The ongoing pandemic is putting a spotlight on mental health as depression and anxiety continues to affect millions of Americans. But even before COVID-19, concern about the well-being of medical students was on the rise. About one in three medical students report symptoms of depression, and one in nine experiences suicidal ideation.
The University of New Mexico School of Medicine (UNM) recognized the need for some sort of intervention and developed a multilevel approach to help destigmatize mental illness among health care workers and raise awareness about support opportunities. UNM wanted to make it normal for medical students to talk about mental health and make it culturally acceptable to ask for help.
To make that happen, UNM had to start the conversation early. Before the school’s formal white coat ceremony, the assistant dean for professional well-being would spend almost an hour talking about mental health with the family members of UNM’s incoming students.
During that conversation, family members would receive a booklet about supporting their loved one during medical school. The booklet shares important things to know about medical school—ranging from the expected time commitment to the fact that it will likely be an emotional roller coaster—as well as tips for communicating with medical students and suggestions for spouses, partners, or significant others. There is a page on random acts of kindness and support, and two pages breaking down the “alphabet soup” that is the language of medical training and medicine.
There also is a page titled “When Students Should Seek Help.” Included in the list of 14 scenarios are more obvious signs such as using alcohol or illicit drugs to “self-medicate” or having thoughts of self-harm, but also included are subtler signs such as when:
- They describe feelings of isolation.
- Their feelings, thoughts or behavior compromise their work—or at least when they think it’s compromising their work.
- They hide details about their feelings or actions that they normally would have shared.
The success of UNM’s work is spotlighted in an AMA STEPS Forward™ module, “Normalizing Mental Health Care During Medical Student Training.”
Emphasis on transparency
During orientation, medical students hear from upper-level students who have accessed the school’s health and wellness resources about why they felt they needed help, whether they found the experience helpful and whether they faced any repercussions for seeking assistance.
First-year students have taken part in an annual wellness retreat that features a panel of three or four physicians who are in recovery from addiction. These panelists have been primary care physicians, cardiologists, residents, psychiatrists, anesthesiologists and infectious disease specialists, demonstrating that addiction can strike anyone. The first-year students hear firsthand about the signs and symptoms of substance-use disorder, as well as the recovery process.
In addition, the wellness dean would meet with small groups of students to discuss the adjustment to medical school and remind them of the resources available to all students.
Students also have had the opportunity to meet with the CEO and chief medical officer of the New Mexico Medical Board, as well as with program directors and the associate dean for graduate medical education to discuss concerns over reporting mental health history as well as ongoing issues they face related to mental health. These conversations led the director of graduate medical education to craft a list of frequently asked questions about mental illness and whether there are any subsequent repercussions handed down.
Overall, feedback for the school’s wellness work has been positive, and in the past five years, the program has grown from three part-time positions to six part-time roles—four faculty, one psychiatrist and one psychologist—as well as a full-time program coordinator.
The AMA’s STEPS Forward open-access modules offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. STEPS Forward is part of the AMA Ed Hub™, an online platform that brings together all the high-quality CME, maintenance of certification, and educational content you need—in one place—with activities relevant to you, automated credit tracking and reporting for some states and specialty boards.
Learn more about AMA CME accreditation.