Commentary: West Virginia’s doctors and federal workers fear the paper trail

Along Interstate 79 in North Central West Virginia, two kinds of workers carry a quiet fear about their own mental health. One group is the physicians, nurses and other clinicians who keep the state’s hospitals and clinics open. The other is the federal workforce in Clarksburg, home of the FBI’s Criminal Justice Information Services Division, which the FBI describes as the largest division in the bureau.

Both groups depend on a credential: a medical license in one case, a security clearance in the other. And both tend to believe that getting help for stress, depression or burnout could put that credential at risk.

I am a licensed clinical social worker. I want to describe what that belief costs West Virginia, and why it is often more fear than fact.

The doctors West Virginians depend on

Physicians across the country worry about how mental health care might affect their license. In a national sample of 5,829 physicians published in Mayo Clinic Proceedings in 2017, nearly 40% said they would be reluctant to seek formal care for a mental health condition because of concerns about repercussions to their medical licensure.

In West Virginia, that fear has company. In a small town, the local counselor may also treat the doctor’s patients. The physician who is the only one for miles cannot easily sit in a waiting room. So many simply keep working, carrying the weight of a stretched health system on their own sleep, families and health.

The cleared workforce

People who hold security clearances face a parallel worry: that seeing a therapist will cost them their eligibility. The federal background form, Standard Form 86, says plainly that mental health treatment and counseling, “in and of itself,” is not a reason to deny or revoke eligibility, and that seeking care “may contribute favorably” to decisions. Its questions focus on court orders, hospitalization and a short list of serious diagnoses, not routine counseling.

Many cleared workers have never read that language. Some prefer to work with a clinician who knows the process, such as a psychologist experienced with security clearance questions, because they want someone who can speak to their specific concern.

Hiding is a calculation, everywhere

The pattern is not unique to medicine or federal work. In a 2026 CEREVITY review of law firm partners, covering 305 equity partners and senior counsel who sought therapy through the CEREVITY network, 67% said they had hidden mental health strain from their firm. People whose careers depend on being seen as reliable make the same decision again and again: say nothing, keep performing, deal with it later.

Later usually means a crisis. By then, the strain has moved into relationships, drinking and health, and recovery is harder.

What would help in West Virginia

Much of the fix is clear information.

Hospital systems and medical groups can tell their clinicians, in plain language, what the state’s licensing process does and does not ask about mental health, and can offer at least one confidential counseling option outside the hospital’s own systems.

Federal employers and contractors in the Clarksburg area can put the Standard Form 86 language in front of their staff, and security officers can say out loud that counseling is not a disqualifier.

Leaders in both worlds can say, without details, that they have used care themselves.

And individuals can use telehealth to see a licensed clinician outside their own town and professional circle, which removes the waiting room problem entirely.

West Virginia cannot afford to lose the people who keep its health care running or the federal professionals who work in Clarksburg. Helping them seek care early, without fear for their credentials, is one of the least expensive ways to keep them.

If you or someone you know is in crisis, call or text 988 at any hour.

Disclosure: The author is a co-founder of CEREVITY, a private-pay therapy network that provides confidential care to professionals.