Age and gender are key risk factors for mental health issues among Australian optometrists, according to concerning findings from a cross-sectional survey conducted by researchers at Queensland University of Technology (QUT).
This was the first study to investigate the prevalence of mental health conditions and burnout among optometrists, and found the highest prevalence of mental health issues were among optometrists 30 years and under, and women. One in five optometrists surveyed said they had received medication and/or counselling for a mental health condition in the previous 12 months.
In an open-ended question, respondents indicated that “the business of optometry” had the greatest impact on their mental health, highlighting increasing retail pressures and a decreasing focus on healthcare, followed by high workload, and career dissatisfaction.
Professor Sharon Bentley, QUT’s Deputy Dean, Faculty of Health and Director, Centre for Vision and Eye Research and lead author of the study, said the results were concerning and called for change.
“It is important that we all do something about this, including individuals, universities, employers, the peak professional body and regulatory authorities,” she said.
It’s important that we all do something about this…
Strong Participation
Conducted pre-COVID over three weeks from November to December 2019, optometrists were invited to complete three validated mental health scales (Kessler Psychological Distress Scale [K10], Depression Anxiety Stress Scales [DASS-21], and Maslach Burnout Inventory [MBI]; then provide an open-ended comment.
With 505 optometrists around Australia responding, Professor Bentley said she was “surprised at how many optometrists chose to participate and, in particular, how many volunteered comments”.
While not all respondents completed the three scales, their mean scores for the K10, DASS-21 and MBI-GS scales were worse than normative values, with the exception of professional efficacy.
Key Findings
- Female optometrists experienced significantly greater psychological distress and anxiety than male optometrists, as well as greater exhaustion and less professional efficacy (P < 0.01).
- The overall prevalence of moderate or worse psychological distress was 31%, moderate or worse depression 30%, moderate or worse anxiety 31% and moderate or worse stress 26%.
- The prevalence of exhaustion and cynicism levels indicative of high burnout was 56% and 57%, respectively.
- The prevalence of a low level of professional efficacy, indicative of high burnout, was just 23%.
- Younger age (≤30 years) and all three dimensions of burnout (exhaustion, cynicism and professional efficacy) were independently associated with moderate or worse psychological distress.
- The three dimensions of burnout (high levels of exhaustion and cynicism and low levels of professional efficacy) were significantly associated with moderate or worse depression.
- Exhaustion was significantly associated with moderate or worse anxiety and moderate or worse stress.
Comparisons with Medicine
The survey found that optometrists’ increased prevalence of psychological distress, mental health conditions and burnout were comparable with other health care providers, such as doctors, nurses, midwives and pharmacists.
However, prevalence of severe psychological distress at 14.7%, was far in excess of the 3.4% prevalence among doctors, and 2.6% prevalence in the general Australian population.
The higher prevalence of mental health problems among younger optometrists and women was consistent with national data for the general population and doctors.
The prevalence of burnout was greater than among doctors but comparable with a survey of 411 pharmacists in the United States. Levels of exhaustion, cynicism and professional efficacy were similar to those found among doctors and pharmacists.
Professor Bentley’s team noted an opportunity in future studies to gain a deeper understanding of the workplace experience for optometrists and associated burnout.
Interventions Necessary
Luke Arundel, Chief Clinical Officer at Optometry Australia said it makes “very good business sense” to prevent or minimise risks to psychological health.
“Work-related stress has been linked with high levels of unplanned absences including sick leave, staff turnover, withdrawal and presenteeism, and poor work and poor product quality. AU$543 million was paid last year in worker’s compensation for work-related mental health conditions (with 91% of these conditions linked to work related stress). Work pressure (31%) and work related harassment and/or bullying (27%) were the two top categories in the mechanisms causing mental stress.”
He said employers are required, by the WHS Act, to ensure the health and safety of their workers, so far as is ‘reasonably practicable’.
“It defines health to mean both physical and psychological health. The best way employers can do this is by designing work systems and workplaces to eliminate or minimise risks to psychological health; monitoring the health of workers and workplace conditions; and consulting with workers,” Mr Arundel said.
Having analysed the survey findings, Professor Bentley said QUT has started working on specific programs to support students.
“We are planning to introduce basic mental health and resilience training into the optometry program, prior to students commencing their career.
“This is a complex problem requiring a variety of strategies that address both personal and workplace factors,” she added.
Resources Available
Optometrists can take proactive steps to protect their own mental health.
“As health professionals we all know the basics but actually finding the time and energy to look after ourselves can often be difficult… Research has found that wellbeing can be improved. You can start building small positive daily habits straight away and with repetition you can create successful changes that support you,” advised Mr Arundel.
“Optometry Australia has been very proactive in the mental health space and has developed a suite of resources to assist optometrists maintain their mental health and wellbeing. Members can access these resources at www.optometry.org.au/practice-professional-support/supporting-your-mental-health.
“Our members also have individual and anonymous access to The Resilience Box. This is a digital support platform developed by leading psychologists with15-minute online learning modules, and a resilience strengthening program across six core areas of wellbeing. It has videos, podcasts and 500 fact sheets on a huge range of topics. The site also has webcasts, podcasts and information on mental health first aid, and how to assist patients suffering with mental health issues.
“If you are however, feeling increasingly overwhelmed and burnt-out, you might benefit from speaking to someone. Visit your GP and discuss taking out a Mental Health Care Plan to help get you back on track,” Mr Arundel concluded.
