Pitt Elaine, Rosenthal Marilynn M, Gay Tamara L, Lewton Elizabeth
Department of Psychiatry (F6226, MCHC), University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0295, USA.
Acad Med. 2004 Sep;79(9):840-4. doi: 10.1097/00001888-200409000-00005.
The mental health of physicians in training is a topic of considerable concern. Recent attention to the issue of patient safety has led to examination of the relationship between residents' stress and compromised clinical performance. Few mental health programs dedicated to residents and formally structured to meet their specific needs are reported in the literature. The authors raise the question of why there are so few programs and why more residents don't take advantage of services that do exist. They then describe the development and utilization of the University of Michigan Health System's House Officer Mental Health Program. The program was structured to overcome barriers to utilization such as lack of funding, concerns about confidentiality, ease of access and residents' financial constraints and to provide comprehensive services for a wide range of diagnoses. Data are presented on the first four years of operation from 1997-01 that show increasing utilization and high levels of satisfaction over this time period by house officers at all levels of training and in all departments of the Health System. As increasing attention is paid to how to deal with medical errors, the establishment of such programs should be considered, not only as a means to address the general mental health of residents but also as an appropriate venue to deal with the stress that can contribute to and be induced by medical mishaps.
住院医师的心理健康是一个备受关注的话题。近期对患者安全问题的关注促使人们审视住院医师的压力与临床工作表现受损之间的关系。文献中报道的专门针对住院医师且正式构建以满足其特定需求的心理健康项目寥寥无几。作者提出了为何此类项目如此之少以及为何更多住院医师不利用现有服务的问题。接着，他们描述了密歇根大学医疗系统住院医师心理健康项目的发展与应用。该项目的构建旨在克服诸如资金短缺、对保密性的担忧、获取便利性以及住院医师经济限制等利用障碍，并为多种诊断提供全面服务。文中呈现了1997年1月至2001年该项目头四年的运营数据，这些数据表明在此期间，医疗系统各级培训的住院医师以及各个科室的住院医师对该项目的利用率不断提高且满意度颇高。随着人们越来越关注如何处理医疗差错，不仅应将建立此类项目视为解决住院医师总体心理健康问题的一种手段，还应将其视为应对可能导致医疗事故并由医疗事故引发的压力的合适场所。
