Med student suicide

[GadRads]

A 27-year-old medical student jumped to her death from her eighth-floor dorm room on the Upper East Side on Wednesday, police sources said.

Student is from Mount Sinai.

Take time to de-stress as needed.

http://nypost.com/2016/08/18/med-student-jumps-to-her-death-from-dorm-room-window/

---

Members don't see this ad.

 

[POTUS1995]

wow is med school and residency that bad?

 

[Foot Fetish]

We have no reason to believe that med school is what led her to suicide. For all we know, med school was the least of her worries. Stop projecting.

 

[Mass Effect]

We have no reason to believe that med school is what led her to suicide. For all we know, med school was the least of her worries. Stop projecting.

We have no reason to believe it wasn't. Stop dismissing the very real possibility. She's just one in the estimated 400 medical students or doctors who will die from suicide this year.

 

[ACSurgeon]

We have no reason to believe that med school is what led her to suicide. For all we know, med school was the least of her worries. Stop projecting.

We have some reasons. Like having a higher rate of depression and suicidal ideation among Med students and physicians compared to the general public. It's not a sure thing, but let's not pretend med school didn't contributed significantly.

 

[Psai]

Damn that's really sad.

 

[Saxappeal1]

Stories like these, in my opinion, really give us some perspective. There is a reason that there are counseling services at medical schools. Yet there is a stigma to "asking for" or "needing" help with mental anguish. It takes so much more strength to attend to your own mental health than to ignore it or let stigmas box you in. Rest In Peace, my friend.

 

[Anicetus]

Prepare yourselves for the med students who say it's "not that bad", spend two hours cooking every day, 2 hours working out every day and 8-9 hours sleeping at night. The super humans who deny their powers. God only knows what their potential could truly be if they stressed and studied as hard as the rest of us.

To the rest of us: you're not alone. Some of us aren't denying the stress and anxiety that sometimes a single exam can dictate our paths. Just press on and have things to look forward to on Friday nights.

 

[Ismet]

wow is med school and residency that bad?

At times, yes, it is very hard. This is why it is imperative to seek help when you're feeling overwhelmed and can't cope.

 

[Stagg737]

wow is med school and residency that bad?

By itself, not usually. Though there are some times like around boards when the stress can seem unbearable. However, it's also common for individuals in our field to have high expectations, sometimes unrealistically high, and put a lot of pressure on themselves to meet those expectations. To a certain extent, those pressures are justified as we're in a profession where our decisions and actions can literally determine whether our patients live or die. Even with that, I think med school and residency are only one factor among many that lead something like this.

Regardless of the reasons, it doesn't change how tragic this is or that no one should feel afraid or ashamed of seeking help when they need it.

 

[lymphocyte]

A 27-year-old medical student jumped to her death from her eighth-floor dorm room on the Upper East Side on Wednesday, police sources said.

Student is from Mount Sinai.

Take time to de-stress as needed.

http://nypost.com/2016/08/18/med-student-jumps-to-her-death-from-dorm-room-window/

At times, yes, it is very hard. This is why it is imperative to seek help when you're feeling overwhelmed and can't cope.

Thank you so much for posting this.

Fellow students: about 10% of our colleagues will feel frankly suicidal at some point during medical school, and around 400 physicians kills themselves every year. That's an entire medical school dedicated to replacing doctors who commit suicide.

There's no doubt we're at increased risk, and there are many reasons why. Chaotic sleep schedules, grueling study regimens, high stakes testing--all of it part and parcel of medical training. But there's one undeniable reason that doesn't have to be: stigma. In fact, in one survey of medical students acutely experiencing depressive symptoms, more than 30% explicitly mentioned "stigma" as being the main barrier to seeking professional help, along with 40% being worried about confidentiality. But HIPAA applies just as much to you as it does to the patient's you'll be taking care of, even for care received on campus, because the Family Educational Rights and Privacy Act specifically prevents the sharing with schools of mental health records created for the purpose of treatment only.

Besides, suicidal ideation should be treated just as seriously as any other acute medical symptom, like chest or abdominal pain; it needs evaluation by a skilled professional. If your dad woke up with difficulty breathing, would you tell him to "tough it out" or suggest he stay quiet lest he risk embarrassing himself? No. You'd loudly tell him to go see a doctor. Immediately. Depending on how worried you were, you might even feel compelled to call for help yourself. What applies to your dad, should apply just the same to your friends and you.

All of this is to say, if you ever feel low, so low that's dragging you down: get help. Like with everything in medicine, early interventions matter. Letting things spiral out of control is completely understandable if you're depressed--because it's often too hard to see simple, practical solutions when you're deep in the pits--but the sooner you get help, the better.

At the very least, just make an anonymous phone call: 1-800-273-8255. 24/7.

http://www.suicidepreventionlifeline.org/
https://www.jedfoundation.org/professionals/programs-and-research/legal-resource

Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. JAMA. 2010;304(11):1181-90. http://jama.jamanetwork.com/article.aspx?articleid=186586

 

[Mansamusa]

These window jumping suicides really get to me. It seems like such a split second, not premeditated, maybe sleep-deprived decision that perhaps would not have been made if it were a different day. And I really feel badly for the roommates who were sleeping in the room she jumped out of. I know if were me, the guilt of being in the room and not helping/stopping her would weigh on me (even though it is entirely not their fault)- I hope they have support.

Hope you all are doing well, and those who aren't find the support they need to work through their emotions

 

[Redpancreas]

We have no reason to believe that med school is what led her to suicide. For all we know, med school was the least of her worries. Stop projecting.

Your internal coping mechanisms for dealing with med school have been interesting to listen to, but this crosses a line. You've admitted that you yourself have anxiety issues and write the most attention-seeking posts over the past few weeks, yet when something actually important shows up you have the nerve to respond with garbage like this? I'm glad that I'm older than you so I wouldn't be tempted to seek you out as a mentor. Your behavior in my opinion demonstrates a severe, and worse, purposeful disregard of human decency. This isn't professional athletics or something related where the only thing that's important is winning and you're not some Kobe Bryant anti-hero who will be respected because you're going to be the most competent so you can get a pass on being the world's biggest a**.

The stuff you're saying on here is very real and is read by people interested in medicine which is a profession of service, not a cut-throat competition. As anyone who's experienced a good chunk of medical school would know (and maybe even you may know by now), medical education is literally your life while you are partaking in it so even if the "last-straw" was not medical-education related, it's perfectly reasonable to assume or at the very least suspect that medical education setting may have played a contributing role.


Sent from my iPhone using SDN mobile

 

[Goro]

I vaguely recall that one of our clinical deans gave us a a seminar on this subject and he mentioned this very thing.

These window jumping suicides really get to me. It seems like such a split second, not premeditated, maybe sleep-deprived decision that perhaps would not have been made if it were a different day. And I really feel badly for the roommates who were sleeping in the room she jumped out of. I know if were me, the guilt of being in the room and not helping/stopping her would weigh on me (even though it is entirely not their fault)- I hope they have support.

Hope you all are doing well, and those who aren't find the support they need to work through their emotions

 

[TedStark]

This is really sad. Are the roommates even suspects? Curious how that works.

 

[bananafish94]

Horrible. May she rest in peace.

 

[Crayola227]

I vaguely recall that one of our clinical deans gave us a a seminar on this subject and he mentioned this very thing.

Eh, I heard something like certain methods are more tied to impulsivity and others to fatality, creating a spectrum that differs by gender.

A lot of the *successful* suicides are planned. A lot of the attempts are not. I don't know where this woman's intentions lay. Tragedy.

 

[CharakaComplex]

We have no reason to believe that med school is what led her to suicide. For all we know, med school was the least of her worries. Stop projecting.

Late last academic year I assisted a professor in carrying out a series of surveys based on mental health on 150 random students in my class. The survey I was in charge of administering was the GAD-7 survey for anxiety, and I also organised the results. A whopping 126 of the 150 (84%!) scored a 10 or above (moderate to severe) on the survey; a still dismaying 16 others scored a 5 or above (mild). This leaves only 8 people who scored 'normal' - a pitiful 5.3% of the sample. Now, my school is reputed for being a bit on the lenient side, as most of our grades come from practical classes or postings as opposed to written/theory exams.

Honestly, I don't think the situation is any any better anywhere else in the world. Medicine isn't easy. There's a lot of subject and a lot of stress. The systems worldover are very flawed. You can't expect everyone to be sunshine and bubblegum.

 

[lymphocyte]

I vaguely recall that one of our clinical deans gave us a a seminar on this subject and he mentioned this very thing.

About 1 in 4 people who survive high-lethality suicide attempts took less than 5 minutes to make the decision before attempting. 70% took less than an hour. Most suicidal crises are self-limiting and usually linked to an immediate stressor, like a breakup or a bad test result (imagine failing Step 1). As the stressor fades, often so too does the urge to attempt suicide. In fact, about 90% of people--the vast majority--who survive a suicide attempt, even high-lethality attempts, do not go on to die from suicide. Hence the concepts of suicidal crises and stabilisation. I'm saying this because there's hope, even if things feel hopeless.

Two important points: 1) That doesn't mean there aren't warning signs. While suicide attempts are often impulsive, they're usually made on a background of a lot of risk factors, including certain occupations, psychiatric illness, or any other serious medical comorbidities. You have to maintain an index of suspicion in high risk patients, because people lie. 2) One goal of care is minimise avenues of impulsivity. There's a reason why "Do you own any guns"? is an important question to ask any suicidal patient, a similar reason to why they're putting up a safety net across the Golden Gate Bridge. In practical terms: if anybody is at high risk for suicide, they really need to stay away from alcohol, hallucinogens, high places, guns--whatever might make it that much easier to impulsively attempt.

A great book on this topic, if anybody you know is suicidal (which will be the case as a doctor), is Key Redfield Jamison's "Night Falls Fast." Sophisticated, engaging, memorable, and practical. Why do I feel so passionate about this topic? Many reasons, but I lost two friends to suicide. It's a trauma I hope is visited on no one else. And I'm really, really sorry if it already has been. Every successful suicide has a survivor, often many survivors--the ones left behind to pick up the pieces and cope with what happened. I suspect there are more than a few in this position now at Mt. Sinai.

Simon OR, Swann AC, Powell KE, Potter LB, Kresnow MJ, O'carroll PW. Characteristics of impulsive suicide attempts and attempters. Suicide Life Threat Behav. 2001;32(1 Suppl):49-59.

Mann JJ, Apter A, Bertolote J, et al. Suicide prevention strategies: a systematic review. JAMA 2005;294:2064-2074

 

[Chelsea FC]

This is sad. I just wanted to say I have a really close experience with Mount Sinai and their medical students in general seem to be the happiest of any group in general (but you cant really knows what is going inside I guess)

 

[Wordead]

Late last academic year I assisted a professor in carrying out a series of surveys based on mental health on 150 random students in my class. The survey I was in charge of administering was the GAD-7 survey for anxiety, and I also organised the results. A whopping 126 of the 150 (84%!) scored a 10 or above on the survey; a still dismaying 16 others scored a 5 or above. This leaves only 8 people who scored 'normal' - a pitiful 5.3% of the sample. Now, my school is reputed for being a bit on the lenient side, as most of our grades come from practical classes or postings as opposed to written/theory exams.

Honestly, I don't think the situation is any any better anywhere else in the world. Medicine isn't easy. There's a lot of subject and a lot of stress. The systems worldover are very flawed. You can't expect everyone to be sunshine and bubblegum.

Do you think that's an issue with all the students or with the survey?

You think there's a reason we overdiagnose anxiety and depression?

 

[cbrons]

Thank you so much for posting this.

Fellow students: about 10% of our colleagues will feel frankly suicidal at some point during medical school, and around 400 physicians kills themselves every year. That's an entire medical school dedicated to replacing doctors who commit suicide.

There's no doubt we're at increased risk, and there are many reasons why. Chaotic sleep schedules, grueling study regimens, high stakes testing--all of it part and parcel of medical training. But there's one undeniable reason that doesn't have to be: stigma. In fact, in one survey of medical students acutely experiencing depressive symptoms, more than 30% explicitly mentioned "stigma" as being the main barrier to seeking professional help, along with 40% being worried about confidentiality. But HIPAA applies just as much to you as it does to the patient's you'll be taking care of, even for care received on campus, because the Family Educational Rights and Privacy Act specifically prevents the sharing with schools of mental health records created for the purpose of treatment only.

Besides, suicidal ideation should be treated just as seriously as any other acute medical symptom, like chest or abdominal pain; it needs evaluation by a skilled professional. If your dad woke up with difficulty breathing, would you tell him to "tough it out" or suggest he stay quiet lest he risk embarrassing himself? No. You'd loudly tell him to go see a doctor immediately. Depending on how worried you were, you might even feel compelled to call for help yourself. What applies to your dad, should apply just the same to your friends and you.

All of this is to say, if you ever feel low, so low that's dragging you down: get help. Like with everything in medicine, early interventions matter. Letting things spiral out of control is completely understandable when you're depressed--because it's often too hard to see simple, practical solutions when you're deep in the pits--but the sooner you get help, the better.

At the very least, just make an anonymous phone call: 1-800-273-8255. 24/7.

http://www.suicidepreventionlifeline.org/
https://www.jedfoundation.org/professionals/programs-and-research/legal-resource

Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. JAMA. 2010;304(11):1181-90. http://jama.jamanetwork.com/article.aspx?articleid=186586

I think the "stigma" thing is a lie. There was a far greater "stigma" attached to mental illness in decades past and so far as im aware, the suicide problem wasnt this bad.

Sent from my SM-N910P using SDN mobile

 

[lymphocyte]

I think the "stigma" thing is a lie. There was a far greater "stigma" attached to mental illness in decades past and so far as im aware, the suicide problem wasnt this bad.

Okay.

 

[CharakaComplex]

Do you think that's an issue with all the students or with the survey?

You think there's a reason we overdiagnose anxiety and depression?

I think that's an issue with the students, not the survey. I also think we underdiagnose anxiety and depression, not overdiagnose it. If you asked me why I'd say it's because my country absolutely does not have a concept of mental health and mental upkeep. And the western world isn't the most progressive place either - accepting attitudes towards mental illness are recent concepts and still not popular. Donald Trump made fun of a mentally ill person on national television and everyone laughed. That's enough to make anyone with a jot of compassion depressed.

Also consider that anxiety and depression are two of the most absolutely widespread mental illnesses considering that they're so easy to get. Work-related anxiety is incredibly commonplace in any high-pressure profession, even amongst those with cast-iron stomachs or infinite willpower. Just because a person doesn't present with the signs/symptoms of a mental illness doesn't mean it's not there. They are diseases after all, there's an underlying problem and then chronically happy people like Robin Williams kill themselves because they can't bottle it up any longer.

Also, remember that we're getting really good at diagnosing illnesses with open attitudes, refined techniques and better technology. You could as well ask why we're overdiagnosing peanut allergies or lactose intolerance these days.

I think the "stigma" thing is a lie. There was a far greater "stigma" attached to mental illness in decades past and so far as im aware, the suicide problem wasnt this bad.

Consider the fact that most of the posts pertaining to mental illness in the admissions-related threads on this website disclaim 'don't make a note of your illness on your application'. I think that codifies the stigma well.

 

[chipwhitley]

Late last academic year I assisted a professor in carrying out a series of surveys based on mental health on 150 random students in my class. The survey I was in charge of administering was the GAD-7 survey for anxiety, and I also organised the results. A whopping 126 of the 150 (84%!) scored a 10 or above (moderate to severe) on the survey; a still dismaying 16 others scored a 5 or above (mild). This leaves only 8 people who scored 'normal' - a pitiful 5.3% of the sample. Now, my school is reputed for being a bit on the lenient side, as most of our grades come from practical classes or postings as opposed to written/theory exams.

Honestly, I don't think the situation is any any better anywhere else in the world. Medicine isn't easy. There's a lot of subject and a lot of stress. The systems worldover are very flawed. You can't expect everyone to be sunshine and bubblegum.

How do we compare to other high stress fields? Has anyone looked at the mental health of law students? or engineering students? or i-bankers?

 

[MudPhudHopeful]

How do we compare to other high stress fields? Has anyone looked at the mental health of law students? or engineering students? or i-bankers?

In a survey of graduate students done at Berkeley last year, 47% of PhD students met the criteria for depression. The survey included students from across all disciplines, including engineering, arts/humanities, and biological/physical

https://www.insidehighered.com/news...igh-levels-depression-among-graduate-students


Sent from my iPad using SDN mobile

 

[Ismet]

This is sad. I just wanted to say I have a really close experience with Mount Sinai and their medical students in general seem to be the happiest of any group in general (but you cant really knows what is going inside I guess)

Not all people who are depressed show that in public or when around friends. Someone can be going through crippling depression internally but are able to turn themselves on when around others.

It's also really important to know that all medical schools should be providing free and confidential mental health services, typically a psychologist and a psychiatrist for both counseling and medical management if necessary. My med school had an awesome counselor who I talked to many times in those 4 years, and I think about 1/3-1/2 of the student body typically goes to see him. It can be something as simple as talking through a stressful personal situation, your struggles with Step 1, anything that you want to talk to someone about or help you worth through something. You don't have to be depressed or anxious or any "diagnosis" in order to need help getting through something. There should be no shame or hesitancy in seeking out this resource, especially early on before things get so overwhelming that it's too late.

 

[cbrons]

Consider the fact that most of the posts pertaining to mental illness in the admissions-related threads on this website disclaim 'don't make a note of your illness on your application'. I think that codifies the stigma well.

That doesnt "codify" anything more than paranoia. People not wanting to reveal intimate details of their health history is not due to "stigma," which (according to google) is "a mark of disgrace associated with a particular circumstance, quality, or person."

Schools might be hesistant to admit someone with uncontrolled Bipolar disorder but its not because they believe such a person is of low character, but because their mental health situation is only going to be made worse by medical school.

And I think you'll find most schools are helpful and understanding of acute mental illness once you are a student.

Please stop the big obvious lie that so-called "stigma" is the reason for any of this.

If anything, the biggest contributing factors to mental illness in the process of med school/residency are the rat race mentality coupled with a 1940s-style of evaluation, greatly decreased respect (and self-respect) for the profession, and the frustrating bureaucracy.

1. Where every single activity requires a number assigned to it. Every test, every rotation (even a single 1/2 day of shadowing). Where a LICENSING exam of rather dubious clinical relevance doesnt only determine licensure but actual career options.

2. Where you have to sacrifice a small part of your sanity in order to grin through the bureaucratic juggernaut of hours of paperwork.

3. Where administrators (aka left-wing social engineers) hammer "tolerance" and "diversity" and acceptance for every inferior degree product (NP, PA, etc.) as equivalent to your own. Where Stalinist-like show-trails called "professionalism" committees can ruin your life for any manufactured reason. Where med students have become too dangerous to do anything more than pay $40,000+ a year to stand in the corner of a crowded exam room doing no active learning.

4. Where the profession no longer has any pride. An ancient and noble profession has eroded into a cynical and self-despising characature of itself, where the older generation and the one before that spent so many decades whoring themselves out to scum in the insurance, pharmaceutical industry, and most of all the federal government for whatever short-term riches they enjoyed at the expense of the current and future generation. Their complete and utter failure to protect the profession from encroachment by lesser trained individuals (in large part for the profit they made off said para-professionals) and to protect the uniqueness of the PHYSICIAN-patient relationship (NOT the PROVIDER-patient or PROVIDER-"client" relationship).

When's the last time a modern medical school invited an older physician to speak to the students about the uniqueness of medicine? To promote a feeling of a PRIDE among students for being one of the few people that can actually do this job? To say to them, "You know, all this garbage youre doing right now is really hard/stressful but youre still doing the right thing." To make them proud to be members of an ancient profession with a rich history, and how becoming a doctor (a real one as opposed to a fake one) is a noble and worthwhile pursuit.

Instead, the schools wheel in these beat-down old suitcases to give talks about horse**** like "diversity" and "team work" (aka being subservient to every other profession) and "sacrifice" (aka letting the government walk all over you). These academic hacks who have largely (much like most politicians) never worked a single day in the private sector.

These are all the real factors that contribute to depression, not some fear that going to see a counselor is going to make you a member of a lower caste or something.

Sent from my SM-N910P using SDN mobile

 

[NotYou20]

We have no reason to believe that med school is what led her to suicide. For all we know, med school was the least of her worries. Stop projecting.

...unless you read the article

"the student said. “This girl wasn’t able to handle the stress, I’ll say that. She joined my class, and I saw her in review sessions. She was happy to be here, she was engaged. I knew her group of friends. She wasn’t quiet or detached.

“[But] she was trying extra hard to do well and succeed. Her stress level was very high, she was somewhat anxious. Many of us have anxiety, she always did.”'

Really sad stuff. Rest in peace and hopefully her family and friends can find comfort

 

[sloop]

Med school is really hard on people psychologically. I don't know why there are people here arguing that it's not likely that med school contributed. I grant that people who commit suicide in medical school likely have some predisposing factors besides being med students, but med school can be very isolating and is an adjustment even for generally well-adjusted people.

Among other things, medical school is when a lot of med students start to hit the wall of their abilities for the first time and they begin to have cognitive dissonance over the mismatch between their ambitions and the reality of their circumstances.

 

[Stagg737]

That doesnt "codify" anything more than paranoia. People not wanting to reveal intimate details of their health history is not due to "stigma," which (according to google) is "a mark of disgrace associated with a particular circumstance, quality, or person."

Schools might be hesistant to admit someone with uncontrolled Bipolar disorder but its not because they believe such a person is of low character, but because their mental health situation is only going to be made worse by medical school.

And I think you'll find most schools are helpful and understanding of acute mental illness once you are a student.

Please stop the big obvious lie that so-called "stigma" is the reason for any of this.

If anything, the biggest contributing factors to mental illness in the process of med school/residency are the rat race mentality coupled with a 1940s-style of evaluation, greatly decreased respect (and self-respect) for the profession, and the frustrating bureaucracy.

1. Where every single activity requires a number assigned to it. Every test, every rotation (even a single 1/2 day of shadowing). Where a LICENSING exam of rather dubious clinical relevance doesnt only determine licensure but actual career options.

2. Where you have to sacrifice a small part of your sanity in order to grin through the bureaucratic juggernaut of hours of paperwork.

3. Where administrators (aka left-wing social engineers) hammer "tolerance" and "diversity" and acceptance for every inferior degree product (NP, PA, etc.) as equivalent to your own. Where Stalinist-like show-trails called "professionalism" committees can ruin your life for any manufactured reason. Where med students have become too dangerous to do anything more than pay $40,000+ a year to stand in the corner of a crowded exam room doing no active learning.

4. Where the profession no longer has any pride. An ancient and noble profession has eroded into a cynical and self-despising characature of itself, where the older generation and the one before that spent so many decades whoring themselves out to scum in the insurance, pharmaceutical industry, and most of all the federal government for whatever short-term riches they enjoyed at the expense of the current and future generation. Their complete and utter failure to protect the profession from encroachment by lesser trained individuals (in large part for the profit they made off said para-professionals) and to protect the uniqueness of the PHYSICIAN-patient relationship (NOT the PROVIDER-patient or PROVIDER-"client" relationship).

When's the last time a modern medical school invited an older physician to speak to the students about the uniqueness of medicine? To promote a feeling of a PRIDE among students for being one of the few people that can actually do this job? To say to them, "You know, all this garbage youre doing right now is really hard/stressful but youre still doing the right thing." To make them proud to be members of an ancient profession with a rich history, and how becoming a doctor (a real one as opposed to a fake one) is a noble and worthwhile pursuit.

Instead, the schools wheel in these beat-down old suitcases to give talks about horse**** like "diversity" and "team work" (aka being subservient to every other profession) and "sacrifice" (aka letting the government walk all over you). These academic hacks who have largely (much like most politicians) never worked a single day in the private sector.

These are all the real factors that contribute to depression, not some fear that going to see a counselor is going to make you a member of a lower caste or something.

Sent from my SM-N910P using SDN mobile

I think you've got some valid points, but that stigma does still exist at some schools. I feel fortunate that I go to a school that is extremely supportive of its students' mental health, but I've talked to friends at other schools where the administration embodies the "suck it up and deal with it" attitude. The profession probably is in a much better place in terms of physician health than it was previously, but that doesn't mean the stigma is completely gone. Example: this popped up in my newsfeed today. Not mental health, but just as egregious imo:

http://www.kevinmd.com/blog/2016/08/hospital-fires-doctor-cancer.html

 

[sloop]

I think you've got some valid points, but that stigma does still exist at some schools. I feel fortunate that I go to a school that is extremely supportive of its students' mental health, but I've talked to friends at other schools where the administration embodies the "suck it up and deal with it" attitude. The profession probably is in a much better place in terms of physician health than it was previously, but that doesn't mean the stigma is completely gone. Example: this popped up in my newsfeed today. Not mental health, but just as egregious imo:

http://www.kevinmd.com/blog/2016/08/hospital-fires-doctor-cancer.html

I agree that there's definitely still stigma out there regarding seeking help for these things, but it is getting better and I, too, am glad to go to supportive school.

One thing I will add is that you are a part of the culture of your medical school and it is within your power to make the situation better for at least a few people just by the way you treat those around you. I know it's a very small thing but during the last few rotations, I've made it a point every Friday and Monday to suggest to the new third years that they go out and do something fun, and then follow up by asking what they did for fun over the weekend. I also make sure to ask people if they have any questions or frustrations and to provide reassurance and validation, especially when they start getting stressed about shelf exams.

Not that I believe any of this alone would prevent a suicide like this, but I try to do my part to make people feel a little more supported when I can.

 

[SilverCat]

Ther's definitely a stigma that still exists. If I recall correctly, during one of our behavioral health lectures, we had a class poll with clickers that asked how many students would seek professional help if they felt they needed it--about 50% said they would not.

 

[lymphocyte]

Please stop the big obvious lie that so-called "stigma" is the reason for any of this.

blah blah blah

These are all the real factors that contribute to depression, not some fear that going to see a counselor is going to make you a member of a lower caste or something.

You call stigma an "obvious" lie. Things are usually only obvious to the naïve and the experts. Which one are you? Certainly nothing about stigma is obvious to me, except that it seems to exist as a meaningful barrier to getting help (as all the survey data indicate).

You talk about the "biggest contributing factors to depression," but you don't mention organic illness as one of them. Doesn't that count? I'm not saying you're denying it exists, but let's not forget the obvious things that go along with depressive relapse, like stress, sleep, and necessary but ego-damaging critique, etc.

You raise two good points: 1) most medical school can be incredibly understanding of acute mental illness, and 2) going to a counselor isn't any kind of disgrace. But neither 1 nor 2 change the fact that the stigma is real (Or do you really feel comfortable mentioning psychiatric illnesses on ERAS? What about to your state's Physician Health Board? What about to your fellow residents if you were acutely depressed and suicidal? Can you address the 4 studies I cite below?). But a key take-away from all the literature: stigma is often perceived in great disproportion to its actual consequences. Hence, it's an important barrier to loudly break down. Everybody needs to get help if they need, sooner rather than later. And attendings need to do their part in breaking down barriers too. @Goro has been a champion at this.

Chew-Graham CA, Rogers A, Yassin N. ‘I wouldn't want it on my CV or their records’: medical students' experiences of help-seeking for mental health problems. Med Educ. 2003;37(10):873-880

Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: a cross-sectional study. Med Educ. 2005;39(6):594-604

Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol. 2001;27(Aug):363-385

Schwenk TL, Gorenflo DW, Leja LM. A survey on the impact of being depressed on the professional status and mental health care of physicians. J Clin Psychiatry. 2008;69(4):617-620

Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. JAMA. 2010;304(11):1181-90.

Tjia J, Givens JL, Shea JA. Factors associated with undertreatment of medical student depression. J Am Coll Health. 2005;53(5):219-224

 

[image187]

1) stigma is real, and 2) anyone who doesn't believe the deranged culture of medical training we all live in has anything to do with this news story is delusional.


Sent from my iPhone using SDN mobile

 

[Goro]

This doesn't surprise me at all. Most medical students are highly achieving people. Seeking help is seen as a loss of face.

The #1 reason my school has lost students to dismissal or withdrawals is mental health issues. Depression, as far as I know, is the most common problem.

Ther's definitely a stigma that still exists. If I recall correctly, during one of our behavioral health lectures, we had a class poll with clickers that asked how many students would seek professional help if they felt they needed it--about 50% said they would not.

 

[zeppelinpage4]

I think the "stigma" thing is a lie. There was a far greater "stigma" attached to mental illness in decades past and so far as im aware, the suicide problem wasnt this bad.

Sent from my SM-N910P using SDN mobile

More than the stigma, it's something deeper with the system I think.

I feel that medical schools can be pretty good acknowledging and helping students with mental illness. Mine was when things got really bad.
The problem is that, they're not addressing the systemic problems contributing to that mental illness and maybe even that the resources being offered aren't enough.

Too much, I feel we take this approach of throwing pills at the problem and saying we fixed it. If there's higher rates of depression and suicide among medical trainees, then the problem lies in the system they are being trained in. Not just in the trainees.
However, rather than seek out ways to improve our system, I feel like we diagnose more and more students w/ depression, put them on SSRIs and say the problem is now solved...w/o addressing any of the issues that lead to that depression in the first place.

Mental illness is often the result of brain chemistry, AND the outside environment contributing together. As the stigma fades, I think we're getting better at giving students help and addressing the brain chemistry part. But until we improve the environment, the illness will persist.

I realize we signed up for the long hours, the high stress, the workload...and at the end of the day, the training must be rigorous, because we'll be responsible for patient lives and to make tough decisions. However, I can't help but feel some of the problems in this system exist for no benefit, not to the students education, nor to their future patient's well being (many of the things you listed and I agree with). From attendings, down to med students, it's just a constant barrage of evaluations, high stress work environments, scut work, and minimal time to take care of oneself physically and mentally. Surely some of these can be improved upon.

Also, not sure if this is an issue for others, but even though a counseling service at my school exists, I was seen by a psychology grad student and I didn't feel it was adequate. Their hours were difficult to accommodate as well, b/c many of us didn't get out of the hospital till the evenings.
So some of us had to seek private professional help on our own time with our own resources, because what the school provided didn't feel like it was enough or appropriate for addressing more serious mental health issues.
Not sure how other schools are, but I feel like little things like this need to be addressed. It's not enough to say, "hey guys this process is gonna suck, so get counseling next door if you need." We should make it easy for someone to get that help, and encourage them to do so. We also need to make sure it's an appropriate level of help being given. If there are too many barriers to getting that help, a busy overwhelmed student is not gonna go out of their way to get it, especially if they're already depressed and just struggling to get out of bed.
We also need to ask, is there any way we can make this process suck just little bit less? It's gonna suck, and some parts need to be tough, but I don't think all of it has to. Just making the healthcare environment kinder and more supportive can make a big difference.

If anyone is having issues and reading this, please seek help and know that you're not alone. I've had suicidal ideations. In the middle of third year, I even wrote a letter, and had a plan once. I never intended to act on them, but there were days where those suicidal thoughts were comforting to me. It's scary to think looking back. I had never been pushed to thoughts like this until I started med school.

However, I'm so glad I did not act on any of those thoughts. Nearly a year has gone by since I began treatment and things have gotten better. Many hurdles that in the moment seemed so big, aren't as scary anymore. Though life is far from perfect and some days are still a struggle, it has gotten much much better for me and will for you too. So please, no matter how dark it seems, seek help, don't give up fighting and know that even this darkness will pass and good days lay ahead.

Lastly, though it's better, I do feel the stigma still exists. I wanted to write about my experience of overcoming depression and how it shaped me as a physician in my personal statement for residencies. But all my advisers discouraged it and said to leave all mental health issues out, just not to bring it up at all.

Edit. Actually cbrons, your second post summed up everything I wanted to say better then I could say it. Though I believe stigma is def still there, I absolutely think a big contributing factor is just how messed up this healthcare and training system has become.

I agree that there's definitely still stigma out there regarding seeking help for these things, but it is getting better and I, too, am glad to go to supportive school.

One thing I will add is that you are a part of the culture of your medical school and it is within your power to make the situation better for at least a few people just by the way you treat those around you. I know it's a very small thing but during the last few rotations, I've made it a point every Friday and Monday to suggest to the new third years that they go out and do something fun, and then follow up by asking what they did for fun over the weekend. I also make sure to ask people if they have any questions or frustrations and to provide reassurance and validation, especially when they start getting stressed about shelf exams.

Not that I believe any of this alone would prevent a suicide like this, but I try to do my part to make people feel a little more supported when I can.

This is an awesome idea. Def agree. My school holds biweekly small group sessions, where third and fourth years can talk to each other and an attending mentor about anything on their mind or issues bothering them, and we all talk about it. Nothing that is said in the room leaves it and our mentors are separate from the academic/teaching faculty. It's essentially a med student support group, but it's helped me and people seem to like it.

 

[cbrons]

You call stigma an "obvious" lie. Things are usually only obvious to the naïve and the experts. Which one are you? Certainly nothing about stigma is obvious to me, except that it seems to exist as a meaningful barrier to getting help (as all the survey data indicate).

You talk about the "biggest contributing factors to depression," but you don't mention organic illness as one of them. Doesn't that count? I'm not saying you're denying it exists, but let's not forget the obvious things that go along with depressive relapse, like stress, sleep, and necessary but ego-damaging critique, etc.

You raise two good points: 1) most medical school can be incredibly understanding of acute mental illness, and 2) going to a counselor isn't any kind of disgrace. But neither 1 nor 2 change the fact that the stigma is real (Or do you really feel comfortable mentioning psychiatric illnesses on ERAS? What about to your state's Physician Health Board? What about to your fellow residents if you were acutely depressed and suicidal? Can you address the 4 studies I cite below?). But a key take-away from all the literature: stigma is often perceived in great disproportion to its actual consequences. Hence, it's an important barrier to loudly break down. Everybody needs to get help if they need, sooner rather than later. And attendings need to do their part in breaking down barriers too. @Goro has been a champion at this.

Chew-Graham CA, Rogers A, Yassin N. ‘I wouldn't want it on my CV or their records’: medical students' experiences of help-seeking for mental health problems. Med Educ. 2003;37(10):873-880

Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: a cross-sectional study. Med Educ. 2005;39(6):594-604

Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol. 2001;27(Aug):363-385

Schwenk TL, Gorenflo DW, Leja LM. A survey on the impact of being depressed on the professional status and mental health care of physicians. J Clin Psychiatry. 2008;69(4):617-620

Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. JAMA. 2010;304(11):1181-90.

Tjia J, Givens JL, Shea JA. Factors associated with undertreatment of medical student depression. J Am Coll Health. 2005;53(5):219-224

Nice straw man. I never said to mention psychiatric illnesses on ERAS. I explained that the reason to not mention them has nothing to do with "stigma." They dont think, "Hm we better not rank this kid with depression. Hes a bad/morally weak person." Thats what a stigma is.


Sent from my SM-N910P using SDN mobile

 

[Seth Joo]

Its not just medical schools where you see this, its also at undergraduate schools:
https://www.bostonglobe.com/metro/2...nal-average/1aGWr7lRjiEyhoD1WIT78I/story.html

Two of the best universities in the country have some of the highest suicide rates as well, Harvard and MIT. At MIT, undergraduates commit suicide at a rate higher than graduate students.

 

[Lost In Transcription]

That doesnt "codify" anything more than paranoia. People not wanting to reveal intimate details of their health history is not due to "stigma," which (according to google) is "a mark of disgrace associated with a particular circumstance, quality, or person."

Schools might be hesistant to admit someone with uncontrolled Bipolar disorder but its not because they believe such a person is of low character, but because their mental health situation is only going to be made worse by medical school.

And I think you'll find most schools are helpful and understanding of acute mental illness once you are a student.

Please stop the big obvious lie that so-called "stigma" is the reason for any of this.

If anything, the biggest contributing factors to mental illness in the process of med school/residency are the rat race mentality coupled with a 1940s-style of evaluation, greatly decreased respect (and self-respect) for the profession, and the frustrating bureaucracy.

1. Where every single activity requires a number assigned to it. Every test, every rotation (even a single 1/2 day of shadowing). Where a LICENSING exam of rather dubious clinical relevance doesnt only determine licensure but actual career options.

2. Where you have to sacrifice a small part of your sanity in order to grin through the bureaucratic juggernaut of hours of paperwork.

3. Where administrators (aka left-wing social engineers) hammer "tolerance" and "diversity" and acceptance for every inferior degree product (NP, PA, etc.) as equivalent to your own. Where Stalinist-like show-trails called "professionalism" committees can ruin your life for any manufactured reason. Where med students have become too dangerous to do anything more than pay $40,000+ a year to stand in the corner of a crowded exam room doing no active learning.

4. Where the profession no longer has any pride. An ancient and noble profession has eroded into a cynical and self-despising characature of itself, where the older generation and the one before that spent so many decades whoring themselves out to scum in the insurance, pharmaceutical industry, and most of all the federal government for whatever short-term riches they enjoyed at the expense of the current and future generation. Their complete and utter failure to protect the profession from encroachment by lesser trained individuals (in large part for the profit they made off said para-professionals) and to protect the uniqueness of the PHYSICIAN-patient relationship (NOT the PROVIDER-patient or PROVIDER-"client" relationship).

When's the last time a modern medical school invited an older physician to speak to the students about the uniqueness of medicine? To promote a feeling of a PRIDE among students for being one of the few people that can actually do this job? To say to them, "You know, all this garbage youre doing right now is really hard/stressful but youre still doing the right thing." To make them proud to be members of an ancient profession with a rich history, and how becoming a doctor (a real one as opposed to a fake one) is a noble and worthwhile pursuit.

Instead, the schools wheel in these beat-down old suitcases to give talks about horse**** like "diversity" and "team work" (aka being subservient to every other profession) and "sacrifice" (aka letting the government walk all over you). These academic hacks who have largely (much like most politicians) never worked a single day in the private sector.

These are all the real factors that contribute to depression, not some fear that going to see a counselor is going to make you a member of a lower caste or something.

Sent from my SM-N910P using SDN mobile

So you just listed a bunch of reasons why med students have depression.

Stigma was listed as the biggest barrier to seeking treatment, not a cause of the underlying depression.

 

[psychMDhopefully]

wow is med school and residency that bad?

The pressure is that bad, one test that determines the next 40 years of you life, and you can't retake it? Wtf came up with that.

 

[MedicineZ0Z]

What is this ridiculous nonsense about "seeking help" lol...

It's the unnecessary workload that causes depression and suicides... Fix the curriculum.

 

[cbrons]

So you just listed a bunch of reasons why med students have depression.

Stigma was listed as the biggest barrier to seeking treatment, not a cause of the underlying depression.

Thats a good point, but still, where is the hard evidence that "stigma" is the reason they dont? I actually think Goro's point about med students being embarrassed to seek help to be wrong. In reality, i think it is more a cost-benefit analysis. Students probably dont seek help as much because they dont think itll help them. Also, there is little help offered by schools directly. Schools dont employ psychologists. I mean how can you pay the salary of someone useful when you can instead hire another Administrative Clerk to do nothing.

Saying students dont seek help because they are afraid of being labelled a disgrace or being looked down upon is just in my mind completely ridiculous. Especially when you compare now vs. the past.

I am not denying med student and physician depression/mental illness/suicide is a problem. Im not even denying that many are hesistant to seek help. I just dont think the main reason for these things has much to do with a prevailing "stigma" of being diagnosed with a mental illness.

Sent from my SM-N910P using SDN mobile

 

[Mass Effect]

That doesnt "codify" anything more than paranoia. People not wanting to reveal intimate details of their health history is not due to "stigma," which (according to google) is "a mark of disgrace associated with a particular circumstance, quality, or person."

Schools might be hesistant to admit someone with uncontrolled Bipolar disorder but its not because they believe such a person is of low character, but because their mental health situation is only going to be made worse by medical school

They're hesitant to admit someone with bipolar disorder because they're worried that person won't be able to get a license, or are you not aware that every state's licensing application includes a question about mental illness and there are still a handful that don't have the type of loose wording that allows you to check NO?

And I think you'll find most schools are helpful and understanding of acute mental illness once you are a student.

Please stop the big obvious lie that so-called "stigma" is the reason for any of this.

Anyone saying there is no stigma to mental illness is flat-out wrong. Those of us working in mental health know, for a fact, that there's stigma, even from other PHYSICIANS. We hear it and deal with it every single day. The ones who deny there's a stigma are usually the biggest contributors and proponents of the stigma.

These are all the real factors that contribute to depression, not some fear that going to see a counselor is going to make you a member of a lower caste or something.

You're confusing your own argument. No one is saying that the stigma is what leads to depression or suicide. Of course all the things you mentioned lead to depression. The BARRIER to seeking help for the depression is stigma. To argue that it isn't is just ridiculous.

 

[charmiedermie]

We have no reason to believe that med school is what led her to suicide. For all we know, med school was the least of her worries. Stop projecting.

What a weird response to have. I know you said that your therapist wasn't working for you, but I think you should find a better one. The article even said she wasn't able to handle the stress, she was very highly stressed, and was always anxious.

 

[Mass Effect]

Thats a good point, but still, where is the hard evidence that "stigma" is the reason they dont? I actually think Goro's point about med students being embarrassed to seek help to be wrong. In reality, i think it is more a cost-benefit analysis. Students probably dont seek help as much because they dont think itll help them. Also, there is little help offered by schools directly. Schools dont employ psychologists. I mean how can you pay the salary of someone useful when you can instead hire another Administrative Clerk to do nothing.

Saying students dont seek help because they are afraid of being labelled a disgrace or being looked down upon is just in my mind completely ridiculous. Especially when you compare now vs. the past.

I am not denying med student and physician depression/mental illness/suicide is a problem. Im not even denying that many are hesistant to seek help. I just dont think the main reason for these things has much to do with a prevailing "stigma" of being diagnosed with a mental illness.

Sent from my SM-N910P using SDN mobile

You don't know what you're talking about.

 

[psychMDhopefully]

Thats a good point, but still, where is the hard evidence that "stigma" is the reason they dont? I actually think Goro's point about med students being embarrassed to seek help to be wrong. In reality, i think it is more a cost-benefit analysis. Students probably dont seek help as much because they dont think itll help them. Also, there is little help offered by schools directly. Schools dont employ psychologists. I mean how can you pay the salary of someone useful when you can instead hire another Administrative Clerk to do nothing.

Saying students dont seek help because they are afraid of being labelled a disgrace or being looked down upon is just in my mind completely ridiculous. Especially when you compare now vs. the past.

I am not denying med student and physician depression/mental illness/suicide is a problem. Im not even denying that many are hesistant to seek help. I just dont think the main reason for these things has much to do with a prevailing "stigma" of being diagnosed with a mental illness.

Sent from my SM-N910P using SDN mobile

Stigma is apart of it for sure, med students are a VERY prideful bunch, and the crap show of an admissions process we have tells them its not okay to be anything less than almost perfect. Second, some schools just provide crappy mental health resources because LCME makes them. Our counseling services are located in a really conspicuous area, they don't make any attempt to provide students with privacy, the only 2 therapist we have working there for the entire university aren't good, and the psychiatrist treats med students who are seeking help for depression as if they are just making excuses. There needs to be higher standards for the people providing mental health service to med students, should be at least one psychologist there.

 

[W19]

Wasn't there a story like that in SDN 2-3 months ago about a med school student in PR that used the same method to end his/her life? Am I right?

 

[W19]

An antiquated system that no one wants to change and everyone (even med student) is defending...

 

[Mass Effect]

Wasn't there a story like that in SDN 2-3 months ago about a med school student in PR that used the same method to end his/her life? Am I right?

There have been a ton of these stories. Several have done it by jumping. There was a med student a few years ago who killed herself and her mother became a poster on SDN, talking about suicide among med students. Her mother also had a blog about her daughter's death. Unfortunately, the mother never recovered from her daughter's death and ended up taking her own life as well.