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Better remedies needed for student distress

Just before lunch one recent Sunday, I walked with a friend I hadn’t seen in a couple of years. We spent a while talking about his semester on exchange in Switzerland and subsequent travels through Europe, and then moved on to discussing why he’s applying to medical school for 2014.

I chuckled when his face lit up while talking of his post-GAMSAT hospital admission, for appendicitis (GAMSAT is the admissions exam for graduate-entry medical programmes). He spoke eagerly of how interesting his three days in the ward had been, and of all the questions he had been able to ask his doctors.

We moved on to discussing my experience of medical school, and I remarked how lucky I thought we were to be learning such interesting material and gaining an expedited, vicarious life experience through the patients and families we meet. The exposure we get is startling, which I mean mostly as a good thing.

It can, however, also be confronting. For most of us, we eventually find at least one of the patients we meet has a story that hits close to home. I remember being particularly distracted in first year by a patient my examination skills group met while practicing something or other.

Mysteriously, this very acquiescent young man had trouble speaking, and something called a PEG tube sticking through his abdomen. It transpired that he had taken a deliberate drug overdose and then suffered damage to his vocal cords during a botched intubation attempt.

In addition to not being able to speak properly, he could now neither eat nor drink, and a return of function was purely hypothetical.

He would soon be discharged and yet, despite maybe never again being able to share a drink or a meal with his friends, we hoped he would not attempt suicide again.

His face has faded in my memory, but as I write this I still empathise and wonder how he is doing now. There are students for whom this experience might have hit even closer to home.

The dearth of epidemiological data specific to the Australian university context is a deficiency AMSA would like to see addressed, but a recent survey of 30,000 students in Canada, reported in The Globe and Mail, revealed that 9.5 per cent had seriously considered taking their own lives in the past year, while 1.3 per cent said they had attempted suicide.

A study of University of Adelaide students, conducted across various faculties in 2010, found that 44 per cent of medical students were classified as psychologically distressed.

This was similar to the rate (48 per cent) the authors found for all students surveyed, which was noted to be 4.4 times that of age-matched peers. If these numbers are accurate and broadly representative, then they are startling.

Improved mental health services for students are a priority for AMSA, which earlier this year adopted the Student Mental Health and Wellbeing Policy.

The issue features prominently in our Federal Election strategy, and – through Universities Australia – we are making sure the nation’s chancellors and vice chancellors are aware of our concerns.

In addition, the National Executive has established two small project teams to help it address this important but somewhat neglected issue: one to document the student mental health services provided by universities across the country, and the other to plan our strategy to push for improvements.

Emphasising the importance AMSA attaches to the issue, we have made mental health the theme of the first edition of our biannual magazine, Panacea, for 2013.

We are particularly grateful for the contributions we received from those students who were brave enough to share their personal experiences.

It’s heartening to read, in some of these stories, of the wonderful support provided to colleagues in need.

Reducing the stigma around mental illness is a crucial step towards improved access to care and enhanced quality of life.

I hope we all take heed of their example and pay careful attention to the wellbeing of ourselves, and others.

After all, it is in patients’ best interests that doctors be healthy, too.

Benjamin Veness is the president of the Australian Medical Students’ Association. He is studying medicine and a Master of Public Health at The University of Sydney. Follow on Twitter @venessb and @yourAMSA. Panacea is available from AMSA’s website, amsa.org.au

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