Story at a glance
- More than half of state medical boards ask applicants intrusive questions about their psychiatric history.
- As a result, some medical professionals are afraid to seek mental health care — even when they need it — according to the American Medical Association.
- Kind and NAMI are petitioning states that ask these questions to reconsider.
It’s been seven months since the coronavirus outbreak was declared a pandemic. While many are getting tired of being in quarantine, those on the front lines are dealing with a different kind of fatigue.
“There are very few physicians who won’t have taken care of people with COVID-19 or known someone who has died of COVID-19,” said Eileen Barrett, an associate professor of medicine at the University of New Mexico.
Although recent studies have shown that at least half of medical health experts are struggling with trauma and depression, a survey found that 40 percent of physicians — who also report high rates of suicide — are afraid to get help due to concern that it could affect their medical license.
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“Those risking their lives the front lines of this pandemic deserve our support, and that includes support for their mental health,” said Katrina Gay, national director of Strategic Partnerships at the National Alliance on Mental Illness (NAMI), in a statement.
Ahead of World Mental Health Day, NAMI and the food company Kind are petitioning five states — Florida, Wyoming, Alabama, Oklahoma and Idaho — to reconsider asking intrusive questions related to mental health on board license applications.
“There are people who want to express their solidarity, compassion and support for healthcare workers,” said Barrett. “This is something that is tactical, tangible and achievable for people to make a difference in healthcare workers' lives.”
Historically, state medical license boards have required applicants to disclose any history of psychiatric difficulties or receiving treatment, through varying lines of questioning. But the American Psychiatric Association has said that having psychiatric history is not an accurate predictor of mental fitness, which makes such questions irrelevant — and potentially a violation of the Americans with Disabilities Act, which prevents discrimination by public entities on the basis of disability, unless shown necessary.
“It’s hard enough to get to get the time off from work; it’s hard enough to access mental health care; it’s hard enough to navigate the health system; and then to worry about whether you will lose your license, that’s a legitimate fear,” said Barrett, who was one of several medical experts who worked with the New Mexico Medical Board to update its language to help destigmatize seeking mental health treatment.
“If we have bias against health professionals getting mental health care, then we have bias towards people getting mental health care,” she said.
Research shows that asking these questions has discouraged many who need it from seeking psychiatric treatment out of fear of losing or not being able to obtain a medical license. But a mental health condition, like physical health conditions, doesn’t necessarily disqualify a doctor from working ever again. The American Medical Association differentiates between having an illness and having an impairment, which is defined as: “the inability to practice medicine with reasonable skill and safety due to 1) mental illness 2) physical illnesses, including but not limited to deterioration through the aging process, or loss of motor skill, or 3) excessive use or abuse of drugs, including alcohol.”
"While member boards strongly feel that questions addressing the mental health of physician applicants must be included on medical licensing applications, we recommend appropriate phrasing of such questions, including focusing only on current impairment, which may be more meaningful in the context of a physician’s ability to provide safe care to patients in the immediate future," said the Federation of State Medical Boards, which released a policy paper advocating for state medicals to reconsider probing questions about a physician applicant’s mental health in 2018. “These questions may be better obtained through means less likely to discourage treatment-seeking among physician applicants.”
As part of its Frontline Impact Project, Kind also committed $50,000 through the sales of one of its snack bars (called "Heroes") to support NAMI and mental health programs for health care workers, first responders, military service members and veterans.
“There's a shortage of things to feel really good about. If individuals are able to work with individual states to make this change, this is something that you can feel good about,” said Barrett.
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