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MENTAL HEALTH MENTAL HEALTH

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DESTIGMATIZING MENTAL

HEALTH AMONG PHYSICIANS

AND MEDICAL STUDENTS

By Niva Shrestha

“I regret that only now, in my last annual meeting speech, am I telling you about my own struggles. My anxiety
and depression were on the verge of derailing my career aspirations. My fear of being judged negatively and the
dark shadow of stigma nearly kept me from seeking help.” – 2018 AAMC President’s Address by Darrell G. Kirch, MD 7

I burnout and depression with potentially per- only 1 in 4 trainees who wanted mental
n the pursuit of helping others, physi-
cians and medical students often forget
compromised medical care. Sometimes this
portedly, the biggest barriers to care were
to take care of themselves. Physicians make manent consequences, such as suicide or health treatment actually seeking care. Re-
a lifelong commitment to medicine, and pressure stems from other responsibilities, “lack of time (77%), concerns about confiden- fore, it is important to continue the conver- “But an extraordinarily empathic Goldstein JL, Anzia J. Mental Health
good mental health is imperative to sustain personal factors or psychiatric illnesses. tiality (67%), concerns about what others sation of mental health in all aspects of med- student affairs dean steered me to the During Residency Training: Assessing
that commitment. It is crucial to acknowl- Whatever the cause of stress, addressing would think (58%), cost (56%) and concern ical training, especially in continuing medical treatment I needed. As a result, I am the Barriers to Seeking Care. Acad Psy-
edge that “suicide is the only cause of mortal- physician mental health starts in medical for effect on one's ability to obtain licensure education. As medical knowledge evolves, so blessed to stand here today. Many of chiatry. 2018 Aug;42(4):469-472. doi:
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ity that is higher in physicians than school. A recent meta-analysis discovered the (50%)”. These barriers are similar for attend- too will understanding of mental health and you have a story like mine. We need to 10.1007/s40596-017-0881-3.
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nonphysicians.” Historically, this is not a prevalence of depression or depressive symp- ing physicians. the vast resources available to physicians. tell our stories and beat back the stigma Epub 2018 Feb 14. PMID: 29450842.
new phenomenon. Documentation dating toms among medical students was 27.2% and These statistics demonstrate how doctors Workplace policies should also evolve to that causes so many of our learners and 5. Gerada C. Doctors, suicide and mental
back to the nineteenth century indicates that suicidal ideation was 11.1%. face not only professional but also personal recognize and support the pressing issue of colleagues to suffer in silence. Speaking illness. BJPsych Bull. 2018;42(4):165-
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suicide rates among physicians has always re- Fortunately, many medical schools are now and institutional stigma regarding mental physician mental health. In the past, physi- out and erasing the stigma around 168. doi:10.1192/bjb.2018.11
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mained higher than that of the general pub- taking steps to normalize student mental health. As an institution, the AGEME in cians who struggled with mental health lived seeking help is a most worthy moun- 6. Henderson M, Brooks SK, Del Busso L,
lic. For decades, however, physicians have health discussions, making it culturally ac- 2011 implemented an 80-hour resident work in fear: fear of being labeled as weak or in- taintop to reach.” – 2018 AAMC Presi- et al. Shame! Self-stigmatisation as an ob-
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been taught to “power through” and “tough ceptable for medical students to ask for week and eliminated extended duration competent, or fear of professional conse- dent’s Address by Darrell G. Kirch, MD stacle to sick doctors returning to work:
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out” the most mentally demanding times of help. Providing staff clinical psychologists, shifts for first-year residents. This is a small quences after the admission of receiving a qualitative study. BMJ Open.
their lives. This unwillingness to acknowl- having access to peer support groups, pro- step in the right direction, acknowledging professional help. Lack of professional sup- References 2012;2(5):e001776. Published 2012 Oct
edge and address mental health fuels per- moting Mental Health Awareness Week— that all doctors have physical and mental lim- port negatively impacts a physician’s critical 1. Albuquerque J, Tulk S. Physician sui- 15. doi:10.1136/bmjopen-2012-001776
sonal, professional and intuitional stigma which is October 3 through October 9 this itations. However, to influence continued pr thinking and ability to help patients. There- cide. CMAJ. 2019;191(18):E505. 7. Kirch DG. AAMC President’s Address
surrounding physician mental health. By des- year—and increasing transparency on the ogressive institutional change, the people fore, destigmatizing and supporting mental doi:10.1503/cmaj.181687 2018 “The Mountaintops”. November 4,
tigmatizing mental health among physicians psychological struggles associated with med- who are a part of the health care system— health among all health care professionals is 2. Rotenstein LS, Ramos MA, Torre M, et 2018.
and medical students, the medical profession ical school are ways in which modern medical physicians, other health care professionals, vital to the welfare of current and future gen- al. Prevalence of Depression, Depressive
can create a more inclusive, healthy commu- schools are helping destigmatize mental health care administrations and health care erations of providers and patients. Symptoms, and Suicidal Ideation Among Niva Shrestha is a second-year
nity that can better serve one another and health. Providing medical students with students— must first address their own bi- The stigma of mental health is not some- Medical Students: A Systematic Review medical student at the University
their patients. comprehensive mental health training and ases about themselves and their colleagues thing that will disappear within a generation. and Meta-Analysis. JAMA. 2016;316 of Incarnate Word School of Osteo-
A myriad of reasons exists as to why physi- resources will set a solid foundation for com- seeking mental health treatment. Implicit bi- While the stigma improves with each decade, (21):2214-2236. doi:10.1001/jama. pathic Medicine (UIWSOM) and a member
cians may feel uncomfortable seeking or ask- petent, healthy future physicians. ases about personal welfare as a physician can there are still strides to be made. That can 2016.17324 of the BCMS Publications Committee.
ing for help. This fear often begins with the In a study of more than 9,900 programs ac- be so ingrained, that the person who needs only happen if the medical community con- 3. Dyrbye LN, Thomas MR,
intense personal and professional pressure credited by the Accreditation Council for help may not understand or recognize they tinues to prioritize mental health amongst Shanafelt TD. Medical Student Dis-
doctors put on themselves, beginning in Graduate Medical Education (ACGME) need it. Some believe staying up all night to themselves. Good mental health not only tress: Causes, Consequences, and Pro-
medical school. Medical education is often during 2000-2014, suicide was found to be study or feeling chronically tired is a badge of benefits the physician but also benefits their posed Solutions. Mayo Clin Proc.
the source of many mental health issues. the second leading cause of death among res- honor—a reflection of their dedication to loved ones, colleagues and the patients they December 2005;80(12):1613-1622
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Chronic, prolonged stress leads to anxiety, ident physicians. Barriers to care have led to the medical profession—but it is not. There- care for. 4. Aaronson AL, Backes K, Agarwal G,

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