Phillips Matthew S, Steelesmith Danielle L, Brock Guy, Benedict Jason, Muñoz Jessica, Fontanella Cynthia A
Keck School of Medicine of the University of Southern California/LAC+USC Medical Center, Los Angeles, CA, USA.
The Ohio State University College of Medicine, Columbus, OH, USA.
Acad Psychiatry. 2022 Apr;46(2):223-227. doi: 10.1007/s40596-021-01584-y. Epub 2022 Jan 10.
The authors investigated levels of perceived need for help, patterns of mental health service utilization, and barriers to care among US medical students with a focus on students who perceived a need for help but did not report service use in the past 12 months.
The authors administered an online survey to 2,868 medical students at three schools in Ohio between January and February 2020 including validated scales for psychological distress, self-stigma, and an exploration of mental health treatment. The authors used multivariable logistic regression to identify factors associated with treatment and qualitative analysis to identify common barriers to care.
Twenty-eight percent (N = 800) of 2,868 students responded to the survey. Fifty-six percent (n = 439) of students reported a perceived need for help, while 34.6% of these respondents (n = 152) did not receive treatment. Among those with perceived need who completed the survey (n = 388), Asian students compared to non-Hispanic white students (adjusted odds ratio [aOR] = 0.45, 95% confidence interval [CI] 0.25-0.82) and those with higher self-stigma (aOR = 0.90, 95% CI 0.87-0.94) had lower odds of service use. Students told by others to seek help (aOR = 2.82, 95% CI 1.71-4.64) were the only group with higher odds of service use. The most common barriers to care were lack of time, difficulty accessing services, and stigma.
Despite a perceived need for help, many students do not seek care and experience treatment barriers. Schools can encourage help-seeking by identifying students in need, using targeted messaging, fostering a low-stigma environment, and removing barriers.
作者调查了美国医学生对帮助的感知需求水平、心理健康服务利用模式以及就医障碍，重点关注那些在过去12个月中感知到需要帮助但未报告使用过服务的学生。
作者于2020年1月至2月对俄亥俄州三所学校的2868名医学生进行了在线调查，包括心理困扰、自我污名化的有效量表以及心理健康治疗探索。作者使用多变量逻辑回归来确定与治疗相关的因素，并进行定性分析以确定常见的就医障碍。
2868名学生中有28%（N = 800）回复了调查。56%（n = 439）的学生报告有帮助需求感，其中34.6%（n = 152）的受访者未接受治疗。在完成调查且有帮助需求感的学生中（n = 388），与非西班牙裔白人学生相比，亚洲学生（调整优势比[aOR] = 0.45，95%置信区间[CI] 0.25 - 0.82）以及自我污名化程度较高的学生（aOR = 0.90，95% CI 0.87 - 0.94）接受服务的几率较低。被他人告知寻求帮助的学生（aOR = 2.82，95% CI 1.71 - 4.64）是唯一接受服务几率较高的群体。最常见的就医障碍是缺乏时间、难以获得服务和污名化。
尽管有帮助需求感，但许多学生不寻求治疗并面临治疗障碍。学校可以通过识别有需要的学生、使用有针对性的信息传递、营造低污名化环境以及消除障碍来鼓励学生寻求帮助。
