Fear of the Impaired Practitioner, Mandatory Reporting, and Clinician Suicide: A Lived Experience of Fitness to Practice Investigation as a Student

Abstract

This article will explore the embedded culture of professional mental health stigma within the mental health professional workforce in Australia, and issues stemming from regulatory complaints processes (i.e., fitness to practice investigations) that translate into workplace stigma, placing mental health workers and student trainees at increased risk for fear and avoidance of help-seeking, isolation, burnout, and suicide. It will discuss the ethics of mandatory reporting of clinician impairment for mental health concerns, and how this compounds risk for vulnerable people, heightens masking of mental health concerns, leads to isolation, and barriers for help-seeking, and paradoxically, heightens risk to the public. The issues faced by clinicians and student trainees with Lived Experience of mental health concerns will be explored, including self-disclosure of Lived Experience of mental health concerns, diagnoses, and/or service-use in the workplace or tertiary settings; stigma and discrimination in health and mental health work and education settings and cultures of shame and ableism. Issues surrounding mandatory reporting for "impairment" and fitness-to-practice investigation, and the ethics and safety of mandatory reporting processes will also be explored. This article will use autoethnographic research methods of the author's own experience as a student subjected to the Australian Health Practitioner Regulation Agency (AHPRA) fitness-to-practice investigation and vexatious complaint, to support the literature and fill in gaps, as real-world illustration of these issues. Finally, suggested adaptations to AHPRA's investigations program and the mandatory reporting process will be discussed.