Mental Health Services for Residents: More Important Than Ever

Abstract

The mental health of physicians in training is a topic of considerable concern. Recent attention to the issue of patient safety has led to examination of the relationship between residents' stress and compromised clinical performance. Few mental health programs dedicated to residents and formally structured to meet their specific needs are reported in the literature. The authors raise the question of why there are so few programs and why more residents don't take advantage of services that do exist. They then describe the development and utilization of the University of Michigan Health System's House Officer Mental Health Program. The program was structured to overcome barriers to utilization such as lack of funding, concerns about confidentiality, ease of access and residents' financial constraints and to provide comprehensive services for a wide range of diagnoses. Data are presented on the first four years of operation from 1997-01 that show increasing utilization and high levels of satisfaction over this time period by house officers at all levels of training and in all departments of the Health System. As increasing attention is paid to how to deal with medical errors, the establishment of such programs should be considered, not only as a means to address the general mental health of residents but also as an appropriate venue to deal with the stress that can contribute to and be induced by medical mishaps.

Health-related quality of life predictors during medical residency in a random, stratified sample of residents

“…Since 2003 in the USA, the Accreditation Council for Graduate Medical Education (ACGME) has required that all postgraduate medical training programs make assistance services available to their residents. 19 Based on our findings and the cumulative experience of the authors in providing psychological and psychiatric assistance to residents, 20,23,24 we believe the major challenge lies in forming technically competent, ethical residents who are socially responsible, are able to establish empathetic relationships, and have a good quality of life.…”

“…1,19 It is known that during the interaction between the variables "occupational stress", "personal wear and tear", and "coping with resources", there is often increase in the first two as a function of the lack or the incipient development of the last one.…”

“If You Build It, They Will Come”: Attitudes of Medical Residents and Fellows About Seeking Services in a Resident Wellness Program

“…[20][21][22] Individual counseling offered through resident-specific counseling services was used and rated as satisfactory by medical trainees in several academic medical centers (AMCs), but resident help-seeking attitudes were not assessed. 23,24 A higher number of residents accessed the AMC's counseling services than an employee assistance program 24 and at 1 institution, residents and faculty who participated in an interactive anonymous screening of depression and suicide risk reported that personalized communication from a clinician (addressing their concerns and risk level) increased willingness to accept referrals to community-based counseling. 25 Improved understanding of real and perceived barriers to help seeking has implications for the development of resident wellness programs and the types of outreach efforts used to reach distressed residents.…”

Peer counselling for doctors in Norway: A qualitative study of the relationship between support and surveillance

“…This element is reported in international programs offering support and treatment for doctors (Cohen et al, 2005;Dabrow, Russell, Ackley, Anderson, & Fabri, 2006;Garelick et al, 2007;Pitt, Rosenthal, Gay, & Lewton, 2004), as well as in a previously described Norwegian program for doctor support (Isaksson Rø, Gude & Aasland, 2007). The service also needed "good colleagues" who listened and cared in order to be useful.…”