The infectious laughter of Dr. Yusla Ahmad, a Toronto psychiatrist, believes in the stress she feels.
Survivors of single mothers and domestic violence are worried that their 12-year-old daughter is effectively learning.
“It’s difficult,” she says. “Online school is definitely bad for her, and it’s hard for me to take her home and juggle my patients.”
Ahmad had to quit his job directly at the Toronto General Hospital when his daughter’s school went online in 2020. I was worried, but I was relieved that the classroom would be reopened on Monday.
She is currently watching the patient online. Many suffer from the same pandemic stress, loneliness, and anxiety that she suffers. In addition to her practice, Ahmad advocates against gender-based racial and religious violence that she understands from her personal experience. To deal with everything, she reduced the burden on the patient to maintain her mental health.
“I found it all too much,” says Ahmad. “Our work sometimes hits near our house.”
As a surge in mental health care demand in Canada, pandemics fuel a little-spoken frontline crisis: psychiatrist burnout, “abnormal” fatigue in heavy occupations.
The public’s anxiety, isolation, and lack of confidence in the future of family illness and unemployment all contribute to the growing demand for mental health services.
The pace is difficult for psychiatrists to catch up with, says Dr. Beb Young, a perinatal psychiatrist in Toronto. The two mothers say they burned out after working non-stop as a clinical director in a downtown hospital in the first year of the pandemic.
“Working at an academic center was too stressful,” says Young.
A psychiatrist at her hospital provides “restorative guidance” to staff treating critical COVID cases, as well as patients suffering from the fear of pandemics and the stress of caring for their children (pregnant and new mothers). ) Has started programs such as “Pregnancy and Fear” classes. Go home from day care or in a virtual classroom.
“And now it’s happening again,” Young is worried. “What are they going to do?”
A new patient from the hospital’s long waiting list, the original patient who was calling her again, and the current patient needed her more than ever. She suffered from insomnia and finally started working part-time last July.
“I said,’I need to change something. I can’t take this anymore.”
She feels guilty about not being able to help more people, but when “here I was sitting in my ass”, to zoom down and exercise for anxious and depressed patients. He says it’s difficult to give advice.
Young is not alone.
According to a study by the Canadian Medical Association, Dr. Lena Tabirella, president of the Ontario Psychiatric Association, says one-third of practitioners are already dissatisfied with the balance between work and life in 2019. Pandemicha made things worse, and many chose to stop caring for their patients — for their own care. Some are reducing caseloads, while others are finding alternative sources of income such as consulting and life coaching. Yet others are retiring early.
“I can no longer handle working with a traumatized patient,” says a 48-year-old psychiatrist who does not want to be identified to protect the feelings of her patient. She plans to retire from patient care in the coming months. “I’m fried. I need to find a job that isn’t emotionally exhausting.”
These departures are leaving Ontario due to a serious shortage of psychiatrists, says Villela. According to the Canadian Medical Association, per capita numbers had already declined before the pandemic. And with half of Canadian practitioners over the age of 55, that shortage could accelerate.
Telemedicine (video treatment) helped stop the shortage by allowing psychiatrists to see more patients at odd hours of the day and reach patients who cannot attend direct appointments. , Says Villela. “But for some, telemedicine comes at the expense of their own mental health.”
She says online patient care is more mentally and physically tiring than face-to-face care.
“It’s a different feeling for a psychiatrist,” says Villela. “They suffer from fatigue and eye strain.” Working from home also erodes the line between work and personal life.
Dr. Nikhita Singhal, a psychiatrist at the University of Toronto, is accustomed to blurring the line between work and personal life. It was her own fight against mental health that led her to the field.
“I saw the system broken and wanted to help break in and change things.”
As a resident, Shinharu has worked with different patient populations in three hospitals during the pandemic. The most serious impact on her was the adolescent eating disorders and suicide attempts she treated in a hospital for sick children in Toronto.
Shinharu himself was “really difficult to see” many adolescents who were hospitalized in sick kids for eating disorders at the age of eight and suffered from a very stigmatized illness with too few mental health professionals. “Is called.
Singhal laments the lack of resources and funding for mental health compared to “millions of people pouring into cancer and heart disease.”
A study by the Organization for Economic Co-operation and Development (OECD) and Carleton University supports her concerns, showing that Canada spends only half of its health care on mental health compared to the OECD average.
“There aren’t enough psychiatrists,” says Young. According to a study by the Institute for Clinical and Evaluative Science, nearly one-third of psychiatrists have an average of less than two new patients each month, limiting access to mental health care for the most vulnerable. increase. “Now everything is reacting. There aren’t enough psychiatrists to do the current maintenance.”
Psychiatry also suffers from a long-standing stigma that has discouraged physicians from specializing in this area. “We are not considered a real doctor by our own colleagues,” says Ahmad.
To increase the number of psychiatrists, a 2018 report by the Ontario Psychiatrists Association will increase exposure to psychiatrists in the medical school, increase the number of psychiatrists trained in Ontario, and psychiatry. I advised the psychiatrist to pay more.
But experts say hiring more psychiatrists isn’t enough to stop Canada’s mental health crisis.
Dr. Paul Kurdyak, Research Leader at CAMH and the Institute for Clinical Evaluation Science, states that family physicians should provide more mental health care. Just as primary care physicians play an important role in heart disease and cardiologists are involved in more complex cases, family doctors become the primary providers of mental health care and psychiatrists as needed. Need to help.
Kurdyak considers a team-based care model that includes psychiatrists, family doctors, and other medical professionals to be the best way to enable more patients to receive mental health care. I am.
But systemic changes take time, he says. Currently, there is no way to match the psychiatrist’s expertise with the patients who need it, Kurdyak says. Also, according to a 2019 Commonwealth Foundation survey, only over 60% of Canadian GPs feel they are ready to treat patients with mild to moderate mental illness.
“There is a long way to go for mental health care in Canada,” says Kurdyak. “It’s very important, and I’m very worried, especially about our youth.”
Both Kurdyak and Villela are concerned about the burden on psychiatrists and are particularly sympathetic to clinicians who have small children at home from school or day care. Psychiatrists say, “We need to stop taking care of others and stop thinking that it’s bad to stop taking care of ourselves,” says Villela.
Young sets an example. She loves her profession again because she works part-time. “I hope my daughters are as happy with my career as I am,” she says.
For Ahmad, stress continues.
She juggles with anxiety about an isolated patient, her daughter’s well-being in a virtual school, and her advocacy.
“I’m in front of the storm,” she says.
“That’s why I have my therapist.”
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Psychiatrist Burnout: COVID-Tired Doctor Resting
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