Gold Katherine J, Andrew Louise B, Goldman Edward B, Schwenk Thomas L
Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI 48104-1213, United States.
International Federation of Emergency Medicine. Electronic address: http://www.MDMentor.com.
Gen Hosp Psychiatry. 2016 Nov-Dec;43:51-57. doi: 10.1016/j.genhosppsych.2016.09.004. Epub 2016 Sep 15.
Physicians have high rates of suicide and depression. Most state medical boards require disclosure of mental health problems on physician licensing applications, which has been theorized to increase stigma about mental health and prevent help-seeking among physicians.
We surveyed a convenience sample of female physician-parents on a closed Facebook group. The anonymous 24-question survey asked about mental health history and treatment, perceptions of stigma, opinions about state licensing questions on mental health, and personal experiences with reporting.
2106 women responded, representing all 50 states and the District of Columbia. Most respondents were aged 30-59. Almost 50% of women believed that they had met the criteria for mental illness but had not sought treatment. Key reasons for avoiding care included a belief they could manage independently, limited time, fear of reporting to a medical licensing board, and the belief that diagnosis was embarrassing or shameful. Only 6% of physicians with formal diagnosis or treatment of mental illness had disclosed to their state.
Women physicians report substantial and persistent fear regarding stigma which inhibits both treatment and disclosure. Licensing questions, particularly those asking about a diagnosis or treatment rather than functional impairment may contribute to treatment reluctance.
医生的自杀和抑郁发生率很高。大多数州医学委员会要求在医生执照申请中披露心理健康问题,从理论上讲,这会增加对心理健康的污名化,并阻碍医生寻求帮助。
我们在一个封闭的脸书群组中对女性医生家长的便利样本进行了调查。这份24个问题的匿名调查问卷询问了心理健康史和治疗情况、对污名化的看法、对州执照申请中关于心理健康问题的意见以及报告的个人经历。
2106名女性做出了回应,她们来自所有50个州和哥伦比亚特区。大多数受访者年龄在30至59岁之间。近50%的女性认为自己符合精神疾病的标准,但未寻求治疗。避免治疗的主要原因包括认为自己可以独立应对、时间有限、害怕向医学执照委员会报告以及认为诊断令人尴尬或羞耻。只有6%被正式诊断或治疗过精神疾病的医生向所在州披露了情况。
女医生报告称,她们对污名化存在持续且强烈的恐惧,这既抑制了治疗,也阻碍了披露。执照申请问题,尤其是那些询问诊断或治疗而非功能损害的问题,可能导致不愿接受治疗。