Improving student mental wellbeingBMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l2421 (Published 13 September 2019) Cite this as: BMJ 2019;366:l2421
All rapid responses
The article and the sole response so far should raise questions about the CAUSES of poor mental well-being. Only then can you ameliorate the poverty of mental well-being.
Some factors may be special to medical education. Some may be common to all students.
As far as medical students are concerned, I ask:
Are medical students encouraged to challenge teachers and "received wisdom" - orthodoxy?
Are medical students encouraged to feel emotion and express emotion when coming across painful, sad episodes of patients deteriorating, dying, in front of their eyes, perhaps despite their best efforts?
Are medical students encouraged to call attention to shoddy care?
Competing interests: No competing interests
Improving Student Mental Wellbeing Rapid Response
There is room for improvement in terms of supporting the wellbeing of medical students in the UK but recent times have shown a major emphasis on improving this aspect of university life for students. This is exemplified by St. George’s University London, where I am currently 4th year medical student.
Pressures of Medical school:
Studying medicine at university is often a highly inspiring and fulfilling degree. However, there is a duality to it. The course is extremely demanding and strenuous for students throughout their 5-6 years, in a variety of ways. Pressures stem from a highly competitive environment, in which students are compared to their peers every year. As well as these academic pressures, there are times in clinical medicine where distressing patient cases can have a negative impact on the mental wellbeing of medical students. These are just two issues medical students are dealing with every day. Developing ‘emotional resilience’ to overcome these obstacles whilst maintaining a work-life balance is a serious challenge for these students.
Tackling the issues:
Mental health problems are experienced by 1 in 6 people every week (1). It is the responsibility of the medical schools to look after wellbeing. St. George’s takes on this responsibility by providing access to numerous support systems. Personal tutors are allocated to each student, with yearly meetings for students, as well as direct contact with the tutor as and when the students need. With only 4,855 students at St. George’s the ‘family’ nature of this educational institution protects and improves the overall wellbeing of students. In addition, new student network systems are being organised to provide further support for students.
15,000 first year students in 2015/16 were reported to have mental health problems in the UK (2). Preventing mental health issues and early intervention are fundamental to lowering these numbers. Raising awareness in educational institutions like St. George’s is the first step.
The stigma attached to mental health may prevent some students from seeking help to improve their wellbeing. Mental health initiatives occur throughout the year to raise awareness and reduce the stigma associated with mental health. University societies provide a balance to the heavy work load. As a personal anecdote, playing football and cricket for the university provides a nice contrast to placement on the wards, allowing me to relieve stress via physical activity and unwind from some of the burden after seeing difficult cases. There are many other societies at St. George’s connecting people and preventing the isolation of students to improve wellbeing.
There is information on the student portal CANVAS on how to look after yourself as a student at St. George’s. Counselling is open to students every weekday for anyone dealing with stress or emotional difficulties. Another option for advice is the student life centre for any student needs. There is access to Cognitive Behavioural Therapy (CBT) courses as well as the big white wall which is St. George’s online support service open 24/7. Apps and websites are also promoted on the CANVAS health and wellbeing page for St. George’s students to provide more methods to cope with daily living including the very useful student minds charity webpage (3).
As another personal anecdote, I find Mindfulness is a powerful tool to improve student wellbeing as it encourages paying attention to the present moment. Professor Mark Williams the former director of the Oxford mindfulness centre, whose Mindfulness course I have attended, suggests that ‘Mindfulness is knowing directly what is going on inside and outside ourselves, moment by moment’ (4). This would allow students across the country to focus on the current task at hand, increase efficiency in studying and help enjoy life in general. Counselling may only be an external coping method, whereas Mindfulness can potentially provide internal resilience to meet the demands of medicine. This could help students as well as qualified doctors.
Extra-curricular societies, counselling and Mindfulness are all examples of actions that can improve and maintain wellbeing. Of course, there is no ‘one way’ to achieve mental wellbeing, but it is imperative for each student to find their way of dealing with life’s challenges- a key lesson to learn at university. Developing this ‘resilience’ will help to handle the difficult situations that medical students will face as qualified clinicians in the future.
1. McManus S, Bebbington P, Jenkins R, Brugha T. Mental health statistics: UK and worldwide [Internet]. Mental Health Foundation. 2019 [cited 6 November 2019]. Available from: https://www.mentalhealth.org.uk/statistics/mental-health-statistics-uk-a...
2. The declining state of student mental health in universities and what can be done [Internet]. Mental Health Foundation. 2019 [cited 6 November 2019]. Available from: https://www.mentalhealth.org.uk/blog/declining-state-student-mental-heal...
3. Mental Health [Internet]. Sgul.ac.uk. 2019 [cited 6 November 2019]. Available from: https://www.sgul.ac.uk/for-students/student-support/health-and-wellbeing...
4. Mindfulness [Internet]. nhs.uk. 2019 [cited 6 November 2019]. Available from: https://www.nhs.uk/conditions/stress-anxiety-depression/mindfulness/
Competing interests: No competing interests