Medical histories are often intimately private information. Often, people don’t feel comfortable disclosing this information to those outside of their immediate family, so would you feel comfortable sharing your private medical history with a room full of strangers? Probably not. This discomfort only grows when those individuals can judge you based on that history in ways that impact your life.
Across the country, professionals ranging from physicians to plumbers are, for good reason, becoming wary of disclosing their mental health statuses to licensing boards. They fear even having a minor and insignificant mental health history could prevent them from practicing their trained occupation.
This problem is prevalent in Utah. Within the state, licensing boards may consider psychiatric evaluations when determining if an individual can be licensed.
At first glance, this may seem reasonable. After all, nobody wants a police officer or their doctor to have major mental health problems that could jeopardize the community they serve. However, what is often overlooked is that individuals with severe mental health problems, that would endanger those they serve, would most likely be unable or unwilling to receive an occupational license due to their extensive application requirements. If someone was able to get licensed despite high barriers to entry, the market would then act as a safety net. The market would demonstrate to consumers, through customer reviews, etc., that these individuals are not professionals who should be receiving business at that particular moment.
The consequences of licensing boards considering psychiatric evaluations include potential privacy and HIPAA violations by government officials, labor shortages, worsening mental health outcomes, and legal concerns in relation to The Americans with Disabilities Act (ADA).
Concerns involving privacy, the ADA, and HIPAA arise from the fact that further questions may be asked following psychiatric evaluations. The state licensing board can require additional medical and mental health records, including intimate details about your upbringing, family, and spouse that one may have divulged in private psychotherapy sessions. Licenses may be contingent upon sharing these records.
A further illustration of the previously mentioned consequences is from a 2016 survey of female physicians. This survey showed that half of the participants believed that they had met the criteria for a mental illness but had not sought treatment, in part due to fear of reporting to state licensing boards. Additionally, in 2011, a survey of surgeons found that one in sixteen had thought of suicide; of those, more than sixty percent had concerns about losing their medical license. This is a problem that most likely extends past physicians. People in many professions may be wary of addressing mental health disorders or reporting them due to fear of losing their license. This may harm the consumers such professionals serve as well as the physicians themselves.
Under the current system, Utah is disincentivizing already licensed individuals and those seeking licenses from seeking treatment for mental health issues and from entering the workforce. This practice endangers both consumers and practitioners more than letting someone with minor mental health issues enter the workforce.
Policy Associate
Ben was a Policy Associate at Libertas Institute.