Improving Physician Mental Health
Physicians perform an essential function in society and work under enormous pressures in doing so. As a result, they experience high rates of mental health issues, including burnout, anxiety, depression, and suicidality. Here’s an introduction to how physicians can take care of themselves and improve their mental health!
What Are Physician Mental Health Issues?
Physicians have incredibly important yet stressful jobs. Not surprisingly, physicians across Canada also have high reported rates of mental health issues, which have become more common in recent years. In surveys from 2017 and 2021, the Canadian Medical Association’s National Physician Health Survey (NPHS) reported disconcerting findings related to physician mental well-being:
53% of physicians reported high levels of burnout, up 22% from 2017 to 2021. Medical residents and general practitioners were especially likely to experience burnout.
48% of physicians screened positive for depressive symptoms, up 14% from 2017 to 2021 (note that this is not the same as meeting formal criteria for a Major Depressive Episode).
24% of physicians reported moderate-to-severe anxiety issues, and a further 34% reported mild anxiety symptoms in 2021. Residents were more likely to report moderate-to-severe anxiety than practicing physicians.
36% of physicians reported having suicidal ideation at some point in their lives. Not surprisingly, physicians with self-reported burnout, moderate-to-severe anxiety, and/or depressive symptoms were significantly more likely to report recent suicidal ideation compared with others.
The NPHS findings highlight the degree to which physicians have been struggling. Of note, the 2021 survey data was collected during the COVID-19 pandemic, an extraordinarily stressful and demanding period for many physicians. However, the NPHS 2017 (pre-pandemic) data and other studies have found that physicians report higher rates of burnout, depression, anxiety, and suicidal ideation than the general population regularly, so the 2021 data, while surely elevated by the pandemic, are not wildly out of keeping with general trends in physician mental health. NPHS has collected data for its 2025 survey and results are likely coming out in the next year.
There are many reasons why physicians are more likely to report increased mental health issues compared with the general population, including:
Long work hours. Physicians report working 54 hours/week on average, with residents reporting up to 66 hours of work per week on average (NPHS, 2021)
Large caseloads and the significant responsibility of managing patients’ health, including encountering death with regularity
Challenging patient encounters, including aggression
Chaotic work environments, unsupportive or unsafe colleagues, and bullying or harassment in the workplace
College complaints and/or lawsuits. Nearly half of physicians have been involved in a complaint or a lawsuit (NPHS, 2021).
Low professional fulfillment. A full 79% of physicians reported low professional fulfillment in 2021 (NPHS, 2021).
Physicians’ professional responsibilities are significant, work hours are long, and workplace support can be low, so it isn’t surprising that many physicians are struggling.
Where Can Physicians Get Help?
The NPHS 2021 report highlighted that a portion of physicians did seek physical and/or mental health support in the five years prior to 2021:
One-third visited their primary care physician
One-quarter visited a mental health professional (psychologist, psychiatrist, counsellor)
15% accessed their provincial physician mental health care program
12% spoke with mentors or coaches
Nearly half of physicians reported having not accessed any wellness supports in the previous five years, which suggests some combination of a genuine lack of need for professional support among those who are doing well and a reluctance to seek help among others who would benefit.
Existing resources for physician mental health care include the Physician Mental Health Care Program and the CMA Wellness Hub.
What Prevents Physicians From Seeking Help?
Despite the high prevalence of mental health issues, physicians can be especially reluctant to seek out treatment. Ng et al. (2024) outline several reasons why:
Personal Factors
Physicians are more likely to see themselves as being self-sufficient, invulnerable, and have perfectionistic tendencies than the general population. This self-perception can lead to experiences of shame and self-stigma, which can delay help-seeking. And like all of us, physicians can also engage in unhelpful coping strategies for managing distress when they aren’t well-versed with more helpful alternatives.Environmental Factors
Some physicians and organizations still believe that physicians who struggle with mental health issues are “occupationally impaired.” Stigma about mental illness remains a significant issue among some providers and organizations. Some physicians also continue to use pathologizing language about patients or colleagues, like casually referring to folks exhibiting inconsistent behaviour as being ‘schizophrenic’ or folks experiencing mood swings as being ‘bipolar.’Systemic and Occupational Factors
Many physicians have concerns about professional consequences from seeking mental health treatment. Mental health declarations are mandatory in some jurisdictions to acquire medical licensure, even though this practice is not evidence-based (well-managed mental health issues have not been shown to affect physicians’ fitness to practice). If they declare a history of mental illness, physicians can be required to undergo occupational assessments or additional supervision and may have restrictions placed on their work.
Some physicians also have worries about being denied private health, disability, or life insurance if seeking treatment for mental health issues. Unfortunately, physicians (and others) seeking psychological help can be denied various kinds of private insurance as a result.
How Can Physicians Improve Their Mental Health?
The reality is that physicians’ jobs are stressful and there is no way to avoid some of this stress, particularly throughout residency. The inevitable stressors notwithstanding, physicians can still manage their mental health through a combination of individual self-care strategies and organizational / systemic approaches, including:
Individual
Individual-level strategies are about making changes in your day-to-day life to help you feel more balanced, empowered, and fulfilled. Try to do the following, if you can:
Practice good ‘lifestyle medicine’ by maintaining balance across six key areas:
Get enough sleep
Maintain a healthy, balanced diet
Engage in regular exercise
Develop and deepen social connections
Manage stress effectively
Avoid or minimize the use of risky substances.
Maintain some degree of work-life balance and try to create a sustainable, meaningful work schedule, at least as much as possible.
Ensure your work involves professionally fulfilling activities. For example, if teaching is your jam, try to maintain a steady stream of teaching or supervision in your schedule to increase professional satisfaction.
Develop a network of colleagues with whom you can debrief stressful interactions or complicated clinical issues.
Increase your facility with emotion regulation and distress tolerance skills, like deep breathing, grounding, progressive muscle relaxation, etc.
Practice mindfulness skills, returning attention to the present moment with openness and acceptance.
Seek professional mental health support if you’ve tried the strategies above and are still finding yourself struggling.
Organizational / systemic
Organizational and systemic strategies may differ significantly depending on your work context. What’s available and feasible in a small group practice may be quite different with what’s available in a hospital setting. Here are some general organizational strategies that may be helpful, depending on your workplace:
Normalize and encourage mental health discussions with patients and colleagues if you don’t already. This can be beneficial for patient care, as well as for yourself and colleagues to help normalize mental health issues and reduce self-stigma.
Foster open communication in the workplace to help navigate challenging clinical or personal situations with colleagues, HR, or management.
Create efficiencies at work to reduce your administrative load and increase the amount that can be delegated to administrative staff or streamlined in your procedures and electronic health record.
Notice your own and colleagues’ language about mental health issues, trying to ensure we always use non-pathologizing language.
Advocate for changes to mandatory disclosures related to licensure if you believe your jurisdiction’s licensing forms include inappropriate or stigmatizing items.
As a physician, you play an integral role in society. Your physical and mental wellbeing are vital for the rest of the population, and you, your loved ones, and your patients benefit most when you are well yourself. Try out the strategies above to maintain your wellness, both for yourself and those who rely on you. If you’ve tried them and are still struggling, connect with a mental health professional to help you through.
Your patients lean on you for support all day, every day. Remind yourself that it’s ok to lean on someone else for a while if you need to!
And click through to learn more about our Physician Mental Health Service!
WG Psychology
WG Psychology is a psychology and psychotherapy clinic in Toronto that helps people live more connected, purposeful lives through compassionate, evidence-based mental health support. Connect with us to see if we’re a fit for you!
Disclaimer: This post is intended for educational purposes only and is not a substitute for psychotherapy. The information provided is general and may not be appropriate for your particular mental health needs. Always consult a qualified health professional to discuss your personal needs and goals.