An epidemic of deaths and the response by medical school News of a suicide by an NYU medical student yesterday is another grim reminder of the pressures of medical school. Some have described the mental health issues in medical schools as an epidemic. Studies show over a quarter of medical students show some symptoms of depression. We invited medical schools from around the country to discuss this epidemic and what can be done about it. Nationally, what needs to be done to help students with mental health issues cope better with the pressures? Srijan Sen, MD, PhD, University of Michigan Medical School and principal investigator of the Intern Health Study, a longitudinal study of depression among interns nationwide:We certainly need to ensure that medical students have confidential and accessible mental healthcare. But with the rates of burnout, depression and suicide at epidemic levels, it is clear that we are dealing with much more of a system-level problem than an individual-level problem. We need to fundamentally redefine medical education so that healthy work-life balance is possible and so that training physicians can focus more of their time on the rewarding aspects of medicine and less on clerical and non-educational aspects. Kelly Holder, PhD, Director of Student Mental Health and Counseling, Department of Psychiatry, Penn State Health: Studies indicate that 27% of medical students show symptoms of depression (Rotenstein 2016), and perceived stress and risk of depression were found to increase from the first year of medical school to the third year (Ludwig 2015). Understanding this data and applying it to improve student outcomes is important. Additionally, research suggests that physicians are not readily seeking mental healthcare, and this stigma is being passed on to the next generation of physicians. As physicians begin to talk openly about mental health within medicine, we will then have a better understanding of how to address student issues and provide students with effective coping mechanisms. Lisa MacLean, MD, psychiatrist, Henry Ford Health System: The medical education community needs to acknowledge the stress imposed on our medical learners as they progress from students to faculty. One of the biggest obstacles is changing the culture of medicine to not only understand the key burnout drivers and pain points but to invest resources into developing strategies which reduce stress. These strategies must include the medical learner taking ownership for the role they play in their lack of well-being. In addition, medical schools and healthcare organizations must reflect on their policies/processes which do not promote wellness. In both situations, there is pointing to the other group as the one who needs to change. Both are right. We do need to change how we deliver a quality medical education AND we need our medical learners to reflect on their personal attitudes and openness to developing their resilience muscles to manage their stress. Equally important, we need to reduce the stigma of seeking help and break down the barriers which would allow our medical learners and physicians to seek help, when needed. We need to create support services which are convenient, accessible, and utilized. What programs does your school have to support medical students' mental health? Holder: At Penn State College of Medicine, in 2016 we consolidated and expanded mental health services for medical students by establishing the Office of Student Mental Health and Counseling. The office provides individual counseling, couples counseling, and psychiatric evaluation & medication management. Additionally, we provide a variety of programs and workshops on topics such as depression & suicide, anxiety, burnout, and stress management. Facilitated group discussions are held on a regular basis with the goal of providing a safe and open atmosphere to discuss the emotional and psychological challenges associated with being a medical student. Mental Health First Aid courses are offered throughout the academic year to students, faculty, and staff. The goal of using Mental Health First Aid is to improve mental health support and confidence in providing help, decrease stigmatizing attitudes for mental illness, and increase mental health literacy within the College of Medicine. K. Craig Kent, MD, Dean, Ohio State University College of Medicine: We offer our students many paths to support, including a full-time personal counselor; a part-time psychiatrist; peer-to-peer support; annual online mental health screenings with an opportunity for in-person follow up; dedicated, free physical fitness classes; a student wellness room; and a student-run support group for students with mental illness." Allison Knight, PhD, Associate Dean for Student Affairs and Director of Student Wellness at Eastern Virginia Medical School, Norfolk, Va.: Well-being has to be considered as important as having the technical skills and knowledge to be a medical professional ... We were one of the first schools to have a true curriculum, Student wellness is a guiding principle in our four-year longitudinal "CareForward" curriculum. We're trying to give students the self-care skills they need to flourish in their careers later on. MacLean: Students (at the Wayne State University School of Medicine) are all assigned a counselor through the Office of Student Affairs upon entry into medical school. For their tenure in the medical program, this counselor meets with students annually and more, when indicated, to discuss their well-being and academic progress. The SOM also has an embedded Wellness Curriculum which includes additional on campus resources for support as well as monthly Wellness events which are informational and community building. University of Michigan Medical School official statement: Every student is included in one of four "M-Home" learning communities which create regular opportunities for students to access support in multiple domains, with wellness being a "pillar" of focus. There is also a developing Peer-to-Peer mental health support network underway. Finally, each student is connected with a counselor who will expediently refer him or her to confidential mental health treatment when needed, either through our own Medical Student Mental Health Program (which matches students with faculty psychiatrists for evaluation and treatment), or with other confidential mental health treatment in the community. Source
