Early recognition and preventative steps can be key to staving off psychological distress among students
We’ve long heard about the rising rate of depression among the general public, and in particular among both doctors and medical students. It is particularly troubling that in a sector that professes to care about people holistically, we the carers find it hard to be cared for.
In 2013, a beyondblue study confirmed that medical students and doctors experienced higher rates of psychological distress than the general public, and higher rates of suicidal ideation as a result. This is not something we should be silent about, nor should we accept it as an inevitable part of a difficult job. Simply put, we need to be proactive early in the medical student curriculum to help protect students and junior doctors.
A good place to start is encouraging all medical students to have a good relationship with their GP. This is something we advocate for all our patients, but it is especially important for medical students.
Many medical students have travelled interstate, or even to other countries, to attend medical school, leaving many of their support network behind.
These students should be encouraged to establish a baseline relationship with a GP even in the absence of any ailment. Depression and other mental illness can hit anyone at any time, and it’s not good enough for us to think, “it won’t happen to me”.
Medical students also need to learn how to recognise the signs of burnout and depression. Useful tools, such as the K-10 questionnaire, can be used as a screen. Additionally, programs that build resilience, and incorporate aspects such as mindfulness, have been shown to be protective of mental health. In my opinion, such programs should become mandatory in every medical curriculum.
Medical students need to be able to take time off to work on their own mental health. The high demands of full-time study, often accompanied by part-time work or research, means that students are often time-poor. In some medical schools, mental health leave is encouraged and the processes for applying for it are very simple. This should be encouraged in all medical schools.
In 2017, depression is the focus of World Health Day, signifying its rise to the number one contributing factor to disability in the world. Fortunately, we’re starting to learn what works. For medical students and doctors, the focus must be on decreasing the stigma associated with getting help – and luckily there is a lot of help out there. Organisations such as Lifeline, the Black Dog Institute, Headspace and the state-based Doctors’ Health Advisory Services are all brilliant places to start.
When seeing medical students in general practice, it’s important to be vigilant for signs of mental illness, often masked by attendance for unrelated issues or physical manifestations.
It is also always worth doing a quick screen for mental-health issues, as the earlier they are detected and treated, the less disruption they tend to cause.
Small interventions can lead to great successes in this area. Universities need to be aware of the issue and provide evidence-based services to students.
Anonymous counselling and on-campus support must be extended so they’re available to students who are primarily off-campus in clinical rotations.
Attending medical school can be a difficult adjustment and cause a large amount of stress and distress. Recognising this early, taking preventative steps and supporting our colleagues to seek help are important factors in forming good habits, ensuring that young graduates are given the tools to be successful in the difficult world of medicine.
Rob Thomas is President of the Australian Medical Students’ Association and a penultimate year student at the University of Queensland
Twitter: @robmtom
Email: rob.thomas@amsa.org.au
