Ending the Stigma

Medical Licensing Application Eliminates Question About Mental Health Status

People experiencing mental health issues often complain of the stigma surrounding their diagnoses.

It's an even bigger problem for physicians, who traditionally have had to answer questions about their mental health in their medical license applications. The stigma associated with a diagnosis - and its possible implications for their ability to practice - often prevents them from seeking the help they need.

A team of University of New Mexico School of Medicine physicians set out to do something about it. As outlined in a newly published article in the Annals of Internal Medicine, they mounted an effective lobbying campaign to get the New Mexico Medical Board to change the way it asks about a physician's competency to practice.

The team - Eileen Barrett, MD, MPH, Elizabeth Lawrence, MD, and Heather Brislen, MD, from the Department of Internal Medicine, and Daniel Waldman, MD, from the Department of Family & Community Medicine - wanted to update the existing language, which asked an applicant to disclose and explain any mental health diagnosis received within the past five years.

Nationally, state medical boards have been moving away from such questions. The team brought its proposal to update the language to local chapters of the American College of Physicians, American Academy of Family Physicians, American College of Emergency Physicians and American Psychiatric Association, as well as county and state medical societies.

Team members also met with medical students who reported declining antidepressant medications and other treatments because they feared it might prevent them from obtaining a medical license in the future.

"A months-long period of negotiation and collaboration with the medical board followed, facilitated by the state medical society and led by the core team of our coalition," they write.

In proposing new language for the license questionnaire, the team wanted to ensure quality patient care while affording physicians greater protection from being stigmatized for seeking mental health treatment.

"We sought two crucial changes to the license application," they write. "[A]n affirmative response should only result from current impairment, and language singling out mental health diagnoses as distinct from other illnesses or causes of impairment should be removed. The final language satisfied both of these goals."

Now, the application asks, "Do you have or have you been diagnosed with an illness or condition which impairs your judgment or affects your ongoing ability to practice medicine in a competent, ethical and professional manner?"

The new question follows recent Federation of State Medical Board guidelines, according to the team.

"We are proud our work is published and can encourage other states to follow our example," says Lawrence, who also heads the Office of Professional Wellbeing in the School of Medicine.

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