Working hours, common mental disorder and suicidal ideation among junior doctors in Australia: A cross-sectional survey

Abstract

Objective: Despite concern regarding high rates of mental illness and suicide amongst the medical profession, the link between working hours and doctors' mental health remains unclear. This study examines the relationship between average weekly working hours and junior doctors' (JDs') mental health in Australia. Design and participants: A randomly selected sample of 42 942 Australian doctors were invited to take part in an anonymous Beyondblue National Mental Health Survey in 2013, of whom 12 252 doctors provided valid data (response rate approximately 27%). The sample of interest comprised 2706 full-time graduate medical trainees in various specialties, at either intern, prevocational or vocational training stage. Consultants and retired doctors were excluded. Outcome measures: Main outcomes of interest were caseness of common mental disorder (CMD) (assessed using a cut-off of 4 as a threshold on total General Health Questionnaire-28 score), presence of suicidal ideation (SI) (assessed with a single item) and average weekly working hours. Logistic regression modelling was used to account for the impact of age, gender, stage of training, location of work, specialty, marital status and whether JDs had trained outside Australia. Results: JDs reported working an average of 50.1 hours per week (SD=13.4). JDs who worked over 55 hours a week were more than twice as likely to report CMD (adjusted OR=2.05; 95% CI 1.62 to 2.59, p<0.001) and SI (adjusted OR=2.00; 95% CI 1.42 to 2.81, p<0.001) compared to those working 40-44 hours per week. Conclusions Our results show that around one in four JDs are currently working hours that are associated with a doubling of their risk of common mental health problems and SI. These findings suggest that management of working hours represents an important focus for workplaces to improve the mental health of medical trainees. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords

Author Keywords

Doctors Mental health physicians mental disorder suicide

Index Keywords

adult cross-sectional study female human male medical education psychology questionnaire Cross-Sectional Studies Humans Surveys and Questionnaires Gender workplace Australia controlled study primary medical care review major clinical study health personnel attitude Attitude of Health Personnel randomized controlled trial clinical trial mental health age depression suicidal ideation working time retrospective study Retrospective Studies multicenter study incidence marriage medical staff Medical Staff, Hospital workload anxiety disorder General Health Questionnaire shift work psychosis Psychotic Disorders

Author Affiliations

Black Dog Institute, Sydney, NSW, Australia, Medicine, UNSW Sydney, Sydney, NSW, Australia

Black Dog Institute, Sydney, NSW, Australia

School of Health and Social Development, Deakin University, Geelong, VIC, Australia, McCaughey Centre: VicHealth Centre for the Promotion of Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, Melbourne, VIC, Australia

McCaughey Centre: VicHealth Centre for the Promotion of Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, Melbourne, VIC, Australia

St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia, Beyond Blue, Hawthorn, VIC, Australia

Alfred Mental and Addiction Health, Melbourne, VIC, Australia

Funding & Acknowledgements

NSW Health

Funding This work was supported by the Health Workforce Programme, Commonwealth Department of Health, Australian Government, iCare Foundation and NSW Health. Beyond Blue, an Australian mental health charity, conducted the initial survey of doctors’ mental health in 2013. KP is supported by an Australian Government Research Training Program Scholarship.

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Working hours, common mental disorder and suicidal ideation among junior doctors in Australia: A cross-sectional survey

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