Mental Health Awareness Month
Posted on Sep. 8, 2023 / DEIC / Subscribe 0
Mental Health Awareness Month Along with the academic and personal pressures medical students are subjected to, the global COVID-19 pandemic has deepened the challenges medical students face by adding unprecedented obstacles. According to a report from the Council on Medical Education, stress, burnout, and depression are risk factors for medical students, with severe consequences. The council reports that medical students are three times more likely to die by suicide than the general public. Hill et al., (2018) conducted a study about the stressors facing medical students in the millennial generation in the students’ own words. The stressors mentioned in the study included academic stress, issues with work-life balance, relationship conflicts, poor student guidance or support, volume of information, finances, uncertainty about the future, lack of time to oneself, responsibility and the need to be successful. In a study done by Siqueira-Campos et al., (2021), the authors examined the association between dysfunctional parenting styles and parental bonding styles on one hand and anxiety, depression, suicidal ideation, and self-efficacy beliefs on the other, in Brazilian undergraduate medical students. In the analysis adjusted for sociodemographic variables, maternal affectionless control was associated with a greater risk of anxiety, depression, suicidal ideation and low self-efficacy, while maternal neglectful parenting was associated with depression and paternal affectionate constraint with suicidal ideation among the students, all were statistically significant. The study confirmed that dysfunctional parenting styles are associated with mental illnesses and low self-efficacy in Brazilian undergraduate medical students, the thing that should be taken into consideration when treating medical students with mental disorders. Romo et al., (2020) stated that the teaching of human anatomy is often based on practices of cadaver dissection and prosected specimens, where exposure to human cadavers might be stressful and anxiety-inducing for students. The authors conducted a study to explore the degree of satisfaction and anxiety among first-year students in the Medicine, Occupational Therapy, Speech Therapy and Nursing programs at the Universidad de Castilla-La Mancha (Spain) who are experiencing their first dissection/prosection practice to develop stress coping strategies. The authors found that state Anxiety (SA) decreased significantly throughout the course (p < 0.05), from 20.7 ± 19.29 to 13.7 ± 11.65 points. Statistical differences (p < 0.05) in SA were found between the different health sciences, and pre-practice SA was significantly different from post-practice SA. The students with the highest pre-practice SA levels were nursing students (31.8 ± 33.7 points), but medical students had the highest post-practice SA levels (18.4 ± 12.82 points). The authors concluded that although students were satisfied with dissection practices, the experience can provoke stressful responses that must be addressed using advanced preparation and coping mechanisms, especially among medical and nursing students. According to Jacob et al., (2020), one of the most significant obstacles for medical students that stands between them and receiving help, is stigma, or a fear of compromising career progression and the pressures of medical training. Early detection and prevention programs were suggested in a study done by Puthran et al., (2016), in which it was mentioned that medical schools and health authorities should provide interventions for depression amongst medical students before graduation. The authors suggested speaking with a private therapist, consulting with a primary care physician, seeking a counselor through the school’s student health services, talking with a trusted colleague or faculty member and confiding in a family member or friends as ways of tackling the problem. The Royal Irish Academy of Music (RIAM) has developed the following ‘Standard Operating Procedures’ system to cope with students with suspected or established mental illness. 1. Directions for Staff in Urgent Cases 1.1 If you have reason to think a student might be a danger to themselves or to others: If you think this is a life-threatening emergency, you should contact emergency services: (i) Overdose or definite threat of self-harm: Request Ambulance. (ii) Student violent, armed, aggressive, or threatening: Contact Emergency. (iii) If you find after incident you are affected, you should talk to Administrative Officer (Registry), who can outline RIAM supports for staff. (iv) If the student withholds consent to contact medical services, consider contacting the services anyway. (v) Advising the student to contact their family is strongly recommended and, in urgent cases, contacting the family directly may need to be considered. (vi) The student’s wellbeing or safety and the wellbeing and safety of others take precedence over issues of confidentiality. Therefore, information may be passed on in these circumstances without the student’s consent. 1.2 If there is no immediate threat but the student still requires medical intervention. The student might be: (i) Expressing suicidal thoughts or wishing they were dead. (ii) Threatening to self-harm. (iii) Expressing bizarre thoughts or ideas. (iv) Unduly agitated or behaving in a bizarre manner. (v) If possible, consult with The Administrative Officer, Registry, or a colleague. Explain your concern to the student and ask would it be possible to contact someone on their behalf (unless you think these actions will exacerbate the situation). (vi) During Office Hours, seek consent of student to contact one an administration personnel. 2. Directions for Staff in Non-Urgent Cases 2.1 If you are concerned that a student is showing signs of distress: Do not avoid the situation! 2.2 Ask yourself: Do you think they are an immediate danger to themselves or others? (i) If yes, proceed to Section 1 above (Directions for Staff in Urgent Cases). (ii) If no, proceed to 2.3. 2.3 Be aware that the student may want to discuss sensitive issues with you and you should arrange to discuss matters with them in a setting where they can be assured of their confidentiality. 2.4 Inform the student about your concerns and reasons for them and listen to the student. The process of listening itself might be helpful for the student. 2.5 Be clear about what you can and cannot do: (i) You should not be expected to solve the problem. (ii) Try and ascertain the extent of the students’ problem and which one of the services might be appropriate to refer the student on to. 2.6 Ask yourself: Are you still concerned about the student? (i) If you are not sure, consider seeking advice from The Administrative Officer, Registry on further steps. If the student has disclosed information to you, you should protect their confidentiality by talking in general terms without naming them. (ii) If anything has given you reason to be concerned about the safety of the student or anyone else, you should treat this as urgent. See ‘Directions for Staff, Urgent Cases’ (iii) If you do not think there is an immediate danger, but you think the student would benefit from additional assistance, consider the options outlined at the end of this document. (iv) If you are satisfied that the student’s situation has improved, thank the student for meeting with you, and invite them to raise any future concerns with you or other staff or services. Consider arranging a follow-up meeting to keep the lines of communication open. It would be of utmost importance to apply a similar ‘Standard Operating Procedures” system to the one RIAM has in effect, in every medical and osteopathic medical school. Other ideas to relieve mental stress among medical students include setting realistic goals, and planning breaks into a student’s schedule, practicing stress-relieving activities such as yoga and meditation, creating boundaries from schoolwork, reaching out for support, spending more time outdoors and practicing self-care and regular exercise. Lastly, I believe that one of an educator’s responsibilities and gifts, that root out of their care towards students as well as from their experience, is to spot a student who is struggling mentally or emotionally, sometimes even before the student identifies with their own problem. Written by: Heba Labib MD, PhD, Assistant Professor of Preclinical Sciences, William Carey University, College of Osteopathic Medicine References 1. REPORT 6 OF THE COUNCIL ON MEDICAL EDUCATION (A-19) Study of Medical Student, Resident, and Physician Suicide (Resolution 959-I-18) (Reference Committee C). 2. Hill, M. R., Goicochea, S., & Merlo, L. J. (2018). In their own words: stressors facing medical students in the millennial generation. Medical education online, 23(1), 1530558. 3. Jacob, R., Li, T. Y., Martin, Z., Burren, A., Watson, P., Kant, R., & Wood, D. F. (2020). Taking care of our future doctors: a service evaluation of a medical student mental health service. BMC Medical Education, 20(1), 1-11. 4. Puthran, R., Zhang, M. W., Tam, W. W., & Ho, R. C. (2016). Prevalence of depression amongst medical students: A meta‐analysis. Medical education, 50(4), 456-468. 5. Romo-Barrientos, C., Criado-Álvarez, J. J., González-González, J., Ubeda-Bañon, I., Flores-Cuadrado, A., Saiz-Sánchez, D., & Mohedano-Moriano, A. (2020). Anxiety levels among health sciences students during their first visit to the dissection room. BMC Medical Education, 20(1), 1-7. 6. Siqueira-Campos, V. M., De Deus, M. S. C., Carneiro, L. A., Naghettini, A. V., Pereira, M. A. D., De Deus, J. M., & Conde, D. M. (2021). Dysfunctional parenting styles are associated with mental disorders and low self-efficacy beliefs in Brazilian undergraduate medical students. BioMed Research International, 2021, 1-10.
0 Comments