Sarah Laurie, 3rd-year medic, reflects on her personal experiences of mental health education and support.
Mental health problems amongst medical students are common – this should come as no surprise. Amidst 100 highly intelligent members of the general public, one would expect to find approximately 20 with a mental illness. And yet, I am willing to bet that for every student who has ‘gone public’ about having a mental health condition, there are a handful who are struggling alone.
The mental health education in my school was shockingly poor and misinformed. After 14 years of compulsory PSHE lessons learning about things like periods, smoking, and abstinence, I cannot recall a single lesson in which obsessive-compulsive disorder was properly explained to me. During our teenage years, we have to balance a heavy workload and simultaneously navigate the emotional minefield of sexuality, health, goals, and aspirations – it is no wonder that 50% of mental illnesses manifest by the age of 14 [1]. So why does the government see no reason to educate us on the matter? If somebody told me that panic attacks weren’t normal reactions to sitting my GCSEs, or that sobbing into a mirror for hours at a time wasn’t just “being a teenage girl”, I may not have had to spend the majority of my teenage years struggling with mental illness.
Sadly, I fear the picture doesn’t seem to brighten on entering university. In 2013, the General Medical Council (GMC) produced a document called ‘Supporting medical students with mental health conditions’ which outlined many fears held by medical students – fears including the i
mpact of declaring a mental illness on their future careers, and that the seeking of support could be interpreted as a sign of weakness [2]. These fears have grown from somewhere, and all too often, come from the medical schools themselves. From day one of our first year here, the emphasis has been placed on ‘Fitness to Practice’. We are told that we must declare and seek help for mental illness because we could otherwise be labeled a danger to our patients. Not because we are young people in the prime of our life, not because we are human beings who do not deserve to live in constant mental pain, but because our whole career could collapse and burn before its even begun. Place yourself in our shoes – you’re terrified that you’re actually going insane, clutching at straws to retain your identity, and you’re suddenly placed in a position where being found out could take away something you’ve worked towards for years. Doesn’t that sound scary?
Don’t get me wrong – I am in no way advocating hiding mental illness from the medical school. Things have gotten so much brighter for me now that there are people who know. I’m just trying to raise the point that I think medical schools approach this issue from the wrong angle. Instead of waiting until we become mentally ill to intervene, there should be a programme promoting mental wellbeing. The charity Student Minds has programmes running up and down the UK with the aim of intervening and making sure us students take care of our minds before it’s too late. We need something like this to be integrated into our curriculum, acknowledging the fact that as intelligent, driven, capable people, we will undoubtedly be more exposed to mental illness and therefore the ideas of ‘self care’ and ‘self compassion’ should not be revolutionary, but integral to student welfare.
The ideas of ‘self care’ and ‘self compassion’ should not be revolutionary, but integral to student welfare.
So what should we do in the meantime? Look out for each other. If you know somebody struggling, let him or her know you’re there for him or her. Invite them out every now and then (I know that being constantly turned down makes you less likely to invite them out – but believe me, for somebody battling alone, the signal that maybe somebody does want you around can be incredibly powerful). More importantly, don’t make it their identifier – I may be depressed or anxious, but that doesn’t mean that that’s all I am.
More importantly, don’t make it their identifier – I may be depressed or anxious, but that doesn’t mean that that’s all I am.
If you are struggling – let somebody know. Talk to your GP or make an appointment with student services. I currently receive weekly counseling from student services and I don’t think I would have made it this far without it. Have a chat with your personal tutor or a prodean. If unable to do so, come and talk to me – I can’t promise a magical cure to how you’re feeling, but I will listen. The main thing is don’t keep it to yourself, because you deserve so much more. Things can and will get better, I promise.
[1] Kim-Cohen, J et al (2003) Prior juvenile diagnoses in adults with mental disorder and Kessler, R. C. et al (2005) Lifetime prevalence and age of onset distributions of DSM-1V disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62, 593-602
[2] Cohen, D et al (2013) GMC – Supporting medical students with mental health conditions. Accessed 18th December 2014.
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