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Mental health: when medical students become the patients

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In the coming weeks, students all over Australia will begin the university semester. Of these students, 17,500 may not know it yet, but their mental health is at a considerably higher risk compared with their peers.

This is not because of their past history, or because of their location, but rather because these 17,500 students chose to study medicine. Of these 17,500 medical students, 3500 will be starting medical school for the very first time. Many of these students are entirely unaware that they now carry these additional mental health risks.

In October 2013, mental health organisation beyondblue released the results of its nationwide survey of medical students and doctors. The results would have been shocking, if they were not so unsurprising.  Some of the key findings included:
• approximately one in five medical students reported experiencing suicidal ideation within the previous 12 months;
• almost half of all medical students reported a minor psychiatric illness, with more medical students than doctors being classified as having a high likelihood of a minor psychiatric disorder;
• levels of very high psychological distress were significantly greater among medical students than in the general population;
• the rates of depression and anxiety are significantly higher in medical students than the general population; and
• one in two medical students will experience emotional burnout.

Medical students may be at an increased risk compared with their peers, but the Australian Institute of Health and Welfare data shows that more than a quarter of 16 to 24 year-olds experience a mental health disorder during a 12 month period – an incidence higher than in any other age group. Mental health is therefore an issue for all tertiary students.

Yet, despite the increased burden of this disease, young people are less likely to seek help, with only 23 per cent of young people with a mental illness accessing health services.

In October last year, just weeks before the release of the monumental beyondblue survey, the National Council of the Australian Medical Students’ Association met and voted on AMSA’s advocacy priorities. At this meeting, the mental health of tertiary students was endorsed as a priority for advocacy in 2014.

As the Mental Health and Wellbeing Campaign begins for 2014, the big unanswered question appears to be: ‘why medical students?’

Naturally, there has been plenty of speculation on this topic. This is understandable, given that identifying a cause could be key to a solution.

Perhaps the experience of medical school is itself responsible: the contact hours are relatively high, the content is expansive, and the clinical exposure can be quite confronting.

Or perhaps the traits of individuals that choose medicine as a career path may be relevant.

At this point, a concrete explanation eludes us.

We therefore await further research in this area, as a more thorough understanding of the specific relevant triggers would allow us a more targeted preventive strategy.

Even without tangible causality, AMSA is committed to maximising the wellbeing of all university students through the prevention and treatment of mental health conditions.

Tertiary education itself provides an opportunity to maximise the health of a large portion of young Australians.

Campus attendance allows access to a supportive environment where health services and education is readily available.

AMSA will work with university faculties to improve the services available and ensure accessibility, while also working directly with students to increase awareness and decrease stigma surrounding mental illness.

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