Although medical schools are paying attention to the issue, more needs to be done to help medical students with mental health problems, experts said following of a medical student at New York University (NYU).
The body of Andrea Liu, 26, was found hanging by a rope inside an NYU-owned dorm just before 11 a.m. Tuesday, according to the New York Post. Police believe it was a suicide and say Liu left a note, the Post reported.
The medical school issued a brief statement about Liu's death. "On Tuesday morning, we learned that an individual died at an NYU School of Medicine residence hall," the statement read. "She was currently a student at NYU School of Medicine and police are continuing their investigation. Counseling services are being offered to students, faculty, and staff. At this time of sudden loss and grief, we extend our deepest condolences to the student's family, friends, and fellow students."
Liu's death is emblematic of a larger problem, according to Darrell Kirch, MD, president and CEO of the Association of American Medical Colleges. "The nation's medical schools and teaching hospitals are extremely concerned about the growing problem of student and physician burnout, depression, and suicide," Kirch said in a statement. "As a psychiatrist by training, I am committed both personally and professionally to ending this epidemic."
He noted that medical students and residents can have elevated rates of stress, burnout, and depression. "Within the profession, we are obligated to do all that we can to help our nation's healthcare professionals safeguard their own health while they work to improve the health of their patients. Medical schools have student counseling and well-being programs in place, which is an element of medical school accreditation. Yet due to fear of stigma and professional and personal consequences, some students may not seek the help they need. Medical schools are actively working to provide mechanisms to address this critical issue."
Medical schools and residency training programs do seem to be a little more aware of the issue, Perry Tsai, PhD, president of the American ľֱ Student Association (AMSA), said on a conference call during which a public relations person was present. "I'd say physician burnout, mental health, and suicide among physicians has become more of a front-and-center topic, and in turn, medical schools and residency programs have been a little more proactive in programs to promote wellness [during training]."
But there is still more to be done, said Coco Tirambulo, chair of AMSA's Wellness and Student Life Action Committee. "I think the systematic approach needs to change," she said on the conference call. "[Medical students and physicians] are dealing with traumatic events daily and they need an outlet to express what they've been experiencing."
She suggested that, similar to the "M&M" (morbidity and mortality) meetings that hospital teams convene to discuss cases that didn't go well, academic medical centers could have "a closed-door event where students come together once a week and talk about the losses they've experienced and the mistakes they've made; that will really affirm what has happened."
In addition, "we need to humanize physicians," she added. Medical students "are taking tests all the time and pretending to appear to be perfect and that's very stressful, and [they] can't let out that they're overwhelmed because the attending will say, 'That's selfish of you; you need to be the best you can for your patient.'"
Although Tirambulo said she knew of many medical students who practice mindfulness meditation or yoga, or go to the gym, "sometimes things are overbearing and you need to have a supportive community," she said. "With the [demanding] curriculum, students might not take mental health seriously, thinking they don't have time because they have to study."
For those students who have difficulty accessing counseling services, AMSA offers 4 weeks of free online counseling to members through a service called , Tsai said.
The American Psychiatric Association (APA) also offers mental health help for medical students and physicians through its website, noted Julie Chilton, MD, a child psychiatrist in Asheville, N.C. who emailed ľֱ on behalf of the APA.
Resources on the site include a PowerPoint presentation for wellness advocates to use to educate medical students and staff about wellness and burnout, a wellness manual that medical schools can use to assess how well the organization supports staff wellness and make needed improvements, and a video encouraging doctors further along in their careers to share their own mental health struggles with students and younger staff members to let them know it’s okay to ask for help.