Care Under Pressure


Ten Care Under Pressure principles for use by those refining/designing interventional strategies to tackle doctor mental ill-health:

  1. Be clear about who the intervention is for (given the continuum from full health, to ‘under pressure’, to mental ill-health).
  2. Give options by signposting to a range of interventions (e.g. a ‘one-stop shop’ of local, regional and national resources).
  3. Ensure that information about the intervention is readily and rapidly available.
  4. Ensure that interventions are accessible to someone who works long and inflexible hours.
  5. At the initial enquiry stage, invest time in building trust and normalising stigma and struggle.
  6. Provide interventions in groups, whenever possible, to prioritise connectedness, relationships and belonging.
  7. Ensure that interventions for individuals are endorsed by or embedded in the workplace, where possible.
  8. Encourage and empower individuals to tackle low-level everyday hassles at work, to free up capacity to deal with bigger issues.
  9. Emphasise that prioritising and investing in physical and mental health is essential for optimal patient care.
  10. Evaluate and improve the intervention regularly, using data such as numbers and types of attendee, programme adherence and user perceptions.

Please note that the research evidence indicates that system-wide approaches are more likely to succeed in tackling mental ill-health in doctors.

For more information, please see our paper (open access): Optimising strategies to address mental ill-health in doctors and medical students: ‘Care Under Pressure’ realist review and implementation guidance