Mental health issues are alive and kicking in your family, friends, patients and team; maybe even you, Anthony Gedge says.
On today’s frantic treadmill, in our stressed-out world, a new threat is at large. It’s like the silent, invisible and deadly disease under the gums. At one of my mastermind meetings, former England Rugby coach Stuart Lancaster told a group of practice owners: ‘When we beat the All Blacks, we had the energy and the attitude, but that day we put the top six inches on.’
I want to talk about the top six inches, and our and others’ brains – and it’s not just the psyche. The emerging and expanding and onerous threat is not only under our skulls and in our hearts, but it touches everybody around.
You may have guessed – I’m talking about mental health in your workplace. It’s a hot topic at the minute, but this article is like no other. It gets straight to the real truth. As you will discover, I have interviewed a five-years-sober recovering drug and alcohol-abusing wet-fingered dentist. I’ll reveal his heartrending story trying to run his practice with shame and guilt. I’ve also chatted with a mental health counsellor who specialises in helping dentists get back on track. I guarantee the following is like no other textbook article.
Returning from lockdown
First, let me ask you – do you have team members who feel they can’t cope after returning from lockdown? If yes, then read on.
In my daily dentist conversations, I’m learning that some therapists on furlough are scared to use AGP, and are delaying getting back to work, claiming their indemnity may not cover AGP. A few nurses are also dragging their feet. The carrot might work for a while, but there will be a few sticks being wielded, as practice owners’ livelihoods are at stake.
And, added to that, a three-month hygiene bottleneck is now halting new patient high-profit AGP work. That is the gold stuff keeping you afloat. It may be necessary to bus in hygiene and nurse locums. But this time around it won’t be Arthur Scargill and his coal miners shouting ‘scab’. It just might be your existing hygienists if they refuse to step up to the plate and muck in. Margaret Thatcher was far harder in the 80s than Boris Johnson is now. There is a surplus of talent, but the A players are often already with the best practices, whose castles were built on the solid ground of putting their people first, patients second, and profit naturally flowing thereafter.
During your closure, did the conversations with yourself increase and get more aggressively negative, fearful, angry, and frustrated, even slipping into being a hopeless PLOMV – ‘poor little old me victim’? If yes, then you are reading the right information. If no, carry on reading; you too may have a mental health issue, because that’s not normal thinking either. But, then, what is normal thinking?
A short story of guilt, shame and rock bottom
As you may know, I’m a recovering alcoholic. I’ve been sober nearly four years, and my life dramatically changed when I stopped picking up drinks.
I met ‘R,’ the first recovering dentist that I came across in 15 years of strategic consulting in dentistry. Although, over the years, I’ve mentored a few dentists to give up alcohol, drugs and other addictions. It was fascinating to actually meet somebody who really engages in an Alcoholics Anonymous for Doctors and Dentists group and The Dentists Health Support Trust (for mental health).
This is a short version of his story. You will see how alcohol and drugs can easily spiral out of control. But, more importantly, how mental health problems in general can easily spiral out of control. I truly believe we are only ever two steps away from being homeless and an addict.
‘How can I get help?’
Now, on to the story about the recovering drug and alcohol-addicted dentist. He has become a friend, whom I’ll call ‘R,’ who nursed a £500-a-day cocaine habit and drank like a fish.
‘I really hit rock bottom,’ he recalls. ‘And at that point, having spent two years, probably, in real pain every day, realising probably a year or two before that, I’d crossed the line they talk about, where I had to have a drink. Now, that’s when fear, shame, and guilt would kick in. And the only way to get rid of those emotions and those feelings was to drink and use more.
‘I knew what I was doing was wrong. I didn’t feel that it was right. And I thought I was the only dentist in the country this was affecting. And [I was] thinking about it every day. “How can I get out of this?…I can do it myself. I can do it myself. It’s too shameful to admit it…Who do I ask? Who do I speak to? How can I get help?…I can’t possibly admit it”.’
Lockdown loss
Next, I interview Rory from The Dentists Health Support Trust, a mental health counsellor talking about loss. His insights are highly instructive, especially for clinicians.
‘What is loss? I think in the beginning of lockdown, there was a loss of the freedom to choose what to do. However small or large that was, there was a loss of freedom. Now, I think what came out of it was maybe more of a “we” for a period of time. “We are all in this together,” but now as we’re emerging out of this, there is more of a sense of perhaps it’s less about “us” and it’s more about “I.”
‘So there is essentially a lack of togetherness about it. That’s just a comment that we may or may not relate to loss, but I think it’s worth making. I think the losses [are] the loss of freedom to make choices, the loss of income, the loss of routine, the loss of getting up in the morning and going into the surgery, and then the loss of connecting with people.
‘Because if you like what you do and you haven’t got connection, then there is a sense of isolation. There is a loss of certainty, whether that’s financial certainty or professional certainty, but the loss of certainty of what’s going to happen. I think the hardest thing with mental health is getting people to have a sense of acceptance of it. So their self-awareness goes with it. But if you have somebody that’s mindful in that way, then simple things that can make a difference would be regular exercise, sensible eating patterns and the capacity for self-reflection. To be able to see what’s going on in my life, to be able to step back and look at it.
‘I think often when you’re a practice owner or somebody in that setting, sometimes it’s quite difficult to more or less take a helicopter view of what’s going on, to look down on what is happening. But that capacity to be able to step back sometimes and do a sort of mental check – “How am I doing? How am I? What’s different?” – maybe, dare I even say, a gratitude list, things feel tight, things feel difficult, “Are there things I could be grateful for?” So, in summary, the element of self-awareness, being able to have a check on where they are, and doing good things like exercise, healthy eating, good sleep hygiene, stuff like that. So, rather than self-medicating, medicate in a different way, which is a healthy way.’
Avoiding burnout and exhaustion
Just think about that in the context of how much time you give to other people in a day. I think the idea of taking care of self allows us to be able to take care of others or to give to others. And if we don’t spend that little bit of time in a 24-hour day on ourselves, where does it leave us? Eventually burnt out and exhausted. Some may say that occasionally having a day off or a rest day is ok. But if you’re paying a high price for it, then maybe being a bit addicted to doing all the time is not so bad and actually helps you. But always remember that self-care requires just a small amount of time. And we often give a lot to others, so a small amount of time for ourselves is a good thing.
Heal yourself first, before you heal others. If you are healed or healing, then heal your people. They need you now more than ever. How to spot if someone has a mental health issue? As dentist ‘R’ says: ‘Look out for people who are a bit late, more isolated than normal.’
Focusing on the first 42 days
Your practice future, at this precarious moment in time, solely depends on engaging your team and monitoring their mental health. Then yes, you’ve absolutely got a strong chance to get back into profit ASAP. But it’s going to be an uphill struggle. To grow your practice over the next 42 days and beyond, or even stabilise your practice over the next 42 days, we’ve really got to focus harder than ever before on our culture.
You can also pick up mental health issues in your monthly 10-minute one-on-ones. It is up to you as a practice owner and, indeed, as a team member to create a dentistry workplace culture people can jump out of bed for. I explain more about this and my complimentary *suite of back-to-work tools, strategies, resources in a special and relevant 2.5-hour video I just recorded on ‘How to prepare your people’s, your patients’ and your own hearts and minds for the first 42 days of opening and beyond’ at www.TripleNetProfit.com.
Mental health issues are not just for the clinically insane. Mental health issues are alive and kicking in your family, friends, patients and team; maybe even you.
Here’s what to do next to protect everybody’s mental health
Get in touch with 35 years sobriety dentist Kevin and counsellor Rory for mental health support through this private and confidential email address, [email protected], or highly confidential phone line, 0207 224 4671. Mention this article and they will welcome you with open arms. Rory mentioned a heart-warming phrase three times in our conversation, concerning anyone who thinks they may have a mental challenge: we will walk together.
Dentists Health Support Trust – dentistshealthsupporttrust.org/contact-html.
Free back to work video training: *complimentary suite of back-to-work tools, strategies, resources in a special and relevant 2.5-hour video I just recorded on ‘how to prepare your people’s, your patients’ and your own minds and hearts for the first 42 days of opening and beyond’ at www.TripleNetProfit.com.
