Psychological Distress in Medical Students: Practices and Barriers
Kristina Dale | October 18, 2019 | Care Providers, Educational Institutions
This post will discuss a peer reviewed article published in the Journal of Social Psychiatry and Psychiatric Epidemiology just this past month, in September of 2019. The article was written by Bartlett and Fowler, and is titled “Beyond the curriculum: a cross-sectional study of medical student psychological distress, and health care needs, practices and barriers.” The primary objective of this study was to explore various factors related to psychological distress in a sample of medical students.
What did they do?
The authors of the study assessed distress, predictors of distress, and health care needs and practices in a sample of 180 medical students with the primary goal of determining levels of psychological stress among medical students, as well as exploring factors that may be predictive to such distress.
Why did they do it?
It is well documented that medical students experience significantly higher levels of depression, anxiety, and general psychological distress compared to their age-related peers. This elevation of pathology is commonly hypothesized as being due to academic and social pressures, which is fairly intuitive. However, there has been far less attention paid to the unique barriers to care that medical students face. These issues include stigma associated with seeking mental healthcare, concerns of being perceived as vulnerable, and more, and often leave medical students in a place of reluctancy. This reluctance to seek treatment can have numerous downstream effects, including self-diagnosis and treatment, self-medicating, and/or substance use. As one can imagine based on the general findings outlined above, the existing research also reports elevated suicide rates among medical students compared to peers in the general population, which is a major concern. In order to address these concerns, the article we are discussing outlined 4 primary objectives:
- Establish the level of psychological distress in medical students
- Explore predictors of psychological distress
- Examine health care needs, concerns, and existing practices
- Consider potential barriers to care
How did they do it?
As mentioned earlier, the study we are discussing consisted of a sample of 180 medical students. The authors explained that they purposefully selected 3 matched groups that were assessed using the same measures as the present study to examine how well their measures were able to capture psychological distress among diverse samples. The 3 comparison groups represented the general Canadian population, full time university students, and individuals experiencing elevated difficulties with anxiety.
Psychological distress was measured using the Kessler Psychological Distress scale (K-10), which consists of 10 items that assess recent perceptions of mood, anxiety, and self-worth. The Perceived Medical Student Stress Scale (PMSS) and the Medical Student Health Survey (MSHS) were used to assess stressors specific to the medical school environment, and student’s experiences with healthcare and healthcare concerns, respectively.
What did they find?
Overall, female medical students had higher average scores on the K-10 compared to male students, and it was demonstrated that regardless of sex, psychological distress was higher for fourth year graduate students compared to those in any year prior.
Compared to the matched sample groups, medical students’ K-10 scores (Mean = 18.93) were significantly higher than the general Canadian sample (Mean = 5.94), the Canadian university/college student sample (Mean = 6.38), as well as the sample of Canadians with an Anxiety Disorder (Mean = 13.31). Regarding medical students’ experience with healthcare, this study revealed that 46% of students did not seek care, even when they required it, and 30% relied on internal consultation with peers due to their inability to take time off from school and training.
What does it all mean (our take)?
This interesting study provides tremendous insight into the highly distressing world of medical school. But, we knew that medical school was tough, right? Well...this study seems to suggest that medical school may actually elicit pathological behavior from students, above and beyond what would be observed across a variety of other comparison groups.
So, what can we do about it? Well...unfortunately we are not going to be able to change the rigorousness associated with medical school. But, we can do our part in continuing to decrease stigma. We can support leadership within medical school environments to promote mental healthcare, and help give them tools to effectively and affordably make sure that all of their students have access to some form of mental health care if they should need it.
With the use of technology and support from leaders, we at Mindyra feel that there actually is a solution to the ongoing problem associated with poor mental health, not just in medical school, but at all levels of academia. It’s time to get started!