Removing mental health stigma in licensure and credentialing to support care team safety and wellbeing

by Liz Boehm
Executive Strategist, Human-Centered Research

In 2023, I had the distinct pleasure of talking with J. Corey Feist on an episode of the Caring Greatly podcast. Corey is the co-founder and CEO of the Dr. Lorna Breen Heroes' Foundation, which is fighting for a world where seeking mental health services is viewed as a sign of strength. This fight started with the death of Corey’s sister-in-law, Lorna, and continues with a national movement that is eliminating intrusive mental health questions in state medical licensing and hospital credentialing applications for clinicians.

The story that sparked a movement

Dr. Lorna Breen was a sister, daughter, friend and physician. During the COVID-19 pandemic, she worked tirelessly in two emergency departments in New York City, one of the hardest-hit areas at the time. As the days wore on, the constant wave of patients and unrelenting trauma began to take their toll. Despite her mounting distress and need for support, Dr. Breen feared seeking help. She was deeply concerned that doing so would cost her the career she loved and worked so hard to build. This fear was fueled by the fact that many state licensing boards across the country require physicians to disclose current and past mental healthcare issues and access, and many hospitals require disclosure for credentialing. She also feared being ostracized by colleagues because, sadly, seeking mental healthcare is often considered a sign of weakness.

In April 2020, Dr. Breen died by suicide. Her death underscored the need to take a hard look at mental health access and how we support our healthcare workers and each other as humans. We must remove stigma around mental health and break down systemic and societal barriers to seeking help. Corey and the Foundation are leading the charge in healthcare, fighting to reform licensure and credentialing processes that foster safer, more supportive cultures for healthcare professionals. 

Champions of change

In addition to championing specific policy changes, the Foundation is increasing awareness about clinician burnout and suicide. From the White House to hospitals across the country, the Foundation is driving changes in attitudes, policies and cultures to protect the emotional, psychological and physical safety of healthcare team members. In 2022, the Dr. Lorna Breen Health Care Provider Protection Act passed, securing funding of $103 million across 45 organizations to implement evidence-informed strategies that reduce and prevent suicide, burnout, mental health conditions and substance use disorders.

In recognition of Suicide Prevention Month in September, ALL IN: Wellbeing First for Healthcare, a national coalition led by the Foundation, announced significant progress in our collective efforts to support healthcare workers’ mental health. As part of the Wellbeing First Champion Challenge program, 34 licensure boards and 375 hospitals verified that their licensing or credentialing applications are now free from intrusive mental health questions and stigmatizing language as of September 1, 2024. This action positively benefits more than 1.1 million licensed and 115,000 credentialed health workers nationwide.

I’m proud to support the Foundation and be part of this movement. Like every person in any walk of life, healthcare professionals deserve the right to seek mental health services without fear of stigma or reprisal. Removing overly invasive mental health questions in licensing and credentialing applications is a critical step to improving the safety and wellbeing of healthcare team members. But there is so much more work to do to create and sustain system-wide changes that protect the just treatment and physical, emotional and psychological safety of everyone who works in healthcare.

A future free from stigma

Care team members at every level of healthcare organizations face unimaginable stress daily. From experiencing cognitive overload and burnout to navigating workplace violence, chronic staffing shortages and overwhelming caseloads, the safety and wellbeing of healthcare professionals are constantly at risk. Yet, many hesitate to ask for help or seek the mental health support.

Why? Because in many communities and cultures, vulnerability is seen as a weakness. And for healthcare workers there is additional fear – fear of losing their profession and the respect of their peers. Too often, healthcare workers feel they have no choice but to “push through” their struggles to ease the pain and suffering of their patients and families. But at what cost? When burnout, depression and emotional fatigue go untreated, it not only threatens the wellbeing of the professionals themselves, but also the quality of care they provide.

While the healthcare industry and the nation have made some policy and process improvements, there is still a real and urgent need to dismantle the stigma around mental health for those working in healthcare and beyond. We must create human-centered environments and cultures where seeking help is viewed as an act of strength – for every healthcare team member, in every healing profession, and in every healthcare setting.

Humans as an essential source of safety: a frameshift for system resilience
September 4, 2024

Centering a more holistic view of workforce safety
September 18, 2023

The 2022 Healthcare Workforce Rescue Package
March 19, 2022

Evidence-based practices support the Coalition’s Declaration of Principles
January 19, 2022

System change is at the heart of wellbeing
November 17, 2021