OBJECTIVE: This study examines barriers to mental health care and factors influencing perceived need and service use in medical faculty and staff. METHODS: Faculty and staff at a large urban healthcare system completed online surveys regarding mental health status, perceived need for mental health services, and barriers to access. RESULTS: The sample included 2,421 participants (44.2% staff; 55.8% faculty). The most common barrier to care was limited time (60.9%). Faculty were significantly more likely than staff to report privacy concerns (33.9% vs. 10.4%). Among those who perceived a need for mental health services, demographic factors (age, race/ethnicity, gender, role, and partner status) and psychiatric symptoms (suicidality, anxiety, depression, and physical violence) were associated with not utilizing mental health services. CONCLUSIONS: indings highlight the need for accessible, destigmatized mental health interventions, improved outreach, and education on healthcare worker treatment privacy.