Mental Health Stigma in Applications?

[Accio]

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Is there a stigma when talking about mental health of the applicant or relatives in medical school applications? There are often many questions asking about greatest achievements or challenges overcome. Does it reflect poorly on an applicant to talk about this type of stuff? I'm asking for personal knowledge and for others who may have a similar question.

 

[Evisju7]

This is just my opinion here, but I have a little experience in this area.

If you've actually overcome the issue and can provide evidence of this, such as mentioning how you're active in therapy groups or have been through counseling. (Ofcouse, this does not necessarily mean you'll never struggle with it again, just you've taken steps to manage it. It would be naiive to think you'll never face the mental health issues again.)
I think this is viewed as a strength rather than weakness. Overcoming obstacles is always positive

 

[Afford]

This is all my personal opinion. I have a brother who has a mental illness and I thought about writing something about it in a diversity essay, but I found it very difficult to make the essay positive as his condition hasn't really improved, so I did not mention it at all. I would not talk about your mental health as that will make you look bad even if you have overcome it. You don't want to point out major flaws in yourself unless it's something out of your control.

 

[Goro]

It raises an eyebrow, and maybe a flag, depending upon how you discuss it. You will need to me that you can handle the pressure cooker of Medical school, which I've sen break even healthy students. With family issues, you need to show me a degree of selfishness, that you won't go running off every time cousin Joe has a breakdown. In short, I look for coping skills.

Is there a stigma when talking about mental health of the applicant or relatives in medical school applications? There are often many questions asking about greatest achievements or challenges overcome. Does it reflect poorly on an applicant to talk about this type of stuff? I'm asking for personal knowledge and for others who may have a similar question.

 

[Sirphillup]

As someone who underwent an eating disorder as an adolescent and as someone who has also interviewed this cycle, I can tell you that mentioning mental illness/personal health issues does not necessarily have to be a drawback. This is, of course, so long as you can talk about what you have learned and how you overcame the issue in a positive, effective way.

One of my interviewers, for example, asked me how I overcame my eating disorder. Also what I learned and how that experience might have influenced my decision to go into medicine. I talked briefly about that, but I was sure to mention that one of the things I learned from having an eating disorder was the way in which social and economic determinants contribute to disease in very real ways. I talked about how my personal knowledge encourages me to be the kind of person that considers people within the broader context of their life, rather than just their disease. I also discussed how having gone through this experience has taught me how to manage stress, deal with failure, and ask for help when I need it. These are all important things to learn in general, but great for a stressful period such as medical school.

I think that if these things were always a drawback, I would not have gotten any interviews. I have four already and in my first interview, both people were interested in learning about that part of my story.

Good luck.

 

[Accio]

I don't think most people in medicine would consider mental illness as something you have control over.

That being said, I also think most people would question the idea that you can truly "overcome" a mental illness, and I think that's why people are reluctant to bring it up in professional settings (not just medicine, but at any job). Mental illness is typically managed or controlled, rather than cured, and it is the risk of recurrence (especially under stressful situations) that gives people pause. This is an issue far beyond just medical school admissions; it comes up with practicing physicians as well, where the diagnosis of a mental illness can have implications for licensing.

The OP's question is *not* one that should be answered by other pre-meds, or students, or residents, or attending physicians. It should be answered by someone with experience in selecting and supervising students and residents. I would recommend either a Confidential Consult on this board, or reaching out to one of the several adcoms/PDs who are members here. Anyone else's opinion (including mine) is nothing but speculation.

That being said, I completely agree with all of you. It is a touchy subject depending on the context and the circumstances around it. I know a lot of people who have dealt with things like this and although it shows strength, I do know that it is stigmatized by the general public as well.

 

[mehc012]

I don't think most people in medicine would consider mental illness as something you have control over.

That being said, I also think most people would question the idea that you can truly "overcome" a mental illness, and I think that's why people are reluctant to bring it up in professional settings (not just medicine, but at any job). Mental illness is typically managed or controlled, rather than cured, and it is the risk of recurrence (especially under stressful situations) that gives people pause. This is an issue far beyond just medical school admissions; it comes up with practicing physicians as well, where the diagnosis of a mental illness can have implications for licensing.

The OP's question is *not* one that should be answered by other pre-meds, or students, or residents, or attending physicians. It should be answered by someone with experience in selecting and supervising students and residents. I would recommend either a Confidential Consult on this board, or reaching out to one of the several adcoms/PDs who are members here. Anyone else's opinion (including mine) is nothing but speculation.

a) Concerning the "mental illness not considered something you have control over", I would say that the healthcare providers I have met and worked with are probably the most judgemental/least understanding people I have interacted with when it comes to mental health conditions. I'm not sure why, but after working a few days I decided to never so much as tangentially mention my own mental health history to anyone I worked with, and not just because it could come off as unprofessional. And as you note, 'not something you have control over' cuts both ways...OK, so it wasn't a personal failing, but if you have no control over it, you also can't really convince someone you won't have a problem again.

b) OP's question has been answered many, many, MANY times by adcoms on this board. If they want adcom answers, they can easily search for them. The gist of their responses has been "almost always a negative unless written about very, very well, which is rare. And DO NOT write about anything in your app which you are not comfortable discussing in an interview"

We answer these things as if we know because we have seen 80 identical threads in the past, and can practically recite the 'valued' responses in our sleep. If OP didn't want a bunch of responses based off adcoms' prior answers to the same exact question, then they ought to have searched for the adcoms' responses in the past themselves. But please, don't devalue everyone's response as meaningless when really what we are doing is filling in for the forum search that OP didn't bother to do.

 

[gyngyn]

The OP's question is *not* one that should be answered by other pre-meds, or students, or residents, or attending physicians. It should be answered by someone with experience in selecting and supervising students and residents. I would recommend either a Confidential Consult on this board, or reaching out to one of the several adcoms/PDs who are members here. Anyone else's opinion (including mine) is nothing but speculation.

As a point of fact, student members of admissions committees also have first-hand knowledge of the process at their schools (for medical school admissions) and residents are active members of the process for selecting house officers.

Attendings are the only ones one on your list of "exclusions" that supervise (and select) both medical students and residents. Some of us have been or are clerkship and/or program directors as well.

The thread illuminates a question for many applicants and opinions from several viewpoints are valuable. Nothing that OP has said identifies him so his query is well suited for an open forum.

 

[mehc012]

Here is a set of quotes from adcoms in prior discussions of this very issue (mostly LizzyM with some Goro because hey, I only ran one search term with various names, and apparently she either discusses this more frequently, or happens to use the full term 'mental health' more than most).

If you missed a year of school, you are going to need to explain that on your application. How much detail you leave out is up to you. You could be vague and say a health condition. This is "sensitive health information" and it shouldn't be disclosed (in a LOR, for example) without your explicit consent. I'd be very careful about letting the genie out of the bottle.

Whether adcoms would view you as a risky prospect would depend on what they know about the disease and what their perception is of the probability of relapse and their estimation of the likelihood that a relapse would result in a bad outcome for you and/or the school. An adcom may also have had some prior experience with students with this condition and depending on whether the student did well, or not, may color their perception.

Steer clear of depression, too, for the same reasons that you wouldn't mention suicide. Adcoms are very skittish about possible recurrence of an illness that would jepardize your performance & class standing.

Best advice is to use the ephemism "life threatening illness". This can pretty much cover mental and physical illness. In either case, the care you received -- including the help of caring health care professionals -- along with other things you did to cope with the stress of your illness is the topic at hand.

I've been told that someone failed to get admitted in >12 schoosl after using the "life-threatening" but otherwise vague description of a depressive illness. Proceed at your own risk.

One big problem applicants have when discussing physical or mental health issues on an application is that physicians and researchers at academic medical centers suffer from what can be called "spectrum bias". This means that the cases of specific conditions that they see are usually more severe than the average or less responsive to therapy than most. In other words, the sickest patients and those who don't respond to the usual treatment are referred to the big med school hospital/clinic. So, when academic physicians hear of a specific condition what comes to mind is usually the worst, least curable most complicated case around For that reason, they tend to thnk the worst when they hear of an applicant with a specific condition.

Complicating matters is the fact that many physical and mental illnesses can become worse when the patient is stressed. There can be this perception when dealing with an applicant with type 1 diabetes or Crohn's disease just to mention two physical ailments so it is not just a concern about mental illness.

Proceed with caution. Better to get some experience as a volunteer iwth a menatl health agency and use that as a hook to describe how you have tested an interest in caring for patients with mental illnesses. However, be prepared to respond to "why not clinical psychology?" and to emphasize that you are interested in learning about all of medicine and not just one specialty.

Do NOT mention it in PS, and make sure your have the 100% OK to go for med school from your doctors/therapists.

Medical school is a crucible and we've dismissed a number of students due to mental illness adversely affecting their academic performance. In fact, I'd esitmate it's the #1 cause of dismissal at my school.

So, don't listen to us uninformed people parroting the adcoms...here's what we're basing it off of. Years of reading these.

 

[DermViser]

Is there a stigma when talking about mental health of the applicant or relatives in medical school applications? There are often many questions asking about greatest achievements or challenges overcome. Does it reflect poorly on an applicant to talk about this type of stuff? I'm asking for personal knowledge and for others who may have a similar question.

Yes, there is.

 

[deleted480308]

Yes, there is.

It's a rough process with a lot of risk of failure and struggles with stress and inadequacy.....I wouldn't want to put someone with unmanaged mental health issues through that.

 

[DermViser]

It's a rough process with a lot of risk of failure and struggles with stress and inadequacy.....I wouldn't want to put someone with unmanaged mental health issues through that.

I 100% agree. There is a stigma for a good reason. Medical school and eventually residency tends to make things more difficult not easier when it comes to mental health. That's difficult when you're already coming in with a condition, as even people who are healthy students with no risk factors can succumb to mental health issues in medical school. I think @Law2Doc might be able to contribute to this discussion (although whether it will actually be listened to or not, is another story).

 

[Accio]

I was purely asking hypothetically as I have had many friends ask me about this and I was curious about it.

 

[gyngyn]

Most medical students and residents do not sit on admissions committees. But you know that.



You quickly equate "supervising" and "selecting" students and residents. Very different. An attending may supervise students (though likely less-so than the residents do), but most will have minimal if any input on selecting them in the first place. Ditto for residency programs. But again, you also know that.



The OP asked if discussing mental health challenges "reflected poorly" on him/her. This was immediately followed by another pre-med student tell him/her that it doesn't, that overcoming challenges is always a good thing, and to discuss specifics of his/her treatment. Is that one of the viewpoints you consider valuable?

Though I disagree with your contention that only certain highly restricted categories of posters should comment on OP's query, I only corrected the statements that might lead the uninitiated to make erroneous conclusions based on your statement. If someone in any of your "restricted categories " has experience in this matter their voice may be heard. Even if they have little experience, their opinion is not worthless. It may be discussed or refuted by anyone who can show that they are better informed.
Yes, I am aware of all of the categorizations added in this post. I have personally been a member of each category at some point in my career. My hope was to clarify that one's title does not confer a monopoly on an informed opinion.

 

[Evisju7]

Some of these comments are particularly irritating because they perpetuate the notion that a person must be some super-human in order to be a doctor. This is simply not true. You're kidding yourself if you think that doctors don't get sick, have depression, suffer from mental illness, etc.

I knew a doctor who was clearly suffering from depression but couldn't label himself as such. He just kept pushing on and ignoring his issue.

Can we please de-stigmatize mental illness? This is in a broader context than OP's question. I'm sure it's still extremely hush-hush in medicine. So silly.
*Recognize* the issue, deal with it through therapy and management, and push forward. Mental illness does not have to control a person, but they must be able to recognize and confront it.

 

[Aerus]

Some of these comments are particularly irritating because they perpetuate the notion that a person must be some super-human in order to be a doctor. This is simply not true. You're kidding yourself if you think that doctors don't get sick, have depression, suffer from mental illness, etc.

I knew a doctor who was clearly suffering from depression but couldn't label himself as such. He just kept pushing on and ignoring his issue.

Can we please de-stigmatize mental illness? This is in a broader context than OP's question. I'm sure it's still extremely hush-hush in medicine. So silly.
*Recognize* the issue, deal with it through therapy and management, and push forward. Mental illness does not have to control a person, but they must be able to recognize and confront it.

That isn't a very easy thing to do. You see, there's already a stigma that mental illnesses are not serious enough in our society. Many people think that you can just "get over it" and that it's "all in your head". This is something we want to step away from.

Admissions considering the consequences that mental disorders can have on your success in medical training is, in my opinion, actually a step in the right direction in terms of representing how serious mental illnesses are in our society. They shouldn't be taken lightly as a "Oh, I'll get over it in med school. It won't be a risk to my success".

In our society, I see a desire to understand just how serious mental illnesses are. On SDN, I see a desire to brush off the consequences of mental illnesses as a risk to success in medical training. It's either one or the other, and frankly, I prefer the latter. Yes, that means if you are confident that you can handle the stress of medical school, you will have to be more cautious in disclosing this (if at all), but would you rather have admissions be like the rest of our society and think that it's something that anyone can just "get over"?

 

[deleted480308]

It's the same reason armies check for heart conditions in soldiers. Sure you might get through it unscathed with a condition but it's important to recognize the increased risks with certain situations. Those risks include admissions that don't make it to attending and potentially more serious consequences to the health of the student doctor. As evidenced by the IM resident who took their life recently and a mother of a student who shared the same fate posting here last year, this is a life and death decision for some people...it is more than, "do I deserve a seat"

 

[AMEHigh]

Just like any other job application, I wouldn't talk about any medical illness I have in my personal statement or application.

I'm a huge proponent of reducing the stigma associated with mental illness and other medical disorders, but I don't think writing about it in your personal statement is the way to go about such stigma reduction.

I personally would focus on something else.

 

[Evisju7]

Just like any other job application, I wouldn't talk about any medical illness I have in my personal statement or application.

I'm a huge proponent of reducing the stigma associated with mental illness and other medical disorders, but I don't think writing about it in your personal statement is the way to go about such stigma reduction.

I personally would focus on something else.

Part of reducing the stigma is being able to admit and communicate something that is part of you, or has shaped your life.

I don't think someone should even be applying to med school if they don't have a handle on their illlness.

I would think that dealing with and "overcoming" (through management) any kind of mental illness would only be beneficial. Most importantly it gives the person empathy for others' struggles. Also, they should have some extra emotional "tools" to cope with the challenges of med school and beyond. I'm the kind of person that thinks everyone could benefit from therapy

 

[Mad Jack]

As a general rule, avoid discussing mental health issues in the application. While it may not be right that they are looked at quite negatively, it is the reality of the situation. Medical school is stressful and can really push you to your mental and emotional limits- what adcom would want to take a person with a serious history of mental health issues and put them in that situation? They're not just looking out for the school, they also don't want to select people that might be made completely miserable by the process of going through med school.

 

[mehc012]

Part of reducing the stigma is being able to admit and communicate something that is part of you, or has shaped your life.

I don't think someone should even be applying to med school if they don't have a handle on their illlness.

I would think that dealing with and "overcoming" (through management) any kind of mental illness would only be beneficial. Most importantly it gives the person empathy for others' struggles. Also, they should have some extra emotional "tools" to cope with the challenges of med school and beyond. I'm the kind of person that thinks everyone could benefit from therapy

Which means that you're also likely the kind of person who actually does. That is not true for everyone.

I can't think of ANY disease which I would want my potential employers/educators to know about me. It's just unprofessional and invokes pity, which is NOT the emotion which I want associated with me. Sure, yeah, there is occasionally some respect mixed in there as well, but I have no problem earning my respect in the traditional ways. Is it frustrating, sometimes, knowing that no one other than a select few friends will ever know that I turned super bad@$$ my junior year and kicked the crap out of a bunch of mental problems, despite simultaneously spending the semester being threatened with bodily harm by an old best friend? Sure. I'm proud of that, and it'd be nice to get credit. But at the same time, it's personal, and personal information makes people feel awkward. I mean, jeez, try having a discussion in a casual friend group about which menstrual product is best...awkward, no? And yet that is a medical issue which 50% of the population has to deal with and should be completely normalized at this point. Now imagine bringing it up in an interview.

So yes, mental health stigma sucks. But a professional interview/application is not the place to advocate change in the public view, because it is NOT a public situation, and it is NOT a personal one...it is a professional one. There barriers to discussing illness in that situation which supersede even the stigma factor...it's just not appropriate in 99% of cases unless done incredibly tactfully in a manner which is incredibly relevant. You are trying to prove to them that you are the man/woman for the job...there's no place in there to start showing them anything which might be a reason why you would not be suited. It's not a respect thing...I can respect your struggles and your progress without thinking you are fit for the position I am interviewing you for.

 

[hmockingbird]

I mentioned "emergency surgery" in my PS and a childhood background of severe illness (this was named). I got in and am very happy with my school, but I am sure my interview season would have gone a LOT better if I hadn't. I thought about not including it and my parents didn't want me to, but I honestly could not come up with even a fake reason to go to med school that didn't involve me being chronically ill/very sick as a kid. I had a lot of vignettes/experiences to choose from, and picked an emergency surgery because it was (hopefully) clear that it was a one-time thing, and not necessarily something that reflected on my overall health (e.g. it could easily be something like appendicitis which happens to healthy people). I know someone else who had a very rough time with a similar statement.

I think it is probably even worse with mental health, so I would suggest if you can avoid it, do it, and if you feel like you really would not even have looked into being a doctor without that experience and can't come up with an alternate idea for your statement, than try to be as vague as possible and try to find a way to write it that shows you have everything under control and it won't get in the way of your studies. ETA: Also write it well - if you are picking any topic that could potentially be controversial or detrimental, get tons of readers/editors.

ETA2: It was talked about in my interviews, so I also agree about making sure you're comfortable talking about it. They did not ask for specific details about the illness (honestly don't think they cared), it was more about coping skills and how I applied that to the rest of my life, and one of them asked if I was better now (thinly veiled "sympathy" attempt at making sure I wouldn't absence fail my way out). And for the above post, people have different comfort levels about sharing their personal lives, and if the person talking about it is comfortable, it's a whole lot less likely to be awkward. Sure I agree there is a line that shouldn't be crossed, but something like a vague reference to illness, or one-liner naming the disease when the rest of the essay talks about other stuff like how that all ties into being a doctor (instead of shadowing vignettes I used my own, basically), could make for a good interview discussion re: adversity questions and the like, IF the applicant is prepared to talk about it. IMO, you invoke pity when you try to sell a sob story and that shouldn't be the point of the PS or interview - talk about your coping skills, specific moments that convinced you to be a doctor, etc.

 

[Evisju7]

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3067995/

Thought I'd share. Finds that pre-meds and med students have a higher rate of major depression than others.

 

[CrimsonKing]

And the article that shows the prevalence at our medical student level: http://www.ncbi.nlm.nih.gov/pubmed/20841531

It's not something that you should disclose to admission committees, as it is in their interest to not have students with mental illness in the class, where the rigors of medical school can exacerbate that illness and lead to failure or worse.

However, please make sure that you are receiving treatment (medication, therapy, or ideally both) and that you are keeping an eye out for warning signs of progression or your disease. Best of luck. 🙂

 

[AMEHigh]

Part of reducing the stigma is being able to admit and communicate something that is part of you, or has shaped your life.

I don't think someone should even be applying to med school if they don't have a handle on their illlness.

I would think that dealing with and "overcoming" (through management) any kind of mental illness would only be beneficial. Most importantly it gives the person empathy for others' struggles. Also, they should have some extra emotional "tools" to cope with the challenges of med school and beyond. I'm the kind of person that thinks everyone could benefit from therapy

Just because it's not advised to write about a medical condition in your personal statement or discuss during a job or school interview has nothing to do with a person denying that it's a part of you and/or how it has shaped your life. I'm not sure what "having a handle on their illness" and "benefiting from therapy" has anything to do with writing of a personal statement. You can still have a handle, have extra tools and not write about it in your personal statement.

I absolutely think that stigma should be reduced, but interviews aren't the time or place for that to occur.

I think you're missing the point of what I'm saying.

 

[mehc012]

Do you think that overcoming a personal loss by speaking to a grief counselor would be a red flag, or interpreted at the level of seeking help for a mental health illness then?

Similar to how some people have mental health issues of different severities, everyone grieves in different manners. Some just need guidance and someone to talk it out with, while others become dysthemic or depressed... not sure if I want to address this in a secondary for this very reason. Though on the other spectrum, facing loss and dealing with death is very much relevant for a physician's emotional and mental wellbeing. What do you guys think?

I just don't see any reason why you would mention something like that...what is the positive side?
It's not necessarily negative, but it's super personal and doesn't really show much about you or why you want to/should be a physician.

 

[Aerus]

Just because it's not advised to write about a medical condition in your personal statement or discuss during a job or school interview has nothing to do with a person denying that it's a part of you and/or how it has shaped your life. I'm not sure what "having a handle on their illness" and "benefiting from therapy" has anything to do with writing of a personal statement. You can still have a handle, have extra tools and not write about it in your personal statement.

I absolutely think that stigma should be reduced, but interviews aren't the time or place for that to occur.

I think you're missing the point of what I'm saying.

I agree with what you're saying about the personal statement not being a place to talk about it, but that's not really the issue that many hear are worried about. It's whether or not people can actually handle the stress of medical education despite having had a mental illness.

 

[AMEHigh]

I agree with what you're saying about the personal statement not being a place to talk about it, but that's not really the issue that many hear are worried about. It's whether or not people can actually handle the stress of medical education despite having had a mental illness.

What?

The question the poster asked is whether there is stigma to talk about mental illness in a personal statement and that's what I responded to. My point being an interview and personal statement isn't the place to disclose a medical illness. He didn't ask whether a person with a mental illness can handle school. Those are 2 completely separate issues.

 

[mysdnhandle]

.

 

[Aerus]

What?

The question the poster asked is whether there is stigma to talk about mental illness in a personal statement and that's what I responded to. My point being an interview and personal statement isn't the place to disclose a medical illness. He didn't ask whether a person with a mental illness can handle school. Those are 2 completely separate issues.

That was OP's question, but it touches upon a whole different issue, like what you said (besides the professionalism that you talked about). The reason why there is this stigma, the reason why people believe it exists, and the reason why it's so controversial on SDN.