Promoting voluntary help-seeking among doctors with mental disorders

Objectives: To explore if the Barcelona Integral Care Program for Doctors with mental disorders (PAIMM, in Catalan) has achieved its goal of enhancing earlier and voluntary help-seeking amongst sick doctors. Material and Methods: We conducted a retrospective chart review of 1363 medical records of physicians admitted to the inpatient and outpatient units of the PAIMM from February 1st, 1998 until December 31st, 2011. The sample was divided into 3 time periods: 1998-2004, 2005-2007 and 2008-2011 (477, 497, and 389 cases, respectively). Results: The mean age at admission decreased (F = 77.57, p < 0.001) from the first period (x = 54.18; SD = 10.28 years) to the last period (x = 44.81; SD = 10.65 years), while voluntary referrals increased from 81.3% to 91.5% (Chi² = 17.85, p < 0.001). Mental disorders other than substance use disorders grew from 71% during the 1998-2003 period, to 87.4% (2004-2007), and 83.9% in the last period (Chi2 = 29.01, p < 0.001). Adjustment disorders increased their prevalence, while inpatient treatment progressively represented less of the overall clinical activity. Conclusions: Sick doctors may feel encouraged to seek help in non-punitive programs specially designed for them and where treatment becomes mandatory only when there is risk or evidence of malpractice.