Okay, something does not make sense here. Why do med students, who are obviously in a stressful and competitive environment for several years, have a high rate of depression and suicidal tendencies? For some reason, one would think that with all that medicine, therapy and peer training surrounding them, persons would have more outlets and methods to ease depression and anxiety. However, med students are less likely to receive the proper treatment for mental health, more often than not because of the stigma associated with depressive symptoms. In the September 15, 2010 issue of JAMA, which is a special edition dedicated to medical education, this topic is discussed.
Thomas L. Schwenk, M.D., of the University of Michigan, Ann Arbor, and colleagues begin:
Medical students experience depression, burnout, and mental illness at a higher rate than the general population, with mental health deteriorating over the course of medical training. Medical students have a higher risk of suicidal ideation and suicide, higher rates of burnout, and a lower quality of life than age-matched populations. Students may worry that revealing their depression will make them less competitive for residency training positions or compromise their education, and physicians may be reluctant to disclose their diagnosis on licensure and medical staff applications.
Schwenk and others chose to go to the 769 medical students at University of Michigan between September and November 2009, and looked deeper into the levels of self-reported suicidal thoughts and depression, and dove deeper into what students thought others think of them when they make these mental ailments known. A good percentage of students participated in the study (65.7% or 505).
The number of depressed and suicidal students were clear. Depression existed in 14.3% of medical students in 2009 on the Michigan campus. Interestingly, double the number of women reported moderate to severe depression than the men. Twenty-two of the 505 student participants, or 4.4%, reported suicidal thoughts while taking classes. One and two year students were far less likely to report suicidal ideation then their year three and four counterparts (1.4% vs. 7.9%).
It is known that it is of utmost importance for persons to seek help when depressed or suicidal. However, many medical students fear the impression that reaching out will generate.
The authors wrote:
Students with higher depression scores felt more strongly than did those with no to minimal depression that telling a counselor would be risky and that asking for help would mean the student’s coping skills were inadequate. Those with moderate to severe depression scores also agreed more strongly that, if depressed, others would find them unable to handle medical school responsibilities (83.1 vs. 55.1%). Medical students with moderate to severe depression scores more frequently reported feeling that, if depressed, fellow medical students would respect their opinions less than did those with no to minimal depression (56 vs. 23.7%).
Male students had the belief that depressed colleagues could potentially endanger patients (36.3%), while women felt this way at a much lower percentage of 20.1%. More early year students (34.1%) felt that if they sought out help, they would feel less intelligent and capable in their studies. Year three and four year students agreed at a rate of 22.9%.
The Michigan University authors conclude:
These results suggest that new approaches may be needed to reduce the stigma of depression and to enhance its prevention, detection, and treatment. The characteristics of medical education emphasizing professional competence and outstanding performance might be explored as reinforcing, rather than potentially sabotaging, factors in the creation of a culture that promotes professional mental health. The effective care of mental illness, the maintenance of mental health and effective emotional function, and the care of professional colleagues with mental illness could be taught as part of the ethical and professional responsibilities of the outstanding physician and become a critical component of the teaching, role modeling, and professional guidance that medical students receive as part of their curriculum in professionalism.
Written by: Sy Kraft, B.A. – Journalism – California State University, Northridge (CSUN)