I would like to congratulate Meerten et al ^{Reference Meerten, Bland, Gross and Garelick1} on their excellent paper about MedNet, a service for doctors experiencing psychological problems; and, furthermore, for setting up and running the service in the first instance.

The authors cite that doctors are a vulnerable group with high rates of psychological disorders. This is in keeping with previous work myself and colleagues conducted on junior doctors using the 12-item General Health Questionnaire, albeit at a time when they were undergoing a period of extreme stress (the MTAS fiasco). ^{Reference Whelan, Jarrett, Meerten, Forster and Bhugra2,Reference Whelan, Meerten, Rao, Jarrett, Muthukumaraswamy and Bughra3} We found that 79% of the sample scored above the cut-off point for psychological distress and 21% for severe distress (i.e. caseness for treatment). ^{Reference Whelan, Meerten, Rao, Jarrett, Muthukumaraswamy and Bughra3}

What perplexed me about the paper, however, were the high rates of suicidality in the MedNet sample (nearly half) but the relatively low scores on the Brief Psychiatric Interview. I am not sure that this discrepancy is explained sufficiently in the discussion or, indeed, why the suicidality persisted post-treatment despite the other range of outcome measures used indicating improvement.

I would like to hear more from the authors about their views about this phenomenon.