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Understanding the Pros and Cons of Our Own Personal Self-Disclosure

July 20, 2019

By H. Steven Moffic, MD
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The opinions expressed by Psychiatry & Behavioral Health Learning Network bloggers and those providing comments are theirs alone and are not meant to reflect the opinions of the publication.

If you felt that you were developing burnout or some sort of diagnosable mental illness, would you tell someone at work about it? Why, or why not?

After all, we tell the public and patients that the stigma of mental illness would be reduced if they were as open about their mental problems as they were about other medical illnesses. And yet, the paradox is that we in the field of mental healthcare seem even more reluctant to self-disclose about conditions ranging from our own burnout to DSM 5 Mental Disorders.

Various reasons are given for this reluctance. It is common for colleagues to view this information negatively, thereby impairing workplace security and success. Depending on state regulations, self-disclosure may even threaten the license to practice. Personally, the potential self-disclosures may feel too much shameful to disclose, as if you were weak rather than strong for doing so. That shame may be why so many don’t recognize that they are among the epidemic of burnout in our field. Privacy, of course, is also important to many.

However, the negative results of not self-disclosing to colleagues at one’s workplace seem significant. Colleagues and patients may not understand the change in behavior. Helpful recommendations for care may not be shared. The opportunities for modeling mental improvement is lost. The quality of patient care is indirectly compromised when clinicians are suffering psychologically.

What is needed is finding ways to normalize self-disclosure without the negative consequences of so doing. This possibility is largely dependent on administrators and leaders making this happen in our relevant institutions via policies and procedures. 

Indeed, this is an ethical priority. In the American Psychiatric Association (APA) principles of medical ethics, the well-being of colleagues and self are clearly stated, though the needs of patients come first. On the APA website for wellness and burnout, I agreed to do a brief video on my own burnout and another colleague did so on her own depression. Perhaps our own well-being should even come first because the best patient care depends on it.

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