Physician Mental Health: An Evidence-Based Approach to Change

Awareness of high rates of physician burnout, depression and suicide is leading to changes within the medical profession at all levels. Most mental health problems can be effectively managed, but real and perceived barriers — such as confidentiality concerns and fear of negative ramifications on one's reputation, licensure, or hospital privileging — keep many physicians from addressing their mental health needs. Unattended distress has ramifications for physicians as well as the health care industry and patient safety. A number of factors contribute: in addition to individual risk factors and stress load, institutional culture plays a critical role in leading physicians to rationalize and internalize distress as part of their professional identity. There are several initiatives with demonstrated effectiveness in medical settings that can be scaled up for greatest impact: education and stigma reduction efforts, policies and procedures that treat mental health on par with physical health, and efforts that promote an overarching culture of respect. Further strides can be made by addressing hospital and state licensing forms' questions related to mental health — ensuring that questions pertain to competence rather than illness — or replacing questions altogether with a statement encouraging proactive actions to protect physician mental health and safe practice.