Doctors Back Mental Health Care in Theory, Yet Few Disclose Illness to Licensing Boards

Physicians spend their careers caring for the health of others, but a new cross-sectional survey suggests that when it comes to their own minds, the picture is far more complicated. A research team led by Nikhita Loomba and colleagues, publishing in BMC Psychiatry, surveyed medical students, residents, and attending physicians at an academic institution and found a striking paradox: attitudes toward mental illness have grown markedly more accepting, yet the people who deliver health care remain deeply reluctant to disclose their own psychiatric struggles to the bodies that regulate their licenses. The findings, published as an open-access article on 19 September 2026, offer one of the more granular snapshots to date of how stigma, symptom burden, and professional fear intersect across the entire training pipeline of medicine.

The study distributed an anonymous survey through the REDCap electronic data capture platform, reaching participants at every stage of medical careers, from students still in lecture halls to attending physicians running outpatient clinics. The investigators paired demographic questions with a questionnaire probing attitudes toward mental illness and with three well-validated screening instruments: the Patient Health Questionnaire-2, or PHQ-2, a two-item screen for depressive symptoms; the Generalized Anxiety Disorder-2 scale, or GAD-2, its counterpart for anxiety; and the CAGE questionnaire, a classic four-item screen for problematic alcohol use whose acronym stands for cutting down, being annoyed at criticism, feeling guilty, and needing an eye-opener drink in the morning. The brevity of these tools is precisely their strength, allowing researchers to capture symptom signals across a busy professional population without imposing a diagnostic interview.

Among the 277 participants who completed the survey, the headline finding on attitudes was genuinely encouraging. Roughly seven in ten respondents, 70.1 percent, agreed that mental illness should be regarded in the same way as any other medical condition. An even larger share, 77.8 percent, said they would be willing to receive care from a physician who has a mental illness, and 71.9 percent indicated that a colleague’s mental illness would not change their perception of that individual. These numbers suggest that the explicit, attitudinal layer of stigma, the kind measured by asking people directly what they believe, has eroded considerably within this academic medical community, and that the erosion holds across age groups.

Yet the symptom data tell a more troubling story. Screening-positive rates were 35.6 percent for anxiety symptoms and 18.7 percent for depressive symptoms, meaning more than a third of the physicians and trainees surveyed carried clinically significant anxiety signals. Most striking of all, 40.5 percent screened positive for problematic alcohol use on the CAGE questionnaire, a figure that was significantly higher among female respondents than male respondents. In a profession where alcohol misuse is often framed as a private coping mechanism, a positive rate above 40 percent on a validated screen is a signal that the occupational stressors of medicine are not being absorbed without cost.

The demographic patterns within the data add texture to that alarm. Anxiety symptoms were significantly more common among medical students than among their more senior colleagues, and among younger respondents overall, a gradient that the authors interpret as reflecting the acute pressures of training years. Self-reported history of mental illness diagnosis stood at 29.3 percent across the sample, and that figure was higher in women than in men, a difference that reached statistical significance. Rates of reported diagnosis also increased with the number of years out of residency and were highest, at 42.2 percent, among those working in outpatient practices, hinting that the cumulative weight of clinical responsibility, and perhaps the isolation of ambulatory practice, shapes mental health trajectories in ways that deserve closer study.

The single most consequential number in the paper, however, may be the smallest. Among respondents who reported having been diagnosed with a mental illness, only 11 percent had disclosed that diagnosis to their licensing board. This disclosure gap sits at the heart of the study’s conclusion. Physicians in the survey overwhelmingly endorse the principle that mental illness is illness, that a colleague with depression deserves the same regard as one with diabetes, and that they themselves would trust a mentally ill physician with their care. But when the question shifts from abstract attitudes to concrete administrative exposure, telling the state board that grants and can revoke their license, nearly nine in ten of those with a diagnosis stay silent.

That silence is not difficult to explain, and the authors point to the structural incentives that produce it. Licensing applications in many jurisdictions still ask probing questions about psychiatric history, and physicians reasonably fear that disclosure could trigger scrutiny, monitoring requirements, or professional repercussions that far exceed what the underlying condition would clinically warrant. Concerns about confidentiality compound the problem: in a profession built on referrals, reputation, and small professional communities, the perceived cost of being labeled can be career-defining. The result is a system in which the people most knowledgeable about psychiatric treatment are among the least likely to seek it through formal, documented channels.

The study’s methodology deserves attention when weighing these findings. As a cross-sectional, anonymous survey at a single academic institution, it captures a moment in time rather than a trajectory, and its 277 respondents, while spanning the career ladder, cannot be assumed to represent physicians everywhere. Screening instruments such as the PHQ-2, GAD-2, and CAGE are designed to flag symptoms that warrant fuller evaluation, not to deliver diagnoses, so the positive rates should be read as signals of probable morbidity rather than confirmed caseness. Self-reported history of mental illness, meanwhile, depends on respondents both remembering and being willing to report a diagnosis. The authors were careful to build in ethical safeguards, with approval from the Valleywise Institutional Review Board under study number 2023-003 and procedures conducted in accordance with the Declaration of Helsinki, and the anonymity of the design was itself a response to the sensitivity of the subject matter.

Even with those caveats, the convergence of the data is hard to dismiss. The pattern, favorable attitudes coexisting with high symptom burden and minimal disclosure, is exactly what models of layered stigma would predict. Explicit beliefs can modernize quickly, driven by education, generational change, and public conversation, while the structural and internalized barriers that govern actual behavior change far more slowly. A medical student may sincerely believe that depression is a medical condition and still decline to answer a licensing question honestly, because the perceived stakes of disclosure operate on a different axis than belief. The gender differences in both diagnosed mental illness and problematic alcohol use further suggest that the pressures of the profession are not distributed evenly, and that wellness interventions calibrated to a generic physician may miss the populations carrying the heaviest load.

The authors close with a call that is both modest and urgent: accessible and confidential mental health resources, and continued wellness initiatives embedded in medical education and practice. The study was presented at the Annual Meeting of the Arizona Psychiatric Society in Phoenix in April 2024, and the researchers report no funding from pharmaceutical companies and no competing interests. What the findings ultimately expose is a gap between the culture physicians say they want and the system they actually navigate. Until licensing questions, confidentiality protections, and institutional support align with the attitudes that younger generations of clinicians already hold, medicine will keep producing professionals who believe in mental health care for everyone, except, in practice, for themselves.

Subject of Research: Physician mental health stigma, self-reported psychiatric illness, and screening for anxiety, depression, and alcohol use across medical training

Article Title: Physicians attitudes towards mental health and self-reported rates of anxiety, depression, and alcohol use

Article References: Loomba, N., Bhattarai, B., Ramos, G., Haerter, S., & Sood, S. (2026). Physicians attitudes towards mental health and self-reported rates of anxiety, depression, and alcohol use. BMC Psychiatry. https://doi.org/10.1186/s12888-026-08640-7

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08640-7

Keywords: physician mental health, stigma, anxiety, depression, alcohol use, medical students, residents, licensing boards, PHQ-2, GAD-2, CAGE questionnaire, BMC Psychiatry