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Mental Health Self-Care in Medical Students: a Comprehensive Look at Help-Seeking

  • Empirical Report
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Abstract

Objective

The authors characterize medical student help-seeking behaviors and examine the relationship with stress, burnout, stigma, depression, and personal health behaviors.

Methods

In 2013, the authors administered an electronic survey of all enrolled students at Yale School of Medicine (183 responders, response rate = 35 %), inquiring about students’ primary medical and mental health care, personal health behaviors, support systems, and help-seeking behaviors. Students completed the Attitudes to Mental Health Questionnaire, the Patient Health Questionnaire-2, and a modified Maslach Burnout Inventory. The authors analyzed the results with logistic regression, the Wilcoxon rank-sum test, the Kruskal-Wallis test, or a test for significance of Kendall rank correlation.

Results

Most students reported having a primary care provider (PCP), yet few reported seeking care when sick (33 %). Nineteen percent of students reported having a mental health provider, fewer than reported having a PCP (p < 0.0001). Twenty-five percent of students reported increased mental health needs since beginning medical school, and these students were more likely to agree that their needs were untreated. The majority of students endorsed stress, which correlated with increased and unmet mental health needs (p < 0.001). Burnout peaked in second- and third-year students and correlated with stress and increased and untreated needs. Most students reported comfort with asking for academic help; those uncomfortable were more likely to have mental health needs for which they did not seek treatment (p = 0.004). Mental health stigma was low.

Conclusions

Medical students had a significant unmet need for health care, influenced by barriers to accessing care, stress, burnout, and depression. Academic help seeking and supportive faculty relationships appear related to mental health treatment seeking. Targeted interventions for stress and burnout reduction, as well as incorporation of reflective practice, may have an impact on overall care seeking among medical students. Future studies should expand to other medical and professional schools.

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Acknowledgments

We sincerely thank the participants who volunteered to participate in these studies. We thank the Yale University School of Medicine, the Yale Teaching and Learning Center, the Yale Department of Psychiatry, and the Yale Center for Analytical Sciences, particularly William Casey King, for their support. We also thank Drs. Nancy Angoff and Janet Hafler for reviewing the survey and the manuscript.

Funding

This study was funded by a grant from the John A. Majda, M.D. Memorial Fund and the Yale Department of Student Research Lowe Endowment Funds. This publication was made possible by CTSA Grant Number UL1 RR024139 from the National Center for Research Resources (NCRR) and the National Center for Advancing Translational Science (NCATS), components of the National Institutes of Health (NIH), and NIH roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH.

Disclosures

The authors have nothing to disclose, including financial or personal relationships with individuals or entities that may influence this work.

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Authors and Affiliations

  1. Stanford University School of Medicine, Stanford, CA, USA

    Jessica A. Gold

  2. Yale University School of Public Health, New Haven, CT, USA

    Benjamin Johnson

  3. Yale University School of Medicine, New Haven, CT, USA

    Gary Leydon, Robert M. Rohrbaugh & Kirsten M. Wilkins

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  1. Jessica A. Gold
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  2. Benjamin Johnson
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Correspondence to Jessica A. Gold.

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Gold, J.A., Johnson, B., Leydon, G. et al. Mental Health Self-Care in Medical Students: a Comprehensive Look at Help-Seeking. Acad Psychiatry 39, 37–46 (2015). https://doi.org/10.1007/s40596-014-0202-z

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  • DOI: https://doi.org/10.1007/s40596-014-0202-z

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