Dr. Brett Gilbert and Sue Jeffries talk about a network to support dental mental health.
by Dr. Brett E. Gilbert and Sue Jeffries
“When we are looking for compassion, we need someone who is deeply rooted, able to bend, and, most of all, we need someone who embraces us for our strengths and struggles. We need to honor our struggle by sharing it with someone who has earned the right to hear it. When we’re looking for compassion, it’s about connecting with the right person at the right time about the right issue.” – Brené Brown, The Gifts of Imperfection
The pervasive climate of perfectionism and individual blame in dentistry plays a significant role in the high levels of depression, career dissatisfaction, and suicide. Many practice owners lack any personal and administrative support, further cause for diminished mental well-being.
All around the world, organizations and individuals are raising awareness about the scope of our mental health crisis. And it is definitely a crisis. More than 300 million people worldwide deal with depression, making it the leading cause of disability.1 Every 40 seconds, a life is lost to suicide.2 As The Guardian put it in a headline last year: “World in mental health crisis of ‘monumental suffering,’ say experts.”3
Dental Mental Network is predicated on the belief that dentistry’s discussion of mental health and wellness must transform from awareness to action. We are creating a first-of-its-kind platform, a safe space unique to dentistry. In this place, the profession will openly and eagerly denounce the existing culture of distress and develop methodologies that provide timely and appropriate mental wellness support and resources. The goal is to break through all stigmas surrounding mental health awareness, illness, and suicide. Dental Mental Network is a community of dental professions committed to supporting one another, being supported, and providing a safe space filled with kind, wholehearted, and empathetic colleagues.
The mental health of dentists remains an important and largely unspoken issue. Job-related stressors, bullying, treatment error, traumatic patient experiences, and perfectionism lead to dentist depression and burnout. Shame – a universal emotion that contributes to low self-esteem, depression, eating disorders, violence, and addiction – underscores these factors. Dentistry can feel isolating, and perfectionism leads to self-flagellation, self-judgment, and a feeling of being trapped in the office. Dentists routinely feel high levels of stress related to clinical struggles, financial concerns, and the requirement of being at the dental chair working to generate income.
Most dentists are idealists who always knew that their calling was to become a doctor who can help others to heal. The decision to enter the profession of dentistry is often chosen early in adulthood before a true understanding of interests and other life events have started. Most enter dental school with an incomplete understanding of what the reality of the lifestyle will be like. No one warns them about the hidden pitfalls and mind-altering stressors of practicing – the costs that leave practice owners and clinicians emotionally wasted and professionally destitute. Sadly, too many students graduate from dental school with PTSD – forever changed and profoundly affected.
Humans are fallible.
Because dentists are human, accidental errors, practice management mishaps, and financial disasters occur. Although unintended, these errors and accidents can negatively impact patients, families, and staff, leading to adverse mental and emotional effects experienced by the clinician. These effects include burnout, loss of focus, poor work performance, post-traumatic stress disorder, depression, guilt, embarrassment, anxiety, fear, and even suicide.
Dentists often feel trapped due to the amount of time and finances already sacrificed. They frequently feel chained to their dental chair, unable to generate income when not performing procedures. They also believe there is nothing they or anyone else can do about it. Support is not substantive in dentistry’s current system, a system that merely wants you to get through.
The pervasive climate of perfectionism and individual blame in dentistry plays a significant role in these adverse effects. Many practice owners lack any personal and administrative support, further cause for diminished mental well-being. Dentists have human problems outside of the office. We, too, experience relationship issues, money troubles, custody battles, and deaths in their own families. Still, many dentists are working long, stress-filled hours focused on strangers’ well-being, leaving little to no time to sort through their own issues. Shame fills this vacuum, as well as thoughts such as “What is wrong with me?” “Why am I the one this happens to?” “Why am I broken?” Shame thrives on secrecy, is insidious, and intensifies by the day. It is imperative that dentists let it out and share their shame stories. But the question is, with whom?
It’s distressing for us as clinicians and caregivers to feel paralyzed and powerless when a problem is so immense and overwhelming; after all, we are in the business of healing and making things better. That’s why moving from a general big-picture understanding to actionable measures that encourage mental well-being is the best use of this moment in time. People want and need support to take action: 91% of Americans say their emotional well-being has been hurt by ignoring or not recognizing their warning signs of overstressing.4
Our goal is to assist our fellow professionals in recognizing the warning signs of mental health issues. This will help our colleagues to obtain the support they need and facilitate the improvements they need to make. Even in difficult times, everyone should have the opportunity to elevate to living the lives they deserve, not merely the lives they settle for.
Dentists are notorious for pouring from an empty cup, always concerned with the wellbeing of others while grossly lacking in their own self-care.
Changing the “Disease Model” of Mental Health Care
A critical examination of the prevailing “disease-model” of mental health care would reveal the necessity for a novel alternative to the notion that psychological distress is a symptom of an illness and should be treated as such. How we care for people with mental health problems is mainly ineffective – a new approach is needed.
Our mental health and well-being depend primarily on the society in which we live, what happens to us, and how we learn to make sense of and respond to our life events. To proceed, we must recognize that distress is usually an understandable human reaction to life’s challenges, especially episodes of abuse, neglect, and inequity. In response to these, practical support rather than prescription medication should become the new norm. Renouncing labels, considering our life circumstances, and documenting our emotional response in a simple and easily understood format, should become our latest recording.
The time for revolutionizing mental healthcare is now. It starts with an unmitigated shift from viewing mental health solely as a biological disease to viewing it through a social and psychological lens. We need to replace unfounded diagnoses with practical, scientific, and understandable alternatives. Instead of treating so-called disorders, we should help people solve the issues leading to distress in their lives. Addressing the cause versus just treating symptoms is critical to a progressive change in how society views and responds to mental illness.
A terrific start to a new approach would be asking people for straightforward descriptions of their problems, using their own words. Our social conditions generally shape our psychological health and well-being, so we need to work collectively in creating a vastly more humane society. A priority for all humans should be safeguarding our fellow men, women, and especially children from abuse, neglect, and inequality while developing healthier communities.
Overcome Through Acknowledgment, Vulnerability, and Compassion
Dentistry can integrate positive strategies by promoting kindness, supportive environments, and constructive rather than negative feedback. Constructive feedback, mentorship, and a collectively supportive resource group are desperately needed to support dentists in a safe space. This allows for sharing and being free to show vulnerability without worry of recourse, reprimand, or concerns about a negative effect on reputation.
Forging meaningful and tangible connections with others is how we overpower our shame. Shame cannot survive interpersonal relations predicated on understanding and trust. Author Brene Brown aptly summarized the burden of sharing our issues with others. She said, “If we share our shame story with the wrong person, they can easily become one more piece of flying debris in an already dangerous storm. We want a solid connection in a situation like this – something akin to a sturdy tree firmly planted in the ground.” Allowing others to view you as imperfect will strengthen your bond and result in relationships that will likely last longer than the other relationships you have.
By joining Dental Mental Network, you can take action by joining this community and showing up to help support yourself, your family, and all dental professionals around the world. We welcome you and are here to support you.
If you would like to join the network or make a donation to allow us to continue to provide support to those we serve, please email: firstname.lastname@example.org.
Besides fostering dental mental health, Dr. Gilbert is a seasoned clinician, who has been featured in our sister publication, Endodontic Practice US. Read more about him here: https://endopracticeus.com/brett-e-gilbert-dds/
- GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2018. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32279-7/fulltext. Accessed January 20, 2021.
- World Health Organization. World Mental Health Day 2019 — Focus on Suicide Prevention. www.who.int/news-room/events/detail/2019/10/10/default-calendar/world-mental-health-day-2019-focus-on-suicide-prevention. Published October 20, 2019. Accessed January 20, 2021.
- “World in Mental Health Crisis of ‘Monumental Suffering’, Say Experts.” The Guardian. www.theguardian.com/society/2018/oct/09/world-mental-health-crisis-monumental-suffering-say-experts. Published October 20, 2019. Accessed January 20, 2021.
- Khidekel M. The COVID-19 pandemic has made spotting our mental health warning signs more critical than ever. Thrive Global. https://thriveglobal.com/stories/mental-health-learn-to-spot-recognize-stress-warning-signs-microsteps/?utm_source=Recirc. Published May 1, 2020. January 20, 2021.