Stigma exists around physician mental health - period. It's one of the main barriers that prevents physicians from seeking help for mental health related concerns. Stigma from society, patients, colleagues, the healthcare system and regulatory bodies - it's all around. That, and the mental health related questions on licensing applications and renewals, really place added fear, shame and doubt on an existing baseline of psychological suffering.
We think we're immune to stigmatizing others until we have to face the fact we're not. It might be subtle and unspoken so we think it doesn't count. But, for instance, if a colleague returns from a stress leave and we don't check in with them to see what they're willing to take on versus not take on, and go ahead and assume they can't handle something, we're adding to the stigma problem. Thinking we're sensitive to someone's situation may in turn make them think we think they're weak.
As the 2018 CMA National Physician Health Survey indicates, "the stigma associated with mental health issues remains a relevant issue within the profession. Indeed, stigma has been consistently identified as a barrier to help-seeking behaviours." Stigma then becomes a circular problem where physicians with mental health concerns start to stigmatize themselves - "Maybe I'm not well enough to practice medicine?" "Maybe my anxiety is clouding my thinking?" "Maybe I can't cope with it all?" "Maybe I'm just not 'enough' in every way?".
Stigma is a "societal creation" that can lead to this self-stigma, further damaging self-esteem and self-efficacy. But stigma at its core is just thoughts and perceptions and we get to choose how we think about others and ourselves. Let’s start with not being afraid to name stigma for what it is when we see it. Whether that's in the mirror or in a colleague, we have the potential to change one of the greatest challenges many physicians will face in their career. Let's work toward a culture that looks upon the shame imposed by stigma as unacceptable; and awareness and support as being the way forward.
"Self-stigma can be just a big a problem as the negative attitudes of others." ~ Megan A. Arroll