Mental Health Disclosure Questions on Medical Licensure Applications: Implications for Medical Students, Residents, and Physicians

Taylor, Nicki W; Porter, Cheryl; Rivera-Rodriguez, Melanis; Miller, I S Keino; Desmarais, Nathaly

doi:10.1097/acm.0000000000004682

Cited by 7 publications

(8 citation statements)

References 21 publications

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“…There is concern among physicians and medical students that seeking help for mental illness will jeopardize an individual's reputation, career prospects, and medical board licensure ( 12 , 56 , 68 , 69 ). These concerns are well-founded because up until 2019, approximately two-thirds of states had medical licensure applications that asked questions about mental health in a way that violate the American Disabilities Act and the American Psychiatric Association's position that information about past mental health treatment is not a salient predictor of current impairment ( 70 – 73 ). For example, prior to April 2021, Florida's medical licensure application included yes/no questions that asked about mental health or substance use diagnoses, symptoms, and treatments within the past 5 years.…”

Section: Discussionmentioning

confidence: 99%

Behavioral and psychosocial factors related to mental distress among medical students

Carlos

Ahmadi

Uban

et al. 2023

Front. Public Health

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IntroductionPhysicians die by suicide at rates higher than the general population, with the increased risk beginning in medical school. To better understand why, this study examined the prevalence of mental distress (e.g., depressive symptoms and suicide risk) and behavioral and psychosocial risk factors for distress, as well as the associations between mental distress and risk factors among a sample of medical students in a pre–COVID-19-era.MethodsStudents enrolled in a large California medical school in 2018–2019 (N = 134; 52% female) completed questionnaires assessing sociodemographic characteristics, depression and suicide family history, health behaviors, and psychosocial wellbeing. Assessment scores indexing mental distress (e.g., depressive symptoms, thoughts of suicide in the past 12 months, suicide risk, and history of suicidality) and risk factors (e.g., stress, subjective sleep quality, alcohol use, impostor feelings, and bill payment difficulty) were compared across biological sex using chi-squared tests, and associations between mental distress and risk factors were determined through logistic regression.ResultsElevated mental distress indicators were observed relative to the general public (e.g., 16% positive depression screen, 17% thought about suicide in previous 12 months, 10% positive suicide risk screen, and 34% history of suicidality), as well as elevated risk factors [e.g., 55% moderate or high stress, 95% at least moderate impostor feelings, 59% poor sleep quality, 50% screened positive for hazardous drinking (more likely in females), and 25% difficulty paying bills]. A positive depression screen was associated with higher stress, higher impostor feelings, poorer sleep quality, and difficulty paying bills. Suicidal ideation in the previous 12 months, suicide risk, and a history of suicidality were independently associated with higher levels of impostor feelings.DiscussionHigher scores on assessments of depressive symptoms and suicidal thoughts and behaviors were related to several individual-level and potentially modifiable risk factors (e.g., stress, impostor feelings, sleep quality, and bill payment difficulties). Future research is needed to inform customized screening and resources for the wellbeing of the medical community. However, it is likely that the modification of individual-level risk factors is limited by the larger medical culture and systems, suggesting that successful interventions mitigate suicide risk for medical providers need to address multiple socio-ecological levels.

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Section: Discussionmentioning

confidence: 99%

Behavioral and psychosocial factors related to mental distress among medical students

Carlos

Ahmadi

Uban

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

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“…Moreover, there is significant underreporting of mental health diagnoses to medical boards which further undermines its purported efficacy. 29 …”

Section: Practical Strategies To Reduce Mental Health Stigma In the M...mentioning

confidence: 99%

Mental health stigma in the medical profession: Where do we go from here?

Ng,

Tan,

Goo

et al. 2024

Clinical Medicine

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“…Raising the issue of time off work is important: many healthcare workers presenting to their GP with work related stress may be reluctant to bring it up or feel a sense of guilt or failure. Stigma is a well documented barrier to those living with mental illness seeking help 1213…”

Section: Considering Time Off Work and The Fit Notementioning

confidence: 99%