December 16, 2005

VUSM forum addresses mental health concerns

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Gerald Hickson, M.D.

VUSM forum addresses mental health concerns

Vanderbilt University School of Medicine is not taking the mental health of its students for granted.

Launched into action by data that shows that 25 percent of first- and second-year students at the University of California-San Francisco suffer from depression, and that medical students across the country are at higher risk for developing certain mental illnesses like depression, the Wellness Committee of VUSM recently gave medical students a way to voice their concerns.

They developed a 10-day online Wellness forum in November that allowed Vanderbilt medical students to ask two Vanderbilt psychiatrists about their mental health concerns. Carol Milam, M.D., assistant clinical professor of Psychiatry, and Ron Cowan, M.D., assistant professor of Psychiatry, donated their time to the effort.

The students were allowed to submit questions anonymously, but other students could read the anonymous questions and the answers given by Milam and Cowan and respond to those questions as well.

The format encouraged open dialogue, says Scott Rodgers, M.D., assistant dean for Medical Student Affairs and assistant professor of Psychiatry. The administration of the medical school was not privy to the students' dialogue.

“We believe it made a difference,” Rodgers said. “We had more than 3,000 hits on the Web site and 158 posted responses.

“Medical school is very demanding, both academically and socially,” Rodgers said. “Adjusting to a challenging basic science curriculum can be difficult for students in their first and second year of medical school. In the third and fourth years, students are more isolated; they're spending longer hours in the hospital and are often sleep deprived. They change from one team to the next, going through rotations. They need to adapt constantly to a rapidly changing environment,” he said.

An article in the September New England Journal of Medicine, “White Coat, Mood Indigo — Depression in Medical School,” started a nationwide dialogue about the importance of the mental health of medical students. The article, written by a fourth-year medical student at the University of Pennsylvania School of Medicine and a contributing editor of NEJM, profiled a similar online forum at Duke University School of Medicine that received more than 100 postings and 1,000 hits during its 10-day existence in April 2005.

The paper cited data from UCSF that showed one-fourth of its student body was depressed, and from Harvard where a psychiatrist and director of the Office of Advising Resources said she met individually with 208 medical students, or one-quarter of the student body during a two-year period, and 15 percent presented with self-described depression, 20 with transient “reactive” depressed mood, and 11 with a history of major depression.

The Vanderbilt forum was led by fourth-year student Adam Tibble, the Wellness Committee's president, and third-year student Kevin James, vice-president. Third-year student Phil Tennant, leader of the Wellness Web site development committee, created the online forum.

“I think the response was pretty impressive,” James said. “We're thrilled, and believe that those who took part in the discussion found the comments helpful. The Wellness Committee feels this technique worked allowing students to communicate their concerns.”

Rodgers said that medical students and physicians are not always capable of recognizing depression in themselves. “Signs are frequently missed and many people suffer unnecessarily, going without treatment. To suffer from depression and not get real help, with psychotherapy and medications readily available, would be a real tragedy.”