Academic Psychiatry最新文献

Objective: This qualitative study explored medical students' decision making in relation to seeking help for mental health problems.

Methods: Fourteen medical students participated in a set of three semi-structured interviews. Interviews explored students' experiences of distress and professional help-seeking for mental health problems. Data were analyzed using thematic analysis.

Results: All students experienced "stress" and seven had previously sought help. In deciding whether to seek help, students considered the meaning of difficult feelings, often attributing them to a stressful career. They considered mental health problems to be a sign of "weakness" which threatened their valued professional identity as a "strong" caregiver. Students questioned the acceptability of seeking help for mental health symptoms and believed they should know better than to seek help inappropriately. Concerns about confidentiality and career implications also led to reluctance to disclose symptoms, particularly thoughts of self harm. Busy timetables and distant clerkships imposed additional practical barriers to accessing support.

Conclusions: The study highlights the complex interplay of individual, social, and cultural factors influencing medical students' help-seeking decisions. The findings resonate with sociological models of help-seeking, emphasizing the role of identity and perceived norms in shaping decisions. Medical educators should emphasize the importance of mental health in clinical as well as pastoral settings, and challenge unhelpful professional norms and stigma towards mental illness. Greater recognition of students' tendency to downplay suicidal thoughts may aid professionals in providing appropriate and timely support.

Objective: Advocacy education is an important competency in physician education. The medical education literature includes several examples of advocacy curricula in graduate medical education programs, but few in child and adolescent psychiatry fellowship programs. The authors describe a survey they conducted on the state of advocacy education in child and adolescent psychiatry fellowship programs.

Methods: In October 2024, the authors sent a survey to child and adolescent psychiatry fellowship program directors. The web-based survey asked questions regarding the purpose of the curriculum/advocacy experience, learning objectives, types of content, teaching formats, faculty, assessment of learning, and facilitators and barriers to the curriculum/learning experiences.

Results: Of the 33 child and adolescent psychiatry fellowship directors who responded to the survey, 27 (82% of respondents) indicated having advocacy experiences or curricula. The most common purposes of the advocacy experiences were to "gain awareness of child mental health systems-level issues," "learn about health policy/health laws and regulations," "gain confidence and learn advocacy skills," and "learn how to influence policy." The most common types of educational content in the advocacy experience/curriculum were "legislative advocacy skills" and "social determinants of health/health equity."

Conclusions: The majority of respondents indicated having advocacy education in their child and adolescent psychiatry fellowship programs. The survey sheds light on common purposes of this training, types of educational content, teaching formats, and common barriers and facilitators to advocacy education in child and adolescent psychiatry fellowship programs.

Objective: The primary objective of this study was to assess the relationship between Adverse Childhood Experiences (ACEs) and well-being in medical students and determine if resilience plays a moderating role in this dynamic. A secondary objective was to provide more descriptive data on ACEs as they relate to medical student demographics.

Methods: The authors administered an anonymous survey to Southeastern US medical students (N = 794) from March to May 2024. The survey included demographics, a 10-item ACE questionnaire, the Brief Resilience Scale, and the Mayo Medical School Well-Being Index.

Results: Fifty-three medical students (65%) reported at least 1 ACE while 21 students (25%) reported at least 4 ACEs. Females, minorities, and students from low-income families (Pearson correlation coefficient = - .288, P < 0.001) tended to report higher ACE scores. Students with an ACE score of 4 or more were significantly more likely to report a state of distress (chi-square test, P = 0.002) compared to individuals with less than 4 ACEs. While 79% of students endorsed either moderate or high resilience levels, the students with low resilience reported poor well-being significantly more (chi-square test, P < 0.001). A logistic regression test found resilience (P = 0.008) and ACE score (P = 0.011) to be associated with well-being status, but resilience did not significantly moderate the relationship between ACEs and well-being (b = 0.069, P = 0.115).

Conclusions: A history of ACEs or low resilience in medical students may contribute to poor mental health outcomes in future physicians and, as a result, should be considered a potential risk factor.