Abstract
Objectives
Resident and fellow physicians are at elevated risk for developing depression compared to the general population; however, they are also less likely to utilize mental health services. We sought to identify the barriers to seeking mental health treatment among residents across all specialties at a large academic medical center in Chicago, IL.
Methods
Residents and fellows from all programs were asked to complete an anonymous self-report questionnaire.
Results
Of the 18% of residents and fellows that completed the survey, 61% felt they would have benefited from psychiatric services. Only 24% of those who felt they needed care actually sought treatment. The most commonly reported barriers to seeking care were lack of time (77%), concerns about confidentiality (67%), concerns about what others would think (58%), cost (56%), and concern for effect on one’s ability to obtain licensure (50%).
Conclusions
Despite feeling that they require mental health services, few trainees actually sought care. This study identifies an overall need for improved access to mental health providers and psychoeducation for medical housestaff.
References
Butterfield PS. The stress of residency: a review of the literature. Arch Intern Med. 1988;148(6):1428–35. https://doi.org/10.1001/archinte.1988.00380060192034.
Ford CV, Wentz DK. Internship: what is stressful? South Med J. 1986;79(5):595–9. https://doi.org/10.1097/00007611-198605000-00019.
West CP, Shanafelt TD, Kolars JC. Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. JAMA. 2011;306(9):952–60. https://doi.org/10.1001/jama.2011.1247.
Maslach C, Jackson SE. Maslach burnout inventory manual. 2nd ed. Palo Alto: Consulting Psychologists Press; 1986.
Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med. 2014;89(3):443–51. https://doi.org/10.1097/ACM.0000000000000134.
Mata DA, Ramos MA, Bansal N, Khan R, Guille C, Angelantonio ED, et al. Prevalence of depression and depressive symptoms among resident physicians a systematic review and meta-analysis. JAMA. 2015;314(22):2373–83. https://doi.org/10.1001/jama.2015.15845.
Key substance use and mental health indicators in the United States: results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NDUH Series H-51). Retrieved from http://www.samhsa.gov/data. 2016.
Yaghmour NA, Brigham TP, Richter T, Miller RS, Philibert I, Baldwin DCJ, et al. Causes of death of residents in ACGME-accredited programs 2000 through 2014: implications for the learning environment. Acad Med. 2017;92(7):976–83. https://doi.org/10.1097/ACM.0000000000001736.
Schernhammer ES, Colditz GA. Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). Am J Psychiatr. 2004;161:2295–302.
Fahrenkopf AM, Sectish TC, Barger LK, Sharek PJ, Lewin D, Chiang VW, et al. Rates of medication errors among depressed and burnt out residents: prospective cohort study. BMJ Br Med J. 2008;336(7642):488–91. https://doi.org/10.1136/bmj.39469.763218.BE.
Gross CP, Mead LA, Ford DE, Klag MJ. Physician, heal thyself? Regular source of care and use of preventive health services among physicians. Arch Intern Med. 2000;160(21):3209–14. https://doi.org/10.1001/archinte.160.21.3209.
Givens JL, Tjia J. Depressed medical students’ use of mental health services and barriers to use. Acad Med J Assoc Am Med Coll. 2002;77(9):918–21. https://doi.org/10.1097/00001888-200209000-00024.
Roberts LW, Hardee JT, Franchini G, Stidley CA, Siegler M. Medical students as patients: a pilot study of their health care needs, practices, and concerns. Acad Med J Assoc Am Med Coll. 1996;71(11):1225–32. https://doi.org/10.1097/00001888-199611000-00019.
Acknowledgements
The authors thank Ashley Bassett, Northwestern University Feinberg School of Medicine, for her help.
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On behalf of all authors, the corresponding author states there is no conflict of interest.
This study complies with Northwestern University’s IRB.
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Aaronson, A.L., Backes, K., Agarwal, G. et al. Mental Health During Residency Training: Assessing the Barriers to Seeking Care. Acad Psychiatry 42, 469–472 (2018). https://doi.org/10.1007/s40596-017-0881-3
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DOI: https://doi.org/10.1007/s40596-017-0881-3