Mental health perceptions: What's in place to protect physician careers?

It’s not surprising that symptoms of depression, anxiety, and burnout are pervasive in the medical community. Physicians and other healthcare providers face immense workplace pressures and long work hours.

The pandemic presented healthcare providers with unparalleled challenges, thrusting the concept of physician burnout into the national spotlight. According to a 2021 Physicians Foundation survey, six in 10 physicians reported feelings of burnout.^[]

“Nearly one-fifth of physicians indicated they know of someone who considered, attempted or died by suicide since the start of the pandemic alone, a time when many physicians have suffered trauma and loss,” stated Gary Price, MD, President of The Physicians Foundation in a press release.^[] “It is vital that we make a conscious and forward effort to break down stigma and encourage physicians to seek mental health support when they need it, especially in the wake of the most significant health event in recent history."

While suicide is one consequence of unchecked burnout, physicians face numerous mental health challenges. But what’s stopping them from seeking help? And what regulations are in place to protect the ones who do get help?

Barriers to seeking help

A study published in Archives of Surgery found that while one of every 16 surgeons reported suicidal ideation, only 26% of those doctors sought help.^[] Sixty percent of the surgeons who didn’t seek help held back due to concerns that it would jeopardize their medical license.

Traditionally, medical licensing organizations have required applicants to disclose any history of mental illness or of treatment for psychiatric conditions. These questions are problematic, because they only focus on a history of diagnosis or treatment, not on behaviors or conduct that would indicate a reason for concern.^[]

This is in stark contrast to requirements of applicants receiving medical care for non-psychiatric conditions. While there’s been pushback against such questions, some professional licensing bodies still use them. The unfortunate result can be that healthcare providers applying for medical licenses don’t seek mental health treatment to avoid answering “yes” to questions about their mental health.

While the stigma associated with mental illness is deeply ingrained, healthcare providers shouldn’t hesitate to pursue treatment.

Americans with Disabilities Act

Attempting to prevent a physician from practicing medicine due to mental health issues is against the law.^[] Discrimination based on mental health status is prohibited under the Americans with Disabilities Act (ADA), which protects Americans with mental illness. The ADA’s definition of mental illness includes depression, attention deficit/hyperactivity disorder (ADHD), anxiety disorder, bipolar disorder, and schizophrenia.

However, there are specific requirements that have to be met to qualify for ADA protection for a mental illness disability. To qualify, a person must present with one of the following:

• A physical or mental disability that restricts their ability to perform a major life activity

• A history of suffering from a physical or mental disability

• The perception that they suffer from a physical or mental disability

After meeting one of these requirements, the doctor must prove that the condition negatively affects their job performance. This places them in the precarious position where they have to admit their illness may impact quality of patient care, further propagating the stigma associated with seeking help.

Dr. Lorna Breen Health Care Provider Protection Act

On March 18, 2022, President Biden signed the Dr. Lorna Breen Health Care Provider Protection Act into law.^[] It aims to address the stigma healthcare providers face when pursuing mental health care, and will provide federal funding for mental health awareness and education campaigns.

The law is named for Lorna Breen, MD, an emergency medicine physician who died by suicide in April 2020 after treating COVID-19 patients at the start of the pandemic. After recovering from COVID-19 and returning to work, she began to struggle mentally and physically.

The law is intended to support the mental health of physicians and other healthcare providers by establishing the following:

• Grants awarded to healthcare professionals to help create evidence-based strategies to decrease burnout and other mental health conditions related to job stress

• A national campaign encouraging healthcare providers to make their mental health a priority, and to use any available mental and behavioral health services

• Grants awarded for employee education as well as peer-support programming