New JAMA Study Highlights Urgent Need for State Medical Boards to Reform Licensing Practices to Protect the Mental Health of Physicians During COVID and Beyond

Mental Health Experts Recommend Taking Immediate Action to Change Medical Licensing Applications

BOSTON, May, 18, 2021 – Leading advocates and researchers in the mental health field published new data today in JAMA showing that state medical board license applications do not follow national recommendations to protect the mental health of physicians.

Physicians have high rates of burnout and consistently report they do not have adequate support for their emotional wellness. Despite this context, physicians infrequently seek mental health care, often fearing that it will result in loss of their medical license. In 2018, the Federation of State Medical Boards (FSMB) published recommendations to limit medical license application questions regarding mental health to only what is necessary and relevant, and to provide language supportive of mental health treatment seeking.

Today’s findings in JAMA show that as of July 2020, these recommendations have not been widely adopted. Only 1 of 54 US state and territory medical licensing applications evaluated in the study fully adopted the FSMB recommendations (North Carolina), and five states were not consistent with any of the recommendations. Thus, broad questions about mental health history remain on medical board licensing applications, even though they are inconsistent with expert recommendations. For the full study findings, the JAMA publication can be accessed at the JAMA Network website.

This latest paper is one in a series of publications over the past year that have brought awareness to the multitude of barriers that physicians face when seeking mental health care. Advocacy organizations such as The Emotional PPE Project, the American Medical Women’s Association (AMWA), and the National Association for Mental Illness (NAMI) have emerged as some of the leaders in the efforts to lift these barriers.

“COVID-19 has significantly increased psychological distress in physicians, above and beyond what was already disproportionately experienced. It is imperative that we act quickly to reduce barriers to help-seeking for physicians, for the benefit of individuals, their families, the healthcare system, and patients,” says Daniel Saddawi-Konefka, MD, MBA, the study’s first author and co-founder of The Emotional PPE Project. “Changing licensing applications so that they comply with the Americans with Disabilities Act and FSMB recommendations is a positive and tangible step in the right direction.”

Mental health advocates suggest taking the following concrete actions to lift barriers to mental health care present in medical licensing applications:

Jessi Gold, MD, MS is a co-senior author on the JAMA paper and a psychiatrist at Washington University St Louis School of Medicine who sees physicians in her practice. She has written extensively on burnout and barriers to care for NPRForbes, and other notable publications. “We have known that physicians have one of the highest suicide rates of any profession, long before COVID-19. The pandemic has just brought our stories to the front pages.” says Dr. Gold. “No one, especially physicians who have dedicated their lives to helping others, should ever have to choose, or think they have to choose, between getting help and their career. This needs to change, and not years from now, but tomorrow.”

“My sister-in-law was afraid to ask for professional help.” says Corey Feist, co-founder of the Dr. Lorna Breen Heroes’ Foundation. Dr. Lorna Breen was the head of New York-Presbyterian Allen Hospital Emergency Department who lost her life to suicide last year during the peak of the COVID-19 outbreak in NY. “One of the real struggles Lorna faced was the worry that she would lose her medical license, that it would end the career that she had spent her entire life working for. I believe this substantiated fear contributed to the loss of Lorna’s life.”

“The barriers to accessing mental health care in our country are already significant, and can be surprisingly more difficult for health care professionals who may face additional risk to their licensure,” said NAMI CEO Daniel H. Gillison, Jr. “Ongoing research and advocacy efforts, along with concrete actions being taken by organizations like The Emotional PPE Project, are major steps toward helping more health care professionals get the care they need and deserve, without stigma or fear of professional consequences.”

In addition to authors Saddawi-Konefka and Gold, co-authors also include Ariel Brown, PhD; Eileen Barrett, MD, MPH; Isabella Eisenhart, BS; and Katharine Hicks, BA.

About The Emotional PPE Project

Healthcare workers are often deterred from accessing mental health care due to barriers such as lack of time, stigma, and concern about professional repercussions. The Emotional PPE Project is a 501(c)(3) nonprofit charitable organization with the mission to reduce these barriers through research, advocacy, and the promotion of our directory of volunteer therapists available to provide no cost, no insurance, confidential therapy to any US healthcare worker in need.

Visit emotionalPPE.org:

  • Healthcare workers, get professional support by contacting any of the volunteer mental healthpractitioners in The Emotional PPE Project directory
  • Licensed therapists, sign up to volunteer your time
  • Anyone, support this charitable organization by making a tax-deductible donation

Media Inquiries should be addressed to media@emotionalPPE.org.