As Director of Student Support at Cardiff University's School of Medicine, Professor Debbie Cohen has seen first-hand how some students suffering from depression, anxiety and other mental health issues struggle to seek help.
Research conducted by Debbie and her team across the UK has shown that there are various barriers to students disclosing mental health issues – including fear of coming forward, stigma and misunderstanding of how their disclosure will be dealt with.
A 2015 survey of over 1000 students, conducted by the BMJ, also concluded that although rates of mental health problems among medical students are worryingly high, many feel that they are not able to find the support they need to address and cope with their problems.
Cardiff University is now launching a campaign called One Act of Kindness, which encourages students to show compassion towards each other and be more proactive in offering support to their fellow students.
The campaign hopes to highlight the power of kindness and compassion, as well as showing students that it's okay to voice their concerns and to disclose earlier any mental health issues they might be experiencing. Cardiff medical students have already taken on the initiative with enthusiasm, and Debbie hopes the momentum will spread across the UK as students work to speak up and support each other.
'We know that simple acts of kindness can make a big difference to people who are struggling,' says Debbie. 'It can be as simple as saying, 'you don’t look too good, is there something I can do to help?' If you can be kind to each other, then you're more likely to be kind to yourself.'
If you can be kind to each other, then you're more likely to be kind to yourself.
Stress and mental health problems in the medical profession have been well-documented by the press. Long hours, heavy workloads and patient demands can compound to create a high-stress environment with the potential to impact on a doctor's wellbeing.
Alongside this, Debbie says, there exists a certain stigma around mental illness which creates obstacles to those in need seeking the right help – meaning many suffer in silence for too long.
'Doctors feel that they need to be invincible; they can't be open and vulnerable. They find it difficult to disclose their problems, because they're worried about what other people will think of them.'
It's a culture which can be changed, Debbie says, if we 'put more compassion and care into medical schools and doctors' training. I believe it can enable students' ability to seek and access support earlier. If we can shift our culture through something that is very simple – and I think we can – this will go a long way to removing some of the obstacles to disclosing and supporting people more effectively.'
As well as removing the stigma around speaking about mental health, Debbie wants to raise awareness of the support options available and how they can be accessed.
'The research shows that students and doctors often don't really understand where to go, and aren't sure how to get what they want in terms of support,' she explains.
'Medical students have long hours, they travel all over the country, which makes it difficult for them to get consistent support. The key issue is that it's really hard for them to access support in the right way, and they don't always feel that the people seeing them understand their situation.'
We need to have a 'smorgasbord' of things to support doctors and medical students. We want to empower people to make their own decisions.
The team at Cardiff University is currently trialling a decision aid which helps doctors and students to decide about when and how they might disclose if they are stressed or distressed. For some, being able to think through their options, but with some guidance via a decision aid, could prove a useful tool for making the all-important first step to get help.
'We need to have a 'smorgasbord' of things to support doctors and medical students. We want to empower people to make their own decisions,' says Debbie.
Although the body of research on mental health and medical students is growing, more is needed for us to fully understand the issues at play and how they can be addressed.
'Before we can really move forward and make a difference, we need better research,' Debbie says. 'With better research we can inform policy, more than just anecdotally.'
Better data and deeper understanding could be the catalyst to shifting attitudes toward mental health and creating a more caring environment.
Debbie's message to students dealing with feelings of stress and not coping is to tackle the problem early, and seek help from wherever seems most comfortable for them.
'Every medical school will have at least one point of contact for support, and you mustn't be frightened to go and get that support. Asking is the first big step; it's often easier when you have shared your concerns with someone you trust.
'Asking for help is the most important thing you can do, and you mustn't feel that there's anything wrong with that. Whether it's through your university or your own GP, go and get help – because it will make such a difference. There is support out there, and you need to find what's right for you.'
Professor Debbie Cohen
Professor Debbie Cohen
OBE MD FFOM FRCGP FRCP FAcadMEd
Debbie is an occupational health physician, Director of Student Support at School of Medicine, Cardiff University. Debbie undertakes research in physician health as well as running a service for Wales for doctors with mental ill health. Her teaching includes value based training and resilience for both medical students and doctors. Debbie leads the Faculty of Occupational Medicine Physician Health training and helped establish the UK Association of Physician Health in 2011. In 2012 Debbie received the OBE for her contribution to occupational medicine.
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