Sarah McKimm advises a dentist who has noticed signs of poor mental health in a colleague – is stepping in the responsible choice or a breach of professional boundaries?
The scenario
I’m reaching out because I’m getting increasingly worried about a fellow associate in my practice. We’ve worked together for several years, and although dentistry is stressful for all of us, something has changed in him over the past few months. He’s withdrawn, noticeably anxious, and often looks exhausted. The changes are small but enough that the nurses have commented. He skips lunch, stays late in his surgery with the door closed, and brushes off any attempts to talk with a joke or a vague: ‘I’m fine.’
The atmosphere in the practice is shifting because of it. Our team is trying to support him, but we’re all quietly worried. I don’t know whether something personal is going on or if the pressure of work is taking its toll. What I do know is that he seems to be struggling, and I don’t want to ignore the signs and later regret not stepping in.
My dilemma is this: I’m not sure what my role should be. I’m a colleague, not a clinician in this context, and I’m conscious of boundaries. I don’t want to overstep or make him feel scrutinised, but doing nothing feels irresponsible. I care about him as a friend and value him as part of our team. I want to ask if he’s okay but I’m worried I’ll make things worse, or that he’ll feel embarrassed or defensive.
I’m torn between wanting to help, respecting his privacy, and ensuring patient safety. How do I approach this sensitively and appropriately?
Sarah McKimm is a qualified counsellor with more than 20 years of experience in the dental profession. She is here to offer a space where dental professionals can explore the human side of dentistry together, looking at what’s behind the mask through a unique perspective.
Each month, she will take a question from one of you and explore it with care, compassion, and insight. Drawing on her dual background as a counsellor and experience as a dental professional, she aims to provide empathic, non-judgmental responses tailored to the struggles faced in this field.
While she can’t offer counselling here (or replace professional support where it’s needed), she hopes to share some practical tips, professional insights and coping strategies.
The scenario
Dear reader,
Thank you for reaching out with such care and thoughtfulness. It takes courage to notice subtle changes in a colleague and to pause long enough to ask yourself what those changes might mean. Many people instinctively turn away from discomfort in others not because they don’t care, but because they’re unsure what to do. The very fact that you’re reflecting on your role, your boundaries, and the wellbeing of both your colleague and your patients shows your commitment to professional integrity and human compassion.
What you’re describing is withdrawal, anxiety, exhaustion, skipping breaks, staying late and ‘I’m fine’ responses. These are all common signs that someone may be quietly struggling. In dentistry, we are often high-functioning professionals who continue to perform despite internal distress. It’s part of why difficulties can remain hidden for long periods. Stress, burnout, and personal challenges don’t always present dramatically; sometimes they show up in the small, persistent shifts you’re observing.
Normalising the problem
Before exploring the ‘how’, I want to normalise your dilemma. It is completely understandable to feel torn. You are balancing three very real considerations:
- Respecting your colleague’s privacy
- Looking after him as a fellow human being
- Upholding your duty to patient safety, which the GDC emphasises clearly:
- ‘Put patients’ interests first’ (Standard 1.1)
- ‘Raise concerns if patients are at risk’ (Standards 8.3-8.5).
While you are not suggesting that patient care has been compromised, your early awareness of changes is exactly the kind of reflective practice the GDC encourages. Noticing is part of safeguarding – of people, of teams, and of the clinical environment.
A person-centred approach
You don’t need to diagnose or fix anything. Your role is simply to be a compassionate colleague who offers a safe, non-judgemental space.
When you approach him, keep it gentle, simple, and grounded in your genuine concern:
‘I’ve noticed you seem a bit more worn down recently, and I just wanted to check in. You don’t have to share anything you don’t want to, but I care about you and want to make sure you’re supported.’
This approach does a few important things:
- It focuses on specific observations, not assumptions
- It communicates care without pressure
- It allows him to choose how much he shares
- It keeps the door open for future conversations.
Even if he brushes it off the first time, you’ve signalled safety. Sometimes that alone is meaningful and powerful.
A personal reflection
I want to share something from my own time in practice, because your dilemma is one I know well. There were moments when I noticed a colleague wasn’t themselves, and I would spend days, sometimes weeks, ruminating on whether to say something. I’d worry about making things worse, embarrassing them or myself, or overstepping the mark. And that familiar voice would whisper: ‘Maybe it’s none of your business.’
That mental load can be incredibly heavy. The fear of ‘getting it wrong’ can leave you frozen in indecision. But every single time I approached someone with authenticity, kindness, and no agenda other than care, the response surprised me. Not once did it make things worse.
More often, it brought relief to both of us. Sometimes they opened up; sometimes they didn’t share much, but they appreciated being seen. Either way, the unspoken burden lightened. That quiet acknowledgement of ‘I see you, and you’re not alone’ can shift the emotional weight for everyone involved. It taught me that empathy delivered gently, genuinely and respectfully is rarely intrusive. It’s human.
Maintaining boundaries while providing support
Many dental professionals worry that asking someone if they’re okay will make things worse. In practice, the opposite is usually true. When framed with empathy and respect for autonomy, gentle curiosity rarely causes harm. You are not overstepping by expressing concern. You are simply acknowledging what you see.
If he continues to withdraw or if his behaviour begins to impact patient care, it may be necessary to escalate your concern to the practice owner or clinical lead, not as a complaint, but as a safeguarding measure. The GDC is clear that raising concerns is a professional responsibility, not a judgement of character.
Signposting support
You might want to remind him (or hold in mind yourself) that there are confidential options available beyond the practice environment. These include:
- NHS Practitioner Health – confidential mental health and wellbeing support for dentists
- Dentist Support UK – peer support and wellbeing signposting
- Dentists’ Health Support Trust – for stress, emotional difficulties, addiction, or burnout
- BACP (British Association for Counselling and Psychotherapy) – a register of accredited and ethical counsellors and psychotherapists
- Counselling Directory – a trusted place to find qualified counsellors, many offering in-person or online sessions
- Mind – information and support for mental health
- Samaritans – 24/7 confidential listening support for anyone who’s struggling.
You can mention these without implying that he ‘needs’ them. Simply affirm that support exists, confidentially and without judgement. Normalising help-seeking remains an important part of reducing stigma within our profession.
The importance of team culture
When one person in a practice is struggling, the whole team feels it. You’re already noticing that shift. A supportive culture – one where people take breaks, check in on each other, and feel able to say ‘I’m not coping today’ – can make all the difference. You don’t have to solve his situation alone. If appropriate, gently encourage open communication within the team or with the practice leadership. Psychological safety is everyone’s responsibility.
Remember: take care of yourself too
It’s easy to become so focused on supporting others that you overlook your own needs. Watching someone struggle can stir anxiety, frustration, and even a sense of helplessness. Please take care of your wellbeing too. You cannot pour from an empty cup. Notice your own stress levels, use your breaks, stay connected to colleagues, and reach out for support yourself if you find the situation weighing on you. Compassion is a strength, but it’s also a resource and it needs replenishing.
Moving forward
Approach him with warmth, humanity, and openness. Observe, don’t diagnose. Offer space, not solutions. And act gently, but responsibly, if concerns escalate. Your colleague is fortunate to have someone who cares enough to notice and to ask questions with such integrity. In dentistry, where pressures can quietly accumulate, this kind of compassion can be life changing.
Take gentle care,
Sarah
Catch up with more Chairside Chat articles here:
- Am I settling by working as a dental nurse?
- I feel trapped by the financial pressure of practice ownership
- Inappropriate behaviour from a colleague: how should I respond?
- I’m nervous to return to dentistry after extended sick leave
- My employee’s personal life is impacting my dental business.
