Society of Bioethics and Medicine
Physician Reluctance to Seek Mental Health Care
Written by Maisha Uddin
Edited by Selma Music
Despite being healthcare advocates, physicians are often the first to neglect their well-being when it comes to mental health. Previous research shows that there tends to be a higher prevalence of depressive symptoms among physicians as compared to the general public. A 2019 study conducted by the Missouri State Medical Association revealed that over 300 physicians die from suicide annually in the United States. Male physicians have suicide rates 40% higher than that of the general population, while female physicians have rates 130% higher. Physician burnout has become a public health crisis, with almost 60% of physicians reporting experiencing its symptoms following the COVID-19 pandemic. Despite all this, only about 13% of healthcare providers have sought out treatment for these concerns.
According to a 2017 Mayo Clinic study, about 40% of physicians report reluctance when seeking formal mental health care out of concern for how it may affect their licensing. State licensing boards can require disclosure of all medical health records, including information divulged during therapy or mental health treatments. Furthermore, following a review of a physician’s records, boards can mandate that they attend physician health programs (PHPs). To attend the PHP, physicians will typically have to pay for and take time off of work to attend, and may even be assigned supervision when practicing medicine following these programs. If a physician doesn’t comply with the PHP, they risk permanently losing their medical license.
To remedy this issue, in 2018, the Federation of State Medical Boards set out recommendations for improving licensing applications, suggesting only asking for a physician’s current impairments rather than requiring questions about past treatment. Although many states have adopted this and altered the application language to be less punitive, some boards have kept the old wording, making physicians continue to worry about licensing.
While worries over licensing play a big role in preventing healthcare workers from seeking mental health care, some additional physician concerns include the fear of ruining their reputation or being judged by their colleagues and patients. Due to the stigma that continues to surround mental illness in both the medical field and society, healthcare providers fear that accessing mental health services will damage their credibility and be seen as a weakness.
Although the burnout and mental health of healthcare workers has recently gained more attention with the pandemic, much more development and reformation still needs to occur. As a start, the current PHP system has to be altered. By penalizing physicians both monetarily and occupationally, physician health programs are contributing to the negative sentiments surrounding mental health instead of providing physicians with the help they need. The toll of grappling with moral dilemmas and life-or-death situations on a daily basis is immense. By capitalizing off of struggling physicians rather than providing assistance, our current healthcare system breeds a culture of rampant mental health stigmatization and neglect. Instead, we need to work towards a system that acknowledges the emotional demands of healthcare professions and seeks to provide free and accessible mental health services proactively.
The ongoing mental health crisis among healthcare workers has far-reaching consequences. If we are unable to address the psychological needs of our healthcare workers, we will only continue the cycle of perpetuating the stigma surrounding mental health within society. The normalization of mental health services has to begin with a shift in how we view and address psychological well-being within the healthcare field.
Behbahani, K., & Thompson, A. (2020, May 15). Perspective | Why don’t doctors seek mental health treatment? They’ll be punished for it. Washington Post. https://www.washingtonpost.com/outlook/2020/05/11/mental-health-doctors-covid/
Kalmoe, M. C., Chapman, M. B., Gold, J. A., & Giedinghagen, A. M. (2019). Physician Suicide: A Call to Action. Missouri Medicine, 116(3), 211.
Weiner, S. (2020, December 10). Doctors forgo mental health care during pandemic over concerns about licensing, stigma. AAMC. https://www.aamc.org/news-insights/doctors-forgo-mental-health-care-during-pandemic-over-concerns-about-licensing-stigma
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