Table 6 A breakdown of meta-themes into their barrier and facilitator components

Meta-theme 1: Perceptions about mental health: refers to the views an individual holds about mental health

The negative views fall under perceived and self- stigma

The positive views under positive perceptions about mental health, as shown in Fig. 5

Meta-theme 2: Confidentiality concerns are worries regarding anonymity when seeking mental health support

Doctors worrying that they will know the HCPs who will be treating them in a professional capacity, leading to a lack of divide between personal and professional life

Having a confidential service for doctors that is separate from their workplace, as shown in Fig. 6

Meta-theme 3: Perceptions of career implications include ideas or concerns about the impact of seeking help on future career prospects

As a barrier, this includes prolonged training periods due to fears of being seen as incompetent

As a facilitator, this includes being able to provide better care for patients through seeking help for oneself when needed, as shown in Fig. 7

Meta-theme 4: A common theme uncovered within the interviews was the concept of time

Time acted mostly as a barrier to seeking help

Time acted as a facilitator to seeking help in a limited capacity, as shown in Fig. 8

Meta-Theme 5: Awareness and Accessibility

A lack of awareness of mental health services and accessibility issues are factors which demote the use of mental health support by reducing the availability

Greater awareness and easy accessibility for doctors provided increased encouragement to seeking help

A lack of awareness meant even doctors willing to seek help are unable to. Poor accessibility to these services acts as a deterrence and could lead to worsening of mental health (Fig. 9)

Meta-theme 6: Culture is defined as “the ideas, customs and social behaviour of a particular people or society” [62]. Culture can be categorised into organisational and societal culture where organisational culture in a healthcare context “represents the shared ways of thinking, feeling and behaving in healthcare organisations” [62]. These may include multiple subcultures and comprise three levels: visible manifestations, shared ways of thinking and deeper shared assumptions [66]

The barriers fall under structural stigma identified in the SLR which refers to “societal-level conditions, cultural norms, and institutional policies that constrain the opportunities, resources, and wellbeing of the stigmatized” [67]

Facilitators include open culture and supportive seniors, as shown in Fig. 10

Meta-Theme 7: Preventative Factors

Preventative factors are defined as any factors that could prevent a doctor from seeking professional help in the first instance

There are ‘protective factors’ which decreases the chance of a negative mental health outcome

There are ‘risk factors’ which may increase the chance of a negative mental health outcome, as shown in Fig. 11