We need better Mental health and Wellbeing education for Medical students & Junior doctors

In school and university, my peers and I got little education about mental health and wellbeing. In contrast, we got a fair bit of education on “physical health”. It’s strange to me that this most important of organs – your brain, which most definitely resides in your physical body – so often got left out of the equation. All due to some arbitrary distinction between physical and mental health. Given the high rates of mental ill health amongst doctors, you would have thought that medical universities would do more to remedy this lack in education. 

So often, we think about mental health from the perspective of the individual suffering with a mental health problem – we think about their personal risk factors, their genetics and their personality. In popular culture though, we often forget to think about the importance of the environment in triggering mental health problems.

Medicine is not an easy profession. This isn’t just because of the nature of the job itself – dealing with life and death at a young age, knowing that we carry the responsibility for people’s lives on our shoulders. It’s also because of cultural and institutional failings. 

Doctors struggle to be vulnerable with each other due to a culture of bravado that still persists and fears about what admitting to a mental health condition would mean for their progression through their career. In some countries like the USA, admitting to a mental health condition – even if historical or not an active concern – can trigger a call to appear before the state board, restrictions being placed on a doctor’s ability to practice, or in the worst cases, loss of their license. We also often think of ourselves (and are encouraged to do so societally) as “superdoctors”, superhumans or heroes who do not have the same needs as others, and give 150% to our patients.

Institutionally, as wonderful as the National Health Service in the UK is, there is no doubt that it is an underfunded and understaffed service. Working in woefully underfilled rotas, in increasingly busy hospitals, especially in the wake of a pandemic, takes its toll. Whilst most of us truly believe that the NHS, which provides medical assistance to all for free at the point of care, is a wonderful thing, this doesn’t mean that every trust is equal or that every trust treats its doctors well. Many hospitals lack adequate overnight rest spaces and food facilities. Some bully their doctors to avoid giving them financial remuneration or time off in lieu for their many hours of overtime. 

Given all this, is it any surprise that doctors have such high rates of mental health issues? Is it any surprise that our suicide rate is 2.5 – 4 times that of the general population? 

These are things that need to be talked about. These are things we need to prepare our juniors for. Not to be alarmist, but because when we look at a room of medical students, up to 58% of them may go on to have symptoms of depression, anxiety, stress, burnout, emotional distress, or another mental health condition related to or made worse by their work (BMA survey Dec 2020).

Waiting for doctors to reach a crisis point and hoping they know where to access mental health support when this happens is not good enough. We need to properly educate our medical students and junior doctors about the emotional realities of life as a medic and give them the tools and resources to cope with stress BEFORE they reach a tipping point, not AFTER. They need to know how poor mental health might present in doctors, how to maintain good mental health, and where to get help should they need it.