Unraveling stigma: Mental health care for physicians is critical for them and their patients

Stefanie Simmons: ©Dr. Lorna Breen Heroes' Foundation

For too long, health workers have faced a dangerous, unnecessary choice between seeking mental health care and protecting their careers. Intrusive mental health and substance use disorder questions in licensing and credentialing applications, which often have nothing to do with clinical competence, have deterred too many from seeking help—at no benefit to health systems or patient care.

Behind every policy that discourages help-seeking is a health worker suffering, often in silence. Many worry that disclosing their mental health history will result in professional consequences, even if they’re entirely capable of providing safe, compassionate care to patients. This chilling effect leaves health workers isolated in their distress, which can prove fatal.

The lasting impact of Dr. Lorna Breen’s story

Dr. Lorna Breen, a respected emergency physician and hospital leader in New York City, worked on the frontlines in overloaded emergency departments in the early weeks of the COVID-19 pandemic. Like many others, she faced severe exhaustion, moral injury, and trauma that took a toll too heavy to bear. In her final days, she expressed fear that getting help meant the end of her career.

Tragically, Lorna died by suicide in April 2020. She wasn’t alone in her struggle—after her death, her family received an outpouring of messages from others who had also lost loved ones in health care to mental health crises and from health workers who faced barriers to seeking mental health care. Recognizing that these losses are far too prevalent and preventable, her family created the Dr. Lorna Breen Heroes’ Foundation to safeguard the mental health of the health workforce through systems-level changes.

A national movement for change

Awareness of Lorna’s death and the systemic barriers that contributed to it sparked a movement. The foundation launched ALL IN: WellBeing First for Healthcare, a coalition of more than 30 leading health care organizations, to build a system where the wellbeing of clinicians is protected.

As an essential first step, the Wellbeing First Champions Challenge recognizes health care facilities, systems, licensure boards, and insurers that eliminate intrusive mental health questions and stigmatizing language from their forms. Free toolkits are available to help guide this process—tailored to both credentialing and licensing pathways—and a verification submission form to help organizations meet best-practice standards and earn recognition as Wellbeing First Champions.

Thus far, 52 state licensing boards and 635 health care facilities are recognized as Wellbeing First Champions, improving workplace wellbeing for more than 1.6 million health workers. Together, they’re helping to create a health care system where seeking mental health care is treated as a strength, not a liability.

ALL In for Mental Health: Getting health workers the care they need

Building on this momentum, the foundation also launched the ALL IN for Mental Health initiative to improve mental health care access for health workers by addressing unique stressors, reducing stigma, and sharing stories of success in creating a system that supports both professional wellbeing and improves care outcomes.

The initiative calls for six actions:

1. Ensure accessible and affordable mental health care;
2. Commit to equal privacy in mental health care;
3. Strengthen access to confidential professional or physician health program (PHP) support;
4. Guarantee confidential peer support;
5. Encourage education and training on mental health and professional wellbeing; and
6. Advance a supportive pathway for re-entry after mental health leave

These measures require broader adoption to drive nationwide change. Until every institution and licensing board commits to these reforms, health workers will continue to face barriers that compromise their wellbeing and their ability to care for others.

We need more organizations to act

Every health care organization can and should take action, beginning with a review of their policies. The Wellbeing First Champion Challenge includes an audit of organizations’ applications, forms, and addendums to ensure they are free of intrusive mental health questions and stigmatizing language.

Once verified to meet best practice standards for reducing barriers to mental health care, participating organizations are recognized as Wellbeing First Champions and provided a toolkit to help spread the word to their workforce about the change. They join a growing national movement committed to protecting clinician wellbeing and building a system where health workers can get necessary care without fear of professional consequences.

But institutional reform alone isn’t enough; policy is another key tool advocates are using to drive change in this space.

Reauthorize and fund the Lorna Breen Act

Enacted in 2022, the Dr. Lorna Breen Health Care Provider Protection Act was the first federal law focused specifically on health worker mental health. Through two HRSA-administered grant programs, it funded 44 initiatives in 24 states, reaching over 250,000 health workers.

Grantees built and expanded wellbeing programs, peer and crisis support, and access to mental health services. Some even redesigned workflows to reduce staff strain. Early results point to lower turnover, less burnout, and stronger workforce infrastructure.

The Act also enabled the CDC’s Impact Wellbeing campaign, equipping hospital leaders with tools to address the operational drivers of burnout, distress, and disengagement among workers.

However, this progress is now at risk. The law’s programs expired in September 2024, and without swift reauthorization and funding, critical progress will stall. Bipartisan reauthorization would expand the Act’s reach and focus more directly on reducing administrative burden, the leading driver of clinician burnout. We invite those who would like to advocate to contact their members of Congress and urge them to fund the Lorna Breen Act.

Support mental health to safeguard the future of care

Stigma isn’t just cultural; it’s structural. It shows up in licensing forms, credentialing policies, and the fear that seeking help could jeopardize a career. But tools like institutional reforms and program funding make life-saving change possible.

What we need now is broad buy-in from all organizations. For the sake of health workforce wellbeing and the future of patient care, we can’t afford to wait.

Stefanie Simmons, MD, FACEP is the chief medical officer at the Dr. Lorna Breen Heroes' Foundation.