You can’t pour from an empty cup – but how does this apply to medical professionals? How do you refill, recharge and take care of your mental state, when your work quite literally demands that you constantly look after others first? Janssen Neuroscience discuss. [This article has been developed and sponsored by Janssen-Cilag Ltd.]

A study recently published in The BMJ found that over 36 percent of NHS consultants had depression, and over 40 percent had symptoms of anxiety. UK doctors experience significant work-related mental health distress, due to a number of factors, including increasing workload, personal experiences, and wider socio-environmental issues.[i] This can directly contribute to anxiety and depression. Clearly, mental health in the medical workforce demands to be put at the forefront of larger healthcare conversations.

The struggle with stigma

It seems counterintuitive that healthcare professionals experience mental health struggles at such disturbing rates and yet the reality persists. While the stigma around mental illness endures, encouragingly, we are seeing awareness improve as researchers work to decipher the biological basis of mental illnesses and the complex interplay between genetics, changes in cellular and brain function, and environmental and lifestyle factors.[ii] Further scientific insights and education around mental illness are key to tackling this stigma: facilitating a change in perception in terms of how mental health conditions are perceived, and ultimately treated.

In response to this, and in light of the 10th Anniversary of the NHS Practitioner Health Programme, Janssen recently hosted a plenary session at the Royal College of Physicians (RCP) 2018 Annual Conference, to discuss the pathophysiology of mental health and integrative approaches to care, with a particular focus on mental health in the medical workforce.

The barriers to seeking help

Alarmingly, healthcare professionals have been found to dismiss their own mental health in a bid to “keep it all together” as a duty of care, believing that the patients and colleagues they support need more help than they do. This tendency to put others first is a key contributing factor which puts healthcare professionals at a higher risk of mental illness. Furthermore, the role that stigma plays in the equation is undeniable. Studies reveal that mental illness-related stigma is a major concern for healthcare practitioners as well as the wider public, both as a cultural issue in the workplace, and as a barrier against seeking help.[iii]  A recent study shows that healthcare professionals' fear of stigma and discrimination from colleagues would dissuade them from disclosing a mental illness.[iv] In order to break down this stigma, there needs to be further education on the biological basis of mental illnesses to increase recognition as a physical disease.

Clearly, there is an incredible need to educate, but there is also the opportunity for practical workplace initiatives. It is only when society takes collective responsibility for the wellbeing of our medical workforce that vital improvements and changes in mental health service delivery for the wider public can be made.

Addressing the dichotomy in mental and physical health services

Today’s healthcare system in the UK tends to dichotomise mental health and physical health, rather than approaching just health from a holistic perspective - not recognising that physical illness and psychological symptoms are inextricably linked.[v],[vi] There is a need to address this dichotomy in terms of how mental health diseases are perceived and the way in which care is delivered. A shift in practice in this area would enable the development of more flexible and integrated approaches to care, to reinvigorate progress in this area and help to pave the way towards greater parity for mental and physical health.

Changing the narrative through scientific research and insight

Today, we have an opportunity to trial new interventions and models of care, as new tools and more advanced technologies are becoming available. Janssen’s continuing research into disease predication and pre-emption presents the chance to intervene at an early stage, and ultimately change the narrative about mental health. The more we can do to predict mental illness through research, the better outcomes we can expect for the lives of millions of people. Key focus areas for Janssen include schizophrenia, mood disorders, neurodegenerative diseases and sleep disorders, investigating the idea that some illnesses demonstrate symptoms before advancing.

Stakeholder collaboration and partnership key to driving change

With over sixty years of expertise and research and development commitments in psychiatry, Janssen is passionate and unwavering in the pursuit of addressing mental health challenges head on. Partnerships and collaborations across all stakeholder groups from across the globe are key drivers in addressing the major challenges and ultimately achieving fundamental changes in mental health care. These include academic researchers, biotech and pharmaceutical companies; government and non-profit organisations and venture capital funds and incubators.

Janssen’s recent collaborations include a programme exploring novel approaches to delivering gene therapies that target the pathological hallmarks of Alzheimer’s disease and research on leveraging Artificial Intelligence to non-invasively predict dementia and neurodegenerative diseases long before clinical symptoms become apparent.

At no time has it been more important to support and nurture neuroscientific research. While we look to the aspirations of researchers and collaborators, we recognise challenges facing all aspects of society, and are dedicated in our mission to make positive change in the treatment and perception of mental health issues.

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[i] Khan A, et al. (2018) Psychosocial work characteristics, burnout, psychological morbidity symptoms and early retirement intentions: a cross-sectional study of NHS consultants in the UK. BMJ Open. 8:e018720. doi: 10.1136/bmjopen-2017-018720

[ii] Van Loo KM, et al. (2007) Genetic and Environmental Factors in Complex Neurodevelopmental Disorders. Curr Genomics. 8(7):429-44.

[iii] Wheat K, et al. (2010) Mental illness and the workplace: conceal or reveal? Journal of the Royal Society of Medicine. 103(3):83-86.

[iv] Waugh A, et al. (2017) Exploring experiences of and attitudes towards mental illness and disclosure amongst health care professionals: a qualitative study. J Ment Health. 26(5):457-63.

[v] The Five Year Forward View for Mental Health. A report from the independent Mental Health Taskforce to the NHS in England. Available at: Last accessed September 2018.

[vi] The King’s Fund. Bringing together physical and mental health: A new frontier for integrated care. Available at: Last accessed September 2018.