Abstract
ObjectivesTo investigate rates of depression and suicidal ideation in medical students in mainland China and to explore wellness curricula and mental health services available to students.MethodsSecond and third year medical students (N=348) at one medical school in mainland China completed the Patient Health Questionnaire-9 (PHQ-9). Based on responses to the PHQ-9, students were labeled as depressed, with suicidal ideation, and/or impaired. Additionally, students’ feedback from a focus group (N=30) evaluating the current state of the school’s wellness curricula and mental health services was thematically analyzed.ResultsA total of 348 students responded (response rate = 99%) to the survey. Forty-seven of 348 (13.5%) students had moderate-severe depression. The mean PHQ-9 score was 6.02 (SD=3.44). Seven and a half percent of students reported suicidal ideation. The frequency of depression and suicidal ideation did not differ between second and third year medical students (p = 0.52). Nearly 30% of depressed students reported suicidal ideation. Depression and suicidal ideation were strongly correlated (r = 0.42, p < 0.001). Students with depression (p < 0.0001) or suicidal ideation (p = 0.004) were more likely to be impaired compared to students who were not. Focus group participants reported only off-campus student counseling services available to medical students in distress. No wellness curricula were established.ConclusionsRates of depression and suicidal ideation are high in medical students in mainland China. Mental health services are deficient and unlikely to address distress in students. Chinese medical schools should offer mental health support and treatment at an early stage, such as wellness curricula and proactive student counseling.
Highlights
Recent studies have revealed poor mental health in Chinese physicians.[1]
Drawing on the established structure of wellness programming at Vanderbilt School of Medicine described above, we inquired about the existence of formal mentoring and advising from faculty and upper class medical students, student organizations focused on wellness, and dedicated curricula designed by the office of medical education to address wellness.[23]
Three hundred forty-eight students responded to the depression and suicidal ideation questions, and 314 students responded to the impairment question
Summary
Recent studies have revealed poor mental health in Chinese physicians.[1] The frequency of depressive symptoms among Chinese physicians is over 65%, which is a rate much higher than their colleagues worldwide.[2] Depression is highly associated with burnout in Chinese physicians.[3] Over 12% of Chinese physicians report burnout, which is a form of physician distress. The effects of depression extend beyond burnout and other forms of physician distress.[3] Depressed physicians provide lower quality patient care and more commonly commit medical errors.[4] Focusing on the causes of distress, depression and its consequences, in Chinese physicians is important. Since physician distress is hypothesized to begin in medical school, medical school presents an excellent opportunity to avert depression via wellness curricula and mental health programming
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