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A sad female in scrubs sitting in a hospital corridor with face in hands A sad female in scrubs sitting in a hospital corridor with face in hands

Doctors are at increased risk of poor mental health – so what interventions help?

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¼ Media / Black Dog Institute
¼ Media / Black Dog Institute,

A new analysis shows which approaches hold promise – and where there are gaps in the evidence.

Doctors are at higher risk of depression, anxiety and suicide than almost any other profession. Now, a global review led by ¼ Sydney and Black Dog Institute reveals which intervention approaches can help - and where urgent research is still needed.

Approaches that built doctors’ skills – like mindfulness – and face-to-face interventions showed the biggest promise in the systematic review and meta-analysis published today in .

“In our study, we analysed 24 international studies involving 2336 practising doctors and found that certain mental health interventions can improve mental health outcomes for this high-risk group, and that these positive effects appear to hold up over time," says lead author Dr Katherine Petrie, Postdoctoral Research Fellow at ¼ Sydney and Black Dog Institute.

"Skills-based approaches – such as mindfulness and mind-body techniques like meditation – had a moderate positive effect on reducing symptoms like anxiety and depression. Other skills-based programs - such as cognitive behavioural therapy (CBT), stress management, and peer support - had an even stronger positive effect."

On the other hand, programs that only provided educational information about mental health - without teaching practical skills - did not show a meaningful benefit.

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Mark Deady
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Mark Deady,
More research is needed into organisational-level interventions to improve mental health. Photo: Adobe Stock

Organisational-level interventions remain largely untested

The review also uncovered a concerning absence of high-quality research into organisational-level interventions designed to improve physician mental health. Despite  that poor working conditions contribute to psychological distress among doctors, no controlled studies have evaluated interventions that target workplace factors at the organisational level.

“We know that working conditions have a major impact on physicians' mental health - yet not one study examined organisational-level interventions that aimed to improve physician mental health through modifications to the work environment - such as modifying working hours or rescheduling rosters," says Dr Mark Deady, Workplace Mental Health Research Lead at Black Dog Institute.

“This gap is now too wide to ignore. Workplaces have real potential to be part of the solution. The evidence shows that multi-level approaches are essential for creating mentally healthy workplaces.”
We know that working conditions have a major impact on physicians' mental health - yet not one study examined organisational-level interventions.
Dr Mark Deady

The findings expose a sharp imbalance in where research efforts are currently focused.

“The promise shown by individual-focused approaches, particularly those based on skills development, is reassuring,” says Dr Petrie.

“But without more research into organisational-level interventions, we are missing the chance to also implement solutions that meet doctors where they are – within the environments that are contributing to their distress.

“Put differently, if organisations do not address the stressors and hazards present in the working environment, it is unlikely that skills-based interventions alone will have a meaningful or sustained effect.”

The review also highlights a stark gap in suicide prevention research. Only two studies examined interventions that targeted suicidal ideation among doctors, despite their .

"The lack of suicide-focused research is particularly alarming given the increased suicide risk among physicians compared to all other professional groups and the general population,” says Dr Petrie. "This must be treated as a critical research priority.”

More research needed

While further research is needed to confirm the most effective delivery formats and strategies, the findings provide guidance for integrating mental health support into broader organisational programs.

“Given the mental health morbidity among physicians, our results provide important guidance for workplaces as to some promising interventions that could improve the mental health of this workforce," says Dr Deady.

“Next, we need to confirm our preliminary findings as to the intervention approaches and delivery formats that are most effective for this professional group.”

The researchers say they also want to establish cost-effective and feasible strategies for wide-scale implementation and build the evidence base for organisational-level interventions and suicide prevention programs for physicians.

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