Canadian Medical Association

Stigma about mental illness is pervasive in the medical profession. In many ways, the culture of medicine discourages physicians from seeking help or accessing psychological care when they need it. Physicians are trained to put the needs of others before their own.

In the CMA National Physician Health Survey physicians and residents ranked stigma or shame as the second-largest barrier to seeking help.

And that can have a huge impact on not only their own wellness but also patient care.

The high costs of stigma in health care

In an article in BMC Medicine, stigma is broadly defined as “a powerful social process that is characterized by labelling, stereotyping and separation, leading to status loss and discrimination.”

In medical settings, this can lead to several negative outcomes:

  • When physicians resist seeking or accepting care, they affect their own wellbeing. By avoiding diagnosis and treatment, they place themselves at risk of more serious health consequences. 
  • Research from the Journal of Medical Licensure and Discipline showed that some doctors fear damaging their careers or putting their medical licence in jeopardy if they seek treatment for mental illness.
  • For each physician who leaves practice (due to untreated mental illness, for instance), thousands of Canadians are left without care. The public funds invested in a medical education — estimated at $285,000 for a family physician and $760,000 for a specialist — are wasted when physicians cannot practice.

Keys to reducing stigma 

To be effective, stigma reduction needs to be embedded in how health services are delivered and evaluated.

Anti-stigma interventions must become part of the pre-service and in-service training of all kinds of health care workers, across multiple levels of the health care system.

The resources on this page look at the impact of stigma on physician wellbeing. They also provide strategies to address and reduce stigma in training and practice environments by normalizing illness, reducing feelings of vulnerability and promoting help-seeking behaviour to foster better physician health and wellness. 

The role of medical educators

According to the Royal College National Physician Wellness Task Force, wellness is a shared responsibility between the profession, the individual, and learning and practice environments. Medical educators can play an important role in reducing stigma among medical learners. An article in the American Journal of Psychiatry explains that few medical students seek medical treatment, often because they fear professional consequences associated with disclosing a mental illness.  

Here are some of the ways medical educators can help reduce stigma:

  • Walk the talk and be a wellness role model — if you want learners to believe wellness should be a priority, then prioritize your own wellness and champion the cause throughout your own work.
  • Ensure learners understand they are participating in a psychologically and physically safe environment where it is safe to speak up or ask for help.
  • Normalize help-seeking behaviour — a key pillar that the entire profession should embrace to help foster a culture of wellness.

For more insights on how medical educators can support the wellness of medical learners, visit the Educators section of the Wellness Hub.

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