Medical schools need to better recognize mental illness in students

At lunch recently, a few of us got into the topic of mental health in medical school. The conversation started when someone brought up the fact that a Harvard College senior and a Harvard Law School student had both recently committed suicide.

We all worried that the medical school wasn’t doing an adequate job caring for students who may be suffering from mental illness. To be fair, University Health Services does provide mental health care and there are fliers posted around offering help for those who are struggling. But I don’t think these go far enough. Someone who has depression or anxiety 1) may not recognize that they have a problem and 2) may not feel the need to seek help. One of the main problems I see is a lack of education and awareness among us med students about the dangers, signs and relevancy of mental illness and how we can best look out for our own peers as well.

This problem is not new nor isolated. Physicians have traditionally experienced higher rates of suicide than the general population – 40% higher for male doctors and a whopping 130% for female doctors. Students who enter medical school with a relatively “normal” mental health profile, in the end, suffer a higher rate of burnout, depression and other mental illnesses. In fact, over the course of med school, up to a quarter of students may suffer from depression and over half from burnout. The reasons for such higher rates include feeling the need to succeed, social isolation, and an unwillingness to show signs of weakness. Unfortunately, many studies have shown that feelings of depression and burnout may lead to unprofessional behaviors and loss of empathy.

Med schools have gotten better at fostering the welfare of their students, but more can be done. Although I’ve only been here for less than a year, there have been times when I’ve felt alone or let the pressure and stress of school get to me. I’m lucky to have close friends whom I can talk to, which, I think, is a great way to address mental health issues. I especially admired a classmate of mine when he shared in tutorial that he suffered from depression in college. It definitely did not make me see him in a lesser light, but rather I felt a strange sense of connection with him.

Schools can bring out into the open a vulnerable issue by increasing awareness and teaching students how to recognize mental illness in themselves and their classmates. By learning how to recognize mental illness, we can help ourselves and others foster a culture where having a mental illness is not synonymous with being weak and where we all work together to make sure our classmates are ok.

Eric Lu is a medical student who blogs at Elusions.

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  • Jim

    I don’t think the problem lies in recognizing burnout or depression in oneself (or even a classmate – we all know someone who has become depressed or withdrawn).  After all, we as a whole seem to have no problem identifying depression & burnout on questionnaires, but gather a group of medical students and ask them to say aloud that they are/have been burnt out & depressed and surely the numbers would not be in accordance with the research.

    You touch upon the real issue in the following paragraph – unwillingness to show weakness.  It’s the culture of medicine & particularly medical school.  Until we change that, I believe this will continue to be a problem.

  • David Lawrance

    Consider that one of every two highly-performing undergraduate students will find themselves stuck for the very first time in their lives in the bottom half of their medical school class. We live largely in our heads, it has always been our intellect that we valued about ourselves, and now that feels extremely threatened. 

    Expenses are tremendous yet there is minimal income. It can economically difficult for young families to deal with.

    It is a lonely experience composed largely of reading, rereading, drill and practice, in up to nine simultaneous classes. Spouses, parents, and friends find it difficult to relate. The teaching itself is disjointed, taught by a faculty of seemingly thousands who would appear to have never met each other before or to completely figured out how to present a coherent curriculum.The deck is stacked in favor of melancholy for many. But, it is a self-imposed angst. There is no shame in being in the lower half of the class. One doesn’t have to abandon families in favor of books. Family can make everything bearable.Then, after graduation, they call all of us doctors.Medical schools and their supporting student health and counseling centers understand the medical student experience. Goodness, we learned the hard way by going through the experience ourselves. Don’t shut us out. We teach you the signs in class. We teach you the psychodynamics. Mood disorders happen. They are treatable. Outcomes are virtually always excellent.

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