Tuesday, September 27, 2016

Fear of Mental Health Diagnosis on Record May Keep Physicians From Seeking Care

“I would never want to have a mental health diagnosis on my record.”

That was the signature quote from a survey of women physicians who reported fear regarding stigma about mental illness that would inhibit them from seeking treatment or reporting their illness to licensing authorities. The survey was published in General Hospital Psychiatry.

Katherine Gold, M.D., of the Department of Family Medicine at the University of Michigan and colleagues surveyed a convenience sample of female physician-parents on a closed Facebook group. The group had approximately 57,000 members at the time of the survey, though not all members were active on the site at any time. The researchers developed an anonymous, 24-question survey that asked about mental health history and treatment, perceptions of stigma, opinions about state licensing questions, and personal experiences with reporting; they posted four invitations to participate with electronic links to the questions. The survey was open for eight weeks from February through April 2016.

A total of 2,109 group participants completed the survey; 357 of the respondents also provided qualitative comments.

Almost 50% of women believed they had met criteria for mental illness but had not sought treatment. Top reasons for not seeking treatment included women’s belief that they could manage independently, had limited time, or the diagnosis was embarrassing or shameful. Two of every five physicians in this study who believed they had met criteria for a mental illness but had not sought treatment reported that one reason for this was that they did not ever want to have to report mental illness or treatment to a state medical licensing board.

Only 6% of physicians who reported having been given a prior mental health diagnosis or undergone treatment said they had disclosed their mental health condition to the state medical board.

“Our findings raise ethical concerns about broad requirements for mental illness disclosure given potentially serious risks to physicians who forgo needed mental health treatment out of fear of adverse consequences, even when it is not clear that such reporting offers any significant protection to patients,” the authors wrote.

In a column appearing September 14 in Psychiatric News, APA President Maria A. Oquendo, M.D. (pictured above), wrote of physicians’ hesitation to seek mental health care. She noted “stigma is alive and well among physicians.” Her column drew attention to the problem of licensing board questions.

In comments to Psychiatric News about the survey, Oquendo said, “I applaud Dr. Gold for shining a light on this very serious problem among physicians. The sample used was one of convenience so it is possible that the problem of untreated psychiatric conditions is even more widespread than found in the Facebook group. That is because these are individuals who are seeking support from an online community, which may be less likely among those who are seriously depressed or anxious.”

For more information, see Oquendo’s latest Psychiatric News From the President column “Why `Physician Heal Thyself’ Does Not Work.”


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