Mental Health / When the carer starts to lose it

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IT’S been known for decades that “caring” professionals, such as doctors, dentists, vets and “emergency first responders”, are among those who are extremely vulnerable to mental disorders including depression, anxiety and suicide.

And now, according to research, we can add other disorders, loosely gathered under the heading of “compassion fatigue”.

“A substantial number of people are profoundly affected by the work they do. For example, mental-health workers, nurses, doctors, palliative-care workers, midwives, aged-care workers, veterinarians, emergency first responders, lawyers, teachers, domestic-violence workers, animal-shelter workers and rape-crisis counsellors are at high risk of developing compassion fatigue and vicarious trauma,” according to Compassion Fatigue Australia, a collaboration of expert consultants based in Adelaide, specialising in high-stress, trauma-subjected workplaces.

“Helping others, whether by occupation, as a volunteer or unpaid carer, can bring deep satisfaction and reward. However, it can also inflict a secondary wounding; one that leaves the helper feeling as if they were injured on a personal level.”

The Australian Work Health and Safety Strategy 2012-2022 has identified work-related mental disorders as a priority of focus.

Signs of compassion fatigue may be bottled-up emotions, substance abuse, excessive blaming, difficulty concentrating, mentally and physically tired, compulsive behaviours such as overeating, overspending, gambling, sexual addiction and isolation from others.

But the most detrimental symptom of compassion fatigue, especially for the medical professional, is apathy.

The source of their stress is dealing daily with trauma situations, long working hours, fear of making mistakes, responsibility at work and difficulties balancing work and personal responsibilities. Young doctors, male and female, also suffer under the high expectations from within their profession. A “stiff-upper-lip” attitude still prevails. Doctors and vets are taught and expected to ignore their emotions and to treat patients with objectivity and a dispassionate attitude.

Ignoring their emotions may lead to burnout, emotional exhaustion, poor professional efficacy and high cynicism. Subsequently, patients may find themselves being consulted by a doctor or vet who has an apathetic attitude, who is mentally and physically tired and in denial about his or her own problems.

Compassion fatigue comes at a considerable economic, cultural and individual cost responsible for chronic absenteeism, increased workers’ compensation costs, high staff turnover rates as well as friction between staff and management, leading to  work-related mental disorder claims each year in Australia of around $480 million.

Safe Work Australia statistics (2015), indicate that about one in five Australian workers is likely to be experiencing a mental health condition such as depression or anxiety at any given time. This is estimated to cost Australian workplaces $10.9 billion a year in absenteeism, presenteeism and compensation claims.

Sadly, there’s more; Australia already ranks highest in the world with its population suffering from depression and the use of antidepressants. Last year saw a 10-year high for suicides in Australia, with men being three times more likely to commit suicide then women.

Globally, the medical profession has the highest suicide rates of any profession followed by dentists. So it is unsurprising that 63 per cent of veterinarians suffer from psychological distress and every 12 weeks in Australia a veterinarian dies from suicide.

These are grim numbers, but the most tragic possibility is that we are losing our most compassionate professionals to compassion fatigue and suicide.

More information at

Heike Hahner is a psychology consultant,

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