Medical Professionals: Licensure Application Questions On Mental Health

Where We Stand

NAMI believes that all people with mental health conditions deserve access to supports that promote wellness. NAMI supports limiting medical license application questions about mental health to only those necessary and relevant to assess an individual’s current ability to practice medicine safely and competently. NAMI further supports and encourages the use of language in the licensure application process that is supportive of seeking mental health treatment.

Why We Care

Medical professionals face many challenges in their day-to-day work life. From the pressure of making sure people get the care they need to working long shifts to the trauma of losing patients — health care is a stressful field of work.

Individuals in medical and related professions, in general, experience many stressors and are at high risk for suicide. Physicians have higher rates of depressive symptoms, burnout and suicide risk than the general population. The suicide rate among male physicians is nearly 1.5 times higher than the general male population, and among female physicians, the relative risk is even more pronounced — more than double that of the general female population.

Unfortunately, many medical professionals delay or forgo seeking mental health care because of fear that doing so will jeopardize their ability to practice medicine. This is because many state licensing boards include questions about mental health status in their applications. These questions perpetuate false generalizations about a person’s functionality based on a mental health diagnosis alone, rather than specifically asking about current functional impairments. Moreover, they perpetuate stigma and discourage many from seeking treatment.

The Federation of State Medical Boards (FSMB) notes that a history of mental illness or substance use does not reliably predict future risk to the public. Additionally, court interpretations of the Americans with Disabilities Act (ADA) have suggested that state medical boards should focus on current functional impairment rather than a history of diagnoses or treatment of mental illness. Yet, a 2016 national analysis of medical licensing applications revealed that two-thirds of states have application questions that are inconsistent with the ADA. A 2021 study showed that only one state’s medical licensing application fully adopted FSMB recommendations related to mental health disclosure.

Seeking mental health treatment should be normalized and encouraged, without fear of losing one’s medical license. NAMI urges state medical boards to remove unnecessary language in licensure and renewal applications regarding an applicant’s mental health diagnosis or prior mental health history. Instead, state licensing boards should ensure that any medical licensing questions regarding an applicant’s mental health focus on current functional impairments that may affect a provider’s ability to practice medicine safely and competently.

How We Talk About It

• The mental health and well-being of our health care workforce is critical, and more than ever, medical professionals need our support.
• Medical-related professions experience many stressors and are at high risk for suicide – in fact, physicians have higher rates of burnout, symptoms of depression and suicide risk than the general population.
• Unfortunately, there are many barriers that prevent medical professionals from seeking needed mental health care.
• Across the U.S., many state medical boards require disclosure of current or past diagnosis of mental health conditions in order to receive or renew a medical license.
• Questions about current or past mental health diagnoses don’t accurately reflect a provider’s ability to do their job, and they do not reflect their professional competence.
• These questions contribute to stigma and discourage many providers from seeking treatment for fear it will impact their ability to practice medicine.
• While some information about a medical provider’s current health status may be important, a history of mental illness or substance use does not reliably predict future risk to the public or patients.
• Seeking mental health treatment should be normalized and encouraged, without fear of losing one’s employment and livelihood from simply filling out licensure application and renewal forms accurately and honestly.
• State licensing boards should ensure that medical licensing questions only ask about current mental or physical functional impairments that affect a provider’s ability to practice medicine safely and competently.

What We’ve Done

• NAMI resources for Frontline Professionals
• NAMI webinar “What Are Your Rights in the Workplace?”
• NAMI letter to Members of Congress expressing thanks for championing the “Dr. Lorna Breen Health Care Provider Protection Act” and ensuring its passage.
• NAMI joint press release, “New JAMA Study Highlights Urgent Need for State Medical Boards to Reform Licensing Practices to Protect the Mental Health of Physicians During COVID and Beyond”
• NAMI press release, “NAMI Praises Enactment Of Dr. Lorna Breen Health Care Provider Protection Act Supporting Provider Mental Health”