When Protection Creates Risk: Licensing Reform and Mental Health Stigma in Health Care

For many in health care, burnout and emotional fatigue have become an accepted occupational hazard. But one factor quietly sustaining that fatigue is less about workload and more about fear. Specifically, the fear that seeking mental health support could jeopardize a clinician’s license or employment.

At Candello’s 2025 Summit, Dr. Stefanie Simmons of the Dr. Lorna Breen Heroes’ Foundation delivered a presentation that reframed this problem as a patient-safety issue. Her session, Reducing Stigma through Licensing and Credentialing, challenged insurers, credentialers, and leaders to examine how licensing and credentialing language can inadvertently compromise both clinician wellbeing and safe patient care.

Dr. Simmons emphasizes, “There needs to be time left for caring—doctors and nurses are not machines, but human beings caring for other humans. [We need to] dismantle the stigma for receiving mental health care.”

A Story That Illustrates the Risk

Early in her career as an emergency physician, Dr. Simmons treated a three-year-old who arrived unresponsive and could not be revived. She comforted the mother in the aftermath, only to be called weeks later to testify in court when the mother was accused of the child’s murder. Pregnant at the time, Dr. Simmons considered therapy but didn’t seek it. She knew her state’s licensing application asked whether she had ever been treated for a mental health condition, and she feared the professional consequences.

Her story is not rare. For too many clinicians, the safest professional choice is silence. The result: untreated distress, escalating burnout, and preventable harm.

The Systemic Impact

Clinicians’ mental health directly affects diagnostic accuracy, communication, and clinical judgment, all of which are core patient safety drivers. Yet the data show persistent deterrents to care:

• Licensing concerns remain among the top three reasons clinicians avoid mental health services.
• In 2022, 46 percent of health-care workers reported burnout, and 44 percent planned to leave their jobs.
• Health-care workers report more poor mental health days per month than workers in any other industry.

For malpractice insurers and health system leaders, these numbers translate to elevated risk exposure, including staffing instability, higher claim potential, and system-wide safety threats.

Asking the Right Question

The intent behind licensing and credentialing is to protect patients. But as Dr. Simmons asked: Are we protecting patients or protecting the paperwork?

Traditional forms often ask, “Have you ever been diagnosed or treated for a mental-health condition?” The implication is that past care signals present risk. In reality, untreated illness is the risk. The Foundation recommends a concise, behavior-based alternative:

“Are you currently suffering from any condition for which you are not being appropriately treated that impairs your judgment or that would otherwise adversely affect your ability to practice medicine in a competent, ethical, and professional manner? (Yes/No)”

This single question aligns with core ethical principles—beneficence, non-maleficence, and justice—while reinforcing parity between mental and physical health. It promotes transparency without punishment and supports earlier intervention.

Progress Across the Country

The Dr. Lorna Breen Heroes’ Foundation founded the ALL IN: Wellbeing First for Healthcare coalition that offers free resources to institutions and has also made measurable national progress:

• Partnering with 35+ organizations through the ALL IN Coalition.
• Launching the Wellbeing First Champion Challenge program to recognize institutions removing intrusive questions.
• Supporting state-level reform in six states.
• Providing free toolkits for health systems to audit and revise their forms.

As of September 19, 2025:

• 60 medical, dental, nursing, and pharmacy licensure boards have eliminated intrusive mental-health questions—benefiting more than 1.85 million licensed health workers.
• 1,850 hospitals, clinics, and other care facilities have updated their credentialing applications.

Additionally in October 2025, the first two professional liability carriers, Curi and EmPRO Insurance, have been recognized as Wellbeing First Champions for verifying their applications do not include intrusive mental health conditions.

While this progress is encouraging, much work remains. Learn how to bring this work to your organization.

Looking Ahead

Originally passed in 2022, the Dr. Lorna Breen Health Care Provider Protection Act authorized the Department of Health and Human Services (HHS) to fund mental health initiatives through grants to qualifying organizations, national awareness campaigns, and research and reporting activities that support these efforts. The Act is now up for reauthorization in the current congressional session.

The challenge and opportunity for insurers and health systems is to lead this cultural shift from compliance to compassion. As Dr. Simmons reminded the audience, “Systems should assist, not punish, providers for taking care of themselves.”