Doctors with mental illness don’t need more suicide awareness — we’re aware. And we don’t need confidential treatment opportunities. What we need is assurance from all invested parties — our employers, credentialing bodies, and licensing officials — that it will be OK if we need help, we can get what we need, and that everything for the job can be sorted out once we’re well. Because it turns out, in most cases, that’s true — and in the instances where it isn’t, that’s the reality we need to work towards.
It strikes me as odd that even today, physicians must be reassured that any care they receive will be confidential. All medical care is confidential. What that actually means is: secret, clandestine, unreported. Another person could discover they had seen a mental health provider, report them, and poof — career gone.
Will the physician reporting mental illness suffer retribution?
After I was diagnosed with bipolar disorder and became well again, I had no trouble with licensing, credentialing, my jobs, etc. Mental illness is not a death sentence. The acutely ill physician has such a hard time seeing this because of the lack of insight, but that’s the precise reason we need reassurance — and a culture change.
I know because I’ve been there. I have been well for many, many years. I wasn’t when I was diagnosed, but luckily, there’s psychiatry! I take medication, and I have regular follow-ups. The idea with any mental illness is that you’re supposed to get better and stable — even with something chronic.
If you have a mental illness that you feel the need to hide, you should probably take it seriously enough not to hide it.
As someone with bipolar disorder, I can tell you it messed with my life to such an extent that everyone noticed. It isn’t something that a clandestine clinic would have helped me deal with on my own without support from my employer.
I had an outpatient hospitalization that took me away from work for several weeks. I worked part-time for a while. Anyway, I wouldn’t have wanted to hide my illness from my employer; no amount of ego preservation is worth it for me to do that.
How could I have gotten the accommodations I needed for the outpatient treatment, or the temporary part-time, if I was hiding it? That would be like hoping to have time off for knee surgery without letting my boss know I was having knee surgery. To save lives, I believe we need to stop hiding what shouldn’t even be shameful in the first place. #stopthestigma begins with being honest.
Let’s tell physicians who need help that everything can be sorted out once they are well. It’s all going to work out. And it has to be true — physicians must believe it.
I believe that a cultural shift can solve the physician suicide epidemic. It’s not going to be by encouraging physicians to use secret “Don’t Ask, Don’t Tell” treatment clinics. I’m too tired of worrying about what people think to try to hide my mental illness by going somewhere low-key. I’m going to see the in-network psychiatrist and get my Seroquel at Walgreens. Peace.
Alison Baum is a family physician.
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