Report, Soapbox

Psychological strains of optometry

In my roles as an employer of optometrists and an academic, it seemed to me mental health issues and burnout in our industry have been increasing during the past 10 years.

Anecdotally, early career optometrists were reconsidering their professional options, academics were burnt out from increasing teaching workloads and research funding constraints, and students were struggling to juggle their studies, need to work and general life challenges.

In 2013 Beyond Blue conducted Australia’s first ‘National Mental Health Survey of Doctors and Medical Students’ and found doctors and medical students had high rates of burnout and were more likely to experience psychological distress than the general community.

This prompted a group of us at Queensland University of Technology (QUT) to conduct the first survey of registered practising Australian optometrists to estimate rates of psychological distress and burnout, and in so doing, determine the likely magnitude of the problem.

The study was conducted in November 2019, prior to the COVID-19 pandemic. Standard mental health and burnout questionnaires were used, in addition to invited comments on the topic.

Nine per cent (505) of Australian optometrists responded to the survey. Rates of burnout and moderate-to-severe psychological distress were high (31%) relative to the general population and consistent with rates for other healthcare professionals, such as doctors, nurses and pharmacists. Optometrists aged under 30 were 3.5 times more likely to report moderate-to-severe psychological distress compared with optometrists over 30 years. Younger age and burnout were significant risk factors for psychological distress.

According to the World Health Organization, ‘burnout’ is a syndrome resulting from chronic workplace stress and is characterised by: feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativity or cynicism related to one’s job; and perceived low self-efficacy and achievement in one’s profession (feeling ineffective at work).

Additional specific studies are needed to explore the exact reasons for burnout among optometrists. However, the most frequent work-related issues mentioned by participants in our study were retail pressures, workload and career dissatisfaction. Too much focus on sales targets rather than patient care was perceived as problematic. Commercial pressures were also noted by optometry business managers and owners.

Most participants talked about insufficient breaks and working late because of seeing too many patients with appointments that are too short, making the pace of work feel stressful. They also described feelings of job insecurity related to increasing numbers of graduating optometrists and frustration with lack of opportunities for career progression. Some find optometry monotonous.

Burnout is a complex issue, affecting individuals as well as healthcare organisations and patients. Studies have shown burnout is associated with reduced productivity, absenteeism, patient errors, poor attitudes to patients, high staff turnover and increased probability of leaving a profession.

It’s essential the situation is addressed, particularly for our early career optometrists. While optometry would benefit from studies to inform the most appropriate next steps and evaluate the effectiveness of strategies, much has been written about how to reduce burnout in medicine, nursing and business, which could be applied to optometry. For example, mental health promotion programs, monitoring and support programs by employers and professional bodies targeted at both the individual and workplace level, workload reduction, fostering a sense of belonging, as well as mental health and resilience programs at university for optometry students prior to entry to the profession.

It’s important to note our study was conducted just prior to the COVID-19 pandemic, which imposed many additional challenges and stresses for optometrists. It’s likely optometrists have been even more susceptible to developing mental health conditions and burnout during this time. We are currently seeking funding to design and evaluate evidence-based interventions for optometry that will enable individuals to thrive, engage, commit and find meaning in their work at the personal and organisational level.

‘The Mental Health and Wellbeing Survey of Australian Optometrists’ by optometrists Professor Sharon Bentley (second from right), Associate Professor Alex Black (far right), Professor Joanne Wood (second from left) and Ms Amanda Griffiths from the Centre for Vision and Eye Research, School of Optometry and Vision Science, QUT, psychologist Professor Nigar Khawaja (far left) from QUT’s School of Psychology and Counselling and health psychologist Dr Fiona Fylan from Leeds Beckett University UK, was published in Ophthalmic and Physiological Optics in 2021.

ABOUT THE AUTHOR

Name: Prof Sharon Bentley
Qualifications: PhD MOptom MPH CertOcTher GAICD CF FACO FAAO (DipLV) AFHEA (Indigenous)
Organisation: Queensland University of Technology
Location: Brisbane
Years in profession: 33

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