Why Do Physicians Hesitate to Seek Mental Health Care?
Many physicians hold back from mental health care because they worry it could affect their medical license. In a 2017 study in Mayo Clinic Proceedings, nearly 40% of surveyed physicians said they would hesitate to seek professional help for a mental health condition for that reason. This is a documented barrier, not a personal weakness, and it is one reason physicians are encouraged to look at how licensing questions are worded.
What the research found
The study, “Medical Licensure Questions and Physician Reluctance to Seek Care for Mental Health Conditions,” was led by Liselotte Dyrbye with colleagues including Colin West, Christine Sinsky and Tait Shanafelt. The team reviewed licensing documents from all 50 states and Washington, D.C., renewal applications from 48 states, and a national survey of more than 5,800 physicians. (ScienceDaily, 2017)
- Nearly 40% of survey respondents said they would hesitate to seek help because it could harm their license.
- About one-third of states had licensing questions consistent with AMA, APA and Federation of State Medical Boards policies, or with the Americans with Disabilities Act. They asked only about current conditions that impair ability to practice, or asked nothing about mental health.
- Most states asked about past diagnoses or treatment. Physicians in those states were 21% more likely to be reluctant to seek care.
The survey is from 2014 data and was published in 2017. State rules may have changed since then, so check your own state’s current forms.
Other reasons clinicians hold back
Beyond licensure, clinicians often describe time pressure, privacy worries and concern about reputation. These are barriers in the system around the person, not signs that a person does not need support.
What you can do
- Check what your state actually asks. Wording varies, and many forms focus on current impairment.
- Ask about confidential options. Some health plans, employee assistance programs and physician health programs offer confidential routes. Ask how information is handled before you start.
- Talk to your own physician or a mental health professional about what you are experiencing. They can discuss options with you.
More barriers, from a hospital survey
A 2012 survey of 108 resident and attending physicians at surgery, emergency medicine and anesthesiology conferences at one large academic hospital asked about barriers to seeking support. 79% had experienced a serious adverse patient event, a traumatic personal event, or both in the preceding year. The barriers named were (Hu et al., 2012):
| Barrier | Share citing it |
|---|---|
| Lack of time | 89% |
| Uncertainty or difficulty with access | 69% |
| Concerns about lack of confidentiality | 68% |
| Negative impact on career | 68% |
| Stigma | 62% |
Physician colleagues were the most popular potential source of support (88%), ahead of the employee assistance program (29%) and mental health professionals (48%). The sample was a convenience sample at one hospital, so the numbers are a snapshot, not a national estimate.
What the Surgeon General’s advisory recommends
The 2022 Surgeon General’s advisory on health worker burnout calls for removing punitive policies around seeking mental health or substance use care among its recommended actions. That is the same concern the licensure research raises. (Office of the Surgeon General, 2022)
If you are weighing whether to reach out
- You are not alone in the hesitation. The research above describes it as common.
- Peer support can be a first step. The Physician Support Line connects US physicians and medical students with volunteer psychiatrists. It is free, confidential and anonymous, and you can call about any issue, not only a crisis. (Physician Support Line)
- Ask before you start. Ask a provider or program how information is recorded and who can see it.
If you are in crisis or thinking about suicide: call or text 988 (the 988 Suicide & Crisis Lifeline in the US), or use its chat, any time of day or night. You can also text HOME to 741741 to reach the Crisis Text Line, which is free and available 24/7 in the US. US physicians and medical students can call the Physician Support Line at 1-888-409-0141 (Monday to Friday, 8:00 AM to 11:00 PM ET, free and confidential, staffed by volunteer psychiatrists), for any issue, not only a crisis. In an emergency, call 911. Sources: 988 Lifeline, Crisis Text Line, Physician Support Line.
This article is education, not medical or mental-health advice.
This article is education, not medical or mental-health advice. Talk with your own clinician about your situation.