When healthcare workers need mental health support, they should be able to seek it without fear of professional consequences. Yet for too long, credentialing applications have included intrusive mental health questions that deter professionals from getting help when they need it most.

Many healthcare institutions ask broad, stigmatizing questions about past mental health treatment. The consequences are serious: healthcare workers avoid seeking mental health care, suffering in silence while their risk of burnout and suicide increases.

Today, we're speaking Jessica Gotjen Seth, Director of Medical Staff Services at Brown University Health, who has helped make some important changes. She will share with us the process they took to protect provider well-being while maintaining high standards of patient care. This work demonstrates that supporting healthcare workers' mental health benefits providers and improves patient care. 

We’re excited to know that these changes are happening & how they will improve the well-being of our learners and faculty.

What specific observations or experiences led your organization to recognize the need for reviewing credentialing forms for mental health stigma?

Our organization recognized the need to review credentialing forms for mental health stigma after hearing firsthand accounts from clinicians who hesitated to seek mental health care due to concerns about how disclosures might impact their licensure, credentialing, and career advancement. National data, including research from the Dr. Lorna Breen Heroes' Foundation, reinforced these concerns, showing that overly broad or stigmatizing questions about mental health history contribute to a culture of fear and silence among healthcare professionals.

Through our teams’ work at the state and local levels, we identified areas where credentialing language may exceed necessary fitness-for-duty assessments, discouraging providers from accessing care. By aligning with best practices and national recommendations, we advocated for reforms that focus on current impairment rather than past diagnoses. These changes support a culture where seeking mental health care is treated the same as any other medical need—without fear of professional consequences—ultimately fostering a healthier, more resilient workforce.

How did you successfully build support among leadership for this initiative?

The initiative to remove intrusive mental health questions from the credentialing applications was actually driven by our Physician Leaders, Dr. Jeffrey Gaines, Chief Medical Officer of Newport Hospital and Dr. Karyn Horowitz, Chief Medical Officer of Bradley Hospital both Chairs of the Brown University Health Physician Wellness Council.  They recognized the importance of creating a more supportive and inclusive environment for our medical staff and understood that addressing mental health with sensitivity was key to fostering this atmosphere. They approached me about the topic after learning about the Lorna Been Initiative, whose mission is to reduce burnout of health care professionals and safeguard their well-being and job satisfaction. In response, we formed a small workgroup to begin a thorough review of our credentialing process. Leadership recognized the importance of creating a more supportive and inclusive environment for our medical staff and understood that addressing mental health with sensitivity was key to achieving this.

What kinds of changes did you make to the forms and questions?

We did a comprehensive review of our credentialing applications, reference and affiliation questionnaires to identify areas that referenced mental health. We then worked to revise the language to make it less intrusive and be more of an attestation rather than a question about their overall health status. We also involved our  HR and legal departments to ensure all revisions aligned with legal and regulatory requirements.

How did you let your medical staff know about these changes?

We communicated our efforts widely to our Medical Staff and Advanced Practice Provider members to show support and ensure they felt safe seeking the mental health care they may need, without fear of repercussions in the credentialing and privileging process. In addition, we raised the topic at our Medical Executive Committees.

What positive results have you seen since making these changes?

When we communicated our efforts, we've received a lot of positive feedback from our Medical Staff and Advanced Practice Providers. Many expressed that they felt supported by both our leadership and the organization. Additionally, I've noticed a shift across the organization where people are more intentional about checking in on one another, asking how their colleagues are truly feeling, and showing genuine care for the answers. This shift toward more open and compassionate communication has fostered a stronger sense of camaraderie and well-being throughout the organization.

What advice would you give to other organizations wanting to do the same thing?

My advice would be to take the time to educate yourself and your leadership to the Lorna Breen Initiative and put in the time to review all relevant applications, reference forms, and affiliation questionnaires to identify areas where mental health is referenced and assess whether the language is intrusive.  Once you make the changes be sure to share the knowledge with your providers, so they are aware of the changes that were made and understand the rationale behind the initiative.