Beyond Burnout: Elevating Mental Health in Gynecologic Oncology | Mental Health Awareness Month
As the demands on gynecologic oncologists and affiliated providers continue to evolve, the imperative to address mental health within the field has never been more critical. During Mental Health Awareness Month, the Society of Gynecologic Oncology (SGO) affirms its commitment to advancing open dialogue, reducing stigma, and supporting systemic solutions that prioritize the well-being of its members.
Recent research conducted by Rebekah M. Summey, MD, illuminates a growing concern: the prevalence of psychological distress among gynecologic oncologists and the persistent barriers that prevent many from seeking care.
The Hidden Crisis
“In the 2015 SGO State of the Society survey, 33% of respondents had a positive depression screen, 13% reported current or past suicidal ideation, and 45% reported reluctance to seek professional mental health assistance if it were needed,” Dr. Summey noted. “These data suggested a high psychological symptom burden amongst gynecologic oncologists, plus a possibly dangerous reticence to access treatment.”
Barriers Beyond Burnout
While wellness has become a widely discussed topic in academic medicine, Dr. Summey’s work pushes the conversation beyond surface-level solutions like sleep hygiene or mindfulness exercises, emphasizing the importance of actual access to psychiatric care.
“While sleep, meditation, and exercise may be helpful in the management of psychiatric symptoms, they are not substitutes for medication or therapy,” she said. “I have always been bothered when I read articles regarding physician burnout that report high depression or suicidality rates but fail to include facilitation of mental healthcare as proposed interventions.”
Her study surveyed a diverse group of professionals, with early-career and female providers representing the majority of respondents. Notably, the results revealed a concerning psychological burden among participants:
“Participants demonstrated higher depression, anxiety, and suicidality scores than expected, and depression and anxiety were highest in women respondents. This symptom burden has been identified in other groups of women physicians,” Dr. Summey explained. “Nine percent of survey respondents reported suicidal ideation in the past year, 3% said they were uncomfortable answering the question despite the anonymity of the survey, and 1% skipped the question. These data highlight current suffering and thus an opportunity for improvement.”
The study also identified systemic barriers that limit access to mental healthcare among providers. Time constraints were cited most frequently, followed by limited availability of services, high cost or poor insurance coverage, and both self- and external stigma.
“It is my opinion that the combination of these factors results in a higher barrier than any of them alone,” she said. “To paraphrase responses, ‘the only therapist or psychiatrist covered by my insurance has time available Monday and Thursday mornings, when I currently have other responsibilities, and I don’t feel comfortable asking for time for these appointments—or if I do, it’s not prioritized.’”
Where Do We Go from Here?
SGO has taken steps to address provider well-being through initiatives such as the SGO Wellness Curriculum for fellows, ongoing wellness webinars, and the 2023 review “System-level recommendations for improved wellness for gynecologic oncologists.” However, Dr. Summey emphasizes that continued, direct engagement with mental health language is essential to meaningful progress.
“One of the National Alliance on Mental Illness’s suggested strategies to reduce stigma surrounding mental health concerns is open and honest conversation,” she stated. “The more that direct mention of mental health, and words like ‘depression,’ ‘panic attacks,’ and ‘suicide prevention’ are included in these resources, the better the stigma reduction.”
What Wellness Should Look Like
Looking forward, Dr. Summey envisions a wellness-oriented gynecologic oncology field as one grounded in flexibility, inclusion, and nonjudgmental support. “In a wellness-oriented field, scheduling flexibility may allow for appointments during business hours, outdoor recreation during daylight, or weekend family event attendance. Since stigma exists, allowing flexibility with minimal questions asked may be helpful,” she asserts. A work environment with camaraderie and inclusion is also a recommended approach to facilitating discussion of shared struggles, allowing participants to disclose as much or as little as they want regarding their wellness endeavors without judgment.
For departments and institutions seeking a place to start, Dr. Summey offers a simple but powerful recommendation:
“Recognize the importance of your own mental health. If you’re comfortable, discuss this with your colleagues or trainees. See if your openness leads to increased comfort from others over time. If you notice an opening to support coworkers’ well-being by covering a responsibility, supporting a need, or providing emotional support, do it.”
For additional wellness resources and mental health support, SGO members are encouraged to visit sgo.org/wellness. If you or someone you know is in crisis, please contact the Suicide & Crisis Lifeline by calling or texting 988.