Doctors, nurses, and other healthcare heroes are often seen as invincible. We’re the ones who care, but who takes care of us when we’re struggling mentally? The unspoken truth is that many healthcare professionals struggle with our mental health, and the stigma surrounding it can make us reluctant to seek help. In this article, we’ll dive into why mental health stigma is a real issue in the medical world, the consequences it brings, and what we can do to create a culture of understanding and support.
Dr. Lorna Breen was an emergency room physician in New York City during the COVID-19 pandemic. She worked tirelessly to save lives, but the overwhelming patient load and witnessing the constant suffering took a toll on her mental health. Dr. Breen contracted COVID-19 herself but returned to work after recovering.
Apparently, a change in her behavior was reported to the hospital administration. Instead of receiving the support and understanding she needed, Dr. Breen faced stigma. She feared losing her job and license and being ostracized by colleagues. Tragically, in April 2020, she died by suicide.
Dr. Breen’s sad and shocking death was not the first nor the last of us dying by suicide. Up to 300 physicians are estimated to die by suicide every year in the US alone. We think that mental health stigma plays a huge part in that.
Up to 300 physicians are estimated to die by suicide every year in the US alone. We think that mental health stigma plays a huge part in that.
So what is it about medicine and mental health stigma that makes things so difficult?
Healthcare workers often feel like they need to be superheroes. Admitting to having mental health challenges can seem like showing weakness, and nobody wants to appear vulnerable. As we’ve previously written, there is an unspoken culture of perfectionism in medicine, which is an unhealthy delusion that fuels not just burnout but mental illness and suicide in doctors.
Imagine working in an environment where your every action is scrutinized, where the stakes are incredibly high, and where the smallest mistake could potentially lead to catastrophic consequences. This is the daily reality for healthcare professionals, and it’s a part of what makes the fear of seeking help for mental health challenges so palpable.
The fear of professional consequences, like harming their career or reputation, can make healthcare professionals keep their mental health issues under wraps.
When I decided to specialize in psychiatry, a revered Internal Medicine Professor reacted with: “But you’re such a good clinician”. My own parents were afraid I would “catch” insanity from my patients. Sometimes, even everyday language within the medical community can be stigmatizing. For instance, calling or even implying that burnout is a sign of weakness can keep the stigma alive.
Despite concerted public education efforts over the last decades (and with some impressive reductions in society-level stigma), both psychiatric patients and those who treat them still attract stigma from other doctors. Even psychiatrists themselves have measurable stigmatic attitudes towards their own profession and patients.
It’s time to drop the stigma. Everyone has mental health just like physical health. Even better, let’s heal the artificial divide between mental and physical health. The evidence of a bidirectional brain-body link makes the current dichotomy seem antiquated.
Despite concerted public education efforts over the last decades, both psychiatric patients and those who treat them still attract stigma from other doctors. Even psychiatrists themselves have measurable stigmatic attitudes towards their own profession and patients.
Healthcare workers often put off seeking help for mental health issues, which means suffering longer and more intensely than necessary.
When healthcare providers are battling their own mental health issues, they might not be able to provide the level of care they’d like. Reduced focus, empathy, and engagement can impact patient care quality.
Stigma contributes to high burnout rates in the medical field, which can lead to more severe problems.
Tragically, mental health stigma also elevates the risk of suicide among healthcare workers, making it a vital issue to tackle.
Stigma about mental health is rife in medicine and does not help us, our suffering colleagues, or our patients. We all have mental health to a greater or lesser degree; a surprising proportion of us have diagnosable psychiatric conditions. Stigma reinforces fear and reduces help-seeking and confidence.
Ultimately, medical stigma may contribute to the high suicide rate in physicians. We need to do something about it.
In next week’s article we suggest 7 ways to deal with stigma in medicine.
Dr Lorna Breen Heroes’ Foundation: This resource includes a map to assess state application alignment with FSMB recommendations and toolkits for advocating for change with licensing boards and credentialling committees. The website includes the ability to directly send an email to your state medical board: https://drlornabreen.org/removebarriers/
American College of Physicians. This organization offers toolkits for advocating for change with licensing boards and credentialling committees which includes sample letters and a slide deck addressing the need to change language on applications. See: Advocacy Toolkit: Modernizing License and Credentialing Applications to Not Stigmatize Mental Health
American Medical Association article on reducing stigma to tackle burnout
Canadian Medical Association resources and strategies page to help physicians reduce the stigma surrounding mental illness and seeking psychological care in medicine
British Medical Association resources page on improving the mental wellbeing of doctors and medical students
UK Doctors Support Network anti-stigma campaign
