Confidentiality, Stigma and Physicians' Mental Health — Letters that should have been in the new york times

To the Editor:

“Doctors Face a Stigma Against Seeking Mental Health Care,” by Seema Jilani (Opinion guest essay, April 1), highlights the particular challenges physicians have in pursuing and receiving the mental health care they need.

The stigma of mental illness is pervasive in our society, though less than it was a generation ago when the biological and genetic roots of these illnesses were less well understood. It is unrealistic to expect this stigma to be eradicated, but structures that impede physicians from getting help should be removed.

It is critical for physicians, including residents in training who work in the trenches, to have their confidentiality protected. Privacy laws, as well as the Americans With Disabilities Act, offer safeguards to all individuals seeking treatment.

It is within the safe space of the doctor-patient relationship that the difficult risk assessment of harm or self-harm can be made. In my experience, most physicians who are disabled are relieved when they recognize that they cannot care for patients until they are better. And if the physician’s judgment is impaired, the psychiatrist has an ethical responsibility to take steps to protect the patient or those who may be harmed.

Larry S. Sandberg
New York