supportive of caring for Bendigo Health junior doctors.   If you contact them, they will arrange for you to be seen by one of their senior GPs.  To make an appointment, ring Primary Care, state that you are a doctor at Bendigo Health, and specify the urgency in which you need to see a GP.  The senior GPs who are professionally independent from Bendigo Health are: Drs Moore, O’Connor, Cheng and female doctors Drs Rewani, Gilford and Mohapatra. 

You should clarify that you are seeing one of these or another senior GP.                                                                    
Bendigo Primary Care Centre: 123 Arnold Street Ph: 54418622

Bendigo Health Staff Advisors
Staff Advisors can help explain Bendigo Health policies in relation to making complaints, issues with conduct, bullying and harassment.  They are also able to help direct you to other available resources for support.

You can contact the staff advisory service here (intranet)
Alternatively, you can contact the staff advisor for medical staff, Belinda Mertens, via email or 5454 9342.

Mentoring program at Bendigo Health ICU
The mentoring scheme has been established to provide junior doctors with the opportunity to have one to one sessions with a senior doctor to talk about life, work, or anything else you need to. The mentors have  plenty of life experience and can listen non-judgmentally to help you work things out from a different perspective. 

There is also a hospital mentoring program that is available to all junior doctors.  Further details can be found here (intranet). 

Director of ICU (Dr Jason Fletcher), Supervisor of Training and HMO Term Supervisor (Dr Tim Chimunda)
These senior staff are very approachable and can be useful people to talk to.  Asking for 5 minutes of their time to debrief an issue or ask for help can be worthwhile.   They are always keen to support junior staff.

Bendigo Health Employee Assistance Program
Bendigo Health has an Employee Assistance Program that is conducted by a confidential external provider (Converge International).  Through this system, staff are able to access phone support 24 hours a day and receive two free counselling sessions for any work or personal issues you might be having.  The counselling sessions can be arranged offsite or at work if preferred.  All matters discussed with the EAP counsellor is confidential and not shared with Bendigo Health or any other health organisation.  Although Bendigo Health engage Converge International for employee support, it cannot identify any person who accesses this service.

For more information see the intranet page EAP.  To access this service phone 1800 337 068

Bendigo Health Debriefing System (Staff Support Response)
A system is in place for multidisciplinary debriefing and support in the event of any critical or distressing event for staff.  They are sometimes very useful but it is also acknowledged that it is not compulsory for you to attend any organized debriefing sessions relating to a critical incident.  Further details can be found on PROMPT.

CICM Welfare Special Interest Group
The CICM Welfare SIG has a collection of useful support resources for trainees and fellows who are seeking further guidance on a multitude of issues, such as, 'mental wellbeing - are you ok?',  'dealing with exam stress', 'the impaired colleague', and 'work life balance' .  These resources can be found at:
https://www.cicm.org.au/Fellows/Special-Interest-Groups/Welfare#CICMResources

Bendigo Health Staff Benefits and Health and Well-Being
Bendigo Health staff have access to amenities and discounts to promote healthy living.  Please see this link for more details:
http://intranet/info-for-staff/Staff_health_wellbeing/ (intranet only)

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Victorian Doctors Health program 
A confidential 24 hour service available to all doctors and medical students with health concerns including stress and anxiety, substance abuse disorders, mental health disorders and any other health problems. They can be contacted by the person themselves, or by a concerned family member, friend, colleague or staff member. Callers do not need to identify themselves. It consists of a group of experienced male and female GPs and psychologists,  It is independent and do not report to any medical organisation. 

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AMA Peer Support Service
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Do you feel you need to talk but are not sure who to approach? Perhaps it is a sensitive or confidential matter. The AMA Victoria Peer Support Service is anonymous and discreet.
As doctors we are under increasing pressure and stress in the workplace. As caring professionals, we help others every day. Yet, often doctors are the last to access the help we need.
The AMA Victoria Peer Support Service provides you with a listening colleague who understands the pressures of medicine. For anonymous and confidential support call 1300 853 338 (for the cost of a local call).

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Supporting someone in the workplace
Having the conversation

Supporting someone at risk of suicide
Taking care of yourself at work

Catalogue for ordering free resources 

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Medical Grand Round June 2017. Doctors' Mental Health - Are we getting there?
Special Beyond Blue Discussion on Clinician’s Health in Grand Round!

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beyondblue
beyondblue aims to reduce the impact of anxiety, depression and suicide in the community by raising awareness and understanding, empowering people to seek help, and supporting recovery, management and resilience. 
 
A 24 hour phone service is available: Call 1300 224 636. There are a range of fact sheets (e.g. covering depression, anxiety, suicide prevention, pregnancy and early parenting) available on the beyondblue website. 


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Australian Psychological Society (APS)
Find a Psychologist Service through APS.  Find further information from their website.

Telephone referrals: +61 3 8662 3300 (Melbourne); Toll Free 1800 33 497 (outside Melbourne)

Email referrals: contactus@psychology.org.au

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R-Cubed
R-Cubed provides GP Registrars, Medical Students and Pre-Vocational Doctors with real strategies to build resilience in busy times. It is an initiative set up by General Practice Registrars Australia (GPRA) in direct response to feedback from GP Registrars and Medical Students about the pressure they are often under and the need to be able to manage this effectively and stay well.

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JMOHealth.org.au
This website is designed to help junior doctors negotiate some of the difficulties they may face upon starting clinical work.  

Medical school prepares junior doctors well with cognitive and practical skills, but it's impossible to fully prepare for the impact of working long hours, being at the bottom of the totem pole, being bullied, and not having enough time for a social life. Nobody wants be perceived as 'weak', 'not coping', etc. It's difficult to talk about the stress of being a JMO and to work out what to do.

This website contains self-assessment tools that can give you a good idea of how you are going.  And vignettes that describe some of the unique things junior doctors commonly face and tips on how to deal with them.  As well as suggestions on self-care.

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Anxiety Disorders Australia
The Anxiety Disorders Association of Victoria (ADVIC) provides a range of services including: phone and email support, information and referral, Facebook support, weekly support group meetings, information sessions, seminars, and workshops, professional development events, social events & outings and referrals to therapists specialising in anxiety and depression
ADVIC website: https://www.adavic.org.au/

Crisis Support available
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13 11 14 (24/7)
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1800 888 236
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1800 187 263 (weekdays, 9am-5pm AEST)
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1300 651 251 (24/7)
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