Why don’t many Medical Students open up about their Mental Health?
In my first year at Medical School, we had a module on health issues within societies. The module explored things like health inequalities, social consequences of health care and the general psychology of consultations. One of the questions that was explored within the module was why patients don’t always go to their doctors when they are unwell.
It could be due to a lack of trust towards the medical profession. Or because people don’t like the thought of appearing to be ill. Or because they feel as though they’d be wasting the doctor’s time. We could spend all day coming up with possibilities – the list is really endless.
However, patients aren’t the only people who seem unwilling to get help. As medical students too, we seem to feel scared to open up about health issues. Mental health issues in particular seem to have an even bigger taboo. Indeed, I remember with my own horrific struggles from last year as to just how scared I was to open up. I am indeed very glad that I did end up opening up, for the support provided has been vital in my journey at medical school.
In cases like this, it is very easy to blame the medical students themselves for not opening up and putting themselves at risk. This is a very narrow minded view, however. Going by my own experiences, here are some factors that I felt were a barrier to me opening up. No doubt many others will feel the same way.
Fitness to Practise
Fitness to practise is constantly drilled into us at Medical School. Never accept a police caution. Be careful with the amount you drink. Don’t do drugs. Stuff like that, basically. What is interesting, however, is that doctors are told that they must also declare some of their health issues, and undoubtedly the guidelines make it so that mental health must be declared. (As a side note – I am talking about the General Medical Council [GMC] of the UK here. I don’t know how things work abroad).
Let’s think about it for a second. Having to declare a mental health condition is in the same guidelines that essentially say things like don’t get into fights, don’t do drugs and that sort. By grouping them in a similar category, it almost feels as though it’s bad to suffer from such health conditions. It almost suggests that declaring such issues would render us to be unfit to practice.
This isn’t true, of course – even the GMC themselves have said that in most cases, it shouldn’t be an issue. I don’t have a problem with the guidelines myself either. After all, if patients could be put at risk – although it’s important for me to add that most mental health patients are NOT a risk to others – these guidelines should be in place. However, this does add a difficulty in opening up, and I do wonder if the guidelines end up doing more harm than good.
Studying medicine is a dream for many. The potential of getting it taken away from us due to fitness to practise issues which are out of our control is one that we want to avoid!
The (wrong) perception of doctors as resistant entities
The media and many others like to portray doctors as somehow being infallible to illness. It’s almost a way to dehumanise doctors, to make it seem like we’re not capable of making ‘mistakes’. This perception does seem to be changing, thankfully, but it is still an issue.
The issue arises with many medical students themselves feeling as though they won’t be ‘strong’ enough to be a doctor if they succumb to illness. It becomes an issue of belonging. Some may feel as though they will be looked down upon their colleagues, whilst others may almost feel guilty as though their illness is something to be ashamed of.
It isn’t. There is no shame in suffering from any illness – physical or mental. One of my CPN’s last year told me: “You’d be surprised how many doctors suffer from mental health issues.” She is so right. We’re not resistant – and that’s OK.
Horror stories from the past
Medical School has changed dramatically in the past few years. Not only are we seeing things like the introduction of Problem Based Learning and new modules as science is progressing but we’re also seeing less of a bullying culture. Going by anecdotal evidence, professors would belittle students, make them look stupid and be entirely unsupportive. Of course, this old attitude does still exist amongst some but thankfully, it seems to be changing.
The same applies for mental health, going by anecdotal stories. In the past, there were many professors who would take a ‘no mental health issues’ approach. Students needing help were ignored. Sometimes they were even bullied about it. They were kicked out for suffering from mental health issues.
As humans, we have a tendency to focus simply on the negative stories. Listening to these stories makes it very difficult for people to open up. Things are changing for the better, thankfully, and we need to concentrate on those positive stories.
There are several barriers to seeking mental health care for medical students. Many suffer in silence – and remembering my own time of being in my room alone, in a lot of pain, sometimes in tears, I remember how debilitating it was. Recovery has been slow for me, but would have been much slower had I not asked for help.
To other medical students – trust me when I say that despite these barriers, it is helpful to open up.