TRENDS
Regular mental health assessments can help identify early signs of mental health issues among dental professionals. 7 Incorporating these assessments into routine health checks could be a proactive approach to combating the issues that the stigmatisation brings with workers choosing against voluntary disclosure. This can encourage them to be transparent. Implementing Employee Assistance Programmes (EAPs), that provide confidential counselling, financial advice, and stress management support can be highly beneficial. Such programmes are becoming more prevalent in Singapore as organisations recognise the importance of supporting the mental wellbeing of their employees. Could you speak to the psychiatry behind burnout and suicidal ideation, and what steps can be taken to support those who are impacted by it? Dr Loh: In the context of dentistry, burnout can be exacerbated by factors such as a high patient load, clinical demands and isolation. 8 Dentists often face long hours and the pressure of treating many patients in a single day can lead to physical and emotional exhaustion. The need for precision and the fear of making mistakes can create a high-stress environment. Finally, many dentists work in solo practices, which can lead to feelings of loneliness and lack of peer support. That said, there are a number of factors that can contribute to burnout and sucidal ideation in dentistry. Chronic stress can lead to constant ruminations and worrying, which in turn increase the risk of burnout, depression and even suicidal ideation. Maladaptive coping mechanisms is also a pressing cause for concern, dentists may turn to unhealthy coping strategies such as behavioural addictions and substance abuse, which can exacerbate feelings of hopelessness and lead to suicidal thoughts. Various levels of support can be provided, ranging from peer-support initiatives, such as mental health advocates within the professional community, to external counsellors and psychotherapists through EAPs, and even formal psychiatric care.
What advice do you have at the personal, organisational, and national level to normalise mental health discourse and action? Dr Loh: Stigma surrounding mental health remains a significant barrier for dental professionals, who often hesitate to seek help due to fear of judgement. 9,10 At Promises Healthcare, we believe that normalising mental health discourse requires co-ordinated efforts at the personal, organisational, and national levels. At the personal level, dentists should actively seek mental health education and self-awareness. 11 This involves recognising symptoms of burnout and anxiety early. Encouraging open conversations with colleagues about mental health experiences can also help reduce stigma. Dentists must prioritise seeking help when needed, viewing it as a sign of strength rather than weakness. At the organisational level, dental practices should implement clear mental health policies, including access to counselling and mental health days. Regular training and workshops on mental health awareness can equip staff with tools to manage stress and recognise mental health issues in themselves and others. Creating a supportive culture where mental health discussions are normalised and encouraged is crucial. Senior dental professionals should help step forwards to recognise that such concerns are not trivial and provide a safe space for such views to be heard.
foster an environment where mental health is prioritised, leading to better wellbeing for dental professionals and improved care for patients. DA REFERENCES 1. Carla Cruvinel Pontes, PhD, MSc, DDS; Kyle Stanley, DDS; and Shervin Molayem, DDS. Understanding the Dental Profession’s Stress Burden: Prevalence and Implications. Compendium of Continuing Education in Dentistry. May 2024 Issue. 2. Owen C, Seddon C, Clarke K, Bysouth T, Johnson D. The impact of the COVID-19 pandemic on the mental health of dentists in Wales. Br Dent J. 2022 Jan;232(1):44-54. doi: 10.1038/s41415- 021-3756-7. Epub 2022 Jan 14. PMID: 35031746; PMCID: PMC8758985. 3. Arora S, Knight A. Questionnaire Survey of Burnout Amongst Dentists in Singapore. Int Dent J. 2022 Apr;72(2):161-168. doi: 10.1016/j. identj.2021.08.054. Epub 2021 Oct 1. PMID: 34602256; PMCID: PMC9275171. 4. Ltd, P. P. P. (2023, November 19). My Journey to a Pain-Free Practice: Dr Nijam Latiff. Progressive Practice Pte Ltd All Rights Reserved. https://www. admetec.com.sg/ergonomic-loupes-singapore- review/ 5. Westgarth D. Mental health in dentistry: Has the profession opened up through the years? BDJ In Pract. 2022;35(6):18–22. doi: 10.1038/s41404-022- 1182-4. Epub 2022 Jun 6. PMCID: PMC9168629. 6. Kriakous SA, Elliott KA, Lamers C, Owen R. The Effectiveness of Mindfulness-Based Stress Reduction on the Psychological Functioning of Healthcare Professionals: a Systematic Review. Mindfulness (N Y). 2021;12(1):1-28. doi: 10.1007/ s12671-020-01500-9. Epub 2020 Sep 24. PMID: 32989406; PMCID: PMC7511255. 7. Søvold LE, Naslund JA, Kousoulis AA, Saxena S, Qoronfleh MW, Grobler C, Münter L. Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority. Front Public Health. 2021 May 7;9:679397. doi: 10.3389/fpubh.2021.679397. PMID: 34026720; PMCID: PMC8137852. 8. Jiménez-Ortiz JL, Islas-Valle RM, Jiménez- Ortiz JD, Pérez-Lizárraga E, Hernández-García ME, González-Salazar F. Emotional exhaustion, burnout, and perceived stress in dental students. J Int Med Res. 2019 Sep;47(9):4251-4259. doi: 10.1177/0300060519859145. Epub 2019 Jul 16. PMID: 31311371; PMCID: PMC6753538. 9. Ahad AA, Sanchez-Gonzalez M, Junquera P. Understanding and Addressing Mental Health Stigma Across Cultures for Improving Psychiatric Care: A Narrative Review. Cureus. 2023 May 26;15(5):e39549. doi: 10.7759/cureus.39549. PMID: 37250612; PMCID: PMC10220277. 10. Knaak S, Mantler E, Szeto A. Mental illness- related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthc Manage Forum. 2017 Mar;30(2):111-116. doi: 10.1177/0840470416679413. Epub 2017 Feb 16. PMID: 28929889; PMCID: PMC5347358. 11. Plessas A, Paisi M, Bryce M, Burns L, O'Brien T, Hanoch Y, Witton R. Mental health and wellbeing interventions in the dental sector: a systematic review. Evid Based Dent. 2022 Dec 7:1–8. doi: 10.1038/s41432-022-0831-0. Epub ahead of print. PMID: 36477677; PMCID: PMC9735078.
Finally at the national level, national campaigns, led by organisations like
Singapore's Health Promotion Board, or even the Singapore Dental Association, can raise awareness about the importance of mental health in healthcare professions. Policymaking should focus on integrating mental health education into dental training programmes and increasing funding for mental health services targeted at healthcare professionals. Where feasible, local research on mental health in dentistry should be promoted to provide data that informs policy and practice. This research can play a crucial role in reducing stigma and improving mental health outcomes within the profession.
By addressing stigma at these three levels, the dental community in Singapore can
16 DENTAL ASIA SEPTEMBER / OCTOBER 2024
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