Mental Health Disclosure Questions on Medical Licensure Applications

Implications for Medical Students, Residents, and Physicians

Bibliographic Data

ID21614983
AuthorsNicki W Taylor (0000-0002-9413-2690, N.W. Taylor is assistant professor, Department of Behavioral Science and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida, corresponding author), Cheryl Porter (0000-0002-9895-9660, C. Porter is associate professor, Department of Behavioral Science and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida ; [email protected]), Melanis Rivera-Rodriguez (0000-0002-2508-2212, M. Rivera-Rodriguez is assistant professor, Department of Psychiatry and Behavioral Health, Florida International University Herbert Wertheim College of Medicine, Miami, Florida ; [email protected]), I S Keino Miller (I.S.K. Miller is a licensed psychologist in private practice, Cimarron Counseling & Sport Psychology LLC, New Orleans, Louisiana ; [email protected]), Nathaly Desmarais (N. Desmarais is assistant professor, Department of Psychiatry and Behavioral Health, Florida International University Herbert Wertheim College of Medicine, Miami, Florida ; [email protected])
Year2022
Volume97
Issue8
Pages1117-1122
Publication date2022-08-01
Open AccessYes
TypeARTICLE
VenueAcademic Medicine (JOURNAL)
Journal identifiersISSN: 1040-2446 • E-ISSN: 1938-808X
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1097/acm.0000000000004682
PMID35353717
OpenAlexW4220722774
LanguageEN
Citations received5
References cited18

Medical trainees and physicians experience high rates of depression, anxiety, suicidal ideation, and burnout. The stigma surrounding mental health may deter help-seeking behaviors and increase informal treatment to maintain anonymity. Invasive health history questions on state medical licensure applications regarding mental health diagnoses and treatment likely increase stigma, reduce help-seeking, and consequently may motivate some applicants to report an inaccurate history to the state medical board. Research on physician mental health, suicide rates, and lack of help-seeking have led to recommendations for changes to licensure questions. In this article, the authors review the language of health history questions, disclosure requirements for applicants, and the potential consequences of disclosing mental health or substance abuse history on state medical licensure applications. They review recent changes to some states’ health history questions, using the changes to Florida’s licensure application in 2021 as an example, and explore the implications of these changes for reducing stigma and encouraging help-seeking. The authors recommend that state medical boards review and refine licensure applications’ health history questions regarding mental health disclosure in ways that strategically address concerns related to stigma, bias, and unwarranted scrutiny. They call for research to examine the impact of such question changes on applicant response accuracy, help-seeking behaviors, and mental health outcomes and stigma. They also recommend that medical schools offer and promote access to mental health services, encourage faculty to normalize help-seeking behaviors, and provide students with information about state licensure processes. Reducing stigma, normalizing trainee and physician experiences, and promoting help-seeking are preliminary steps to promote a culture in academic medicine that prioritizes mental health. In turn, this will encourage trainees and physicians to care for themselves and cultivate physicians who are better equipped to heal and support their patients

Licensure · MEDLINE · Mental health · Occupational safety and health · Poison control · Suicidal ideation · Suicide prevention · Diversity and Career in Medicine · Healthcare professionals’ stress and burnout · Occupational and Professional Licensing Regulation

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