'Physician, heal thyself' doesn't work: on mental health stigma in high performers

Physicians spend their careers urging patients to seek care early. Many may not take that advice when it comes to their own mental health due to fear of professional repercussions.

The June 2026 TELUS Health Mental Health Index found stigma (23%), confidentiality concerns (20%) and fear of disclosure at work (18%) were among the top barriers keeping U.S. workers from seeking help for substance use. Younger workers are struggling most: Those ages 20-29 scored 60.5 out of 100, compared with 75.4 for workers ages 60-69.

Paula Allen, global leader of research and insights at TELUS Health, said licensing concerns, self-stigma and the habits of high performers all keep health care workers from getting help. She spoke with Medical Economics about why "physician, heal thyself" doesn't work and why younger workers need attention.

This transcript has been edited for length and clarity.

Stigma is present in health care, from worries about what co-workers will think to very real concerns about licensing and credentialing. How would you describe the situation around mental health stigma in health care?

Paula Allen: I hope it's changing for the better, but I'll tell you the three things that are concerning about it. One, you mentioned licensing and credentialing. Like in other professions — the legal profession is going through this as well — the question is how you protect the public, but not doing so in a way that actually puts the public and the individual more at risk.

People have to feel comfortable getting help. And when you get help, the earlier that you get it, the less likely you are to have any kind of life or work impact. This is something that the associations really have to continue to do better on, and I know that there is a lot of awareness around that problem. So that's one thing. It's moving in the right direction.

What about self-stigma?

Paula Allen: The other piece is around self-stigma. You've probably heard "physician, heal thyself." But you really can't — you're not going to perform surgery on yourself.

Very often you have individuals in helping professions, and counselors fall into this as well, who feel that because of their knowledge, they somehow have better problem-solving skills, and they should be able to pull themselves out of a situation. They feel worse about themselves if they're having a mental health issue, than they would feel about someone else having a mental health issue. The lack of self-acceptance is quite high, and very often people will externalize and say the problems are around them, not them.

How does mental strain show up differently in high performers?

Paula Allen: The third issue is that we find special challenges and different presentations of mental strain in high performers. If you are a high performer, you're used to problem-solving. You're used to being able to get forward. You might have a lot of personal investment and your identity wrapped up in your profession, and that's the last thing that's going to suffer. Your marriage will suffer. Your family relationships, your personal health will suffer, but you'll continue on with work.

Your superpower then becomes your deficit. If you are very detail-oriented, you become super perfectionistic and drive everybody around you a little bit around the bend. If you are very organized, you start to become very controlling. If you have good critical thinking, you start to become super critical of everyone around you. You start overusing the thing that made you great, and that creates a whole lot of problems, because you're not addressing yourself and you are creating environments that are unhealthy.

The other thing around high performers, and I'm talking in generalities here, is that because you are so driven, you're more likely to seek quick fixes, and unfortunately, quick fixes tend to be drugs, alcohol, they're things that actually create problems long term.

High-performing, high-demand helping professions, and those that have regulation, have their own unique risks, but awareness of those risks is really important. We mentioned awareness in terms of professional bodies, but people themselves have to be aware that just because you are in a helping profession doesn't mean that you are not vulnerable. Every human being is, and the earlier that you get help, the less of an impact it's going to have. Nobody's going to say they want to wait until they have stage 4 cancer because only then will it be worth the effort of changing. You want to address things early on.

If you are a high performer, really pay attention to the changes in your behavior with respect to others. Pay attention to what you are ignoring, and especially pay attention to this drive toward quick fixes, because you are uniquely vulnerable as well.

What did we not discuss that you would like our audience to know?

Paula Allen: The only other thing that has come across very clearly in our index is that, for many reasons, we do have a higher level of risk among younger individuals, and this impacts all professions. I want to make sure that people don't take that as only being that younger individuals are more comfortable talking about mental health issues. We have that, but it doesn't fully account for everything.

For one, they aren't always more comfortable talking, because your environment tells you whether it's safe to talk. If you have a highly stigmatized environment, I don't care whether you're 20 or 40 or 60, you're probably not going to be open. Everything that I mentioned around high performers and self-stigma still applies.

But also, we have an environment right now that is higher risk in terms of our mental health. We have rapid change, we have more uncertainty, we have that social isolation, we have that incivility. If you were born in 2000 or 2010, your life experience is very different than if you were born before, and that impacts your mental health.

So I do think there's a need to up our interventions and really pay attention to it, like we did with physical health. When life changed, our physical health was damaged because we were driving around in cars, not exercising and eating more poorly, and we had to be more conscious about how to counter that. The same thing is happening right now for mental health.