Utilization and Barriers to Mental Health Services Among Depressed Medical Interns: A Prospective Multisite Study

Guille, Constance; Speller, Heather; Laff, Rachel; Epperson, C. Neill; Sen, Srijan

doi:10.4300/jgme-d-09-00086.1

Cited by 117 publications

(114 citation statements)

References 34 publications

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“…These data support the fact that participants in this study address the problem without seeking help from third parties (self-medication).This is also consistent with the study by Guille et al 22 , where 3 out of 4 medical students preferred to find a solution on their own. This situation becomes even more important because students also favor to keep an ideal image of their professional role over their mental health 23 .…”

Section: Discussionsupporting

confidence: 92%

Utilization of therapies for stress management in Chilean clinical dental students.

Pérez¹,

Ortíz²,

Caro³

et al. 2015

J Oral Res

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Dental students suffer greater stress than the rest of the university population. In general, most health students seek little assistance to help them cope with stress. The aim of this study is to evaluate the use of therapies to manage stress in Chilean clinical dental students. A cross-sectional study was conducted nationwide; this report is a secondary data analysis. The study population was dental students in clinical years (4 th and 5 th ) of 5 Chilean dental schools: Antofagasta, Valparaíso, Viña del Mar, Concepción, and La Frontera. This paper reports the use of therapies for stress management during the past six months considering four options: medical/psychiatric, psychological, self-medication and alternative. Tabulation and analysis were done in STATA 10/SE. Three hundred thirty-seven students were surveyed, 54.01% were men and 64.99% were in fourth year, with an average age of 22.94±2.04. The 48.07% of students have used any of the four types of therapies; women and fourth-year students use more any form of therapy with 53.30% (p=.037) and 48.86% (p=.694), respectively, than men and fifth year students. About half of the students have used some form of therapy to manage stress in the last six months; of the students that received therapy, the percentage of women was significantly higher.

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Section: Discussionsupporting

confidence: 92%

Utilization of therapies for stress management in Chilean clinical dental students.

Pérez¹,

Ortíz²,

Caro³

et al. 2015

J Oral Res

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“…10 Yet, concerns about confidentiality, stigma, accessibility, affordability, and questions about reporting to medical licensing boards remain barriers to physicians accessing these services. [11][12][13][14] In 2004, we set out to develop a resident wellness program (RWP) in an urban, Pacific Northwest universitybased hospital with more than 800 residents and fellows, with the aim of reducing these barriers through educational outreach and resident-specific counseling on-site.…”

Section: Introductionmentioning

confidence: 99%

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

Ey¹,

Moffit²,

Kinzie³

et al. 2013

Journal of Graduate Medical Education

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Background High rates of burnout and distress in resident physicians suggest a significant number would benefit from counseling. Intervention A resident wellness program (RWP) was designed to lower known barriers limiting resident access to services. Methods In 2011, medical residents and fellows were surveyed and logistic regression analyses were conducted to identify demographic and training program differences in perceived barriers and willingness to access the RWP. Results Of the 88% of trainees who knew about the RWP, 87% indicated they would be very likely or somewhat likely to seek out services. Time remained the biggest barrier for residents to getting help. Being male (odds ratio [OR] = 0.54, 95% confidence interval [CI] 0.34–0.84) or an ethnic/racial minority (OR = 0.49, 95% CI 0.28–0.85) was associated with greater unwillingness to seek counseling. Reluctance to access the RWP was associated with concerns about helpfulness, confidentiality, being unable to take a break, and stigma. Women (OR = 1.60, 95% CI 1.06–2.42) and primary care residents (OR = 1.58, 95% CI 0.98–2.54) were more likely to be concerned about taking a break. Men were more likely to question the helpfulness of counseling (OR = 0.55, 95% CI 0.36–0.85). Conclusions The RWP removed barriers of cost and knowledge about counseling services. More educational outreach is needed to address sex and ethnic differences about RWP utilization and attitudes in medical culture about a physician's right to address personal health care needs.

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“…Concerns about the potential for negative ramifications on their reputation, licensure, or hospital privileging, in addition to numerous other barriers -such as time constraints, uncertainty about whether treatment would help, and worries about confidentialitykeep those in need of help from reaching out. 8,9 Consequently, life stressors converging with deteriorating mental health creates a serious risk for the physician -a risk that often goes unrecognized and unaddressed, leading to the high rates of depression and other mental health problems, and suicide within the profession. Moreover, left to informal ways of alleviating symptoms such as anxiety, agitation or insomnia, self-prescribing may be a common but dangerous practice, given the shortsighted albeit understandable desire for symptom relief, but without an assessment of the overarching changes in mental health, potential causes/ contributors, comorbid conditions and a comprehensive treatment plan with ongoing follow-up.…”

Section: Physician Suicide Rates: Higher Than the General Populationmentioning

confidence: 99%

Physician Mental Health: An Evidence-Based Approach to Change

Moutier

2018

Journal of Medical Regulation

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Awareness of high rates of physician burnout, depression and suicide is leading to changes within the medical profession at all levels. Most mental health problems can be effectively managed, but real and perceived barriers — such as confidentiality concerns and fear of negative ramifications on one's reputation, licensure, or hospital privileging — keep many physicians from addressing their mental health needs. Unattended distress has ramifications for physicians as well as the health care industry and patient safety. A number of factors contribute: in addition to individual risk factors and stress load, institutional culture plays a critical role in leading physicians to rationalize and internalize distress as part of their professional identity. There are several initiatives with demonstrated effectiveness in medical settings that can be scaled up for greatest impact: education and stigma reduction efforts, policies and procedures that treat mental health on par with physical health, and efforts that promote an overarching culture of respect. Further strides can be made by addressing hospital and state licensing forms' questions related to mental health — ensuring that questions pertain to competence rather than illness — or replacing questions altogether with a statement encouraging proactive actions to protect physician mental health and safe practice.

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Utilization and Barriers to Mental Health Services Among Depressed Medical Interns: A Prospective Multisite Study

Cited by 117 publications

References 34 publications

Utilization of therapies for stress management in Chilean clinical dental students.

Utilization of therapies for stress management in Chilean clinical dental students.

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

Physician Mental Health: An Evidence-Based Approach to Change

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