Integration of mental health comorbidity in medical specialty programs in 20 countries

Abstract

Methods A systematic analysis was performed of the medical specialization academic programs of 20 different countries to establish which medical specialties take into account mental health issues in the specialty curricular design and which mental health content these programs address. The criteria that were explored in the educational programs include: 1) name of the medical specialties that take into account mental health content in curriculum design, 2) name of the mental health issues addressed by these programs. After independent review and data extraction, paired investigators compared the findings and reached consensus on all discrepancies before the final presentation of the data. Descriptive statistics evaluated the frequency of the data presented. Results Internal medicine, family medicine, neurology, pediatrics and geriatrics were the specialties that included mental health topics in their programs. In four countries: Bangladesh, Serbia, the Netherlands and France, 50%of all graduate specialty training programs include mental health content. In ten countries: Germany, Sweden, the United Kingdom, Mexico, Belgium, India, Russia, Canada, Israel and Spain, between 20% and 49% of all graduate specialty training programs include mental health content. In six countries - Brazil, Chile, Colombia, Croatia, Kenya, and the United States-less than 20% of all graduate specialty training programs include mental health content. Discussion The proposal that we have made in this article should be taken into account by decision-makers, in order to complement the different postgraduate training programs with mental health issues that are frequently present with other physical symptoms. It is not our intention that the different specialists know how to treat psychiatric comorbidities, but rather pay attention to their existence and implications in the diagnosis, evolution and prognosis of many other diseases. The current fragmentation of medicine into ever finer specialties makes the management of comorbidity ever more difficult: a reorientation of post- graduate training might improve the situation.

Mortality gap and physical comorbidity of people with severe mental disorders: the public health scandal

“…A revision of educational requirements for healthcare professionals to improve their training curricula has also been proposed in order to adequately prepare the young generation of professionals to manage physical comorbidities in patients with severe mental disorders. In particular, the WPA, the world’s largest professional association of psychiatrists and mental health professionals [ 72 , 73 ], has recently established a WPA Working Group on Physical Comorbidities [ 74 , 75 ], so to promote attention to management of physical comorbidities in people with severe mental disorders, to update training materials available on the educational portal of the Association [ 76 ], to organize webinars and seminars with international experts in the field [ 77 – 79 ] and to promote the dissemination of good clinical practice for improving physical health in patients with severe mental disorders [ 80 – 83 ].…”

Obsessive-Compulsive Disorder: A Medical School Curriculum and Textbook Review

“…In terms of medical graduate training, a recent systematic review of medical specialty programs (internal medicine, family medicine, neurology, pediatrics and geriatrics) across 20 countries found that less than 50% of the academic programs included content on mental health. 39 Further, of the 20 countries, Germany, France, and Croatia excluded context on anxiety disorders in their postgraduate specialty programs. In general, the variability in length of mental health education at the undergraduate level and lack of emphasis on practical teaching combined with a lack of mental health education at the graduate level (and for some countries, direct exclusion of anxiety disorders) sets the stage for the misdiagnosis of OCD.…”

The Economic Impact of Providing Evidence-Based Pediatric Mental Health Literacy Training to Primary Care Physicians

“…This ratio is perhaps a primary index of the state of the art in child and adolescent mental health education in primary care, especially given the essential centrality of youth mental disorder and lifespan health. [15][16][17]…”

“…Only about 24% of the participating physicians were evaluable as they had made referrals to child and adolescent mental health services over the last 18 years. This ratio is perhaps a primary index of the state of the art in child and adolescent mental health education in primary care, especially given the essential centrality of youth mental disorder and lifespan health [ 15 - 17 ].…”