Sarah Barnard speaks to Rory O’Connor from the Dental Health Support Trust, which provides free support and advice on mental health, alcohol and drug issues…
It feels as though barely a month goes by without some news or fresh statistics about the poor mental health of dentists. One of the organisations that is trying to help the profession, by providing a helpline and further support services for those with mental illness and addictive disorders, is the Dental Health Support Trust (DHST).
The DHST has been around since the 1980s, suggesting that there is nothing new about the struggles many of the profession face. However, Rory O’Connor, National Coordinator at the DHST, said that there has recently been a significant increase in the number of calls being taken and that more people are calling in relation to mood disorders, such as anxiety and depression.
I spoke to Rory to find out more about the programme and what his work there tells him about the state of the mental health of the profession…
Sarah Barnard (SB): How does the DHST work?
Rory O’Connor (RO): We have a phone, funded by the BDA, which anyone needing help can call between 7.30am and 10.30pm 365 days a year. Sometimes it can just be a relatively straightforward enquiry that just needs advice.
Other times more action may be needed, which can involve an assessment and a treatment plan. Then, post-treatment we would monitor the individual and support them in whatever way they need, e.g. back into work or if their condition has led them to the attention of the GDC and they need a report from us to return to work/continue working, we can produce those documents.
We have a memorandum of understanding with the GDC which allows us to intervene and look after dentists without that information being passed to the regulator, and we are developing that further, which may lead to less challenging Fitness to Practise experiences for dentists in difficulty.
SB: From the number and type of calls you receive, what’s your sense of how the profession is faring mentally?
RO: There has been a gradual increase and in the past nine to 12 months the number of inquiries and people using the service has risen significantly. You can take two views on this. It could be due to there being more awareness about mental illness and addictive disorders. Hopefully there’s been a greater sense of acceptance and de-stigmatisation of mental illness, so more people may be coming forward.
But it may also be a reflection of changes in dentistry, how challenging it is and that there are aspects of dentistry that are stressful, such as UDAs, what feels like financial squeezing of the service, patient expectation, complaints culture, etc. There is also a shift away from single-handed practices, where the dentists have a very close relationship with their patient group, to larger practices. There’s no perfect system, so it’s not a slight at any particular group, but there’s a general feeling of pressure within the NHS, and dentistry hasn’t been immune to that.
SB: Do you get a feeling about the future direction of dentists’ mental health?
RO: At this point, the trajectory is that more people than ever before are accessing the service, whether that’s for mood disorders or addiction.
In terms of addiction, this could be partly due to an increase in drug and alcohol use in society in general, and dentists aren’t immune from that. So, there is more recreational drug use than we’ve seen in the past and there may be a slight shift towards drug use among younger dentists, so this is perhaps something dental schools need to be aware of.
SB: How do you know if you cross the line into drug or alcohol addiction?
RO: The simple answer is that if your substance use is costing you more than money, then you have a problem. Some of the signs can be the ‘Monday morning syndrome’, people not coming into work on Monday, or maybe a change in mood or in performance at work, defensive practise in dentistry, so not treating what they would normally treat, and end-of-day impatience where you can’t wait to get out of the practice.
You can also look out for signs in others, by seeing if you notice a change in people’s demeanour and considering why that might be. Don’t be frightened to ask, ‘how are you?’, provided that you mean it and you’re prepared for the answer.
SB: Is there anything that dentists can do themselves to try and improve their mental health?
RO: When it comes to stress, burnout or anxiety at work, something to think about is your own self-care. A good place to start is sleep hygiene, such as whether you’re going to bed at a reasonable time, and doing so consistently. Also, look at how healthy your diet is, and how much exercise and relaxation you get. Involve yourself with other groups that enjoy the things you like doing, whether that’s dancing, singing or exercising.
Be mindful of how much you’re drinking, because alcohol, as well as other substances such as cocaine or cannabis, can be a good self-medicant.
If you do have a sense that things aren’t right, then have the courage to talk to somebody and seek help. Look at things like mindfulness and relaxation apps, and online Cognitive Behavioural Therapy (CBT). The single most important thing is the recognition there’s a problem, acceptance that there’s a problem and then exploring the solution. Ultimately, one of the reasons why this programme exists is to help explore the solution and provide ease of access to appropriate services to individuals who are in difficulty with mental health and addictive disorders.
SB: Is there a way for dentists to help each other and improve the situation for the profession as a whole?
RO: One thing is to have a sense of responsibility in terms of looking at how you see your own mental wellbeing, and how you perceive mental wellbeing in others? Do you think that they’re weak or stupid? This kind of reflection can help you to become more accepting and unashamed of any mental health issues with yourself, and, of course, with others.
And, if you have a colleague or friend who is struggling with some aspect of mental health, meet them where they are and walk with them there, not where you want them to be. So, if they are in a low place, meet them there, don’t pretend that they’re other than that. That sort of unconditional acceptance can make a huge difference.