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Maintaining med student mental health

 Medical students studying pathology are often warned not to self-diagnose, lest they find themselves suffering from full-blown hypochondria. Yet one area of illness that is too often overlooked by medical students is deterioration of one's mental health. Though rates of depression and anxiety among students upon entering medical school are comparable to that of their peers, medical students suffer disproportionate increases in prevalence of depression during the course of their education. Students often fall into patterns of chemical dependency to cope and must conceal their behavior to avoid damaging their chances of advancement in the field. Moreover, left unaddressed, depression and burnout have serious adverse effects during postgraduate years on empathy and rates of medical error.
There is an unfortunate irony in the fact that those charged with the duty of caring for the health of others do so to the detriment of their own well-being. Given the taxing nature of training for a career in medicine, it is up to schools and policymakers to ensure medical students have the resources they need to prevent and remedy unhealthy ways of dealing with mental distress. The Journal of the American Medical Association recently published a study indicating that the majority of medical schools do not offer adequate insurance coverage for mental health and substance abuse treatments. Furthermore, according to an Inside Higher Ed article, many plans send students to providers within the institution, meaning mental health professionals available to students are the same individuals who are preceptors and academic advisers for them, posing a threat to confidentiality. Considering that students may already lack motivation to seek help for fear of punishment or stigma, the added disincentive of financial burden associated with treatment must be mitigated. Elevated need among medical students warrants an extended provision of access to treatment for this population, and it is crucial that medical schools take steps to ensure adequate support for their students.
It is heartening to know that here at Brown, Alpert Medical School has instituted a Student Health Council to address many of these issues. The explicit mission of the council is to help students address issues of distress and chemical dependency without fear of repercussion. It is organized such that impaired students can seek help from the faculty or other medical students on the council without having their identity known. Decisions to seek treatment are recommended by and accessible to only council members, and penalty through the Dean of Medicine's office only arises when treatment is refused. We find this an exemplary program, and we hope it takes root at other institutions.
Given the serious nature of mental health needs among medical students, we encourage Alpert and other medical schools to make it a priority to share the financial costs of seeking treatment. Expanding insurance coverage for mental health care for students may incur costs, but the costs of not adequately supporting future physicians is certainly greater. There is a demonstrated deficiency of resources for medical students seeking to maintain their emotional well-being, and we hope medical education administrators actively seek to redress it.

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