In this world we live in young an old alike are awash with stress in our lives. For young people seeking to advance themselves through education, the mountain to climb on the path to a successful career is, it seems, increasingly taking its toll on their mental health and well being, and it is beginning at a younger and younger age. National data indicate that 17% of high school students reported seriously considering suicide and 8% reported making one or more suicide attempts in the preceding 12 month period.
Medical students have been shown to have a high rate of depression, anxiety and suicidal thoughts, and their suicide rate is much higher than the general population. The same is true for doctors.
Much of the response to this challenge all across the United States has been to focus on identification of those who are suffering from depression and who are at risk for suicide and offering support and treatment to them. Those efforts are great and should be continued, but are not enough. The academic process needs to be re-evaluated and in some cases restructured to reduce the damage being done to students rather than only seeking to bind up their wounds after the damage has been done. In my view the performance measurement of educational institutions needs to include a measurement of the mental health and well being of the students at all stages of their education.
For instance our medical schools should not only be evaluated by the Board Exam Scores that their students and graduates achieve, but it should be asked and answered ” at what cost were those scores achieved?” If the ‘cost’ of achieving a 5% improvement in academic scores is a corresponding increase in the prevalence of depression, and suicidal thoughts then the Academic institution should not be the sole judge of whether or not the trade-off is worth it. Prospective students and parents and families have the right to know the mental health outcomes that can be expected if one chooses to attend a particular school.
Reporting of mental health measurements should become an essential performance measure of our schools every bit as important as academic achievement– and those results need to be available to the general public, not just to the counselors and administrators of the school.
I introduced HB 867 in the Missouri Legislature last year, the “Show Me Compassionate Medical Education Act” and it would have become law had it not been for the filibuster in the Missouri Senate brought on by the right to work vote taken in that chamber. The measures called for in that bill would result in a significant step forward for medical education. The problem goes far beyond our medical schools however; in my opinion our high schools and colleges need to begin to screen students to identify prevalence rates for depression and anxiety and re-think educational methods to reduce the damage to students’ mental health that is occurring on a large scale in this country. There is an ongoing need for support and treatment but that alone is no longer sufficient- just like physical illness- prevention is the key.
Missouri HB 867: http://openstates.org/mo/bills/2015/HB867/
St. Louis Medical News article July 9, 2015:House-Bill-867-first-in-nation-to-address-medical-student-mental-health