Health workers with mental illness or addiction often face stigma and discrimination when they seek professional help or renew their licenses. However, more states are moving to protect their licenses and encourage them to get treatment without fear of losing their careers.
The Problem of Stigmatization and Punishment
Many health workers struggle with mental health issues or substance use disorders, especially amid the stress and trauma of the COVID-19 pandemic. According to a survey by the American Medical Association, 40% of physicians reported experiencing burnout, depression, anxiety, or suicidal thoughts in 2020. A study by the American Nurses Association found that 62% of nurses reported feeling overwhelmed, 51% reported feeling anxious, and 43% reported feeling depressed in 2020.
However, many health workers are reluctant to seek help or disclose their conditions, fearing that they will be stigmatized, punished, or lose their licenses. In most states, health workers have to answer questions about their current or past mental health or substance use history when they apply for or renew their licenses. These questions are often vague, broad, and intrusive, and may violate the Americans with Disabilities Act. If health workers admit to having a mental illness or addiction, they may be subject to investigations, sanctions, monitoring, or restrictions on their practice. This can deter them from getting the care they need and jeopardize their well-being and performance.
The Movement for Licensing Reform
In recent years, more states have recognized the need to reform their licensing rules to support health workers with mental illness or addiction, and to destigmatize and normalize their conditions. According to the Federation of State Medical Boards, 24 states have changed their licensing questions to focus on current impairment or functional ability, rather than past diagnosis or treatment, since 2017. These states include California, Colorado, Florida, Illinois, Massachusetts, New York, and Texas.
The licensing reform movement is driven by various stakeholders, such as professional associations, advocacy groups, legislators, and health workers themselves. For example, the American Psychiatric Association has launched a campaign called “Physicians Supporting Physicians” to raise awareness and provide resources for physicians with mental health issues. The American Foundation for Suicide Prevention has published a model policy for state medical boards to adopt more appropriate and compassionate licensing questions. The National Council of State Boards of Nursing has issued a position statement urging state boards of nursing to eliminate stigmatizing language and practices from their licensing processes.
The Benefits of Licensing Reform
Licensing reform can have multiple benefits for health workers, patients, and the health care system. By removing the barriers and fears that prevent health workers from seeking help or disclosing their conditions, licensing reform can encourage them to get the treatment they need and deserve, and improve their recovery and well-being. By focusing on current impairment or functional ability, rather than past diagnosis or treatment, licensing reform can respect the privacy and dignity of health workers, and comply with the federal law and ethical standards. By reducing the stigma and discrimination associated with mental illness or addiction, licensing reform can foster a culture of support and compassion among health workers, and enhance their morale and satisfaction.
Licensing reform can also benefit patients and the health care system, by ensuring the quality and safety of care, and addressing the workforce shortages and challenges. By helping health workers with mental illness or addiction to get treatment and stay in practice, licensing reform can prevent or mitigate the adverse effects of their conditions on their performance, such as errors, absenteeism, turnover, or burnout. By retaining and supporting health workers with mental illness or addiction, licensing reform can also contribute to the diversity and inclusivity of the health care workforce, and meet the needs and preferences of patients with similar conditions.
Licensing reform is a positive and necessary step to support health workers with mental illness or addiction, and to improve the health care system. More states should follow the example of the 24 states that have changed their licensing questions, and adopt more fair and humane policies and practices. Health workers with mental illness or addiction deserve to be treated with respect and compassion, and to have the opportunity to pursue their careers without fear or shame.
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