Taking care of our future doctors: a service evaluation of a medical student mental health service

• Published in: BMC medical education 2020-05, Vol.20 (1), p.172-172, Article 172
• Main Authors: Jacob, Rebecca, Li, Tsz-Yan, Martin, Zoe, Burren, Amanda, Watson, Peter, Kant, Rhian, Davies, Richard, Wood, Diana F
• Format: Article
• Language: English
• Subjects: Adult; Analysis; Anxiety disorders; Behavior modification; Behavioral medicine; Clinical outcomes; Clinical Psychology; Cognitive-behavioral therapy; College students; Cross-Sectional Studies; Depression (Mood disorder); Depression (Psychology); Educational Environment; Eye Movements; Feedback; Female; Fitness to practice; Health Conditions; Health services; Higher education; Hospitals; Humans; Intellectual Disciplines; Male; Medical education; Medical referrals; Medical research; Medical schools; Medical Student; Medical students; Mental depression; Mental disorders; Mental Disorders - therapy; Mental health care; Mental Health Programs; Mental Health Services; Meta Analysis; Motor Reactions; Occupational health; Occupational Safety and Health; Physicians; Primary care; Program Evaluation; Psychiatry; Psychological aspects; Psychological Distress; Psychologists; Psychology; Quality Assurance; Quality Control; Referral; Resilience (Psychology); Resistance (Psychology); Service evaluation; Social Adjustment; Students; Students, Medical - psychology; Suicides & suicide attempts; Surveys and Questionnaires; Treatment Outcome; Well being; Young Adult
• ISSN: 1472-6920; 1472-6920
• DOI: 10.1186/s12909-020-02075-8

Studies suggest medical students experience high levels of mental distress during training but are less likely, than other students, to access care due to stigma and concerns regarding career progression. In response, The School of Clinical Medicine, University of Cambridge supported the development of the 'Clinical Student Mental Health Service' to provide specialist input for this vulnerable group. This study evaluates the efficiency and effectiveness of this service. Using mixed-methods, cross-sectional analysis of validated psychiatric rating scales and qualitative feedback, 89 responses were analysed from 143 clinical students referred, between 2015 and 2019. The care pathway included initial review by a psychiatrist, who triaged students to psychologists delivering therapies including: Cognitive Behavioural Therapy, Interpersonal Therapy, Eye Movement Desensitization Reprocessing Therapy or Cognitive Analytic Therapy. Efficiency was assessed by waiting times for psychiatry and psychology interventions, and number of sessions. Academic outcomes included school intermission and graduation. Clinical effectiveness was analysed by measuring global distress, depression, anxiety, functioning and suicidal risk. Pre/post intervention changes were captured using t-test and McNemar test with thematic analysis of qualitative feedback. Referral rates increased from 3.93% (22/560) in 2015 to 6.74% (45/668) in 2018. Median waiting times for initial psychiatric assessment and start of therapy was 26 and 33 days, respectively. All graduating students moved on to work as junior doctors. Levels of distress, (t = 7.73, p