“Mental illnesses are as important as visible illnesses,” our professor said as she stood at the podium.
She mentioned how many mental illnesses are silent killers because many people do not present with symptoms until it is too late.
“It is crucial as future physicians that you learn the signs and symptoms so that you can recognize them in your patients,” she said as her eyes scanned the lecture hall.
As I reviewed the notes, it occurred to me that many of my peers and I have displayed some of the signs and symptoms of mental illness. Our professor’s lectures emphasized the importance of recognizing these features in patients, but what about identifying them in ourselves? Should it also be our duty to recognize the signs and symptoms in our colleagues?
Between 25% and 40% of primary care visits involve a range of patients dealing with mild or self-limiting anxiety, depression and adjustment reactions but many others dealing with severe psychological complications. With the recent changes in our culture, people are seeking treatment for and talking more freely about their mental health issues. The National Alliance on Mental Illness (NAMI) states that in 2018, 64.1% of adults with a serious mental illness, and 43.3 % of adults with mental illnesses received treatment.
This is a great development. However, while the overall stigma of mental illness worldwide is decreasing, the stigma still remains prevalent among those in the medical community. Fifty-four percent of physicians feel mental health is a taboo topic to discuss. Medical professionals are not exempt from experiencing a mental illness simply because they can help treat it. In fact, medical professionals may be more vulnerable to mental illness due to the nature of their professions.
Medical professionals like doctors and nurses are tasked with taking care of people and modeling exemplary health-related behaviors. Anyone who has experience in the medical field knows that the stakes are high and that one must always be at the ready. These unrealistic expectations can create an undue burden for those involved in direct patient care. Oftentimes, there is a lack of resources such as counseling, support groups or respite, to combat this issue. Medical professionals face a tremendous amount of pressure at work leading to higher rates of burnout and extreme stress. Seventy-four percent of physicians have reported seeing symptoms of burnout in their colleagues. Furthermore, while more than 51% of physicians mention that their workload impacts their mental health, only 17% have sought help.
Looking at these statistics, one has to wonder where these health concerns arise. It is a complicated issue, and for many of my peers, the crisis of mental health arises in medical school. No one can deny the intensity and demanding nature of medical school. Medical students lack the time for adequate sleep, eating properly, exercising and maintaining a healthy support system. All of these factors can lead to a toxic cycle of anxiety, stress and depression. According to a study in the Journal of American Medical Association, 27% of medical students exhibit symptoms of depression, but only 16% seek psychiatric help.
There are many reasons why students do not seek help when they need it. Some students feel like there are not enough hours in the day to seek out help. Medical schools can take an active role in helping to reduce student stress and anxiety, and ultimately alleviate concerns that students don’t have the time to address their mental health concerns. Many have proposed changing the grading system to pass/fail, reducing the amount of material covered in lecture and even decreasing the amount of time spent in lectures. These are all great ideas that will allow students to take time for themselves and pursue mental wellness resources if they feel like it’s necessary. Furthermore, by implementing practices such as having therapy appointments outside of business hours when students might be stuck in classes or clinical rotations, medical schools can demonstrate support in providing students with the time they need.
Another reason why students might not seek help is fear of the stigma. Medical schools have the ability to implement changes that can benefit students by promoting student wellness and support. For example, Saint Louis University School of Medicine (SLU) promotes student interests in correlation to medicine though learning communities focused on service, advocacy, research, global health, wellness and more through non-graded elective courses. SLU believes that this will allow students the opportunity to form meaningful relationships and allow the school to implement stress management and coping mechanisms into the curriculum. SLU is one of many medical schools hoping to expand conversations around mental wellness.
It is equally important for these institutions to allow students to have access to a mental health service on campus as well as provide adequate funding so that these services are fully staffed with counselors. Currently, there needs to be more research on how effectively medical schools are able to provide this resource, and whether fully staffed counselors can help lower the mental health stigma. Nevertheless, it is a step in the right direction. The goal is that medical schools create an environment where no one feels ashamed of seeking mental health care. All of these solutions serve as a way to stop mental health issues from being swept under the rug and teach students to prioritize their mental wellbeing.
In our society, battling any type of stigma is not easy, especially one as prevalent as mental illness. The best way to break down any stigma is to face it head-on; this begins with each other in our communities. No one should feel ashamed of reaching out and asking for help when needed. We need to start taking better care of each other and ourselves. Whether you are a medical professional, a medical student or a patient, seeking treatment takes strength; it is okay to ask for help.