Dr. Paula Henry a Family Physician and Public Health Practitioner from Trinidad and Tobago, with a passion for global health. She attended the University of the West Indies (UWI) Mona, Jamaica, and graduated in 1980, earning her MBBS degree. She also holds a Diploma in Theology from Codrington College, Barbados, an MBA from the University of Edinburgh, a Diploma in Political Science from University of London, School of Economics, and an MPH from UWI St Augustine. Dr. Henry is currently the lead for the WONCA Working Party for Women and Family Medicine (WWPWFM), and the Caribbean Lead WONCA Working Party in Planetary Health. As a director of EarthMedic and EarthNurse Foundation for Planetary Health, she works with other Public Health institutions to underscore that the climate crisis is a health crisis. This is achieved through heightened awareness, education, advocacy and research. Dr. Henry shares her perspectives on what mental resilience means to a family physician, below.
Question: Have you noticed any
generational differences in how people cope with stress?
AGE PLAYS A BIG ROLE IN HOW PEOPLE MANAGE STRESS.
Expectations were different
Graduating as a doctor in
1980, stress was seen as a normal part of life. The expectation was to ‘toughen
up’ and get the job done, while maintaining professionalism. Life was different
then, being born a decade after World War II, in a colonial era where poverty,
malnutrition, food shortages and infectious diseases like polio, measles and
chicken pox were a part of life, as vaccines for such childhood diseases were
still being developed. There was limited technology and medical resources to
diagnose even severe diseases. Resource maximization was an imperative. One
kept focused on the task, while plating the Chocolate Agar disc to diagnose TB,
because the microbiology lab was closed for the day, or retrieving a patient’s
medical file from the hospital’s filing room at midnight. Continuity of care
meant working for 24 hours on-call and 8 hours the following day. There was no
doubt that resilience emanated from one’s prayer life, in addition to the use
of stress relievers like exercise and meditation. Social and community support were
the norm and living in extended family circles where grandparents played an
active part, was an assured safety net. Professional
women with children often had live-in domestic help.
Redefining self from the perspective of Human Rights
The Human Rights Act of 1998
came into full force in the UK, in 2000. It allowed persons to bring claims related
to breaches of their human rights. It is no doubt that this had a trickle-down
effect, which gave rise to the expectation of entitlement.
Life for the younger
generation is centered around digital platforms and technology. This has led to even more challenges for physicians
who can now receive personal and professional information real-time with the
click of a button. Technology is great. On one hand it makes life simpler,
however it increases complexity and uncertainties, both of which challenge one’s
mental capacity. Indeed, the challenges of exponential technology coupled with
the enforcement of one’s human rights brings with it, an even deeper level of
mental health distress. It is not
surprising therefore, that in this era, structured programs were developed as
coping mechanisms to reduce stress. Self-care programs, training to ensure
work-life balance and mitigation against burnout are normative for the younger
generation of doctors, to cope with the daily stressors of life.
Collegiality and Building Relationships
This is a universal
principle that was well-developed in the older population of doctors. The older
generation viewed the elders in the fraternity as mentors, both within the
work-environment and social circles outside. There were open lines of
communication, so that concerns could be voiced and heard without fear of
judgement or victimization. This created a culture of psychological safety and
support. The self-esteemed engendered served as a potent stress reliever. One benefited
from the medical care of peers free of charge. Strong horizontal relationships bred
trust. These were bi-directional. Attending dinner at the home of the consultant
on the team, was just as important as me sitting at the bedside of an older
colleague, just hours before her departure from life.
The younger generation
builds social relationships often through social media platforms like Instagram,
Tik Tok and Twitter. These communication channels can be socially challenging
from user vulnerability to personal attacks.
There is nothing
comparable to building vertical relationships, through communication with a Higher
Power. I refer to this as the ultimate stress reliever.
Online and Self Care modules
The concept of self-care
grew in popularity in the 1950’s with the civil rights movement. Online and
Self-care modules however only gained prominence when e-technology formats were
introduced. Covid 19 has augmented mental health challenges worldwide, including
the CARICOM region. In a paper recently
published in the Lancet, (Quinta Seon et al January 2023), reference was made
to pre and post-pandemic mental health challenges with overburdened systems.
Despite the strengthening of online and self-care modules, there were no clear
structured guidelines for the way forward. Since there is still an urgent need for
targeted interventions demonstrating efficiency, it is worthwhile for both the
younger and older generations to collaborate for a sustainable solution.
In conclusion
The exponential use of information
technology, digital platforms and the threat of epidemics and pandemics with
increasing mental health challenges, has intensified stress management programs.
Successful stress management involves the balance of traditional methods with
the newer structured programs. For maximum utility however it must be rooted in
self-discipline.
