Security Clearance Holders Are Avoiding Therapy for No Good Reason

By Elijah Fernandez

Washington runs on people who hold security clearances, and a quiet belief runs through that workforce: that seeing a therapist could cost them their clearance.

So many of them do not go. They carry stress, grief, insomnia and burnout through years of demanding work rather than risk a question on a form. I have spent about 20 years in healthcare IT, and I hold the CISSP security certification. From a security standpoint, that choice is backwards.

Start with what the form actually says. Section 21 of the Standard Form 86, the Questionnaire for National Security Positions, revised in November 2016, opens with this: “Mental health treatment and counseling, in and of itself, is not a reason to revoke or deny eligibility for access to classified information.” It goes further: “Seeking or receiving mental health care for personal wellness and recovery may contribute favorably to decisions about your eligibility.”

The questions that follow are narrow. They ask whether a court or administrative agency has ever declared you mentally incompetent or ordered you to consult a mental health professional, whether you have ever been hospitalized for a mental health condition, whether you have ever been diagnosed with one of a short list of specific conditions such as psychotic disorder, bipolar mood disorder or borderline personality disorder, and whether you have a condition that substantially and adversely affects your judgment, reliability or trustworthiness. Counseling for stress, grief or burnout is not on that list. Anyone unsure should read the current form for themselves and talk with their security officer.

Yet the fear persists, and it is not unique to this workforce. A review of 144 studies covering more than 90,000 people found that fear of others learning about treatment is the most commonly reported stigma barrier to seeking help, and that people in military and health professions were disproportionately deterred. Cleared professionals carry their own version of that fear into every reinvestigation.

There is a second problem: the people under the most strain often look the least strained. CEREVITY's 2026 High-Achiever Burnout Index calls it the Performance Paradox. In high achievers, output stays stable, or even improves, while the internal experience of work deteriorates. Any check that waits for performance to drop never fires. A cleared analyst or program manager can deliver every briefing on time while sleeping four hours a night.

That is where the security logic turns around. Hidden, untreated strain that builds for years because someone misread a form is a far bigger concern than a record of getting help early. The form itself says as much.

Agencies and contractors can fix the incentive with three steps.

Say it plainly and often. Security officers and managers should walk new hires and people facing reinvestigation through Section 21 line by line, so employees hear from their own chain that counseling is not disqualifying.

Make confidential care easy to reach. Cleared employees should have access to care that does not run through a supervisor or a shared employer system, so using it does not depend on trusting the whole office.

Model it from the top. When senior leaders say they used counseling during a hard stretch, everyone below them gets permission to do the same.

The government already wrote the right words into the form. The job now is getting the people who fill it out to believe them.

Elijah Fernandez, MSW, PMP, CISSP, is co-founder and CTO of CEREVITY, a private-pay concierge network of independent licensed clinicians built for high achievers. He has spent about 20 years in healthcare IT, including as director of IT operations at a national mental health company, and holds a Master of Social Work from the University of Southern California. The views expressed are the author’s own.