The DOI matches its Crossref record; 14 of the 14 references it cites were found in a registry or an index.
Depressed Medical Studentsʼ Use of Mental Health Services and Barriers to Use
Abstract
PURPOSE: Depression is an underrecognized yet common and treatable disorder among medical students. Little is known about the rate of mental health service use by depressed medical students. This study sought to determine the level of mental health service use by depressed medical students and their reported barriers to use. METHOD: In the spring of 1994, a one-time survey of 194 first- and second-year medical students was conducted in the School of Medicine at the University of California, San Francisco. Outcome measures were self-reported use of counseling services, barriers to use, suicidal ideation, and depressive symptoms as measured by the 13-item Beck Depression Inventory (BDI). RESULTS: Twenty-four percent (n = 46) of the medical students were depressed by BDI criteria. Of the depressed students, only 22% (n = 10) were using mental health counseling services. The most frequently cited barriers to using these services were lack of time (48%), lack of confidentiality (37%), stigma associated with using mental health services (30%), cost (28%), fear of documentation on academic record (24%), and fear of unwanted intervention (26%). CONCLUSION: These data demonstrate that depression among medical students may be undertreated. Medical schools can assist depressed students by addressing issues such as the stigma of using mental health services, confidentiality, and documentation. Early treatment of impaired future caregivers may have far-reaching implications for the individual students, their colleagues, and their future patients.
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In the citing paper
“only 22% of medical students who are depressed actually access mental health services [4].”
In the citing paper
“medical students experience significantly higher levels of anxiety, depression, and stress compared to their age-matched peers in the general population [4].”
In the citing paper
“Common barriers that prevent students from using these services include time constraints, limited accessibility, concerns about confidentiality, stigma, fear of unwanted interventions, and cost [4,25].”
In the citing paper
“Self-help online therapy programs can address many of these problems [7, 8].”
In the citing paper
“Many students do not seek treatment partly due to the lack of time, privacy concerns, stigma [16], lack of emotional openness [17], and financial constraints [18-21].”
From Efficacy of the Mindfulness Meditation Mobile App “Calm” to Reduce Stress Among College Students: Randomized Controlled Trial (2019) · cites this paper as [18]
Citations
Cites
Screening Depressed Patients in Family Practice
Beck, A. T., & Beck, R. W. (1972) · Postgraduate Medicine · doi:10.1080/00325481.1972.11713319 · Cited by 1,836
Hirschfeld, R. M. A. (1997) · JAMA · doi:10.1001/jama.277.4.333 · Cited by 896
Screening for Depression in Primary Care Clinics: The CES-D and the BDI
Zich, J. M., Attkisson, C. C., & Greenfield, T. K. (1990) · The International Journal of Psychiatry in Medicine · doi:10.2190/lykr-7vhp-yjem-mkm2 · Cited by 570
A longitudinal study of studentsʼ depression at one medical school
Rosal, M. C., Ockene, I. S., Ockene, J. K., Barrett, S. V., Ma, Y., & Hebert, J. R. (1997) · Academic Medicine · doi:10.1097/00001888-199706000-00022 · Cited by 464
Stress, coping, and well-being among third-year medical students
Mosley, T. H., Perrin, S. G., Neral, S. M., Dubbert, P. M., Grothues, C. A., & Pinto, B. M. (1994) · Academic Medicine · doi:10.1097/00001888-199409000-00024 · Cited by 358
Vicissitudes of Depressed Mood During Four Years of Medical School
Clark, D. C. (1988) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1988.03410170069036 · Cited by 249 · cited 1×
“year of school.(2) Although counseling is known to be an effective treatment for depression, depressed medical students have low rates of using mental health counseling services and may not have access to such services at all.”
BackgroundDepression among medical students
Zoccolillo, M., Murphy, G. E., & Wetzel, R. D. (1986) · Journal of Affective Disorders · doi:10.1016/0165-0327(86)90065-0 · Cited by 173
Suicidal Ideation and Behaviours among University Students in Australia
Schweitzer, R., McLean, J. P., & Klayich, M. (1995) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048679509064956 · Cited by 79
A biopsychosocial model of medical student distress
VITALIANO, P. P., Maiuro, R. D., Russo, J. E., Mitchell, E. S., Carr, J. E., & Citters, R. L. V. (1988) · Journal of Behavioral Medicine · doi:10.1007/bf00844933 · Cited by 59
Roberts, L. W., Hardee, J. T., Franchini, G., Stidley, C. A., & Siegler, M. B. (1996) · Academic Medicine · doi:10.1097/00001888-199611000-00019 · Cited by 53
Research works printed but not linked: 3
- Seigle, 1983, J Med Educ, 58, 542
- Hirshfeld, 1997, JAMA, 277, 333, 10.1001/jama.1997.03540280071036 · DOI
- Oppenheimer, 1987, J Med Educ, 62, 504
Cited by
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Metadata
- Authors
- Givens, J. L., & Tjia, J.
- Affiliations
- University of Pennsylvania (US)
- Corresponding author
- Tjia, Jennifer
- ORCID
- Tjia, Jennifer
- Venue
- Academic Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2002-09
- Volume
- 77
- Issue
- 9
- Pages
- 918-921
- ISSN
- 1040-2446 (ISSN-L)
- OpenAlex
- W2045639353
- Cited by
- 583
- References
- 14
- Citations by year
- 2026: 14 · 2025: 15 · 2024: 45 · 2023: 32 · 2022: 41 · 2021: 57 · 2020: 39 · 2019: 36 · 2018: 31 · 2017: 31 · 2016: 31 · 2015: 30 · 2014: 21 · 2013: 32 · 2012: 23
- FWCI
- 11.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Academic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Education › Innovations in Medical Education
- Keywords
- depression, medical students, mental health service utilization, barriers to care, help-seeking, stigma, confidentiality, suicidal ideation, Beck Depression Inventory, counseling services, undertreatment
- MeSH terms
- Adult, Confidentiality, Cross-Sectional Studies, Depressive Disorder, Female, Health Services Accessibility, Health Surveys, Humans, Male, Mental Health Services, Severity of Illness Index, Students, Medical, Time Factors
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