Why Doctors Avoid Mental Health Treatment

Medical professionals fear repercussions for disclosing their mental health.

Posted Feb 07, 2020

As I write this article, I am a few weeks shy of 6 years of sobriety and have undergone a decade of treatment for depression and anxiety. I write as a man who traveled down into the darkest depths of addiction’s despair with a desperate suicidal plan to relieve the pain-filled suffering in my life.

I write this reflection now as a man who has been successful in recovery. I speak out publicly to help other people so they don’t feel alone in their own struggles. And I write as a doctor, in the midst of a national epidemic of suicide and distress in medicine, who still can’t give an earnest answer to the simplest of questions when posed by a suffering colleague:

“Will seeking help for my mental health affect the rest of my career?”

It might. It might not. Maybe it won’t at all.

The answer is complicated and that is the problem. In a cultural time and place where the Federal Communications Commission has just approved a three-digit telephone number to call for mental health and suicidal emergencies, we should be focused on making it easier for medical professionals to seek help, not harder. 

 Jonathan Borba/Pexels
Source: Jonathan Borba/Pexels

So why are doctors afraid to seek treatment for their depression, anxiety, or substance use disorders? Why do so many suffer in silence and record numbers of people are dying by suicide?

Partially, the answer is because we can’t give an honest, transparent, and consistent message about if or how seeking treatment will affect your career. 

And in this inconsistency, a culture of fear propagates.

The problem in itself isn’t that it might affect an individual’s professional life and/or career. In the haze filled grayness of a lack of transparency and consistency, the problem is that it already has. For decades, overreaching policies and institutional stigmatization have fearfully railroaded individuals away from seeking proactive mental health services while working in the medical profession. Licensing boards may ask questions about mental health/addiction treatment history; hospital credentialing processes may require applicants to disclose mental health treatments; medical boards may require public hearings where medical professionals must disclose what mental health treatments they pursued; or potential employers might scrutinize personal health records before deciding on a placement.

In my experience, these policies have created systems that necessitate a self-preservation mindset that demands that medical professionals work sicker and sicker in order to protect against any form of public disclosure for their mental health conditions. This, in turn, forces them into a position where their own health matters less than those under their care, thereby encouraging a necessary form of secrecy to continue to work.

As a result, people die every single day because we have enabled and been complicit in structural organizational discrimination against medical professionals with mental health and addiction stories. A plight I recognize is not unique to the medical professional alone, with similar obstacles and barriers in fields such as the military, education, criminal justice, and aviation. And so, in the universality of this issue, our individual voices must be heard. 

In raising individual voices, a groundswell movement of support has been building for the last handful of years. More and more people are now willing to share their stories, speaking up without shame, judgment or fear about the truth of their lived experiences. These stories are a call to action to serve and support those still suffering in silence while rewriting the cultural narrative of what it means to live and work as a medical professional with a mental health condition. Collectively, those of us that have made it through the darkest times are shedding a light on the pathway out to a new life, a better career, and a healthier future. In sharing these experiences, we all add our voices to advocate for changes in policy reformation and in the restructuring of how individuals are treated with their own mental health conditions in medicine. Together, we also wish to set a more productive tone for the people under our care, because if we can’t lovingly accept and treat individuals fairly within our own medical field because of the presence of mental health conditions, what kind of message are we sending to our patients?

So now, when a colleague grappling with depression, anxiety, or addiction asks me the question, “Will this affect the rest of my career?” I answer boldly.

It may save your career. Maybe it will save your life. And it might even save the life of one of your colleagues. I don’t know, it may even open doors that you never even dreamed were possible.

Seek help, seek treatment, and reclaim your life. Make yourself a priority for possibly the first time in your career. Then, when you are feeling better, you can add your name to this growing movement to speak up for systemic change. You can add your voice to help save other people’s lives and fight for the preservation of the oath we all once took: to do no harm and to help treat all people with the dignity and respect they deserve.

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