A stigma—that widespread negative attitude a society attaches to a person or group—has long been associated with mental health needs. According to the Mental Health Foundation, the vast majority of people dealing with mental health needs feel that stigma. Medical professionals, in particular, are burdened by the stigma attached to mental health. There’s a perceived incongruity for “healers” to deal with a mental illness or face emotional distress such as anxiety, depression, or PTSD. This article explores the stigma of mental health in the medical field, provides strategies for reducing stigma, suggests resources for seeking help, addresses legal concerns and protections for physicians, and explains the importance of changing medicine’s corporate culture regarding mental health.

Key Takeaways:

• Despite the prevalence of mental health issues among physicians, there exists a silent perception that physicians should be immune to such problems, creating a barrier to seeking help.

• This stigma contributes to significant negative effects on physicians' mental and physical health. 

• There is a call to change medicine's culture to foster an environment of support and openness among colleagues.

• Physicians need to prioritize their own mental and physical health. This includes seeking treatment, setting boundaries between work and personal life, and advocating for systemic changes within the medical profession to create a supportive and inclusive environment for all practitioners.

The Stigma of Mental Health in the Medical Field

The stigma surrounding mental health in the medical field is broad and detrimental. In virtually any field of medicine, physicians are expected to provide quality care in a professional manner. Patients assume that their physicians are physically, emotionally, and mentally healthy, even though they would admit that, in the general population, many people face physical, emotional, or mental health issues. There’s a silent perception that physicians are “super” humans.

Consequently, physicians tend not to reveal mental health needs or seek help for themselves. They fear adverse effects that include self-doubt, discrimination such as bullying, limited opportunities, inadequate insurance coverage, or loss of employment.

The negative effects on physicians’ health are significant. According to a recent article by EDUMED, the top 5 mental health issues faced by medical professionals include chronic stress, sleep disorders, substance abuse, depression, and suicide. Some of the statistics are alarming. For example, while the general public has substance abuse rates that range from 8-10%, the rate among physicians is estimated to be around 15%.  Additionally, the Journal of the American Medical Association believes that almost 30% of all resident physicians have been diagnosed with depression or show signs of it. Most disturbing is the fact that each year, between 300-400 physicians take their own lives. Often, these physicians are highly qualified and well-respected doctors in their fields.

Legal Concerns and Protections for Physicians

Beyond the concerns about judgment and confidentiality, physicians often face legal concerns associated with the stigma that mental health problems place on their reputation and their ability to maintain their careers. Frequently, physicians delay or halt their decision to seek mental health support because they worry that their current job—or their entire career—will be at risk.

Emergency room physician Dr. Lorna Breen is a case in point. Overworked to the state of physical and emotional exhaustion during the pandemic, she finally sought help. Afterward, she admitted to family members, “Now my career’s over. Now I’m done.” Shortly afterward, Dr. Breen took her own life. Her shocked family members learned later that she had reason to be concerned about her career.

Things that trigger concerns for Dr. Breen and other physicians include the sense of shame and guilt placed upon them by some of their colleagues if they admit to their mental health issues. Some are shunned or belittled. The thought of how their colleagues will respond is sufficient to make some physicians delay or stop seeking help.

Doctors who feel they absolutely must seek assistance are often advised by older doctors to “drive out of town, pay cash, and use a pseudonym,” even though seeking counsel is not illegal. Physicians are made to feel that what they are doing is less than honorable. This exacerbates the physician’s problem. It also increases the likelihood that patients may be adversely affected by their physician’s burnout.

Another significant problem that mental health issues pose is the moral dilemma they place physicians in as they complete the paperwork required to maintain their licenses and credentials to practice in their fields. Traditionally, the forms asked personal questions about mental health treatment, even if those issues happened years ago and had been completely resolved. Should physicians be truthful and risk being passed over, shamed, or penalized, or should they not disclose an issue that is no longer relevant, knowing that they aren’t being completely honest?

Until recently, the situation was considerably worse in some states than others. While some states like Nevada and Michigan either limited their board questions to current impairments or omitted them entirely, others like Alaska and Washington required full disclosure.

Thankfully, things are beginning to change. As of October 2023, 26 state medical boards—including those in Washington and California—changed the intrusive language in their licensure applications. The medical boards in 11 other states—including Alaska—are in the process of making the changes.

It is noteworthy that older doctors exhibit the lowest rate of stigmatizing attitudes and the highest rate of actual help-seeking compared to their younger counterparts. Additionally, significant differences by age exist in the type of treatment received by practitioners with depression, with older practitioners being the least likely to receive counseling.

Resources and Support for Mental Health in the Medical Field

Physicians have access to various resources for mental health support, including counseling, support groups, and evidence-based practices aimed at decreasing stigma and discrimination in the workplace. It is crucial for medical professionals to seek help and avoid self-doubt and shame by utilizing person-first language, joining support groups, and speaking out against the stigma associated with mental health issues. However, despite the availability of resources, physicians are often reluctant to seek mental health treatment due to concerns about judgment, confidentiality, and the potential impact on their careers.

Changing the Professional Culture

To cope with this stigma, physicians can employ strategies such as seeking treatment and reaching out for support from colleagues and professional mental health services. Ultimately, it’s critical to change the professional culture to reduce stigma. Effective steps in this process include storytelling, advocating with governing bodies, and expanding perspectives of mental health disorders within the medical community. Strategies for changing the professional culture in the medical field to reduce stigma around mental health include advocating with state governing bodies and medical boards, eliminating the use of stigmatizing language, and creating a culture of caring and support among colleagues.

It’s crucial, too, that physicians prioritize their own health by setting boundaries between work and home, making sure they get enough rest, and nourishing both their body and their mind.

Only when these changes are made will physicians be able to practice in an environment that fosters a supportive and inclusive environment for all medical practitioners.

Conclusions and Next Steps

When seeking mental health treatment, physicians face many difficulties, including stigma, concerns about confidentiality, fear of judgment, and potential career implications. Physicians must take proactive steps to change the current culture in the medical profession, ultimately decreasing the stigma and discrimination associated with mental illness to reduce the risk of adverse outcomes, including suicide.

The trend toward eliminating intrusive questions from licensing board applications is a huge step toward combating the stigma associated with mental health needs. Other critical changes include changing the professional culture of medicine and ensuring confidentiality. Additionally physicians need to be proactive about prioritizing their own health.

Our professionals at Montenegro & Associates Behavioral Health have helped physicians with mental health needs. We understand the stigma and other difficulties that physicians face when they seek mental health support. Our services are confidential, caring, and professional. Click here to schedule an appointment with one of our expert psychiatrists.