California joins nationwide movement to destigmatize physician mental health

© Volha - stock.adobe.com

The path to becoming a doctor equips us with the tools to diagnose and treat diseases, but it does not prepare us to cope with the relentless exposure to death and suffering. Physicians try to compartmentalize and keep going, even when the weight of our experiences threatens to break us.

Thankfully, the culture of medicine is evolving. The stoic silence that once permeated the profession is beginning to shift. There is now space to seek help and care for ourselves, and in California, our leaders and institutions are further encouraging this shift.

The Medical Board of California in August revised its licensure application to emphasize that seeking mental health treatment is encouraged and not subject to disciplinary action. And on Sept. 29, Gov. Gavin Newsom signed Assembly Bill 2164 by Assemblymember Marc Berman, which prohibits requirements in physician licensure applications to disclose personal medical information that does not impact their ability to practice medicine, helping reduce the stigma around mental health support for physicians.

Dayna Isaacs, MD, MPH

This new law brings California in line with more than 20 other states that have made similar reforms, supporting physicians by alleviating the fear of professional repercussions.

I know firsthand how important encouraging mental health care for physicians is. I still carry the weight of the patients I lost during my residency. A middle-aged woman with a bilateral lung transplant, pushed to the brink by a viral respiratory infection. A gentleman with lung cancer, whose disease had spread, triggering relentless, life-threatening arrhythmias. A young woman my age with lupus, whose immunosuppressive medications left her vulnerable to a deadly fungal infection, leading to septic shock.

I remember their final moments: the shallow, labored breaths, the monitors slowly going quiet, the speechless devastation of a loved one at the bedside and the unbearable weight of grief in the room.

In those moments, I felt inseparable from their pain. The bonds formed in the medical intensive care unit — where the mortality rate felt staggering, with nearly half my patients dying each week — run deep. The physical and emotional exhaustion was unrelenting.

I was growing every day as a physician, yet I was not aware of the toll it was taking.

Fortunately, my residency program emphasized mental health support as an important component of our training and recognized the pervasive trauma that physicians can experience. The extent of this trauma became painfully clear through a recent study, which revealed that nearly one in five physicians experienced post-traumatic stress disorder during the COVID-19 pandemic.

The mental health crisis among physicians existed long before the pandemic. High rates of depression, burnout and suicide have afflicted the medical profession for decades. Physicians have one of highest rates of suicide of any profession. It is estimated that roughly one doctor dies by suicide every day, and 1 million patients lose their doctor to suicide each year.

When physicians face challenging circumstances, we should encourage them to seek the help they need — both for themselves and for the benefit of their patients. However, too many physicians have been hesitant to do so due to stigma and concerns about negative consequences. A survey of U.S. physicians found that 60% were reluctant to seek psychiatric or psychological help due to fear of jeopardizing their medical licenses.

These troubling statistics drive home why California’s recent moves to encourage physicians to seek mental health treatment are so important.

I, along with many others in the medical community, applaud the governor, the California legislature and the state medical board for taking action to foster a culture of understanding and support that encourages doctors to seek mental health services when they need it.

Dayna Isaacs, MD, MPH, is a hematology/oncology physician based in Sacramento, California.

If you or someone you know is experiencing mental distress, the national Suicide & Crisis Lifeline can be reached by dialing 988 for free and confidential help. Additional resources to support mental health and alleviate workplace burnout are available from the American Foundation for Suicide Prevention and the Dr. Lorna Breen Heroes’ Foundation.