04-06-2025
Be silly, show you care about healthcare workers' mental health in your crazy socks
Friday 6 June is CrazySocks4Docs Day – and your chance to rescue the oddest pair of socks from your drawer and show you care about those who care for us: our healthcare workers, writes Lizette Rabe.
'I write this because I am a medical student typing on a small laptop in my wardrobe in the dark. Because I am sitting on the floor with my back against the wall. I write this because I cannot ask for help.' Because, she writes, if anyone should know how ill she is, she will not get a position as an intern after her studies.
This is how a medical student in America described her experience of depression a couple of years ago. But it could just as well have been a South African medical student. When I quote her when speaking to students, nods of agreement of students in front of me prove they know exactly what I'm talking about. No one is allowed to realise the level of their mental suffering. And after they are placed, the worst is to come.
Indeed, a recent report on News24 highlighted the harsh conditions junior doctors in public hospitals have to endure, and that many are already on antidepressants.
Healthcare workers – including students in healthcare – experience some of the highest levels of stress which lead to severe mood disorders. That's exactly why the CrazySocks4Docs (CS4D) campaign started several years ago.
Dr Geoff Toogood, an Australian cardiologist who lives with severe depression, started the campaign to raise awareness that also healthcare workers can suffer from serious mental illnesses. It was after he wore a funny combination of socks one day – and then heard colleagues giggling that he had 'lost it again'. The truth is that he was quite healthy at the time, but that a puppy got hold of his socks – those mismatched socks were the first ones he could find that morning.
While he continues fighting his battle against depression, Toogood's advice to all healthcare workers – including students – is to not see their mental illnesses as a 'failure'. Instead, they should seek help. And know that they are not alone.
In South Africa, healthcare workers are working under acute stress. Some state hospitals cannot even afford food for patients, or pay doctors overtime. Our healthcare system is failing, what with 2 000 vacant posts in state hospitals. With the withdrawal of American financial support for Aids programmes, the picture gets even darker.
Highlighting a serious problem
The CS4D awareness campaign exists so that those who care for us realise that they also need to care for themselves. Besides, it is our opportunity as the public to show we #Care4OurCarers.
It may sound frivolous to wear silly socks to highlight a serious problem. But it is a way to break the silence and the stigma. According to studies, suicide rates are higher among doctors than among other groups. Suicide is even described as an 'occupational hazard' for medics.
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Research shows suicide ideation begins on medical campuses. The tragic incidence of suicide is also significantly higher among medical students than among other groups. A South African study found that a third of medical students experience suicide ideation and that more than 6% attempt suicide. Another study found that 30% of primary healthcare doctors suffer from moderate to severe depression – a condition 'that is unrecognised, stigmatised, and undertreated – one which can have fatal consequences'.
Moral distress
In 2023, another South African study found that 46.2% of doctors tested positive for burnout and 53.73% for depression.
The irony is that healthcare workers work in the 'caring professions', but seemingly often do not take care of themselves.
A professor of psychiatry has described burnout – dysphoria is the medical term – in the healthcare sector as a burning ship that is getting closer and closer. According to him healthcare workers are in 'moral distress'. Plus: Interventions should not just be a 'band-aid', or, as he refers to it, 'baby goat yoga'. Their plight requires 'continuous attention'.
Of course, the medical student's cry for help above is a catch-22 situation. They cannot show they are suffering. And then that black dog sneaks up on them; and it can destroy everything.
Toogood also referred to how he postponed his own search for help because he was afraid of the consequences. What if it became known that he, as a cardiologist, suffers from severe depression? He also experienced feelings of shame. As a doctor, he thought he must be 'bulletproof'; and comments around the condition made him feel like a failure. That he couldn't handle a demanding profession. That he had chosen the wrong profession. That he wasn't resilient enough. Even that it was his 'choice' to feel the way he did – as if a cancer patient chooses to have cancer. Or this one: 'Everyone feels 'down' or 'a little sad' sometimes.'
The importance of self-care
Awareness-raising needs to make healthcare workers realise it's okay to seek help and to support each other, says Toogood. Mental health is about the health of your brain – which affects your entire body and life. It's not something you 'imagine'.
There is still a long way to go to destigmatise mental illness in the healthcare sector to help more healthcare workers – and students – to seek help sooner.
So, dear doctor, nurse, caregiver, student: learn the importance of self-care. CS4D is the ideal opportunity. You are not supermen or superwomen.
To help students break the stigma, a 'sock selfie' competition will be held on all South Africa's medical campuses. All you have to do is post your sock selfie on social media with the hashtag #CrazySocks4Docs by 13 June, link it to the Ithemba Foundation's Facebook (IthembaFoundation1) or Instagram pages (@ithembafoundation) and ask family and friends for 'likes'. The student with the most 'likes' on each campus wins a whopping R2 000 in cash.
Simultaneously, this is our opportunity as the public to show we care for those who care for us. Find your silliest mismatched socks to wear on Friday (and don't forget to post your sock selfie on social media). It may be a light-hearted way to draw attention to a serious topic, but together we can show we #Care4OurCarers.
- Lizette Rabe is professor emeritus at Stellenbosch University and founder of the Ithemba Foundation which promotes awareness of mental health and funds research.
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