The highly regarded Journal of the American Medical Association has published a comprehensive review examining the prevalence of depression, depressive symptoms and suicidal thoughts among medical students.
The pooled findings of 195 studies from 47 countries demonstrated that the mental health of medical students is a significant global problem. Overall, around a quarter of students screened positive for symptoms of depression, and one in ten reported suicidal thoughts. The authors said that these estimates are around two to five times higher than those reported in the general population.
While this report has caused a notable stir in the medical academic community, sadly it adds to a body of existing evidence. Concerns about unacceptable levels of mental health problems in medical trainees have been voiced for decades. The current study follows a 2015 publication by the same group, in which they reported prevalence of depressive symptoms in trainee resident physicians of almost 29%.
Recent evidence shows that Australian medical students also face mental health problems. Beyond Blue conducted the first nation-wide study in 2013. Of 1,811 medical students surveyed, one in five reported suicidal thoughts over the previous year, and 40-50% experienced emotional exhaustion and symptoms of depression and/or anxiety above case level (as measured by the General Health Questionnaire). The documented rates of distress and suicidal thoughts were significantly higher than those of the Australian population and other professional groups.
Collectively these findings present serious cause for concern. It is clear that training to become a doctor is associated with a high personal burden of mental health problems. But there are ramifications beyond the personal level, with research documenting significant links between the mental health of medical professionals and the overall effectiveness of health care, including patient safety. In the medical context, ensuring good mental health in trainees is central to addressing and improving the future health of Australia as a nation.
Why then has this problem remained unaddressed for so long? Perhaps it’s habit. Medical training continues to reinforce the idea that the profession is demanding and that doctors should be invincible and immune from the effects of stress.
Significant stigmatising attitudes of doctors and medical students in regard to the competency of colleagues with known mental health conditions have been documented. These attitudes lead to underreporting of mental health problems and impede appropriate help-seeking behaviours. Notably, this new systematic review found that only 16% of students who screened positive for depression actually sought professional help.
