Research

• Prevalence of Depression and Depressive Symptoms Among Resident Physicians, Mata, 2015. This systematic review found that 28.8% of resident physicians experience depression or depressive symptoms, with prevalence varying based on the assessment instrument and showing an increase over time; highlighting a need for effective prevention and treatment strategies for these professionals.
• Suicide among physicians and health-care workers: A systematic review and meta-analysis, Dutheil, 2019. The study reveals that physicians face a heightened risk of suicide, especially female physicians and physicians in the United States; suggesting the need for preventive strategies in the workplace and more research on other healthcare workers.
• Mental illness and suicide among physicians, Harvey, 2021. This article emphasizes the significant mental health challenges faced by physicians, especially female doctors, and proposes an evidence-based framework for multi-level interventions to safeguard their well-being.

• Cognitive behavioural therapy halves the risk of repeated suicide attempts: systematic review, Gøtzsche, 2017. The review finds that cognitive behavioural therapy significantly reduces the risk of repeated suicide attempts in individuals with a history of such attempts, suggesting it should be the preferred treatment for patients with depression.
• The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression: a meta-analysis, Kamenov, 2016. The study finds that combined treatment of psychotherapy and pharmacotherapy is most effective for depression, but both individual treatments also significantly improve functioning and quality of life, though therapies might need tailoring for better individual outcomes.

General Barriers

• Depressed Medical Students’ Use of Mental Health Services and Barriers to Use, Givens, 2002: Although 24% of surveyed medical students at the University of California, San Francisco were found to be depressed, only 22% of them sought mental health counseling, citing barriers like lack of time, confidentiality concerns, stigma, cost, and fear of documentation on academic records.
• What stops us from healing the healers: a survey of help-seeking behaviour, stigmatisation and depression within the medical profession, Adams, 2010: A survey found that doctors perceive depression to be stigmatized within their profession, with 46.2% reporting personal experiences of depression and indicating that this stigma significantly reduces their likelihood to seek help, especially due to concerns about confidentiality, letting colleagues and patients down, and career implications. 7.4% of respondents admitted to self-prescribing anti-depressants rather than receiving prescriptions from another professional, citing reluctance to seek help, inability to take time off and lack of confidentiality as primary issues.
• Taking Care of Our Own: A Multispecialty Study of Resident and Program Director Perspectives on Contributors to Burnout and Potential Interventions, Holmes, 2017: While 69% of residents experience burnout, many hesitate to seek help due to barriers like inability to take time off (42%) and misconceptions about burnout being reportable to the medical board (25%).
• Mental Health During Residency Training: Assessing the Barriers to Seeking Care, Aaronson, 2018. Despite 61% of surveyed resident and fellow physicians feeling the need for psychiatric services, only 24% sought treatment, citing barriers like time constraints, confidentiality concerns, stigma, cost, and potential licensure impact.
• Barriers to mental healthcare for psychiatrists, White, 2018: Despite being in the psychiatric profession, a majority of psychiatrists (86.2%) would hesitate to disclose their mental illness to peers due to concerns about confidentiality (66%), stigma (22%), and career implications (35%). Only 16% would make decisions based on the quality of care they would receive.
• Perceived stress and barriers to seeking help from mental health professionals among trainee doctors at a tertiary care centre in North India, Grover, 2019: Trainee doctors experience significant stress due to long working hours, lack of off-days, and academic pressures, yet few seek mental health support due to stigma, being labeled as weak, and lack of time.
• Barriers and Facilitators to Seeking Mental Health Care Among First Responders, Jones, 2020: The study reveals that cultural values of strength and self-reliance among first responders, along with various barriers like fear of confidentiality breach and negative therapy experiences, deter them from seeking mental health care, while increased knowledge and positive therapeutic experiences can act as facilitators.
• Stigma: A Barrier in Supporting Nurse Well-Being During the Pandemic, Weston, 2022: Despite the availability of support services, stigma related to mental health is causing nurses to resist using these resources during the COVID-19 pandemic, underscoring the need for strategies to overcome these perceptions and barriers.
• What do healthcare workers need? A qualitative study on support strategies to protect mental health of healthcare workers during the SARS-CoV-2 pandemic, Halms, 2023: Despite the increased burden of the pandemic, healthcare workers rarely accessed available support services due to fear of negative consequences, shame of admitting mistakes, and the tradition of showing no weakness in the profession, indicating a need for low-threshold support services and a reevaluation of hospital system norms.

Licensing Barriers

• Medical Licensure Questions and Physician Reluctance to Seek Care for Mental Health Conditions, Dyrbye LN, 2017. The study underscores that state medical licensure questions related to mental health are a barrier to physicians seeking help, with a significant number avoiding care due to concerns about repercussions on their medical licensure.
• Physician Wellness and Burnout Report, FSMB, 2018. The Federation of State Medical Boards highlights the critical issue of physician burnout, emphasizing the need to reconsider probing questions on medical licensure applications, advocating for a non-punitive approach, and stressing the importance of supporting physician wellness, while also promoting a cultural shift to reduce stigma around seeking help.
• * Consistency Between State Medical License Applications and Recommendations Regarding Physician Mental Health, Saddawi-Konefka, 2021. This study evaluates the alignment of medical license applications with Federation of State Medical Boards’ recommendations on physician mental health, finding that the majority of state applications still include potential deterrents for physicians seeking mental health care.
• * Mental Health Questions on State Medical License Applications and Evaluation of Updates, Douglas, 2023. This study evaluates the consistency of medical license renewal applications with FSMB recommendations, revealing low adherence, especially in supporting physician mental health, and showing mixed progress since 2020 with areas like ‘only if impaired’ improving, but others, such as ‘supportive language’, remaining stagnant.