\n\tKatheryn Houghton<\/span><\/p>\n

States are redefining when medical professionals can get mental health treatment without risking notifying the boards that regulate their licenses.<\/p>\n

Too often, health care workers wait to seek counseling or addiction treatment, causing their work and patient care to suffer, said Jean Branscum, CEO of the Montana Medical Association, an industry group representing doctors.<\/p>\n

\u201cThey\u2019ve invested so much time in their career,\u201d Branscum said. \u201cTo have anything jeopardize that is a big worry on their mind.\u201d<\/p>\n

Montana, like other states, has a recovery program for health professionals who have a substance use disorder or mental illness. However, medical associations say such programs often come with invasive monitoring, even for voluntary care. And gray areas about when a mental illness should become public breeds fear that seeking care jeopardizes a medical career.<\/p>\n

Montana is among the states looking to boost confidential care for health professionals as long as they\u2019re not deemed a danger to themselves or patients. In recent years, at least a dozen states have considered or created confidential wellness programs to offer clinicians help early on for career burnout or mental health issues. States have also reworked medical licensing questions to avoid scrutiny for providers who need mental health treatment. The changes are modeled after Virginia legislation from 2020<\/a>.<\/p>\n

During a legislative committee meeting last month, advocates for Montana medical professionals asked state lawmakers to follow Virginia\u2019s lead. They say the goal is twofold: to get clinicians treatment before patients are at risk and to curtail the workforce burnout that\u2019s partly fueled by untreated stress.<\/p>\n

Montana\u2019s existing medical monitoring program, the Montana Recovery Program, is run by the global company Maximus<\/a>. Montana\u2019s professional advocates had backed another nonprofit to run Montana\u2019s program, which didn\u2019t win the state contract.<\/p>\n

The Montana Recovery Program declined a request for an interview, instead referring KFF Health News to the Montana Department of Labor & Industry, which oversees the state\u2019s medical licensing boards. Department staffers didn\u2019t comment by deadline.<\/p>\n

In a Medscape survey<\/a> released this year, 20% of physicians said they felt depressed, with job burnout as a leading factor. The majority said confiding in other doctors wasn\u2019t practical. Some said they might not tell anyone about their depression out of fear people would doubt their abilities, or that their employer or medical board could find out.<\/p>\n

Health professionals are leaving their jobs. They\u2019re retiring early, reducing work hours, or switching careers. That further dwindles patients\u2019 care options when there already aren\u2019t enough providers to go around. The federal government estimates<\/a> 74 million people live in an area without enough primary care services due to a workforce shortage.<\/p>\n

Aiming to ensure patient safety, state medical boards can suspend or revoke clinicians\u2019 rights<\/a> to practice medicine if substance use or psychological disorders impair their work. Those cases are rare. One study found<\/a> roughly 4,400 actions against the licenses of U.S. physicians for either substance use or psychological impairment from 2004 to 2020.<\/p>\n

Nonetheless, workforce advocates say disclosure requirements cause some health professionals to dodge questions about mental health histories on licensing and insurance forms or forgo care altogether. They\u2019re worried divulging any weakness will signal they shouldn\u2019t practice medicine.<\/p>\n

The mental health questions health workers are asked vary by state and profession. For example, nurses in Montana renewing their license are asked if they have any psychological condition or substance use that limited their ability to practice \u201cwith reasonable skill and safety\u201d in the previous six months. Along with being asked about substance use on the job, doctors are required to say whether they\u2019ve experienced a mental condition that \u201cmight adversely affect any aspect of your ability to perform.\u201d<\/p>\n

\u201cWhen I see that question on my renewal, do I have to report that I was depressed because I was going through a really tough divorce?\u201d Branscum cited as an example of workers\u2019 uncertainty. \u201cYou know, my life is turned upside down now. Am I obligated to report that?\u201d<\/p>\n

A \u201cyes\u201d wouldn\u2019t immediately result in licensing problems. Those who do report mental health troubles would be flagged by state workers as a potential concern. They could end up before the board\u2019s same screening panel that recommends whether to revoke a license, or be referred to long-term monitoring with regular screening.<\/p>\n

Additionally, health professionals are required to report<\/a> when other clinicians show unprofessionalism or have potential issues that affect performance. Branscum said medical professionals worry that what they say in a counseling session could be flagged for licensing boards, or that a co-worker may make a report if they seem depressed at work.<\/p>\n

Bob Sise, a Montana addiction psychiatrist and co-founder of the nonprofit 406 Recovery, told state lawmakers that job stressors are playing into workers\u2019 mental health challenges, such as long shifts and heavy patient loads. And with the rising cost of health care, physicians feel they\u2019re sacrificing their commitment to healing as they routinely substitute optimal treatment for lesser care that patients can afford.<\/p>\n