Literature DB >> 21975622

Utilization and barriers to mental health services among depressed medical interns: a prospective multisite study.

Constance Guille, Heather Speller, Rachel Laff, C Neill Epperson, Srijan Sen.   

Abstract

BACKGROUND: Compared with graduate students and young adults in the general population, depression is more prevalent among training physicians, yet physicians are often reluctant to seek mental health treatment. The purpose of this study is to identify perceived barriers to mental health treatment among depressed training physicians.
METHODS: Subjects for this study were drawn from intern classes during the 2007-2008 and 2008-2009 academic years from 6 and 13 participating community and university hospitals, respectively. At 3-month intervals throughout the intern year, participants completed the Patient Health Questionnaire regarding current depressive symptoms and questions regarding current mental health treatment. We explored potential barriers to mental health treatment at the end of the intern year and determined the proportion of subjects screening positive for depression and seeking treatment through analysis of subject responses. Stepwise binary logistic regression was conducted to compare baseline characteristics among depressed interns who sought mental health treatment and those that did not.
RESULTS: Of the 42.5% (278 of 654) of interns who screened positive for depression, 22.7% (63 of 278) reported receiving treatment during the intern year. The most frequently cited barriers to seeking treatment were time (91.5%), preference to manage problems on their own (75.1%), lack of convenient access (61.8%), and concerns about confidentiality (57.3%). Interns who had previously sought treatment for depression were more likely to seek treatment during internship.
CONCLUSIONS: Despite high rates of depression, few interns appear to seek mental health treatment due to time constraints, lack of convenient access, concerns about confidentiality, and a preference to manage problems on their own. By identifying barriers to mental health treatment we can begin to remove obstacles to the delivery of evidence-based treatments and implement prevention, screening, and early detection programs to improve the mental health of physicians in training.

Entities:  

Year:  2010        PMID: 21975622      PMCID: PMC2941380          DOI: 10.4300/JGME-D-09-00086.1

Source DB:  PubMed          Journal:  J Grad Med Educ        ISSN: 1949-8357


  30 in total

1.  A prospective cohort study investigating factors associated with depression during medical internship.

Authors:  Srijan Sen; Henry R Kranzler; John H Krystal; Heather Speller; Grace Chan; Joel Gelernter; Constance Guille
Journal:  Arch Gen Psychiatry       Date:  2010-04-05

2.  The PHQ-9: validity of a brief depression severity measure.

Authors:  K Kroenke; R L Spitzer; J B Williams
Journal:  J Gen Intern Med       Date:  2001-09       Impact factor: 5.128

3.  Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire.

Authors:  R L Spitzer; K Kroenke; J B Williams
Journal:  JAMA       Date:  1999-11-10       Impact factor: 56.272

4.  Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study.

Authors:  Colin P West; Mashele M Huschka; Paul J Novotny; Jeff A Sloan; Joseph C Kolars; Thomas M Habermann; Tait D Shanafelt
Journal:  JAMA       Date:  2006-09-06       Impact factor: 56.272

5.  A study of anxiety/depressive symptoms of medical students, house staff, and their spouses/partners.

Authors:  H C Hendrie; D K Clair; H M Brittain; P E Fadul
Journal:  J Nerv Ment Dis       Date:  1990-03       Impact factor: 2.254

6.  Burnout and self-reported patient care in an internal medicine residency program.

Authors:  Tait D Shanafelt; Katharine A Bradley; Joyce E Wipf; Anthony L Back
Journal:  Ann Intern Med       Date:  2002-03-05       Impact factor: 25.391

7.  Depressive symptoms in medical house officers. Effects of level of training and work rotation.

Authors:  D B Reuben
Journal:  Arch Intern Med       Date:  1985-02

8.  Preventing the onset of depressive disorders: a meta-analytic review of psychological interventions.

Authors:  Pim Cuijpers; Annemieke van Straten; Filip Smit; Cathrine Mihalopoulos; Aartjan Beekman
Journal:  Am J Psychiatry       Date:  2008-09-02       Impact factor: 18.112

9.  Variation of mood and empathy during internship.

Authors:  Lisa M Bellini; Michael Baime; Judy A Shea
Journal:  JAMA       Date:  2002-06-19       Impact factor: 56.272

10.  Job performance deficits due to depression.

Authors:  David A Adler; Thomas J McLaughlin; William H Rogers; Hong Chang; Leueen Lapitsky; Debra Lerner
Journal:  Am J Psychiatry       Date:  2006-09       Impact factor: 18.112

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  40 in total

1.  Prescription drug use and self-prescription among training physicians.

Authors:  Constance Guille; Srijan Sen
Journal:  Arch Intern Med       Date:  2012-02-27

2.  Beyond must: supporting the evolving role of the designated institutional official.

Authors:  Lisa Bellini; Diane Hartmann; Lawrence Opas
Journal:  J Grad Med Educ       Date:  2010-06

3.  Factors Associated With the Mental Health and Satisfaction of Oral and Maxillofacial Surgery Residents in the United States: A Cross-Sectional Study and Analysis.

Authors:  Charlie Smith; Aarathi Rao; Paul C Tompach; Ashley Petersen; Diana Lyu; Robert A Nadeau
Journal:  J Oral Maxillofac Surg       Date:  2019-07-23       Impact factor: 1.895

4.  In Their Own Words: An Analysis of the Experiences of Medical Interns Participating in a Prospective Cohort Study of Depression.

Authors:  Douglas A Mata; Marco A Ramos; Michelle M Kim; Constance Guille; Srijan Sen
Journal:  Acad Med       Date:  2016-09       Impact factor: 6.893

5.  "If you build it, they will come": attitudes of medical residents and fellows about seeking services in a resident wellness program.

Authors:  Sydney Ey; Mary Moffit; J Mark Kinzie; Dongseok Choi; Donald E Girard
Journal:  J Grad Med Educ       Date:  2013-09

6.  Factors associated with mental health status of medical residents: a model-guided study.

Authors:  Fotios Anagnostopoulos; Evangelia Demerouti; Panagiota Sykioti; Dimitris Niakas; Panagiotis Zis
Journal:  J Clin Psychol Med Settings       Date:  2015-03

Review 7.  Intern Mental Health Interventions.

Authors:  Sarah Bommarito; Matthew Hughes
Journal:  Curr Psychiatry Rep       Date:  2019-06-04       Impact factor: 5.285

8.  Resident Preferences for Program Director Role in Wellness Management.

Authors:  Russ C Kolarik; Richard L O'Neal; Joseph A Ewing
Journal:  J Gen Intern Med       Date:  2018-03-05       Impact factor: 5.128

9.  Burnout and Emotional Well-Being among Nephrology Fellows: A National Online Survey.

Authors:  Varun Agrawal; Laura Plantinga; Khaled Abdel-Kader; Kurtis Pivert; Anthony Provenzano; Sandeep Soman; Michael J Choi; Bernard G Jaar
Journal:  J Am Soc Nephrol       Date:  2020-03-02       Impact factor: 10.121

10.  Web-Based Cognitive Behavioral Therapy Intervention for the Prevention of Suicidal Ideation in Medical Interns: A Randomized Clinical Trial.

Authors:  Constance Guille; Zhuo Zhao; John Krystal; Breck Nichols; Kathleen Brady; Srijan Sen
Journal:  JAMA Psychiatry       Date:  2015-12       Impact factor: 21.596

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