The topic of mental health has been a famous subject for the past few months following the recent death of Chester Bennington, former frontman of prominent rock band Linkin Park and another suicide of another prominent rock star, both linked to mental health.

The matter shows that mental health could happen to anyone and more experts are letting patients know that it is okay to seek for help. However, such is not the case with doctors who experience the same issue.

Reuters Health reported that nearly 40% of US physicians hesitate to seek mental health care out of fear that their license might get revoked.

Medical license questions to blame

“The medical license application questions are getting in the way of very treatable mental health disorders and probably contributing to the high rates of suicide among physicians,” said lead author Dr Liselotte Dyrbye, a professor of medicine and medical education at the Mayo Clinic in Rochester, Minnesota.

The study done in 2016 found that medical licensure application questions (MLAQs) regarding mental health conditions present a barrier to physicians seeking help.

The study, aimed at finding out whether MLAQs affect doctors seeking help, collected initial and renewal medical licensure application forms across 50 states and the District of Columbia. Researchers then obtained data on care-seeking attitudes for a mental health problem from a nationally representative convenience sample of 5,829 physicians who completed a survey between 28 August 2014 and 6 October 2014.

Invasion of privacy

To curb the problem, The Federation of State Medical Boards has advised medical licensing boards not to ask physicians about a history of mental illness. Employers who do so would violate the Americans with Disabilities Act of 1990. The American Psychiatric Association (APA) has also stated that impairment and potential risk for harm to patients cannot be concluded from a diagnosis or treatment alone.

Instead, there is a push to include only current impairment of professional performance questionnaire and that decisions regarding medical license should be solely based on professional performance. As a result, some state licensing board modify their questions regarding mental health.

"However, many may remain in violation of the Americans with Disabilities Act, and the prevalence of licensure questions about physicians' history of mental illness appears to be increasing," Dr Dyrbye wrote.

Based on the study done, the result found that “only one-third of states (16 of 48) had questions on initial and renewal application forms that were congruent with the American Medical Association, American Psychiatric Association, and Federation of State Medical Boards polices and recommendations or in clear compliance with the Americans with Disabilities Act of 1990."

Doctors have high rate of depression

Dr Katherine Gold, a professor at the University of Michigan in Ann Arbor said that the questions provided by the licensing boards are creating barriers for doctors to seek help. “Physicians are appropriately afraid they could lose their license or have restrictions on their license. So, of course, they are hesitant to seek care.”

She also added that the hesitation in seeking treatment is worrisome as doctors suffer a high rate of depression and suicide.

Doctors and physicians have high rates of depression and suicide.
Doctors and physicians have high rates of depression and suicide.

“We do not have evidence that a physician’s past episode of depression or anxiety poses any risk to patient care,” Gold said. “So instead of protecting patients, these questions basically serve to stigmatise physicians.”

In response to this fact, Dr Thomas Schwenk, dean of the University of Nevada, Reno, School of Medicine, also called for dropping questions about prior history of mental illness from medical licensing and renewal applications.

“There are well-accepted and appropriate ways for state licensing boards to ask about physician impairment, and my hope is that this study will move licensing boards to consider those changes,” he said.

Depression in Malaysia

Earlier this year The Star reported that four out of 10 Malaysians suffers from some sort of mental illness and the number is predicted to grow. The report however stated that unlike Western countries, Asians are less likely to report mental illness as fear of being seen as weak.

"Many go unreported because firstly the difficulty in diagnosing depression, followed by the inability of people to recognise the symptoms of depression themselves,” said Datuk Dr Andrew Mohanraj, a consultant psychiatrist. MIMS

Read more:
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Stigma, impacts, solutions: Addressing mental health in the workplace
5 peculiar mental disorders
The indirect psychosocial effects of “moving on” and being the “second victim” in healthcare professionals