Barriers to mental health care: What is the state of mental health of physicians?

Mental health struggles are not uncommon among physicians, but they receive relatively little dialogue on solutions in contemporary U.S. health care. Daniel Saddawi-Konefka, MD, MBA, and Christine Yu Moutier, MD, are co-authors with Jesse M. Ehrenfeld, MD, MPH, of the special communication, “Reducing Barriers to Mental Health Care for Physicians: An Overview and Strategic Recommendations,” published in JAMA. They discuss the current state of mental health in that system.

Medical Economics: How would you describe the current state of mental health among physicians and other clinicians in the United States?

Daniel Saddawi-Konefka, MD, MBA: What strikes me about the data is how hidden the mental health struggles are. It's around 30% of physicians have depression, 10% of physicians have had suicidal ideation, and one to two and a half percent have attempted suicide. Those numbers are incredibly high. Amongst trainees in the U.S., suicide is the leading cause of death. But we relative to how big it is, we don't hear about it all that much. And I think the silence around the statistics really underscores how deeply embedded the stigma is and the barriers to help-seeking are. Overall, it's, fewer than 1/3 of physicians will actually seek help for for bona fide mental health conditions that could really benefit from help.

Christine Yu Moutier, MD: And I'll just add to that — that silence around these issues is particularly vexing when, as a field, most organizations and leaders are trying to do something about it and actually care a great deal. And yet, the culture, the pressures, the policies, any number of real, you know, complicated issues that we try to break down in terms of the solutions potentially to these barriers, they're still creating that tremendous gap between suffering and the ability to access treatment and care and support, like we would for any other type of health issue. So, yeah, we're very pleased that that are kind of summing up of this was, was was put forth by JAMA.