Resolution: S-20-15: ENCOURAGE MEDICAL SCHOOLS TO HAVE IN-SCHOOL MENTAL HEALTH COUNSELORS AVAILABLE TO STUDENTS

[Valerie Lile]

1  WHEREAS, 1/3 of medical students experience depression with low treatment rates; and

2  WHEREAS, The prevalence of depression or depressive symptoms among medical students is 27.2%
3  and suicidal ideation is 11.1%; and

4  WHEREAS, Approximately 50% of medical students experience burnout; and

5  WHEREAS, Burnout and declining satisfaction are strongly associated with actual reductions in
6  professional work effort; and

7  WHEREAS, Burnout can undermine trainees’ professional development, place patients at risk, and
8  contribute to suicidal ideation; and

9  WHEREAS, Medical students are less likely to look after their personal concerns and to seek mental
10  health treatment due to fears about stigmatization, confidentiality, and any impact such treatment may
11  have on their future careers; and

12  WHEREAS, Medical students are three times more likely to commit suicide than the rest of the general
13  population in their age range; and
14  WHEREAS, Stress and depression are common in students, but two times more common in medical
15  students; and

16  WHEREAS, These students are more susceptible to psychiatric stressors, and therefore have alarming
17  rates of burnout, anxiety, and depression; and

18  WHEREAS, Depression in particular is frequently documented as one of the risk factors most likely
19  to lead to suicidal thinking, and studies have shown that many students are depressed when they
20  commit suicide; and

21  WHEREAS, Studies that investigate the mental health of physicians in practice have shown that the
22  stresses that begin in medical school tend to continue throughout the years of practicing medicine; and

23  WHEREAS, Defenses and coping strategies utilized prior to medical school may be inadequate in the
24  setting of rigorous medical education; and

25  WHEREAS, Students with no prior mental health history may find themselves in need of
26  psychotherapy and sometimes medication management; and

27  WHEREAS, Of depressed students, only 22% (n = 10) were using mental health counseling services.
28  The most frequently cited barriers to using these services were lack of time (48%), lack of
29  confidentiality (37%), stigma associated with using mental health services (30%), cost (28%), fear of
30  documentation on academic record (24%), and fear of unwanted intervention (26%); now, therefore,
31  be it

1  RESOLVED that the American Osteopathic Association (AOA) encourage medical schools to have
2  in-school mental health counselors available to students; and, be it further,
3  RESOLVED, that counseling services not be documented on a medical student’s academic record.

Explanatory Statement

The purpose of the resolution encouraging having mental health counselors on medical school campus is to reduce some of the mental stress that the medical school environment has on many students. It is known that over a quarter of medical students suffer from depression, with over 10% experiencing suicidal thoughts. Half of all medical students experience burnout, which can lead to suicidal ideation and poor professional outcome. Many of these students do not seek help and therefore continue to suffer and eventually there could be negative outcomes in their workplace or in their homes. Not seeking help could be due to: the still-present stigma of mental health suffering; the perception of punitive action professionally if being medicated or for admitting to having an issue; not having access to mental health professionals on campus. It is imperative, with overwhelming data showing medical students and physicians have a higher rate of depression, burnout, and suicide than other professional fields and the general public, that there be easily accessible resources for students to use at their times of need.

References

1. Coentre, R., & Góis, C. (2018). Suicidal ideation in medical students: recent insights. Advances in Medical Education and Practice, Volume 9, 873–880. doi: 10.2147/amep.s162626
2. Dyrbye, L. N., Thomas, M. R., Massie, F. S., Power, D. V., Eacker, A., Harper, W., … Shanafelt, T. D. (2008). Burnout and Suicidal Ideation among U.S. Medical Students. Annals of Internal Medicine, 149(5), 334. doi: 10.7326/0003-4819-149-5-200809020-00008
3. Dyrbye, L., & Shanafelt, T. (2015). A narrative review on burnout experienced by medical students and residents. Medical Education, 50(1), 132–149. doi: 10.1111/medu.12927
4. Gentile, J. P., & Roman, B. (2009). Medical student mental health services: psychiatrists treating medical students. Psychiatry (Edgmont (Pa. : Township)), 6(5), 38–45.
5. Givens, J. L., & Tjia, J. (2002). Depressed Medical Studentsʼ Use of Mental Health Services and Barriers to Use. Academic Medicine, 77(9), 918–921. doi: 10.1097/00001888-200209000-00024
6. Kosik, R. O., Nguyen, T., Ko, I., & Fan, A. P. (2017). Suicidal ideation, attempt, and determinants among medical students. Neuropsychiatry, 7(1). doi: 10.21203/rs.2.14532/v1
7. Moir, F., Yielder, J., Sanson, J., & Chen, Y. (2018). Depression in medical students: current insights. Advances in Medical Education and Practice, Volume 9, 323–333. doi: 10.2147/amep.s137384
8. Rotenstein, L. S., Ramos, M. A., Torre, M., Segal, J. B., Peluso, M. J., Guille, C., … Mata, D. A. (2016). Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students. Jama, 316(21), 2214. doi: 10.1001/jama.2016.17324
9. Shanafelt, T. D., Mungo, M., Schmitgen, J., Storz, K. A., Reeves, D., Hayes, S. N., … Buskirk, S. J. (2016). Longitudinal Study Evaluating the Association Between Physician Burnout and Changes in Professional Work Effort. Mayo Clinic Proceedings, 91(4), 422–431. doi: 10.1016/j.mayocp.2016.02.001

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Submitted by:

Student Association of the American College of Osteopathic Family Physicians (SAACOFP) Resolutions Committee 2019-2020
Sophia Jaffri, OMS II, Alabama College of Osteopathic Medicine
Amanda McMellon, OMS II, Arkansas College of Osteopathic Medicine

Action Taken: [Leave Blank. Will be Approved by the House of Delegates or Not Approved.]
Date: [Leave Blank. Date submitted to National Vice President and the National Office.]
Effective Time Period: Ongoing

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