Perceptions and intentions relating to seeking help for depression among medical undergraduates in Sri Lanka: a cross-sectional comparison with non-medical undergraduates

BMC Medical Education

Nicola J. Reavley¹  Anthony F. Jorm¹  Santushi D. Amarasuriya¹ 

[1] Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Victoria 3010, Australia

关键词: Sri Lanka;    Intentions;    Perceptions;    Beliefs;    Attitudes;    Help-seeking;    Depression;    Undergraduate;    Medical;   

Others  :  1228677
DOI  :  10.1186/s12909-015-0453-8

 received in 2015-06-01, accepted in 2015-09-22,  发布年份 2015

【 摘 要 】

Background

This study attempts to understand whether medical undergraduates in Sri Lanka would seek help for depression. This was done by examining their perceptions and intentions relating to seeking help for depression, using the responses of non-medical undergraduates as the baseline for comparison.

Method

Medical (n = 620) and non-medical undergraduates (n = 4050) at the University of Colombo responded to a questionnaire which included a vignette about a depressed undergraduate, a depression measure, an open-ended question examining their intentions to seek help if affected by the problem described in the vignette, and scales examining their perceptions about the helpfulness of various help-seeking options for dealing with the problem. The latter items were also administered among mental health professionals to assess expert opinion on dealing with depression. Logistic regression models were used to examine if medical undergraduates differed from non-medical undergraduates in their rates of depression, help-seeking perceptions and help-seeking intentions. These models were also used to examine if being depressed was associated with differences in the help-seeking perceptions and intentions of medical undergraduates.

Results

Medical and non-medical undergraduates did not differ in their odds of being depressed. Overall, the medical undergraduates were more likely to appraise professional help positively. However, they did not differ from non-medical undergraduates in relation to their intentions to seek such help if affected by the problem personally. They were also more likely to indicate their intentions to seek help from parents and family. Furthermore, medical undergraduates who screened positive for Major Depression were less likely to appraise some of the recommended professional and informal help-seeking options as being ‘helpful’, with only 50 % considering that it was ‘unhelpful’ to deal with the problem alone. There was also no difference in their help-seeking intentions as compared to those screening negative for Major Depression.

Discussion and Conclusions

Although medical training seems to be associated with better help-seeking beliefs, interventions are needed to improve these medical undergraduates’ intentions to personally seek professional help for depression. It is concerning that medical undergraduates who are depressed might be less likely to consider it beneficial to seek help and instead, deal with the problem alone.

【 授权许可】

   
2015 Amarasuriya et al.

【 图 表 】

Figure 5.

【 参考文献 】

• [1]Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2013; 47(3):391-400.
• [2]Steptoe A, Tsuda A, Tanaka Y, Wardle J. Depressive symptoms, socio-economic background, sense of control, and cultural factors in university students from 23 countries. Int J Behav Med. 2007; 14(2):97-107.
• [3]Vankar JR, Prabhakaran A, Sharma H. Depression and stigma in medical students at a private medical college. Indian J Psychol Med. 2014; 36(3):246-54.
• [4]Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Acad Med. 2006; 81(4):354-73.
• [5]Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: a cross-sectional study. Med Educ. 2005; 39(6):594-604.
• [6]Roh MS, Jeon HJ, Kim H, Han SK, Hahm BJ. The prevalence and impact of depression among medical students: a nationwide cross-sectional study in South Korea. Acad Med. 2010; 85(8):1384-90.
• [7]Givens JL, Tjia J. Depressed medical students' use of mental health services and barriers to use. Acad Med. 2002; 77(9):918-21.
• [8]Bacchi S, Licinio J. Qualitative literature review of the prevalence of depression in medical students compared to students in non-medical degrees. Acad Psychiatry. 2014; 39(3):293-9.
• [9]Midtgaard M, Ekeberg Ø, Vaglum P, Tyssen R. Mental health treatment needs for medical students: a national longitudinal study. Eur Psychiatry. 2008; 23:505-11.
• [10]Clark DC, Zeldow PB. Vicissitudes of depressed mood during four years of medical school. JAMA. 1988; 260(17):2521-8.
• [11]Tyssen R, Vaglum P, Grønvold NT, Ekeberg Ø. Factors in medical school that predict postgraduate mental health problems in need of treatment. a nationwide and longitudinal study. Med Educ. 2001; 35(2):110-20.
• [12]Firth-Cozens J. Individual and organizational predictors of depression in general practitioners. Br J Gen Pract. 1998; 48(435):1647-51.
• [13]Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B, Pollitt P. “Mental health literacy”: a survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Med J Aust. 1997; 166:182-6.
• [14]Chan WIPHC. Suicide literacy, suicide stigma and help-seeking intentions in Australian medical students. Australas Psychiatry. 2014; 22(2):132-9.
• [15]Hickie IB, Davenport TA, Luscombe GM, Rong Y, Hickie ML, Bell MI. The assessment of depression awareness and help-seeking behaviour: experiences with the International Depression Literacy Survey. BMC Psychiatry. 2007;7(48). doi:10.1186/1471-244X-7-48.
• [16]Dahlin ME, Runeson B. Burnout and psychiatric morbidity among medical students entering clinical training: a three year prospective questionnaire and interview-based study. BMC Med Education. 2007;7(6). doi:10.1186/1472-6920-7-6.
• [17]Gold JA, Johnson B, Leydon G, Rohrbaugh RM, Wilkins KM. Mental health self-care in medical students: a comprehensive look at help-seeking. Acad Psychiatry. 2015; 39(1):37-46.
• [18]Dyrbye LN, Eacker A, Durning SJ, Brazeau C, Moutier C, Massie FS et al.. The Impact of stigma and personal experiences on the help-seeking behaviors of medical students with burnout. Acad Med. 2015; 90(7):961-9.
• [19]Tija J, Givens JL, Shea JA. Factors associated with undertreatment of medical student depression. J Am Coll Health. 2005; 53(5):219-24.
• [20]Chew Graham CA, Rogers A, Yassin N. ‘I wouldn’t want it on my CV or their records’: medical students’ experiences of help-seeking for mental health problems. Med Educ. 2003; 37(10):873.
• [21]Brimstone R, Thistlethwaite JE, Quirk F. Behaviour of medical students in seeking mental and physical health care: exploration and comparison with psychology students. Med Educ. 2007; 41(1):74-83.
• [22]Thistlethwaite J, Quirk F, Evans R. Medical students seeking medical help: a qualitative study. Med Teach. 2010; 32(2):164-6.
• [23]Hooper C, Meakin R, Jones M. Where students go when they are ill: how medical students access health care. Med Educ. 2005; 39(6):588-93.
• [24]King MB, Cockcroft A, Gooch C. Emotional distresss in doctors: sources, effects and help sought. J R Soc Med. 1992; 85(10):605-8.
• [25]Hassan TM, Sikander S, Mazhar N, Munshi T, Galbraith N, Groll D. Canadian psychiatrists’ attitudes to becoming mentally ill. Br J Med Pract. 2013; 6(2):1-6.
• [26]White A. Barriers to mental healthcare for psychiatrists. Psychiatr Bull. 2006; 30(10):382-4.
• [27]Adams EFM, Lee AJ, Pritchard CW, White RJE. What stops us from healing the healers: a survey of help-seeking behaviour, stigmatisation and depression within the medical profession. Int J Soc Psychiatry. 2010; 56(4):359-70.
• [28]Roberts LW, Warner TD, Lyketsos C, Frank E, Ganzini L, Carter D. Perceptions of academic vulnerability associated with personal illness: a study of 1,027 students at nine medical schools. Compr Psychiatry. 2001; 42(1):1-15.
• [29]Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. JAMA. 2010; 304(11):1181-90.
• [30]Bruckner TA, Scheffler RM, Shen G, Yoon J, Chisholm D, Morris J et al.. The mental health workforce gap in low- and middle-income countries: a needs-based approach. Bull World Health Organ. 2011; 89(3):184-94.
• [31]Fernando SM, Deane FP, McLeod HJ. Sri Lankan doctors’ and medical undergraduates’ attitudes towards mental illness. Soc Psychiatry Psychiatr Epidemiol. 2010; 45(7):733-9.
• [32]Eisenberg D, Downs M, Golberstein E, Zivin K. Stigma and help-seeking for mental health among college students. Med Care Res Rev. 2009; 66(5):522-41.
• [33]Downs MF, Eisenberg D. Help seeking and treatment use among suicidal college students. J Am Coll Health. 2012; 60(2):104-14.
• [34]The global burden of disease: generating evidence, guiding policy – south asia regional edition. IHME, Seattle, WA; 2013.
• [35]Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE et al.. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet. 2013; 382:1575-86.
• [36]Schreiber V, Renneberg B, Maercker A. Seeking psychosocial care after interpersonal violence: an integrative model. Violence Vict. 2009; 24(3):322-36.
• [37]Reavley NJ, McCann TV, Jorm AF. Mental health literacy in higher education students. Early Interv Psychiatry. 2012; 6(1):45-52.
• [38]Chen A, Mond JM, Kumar R. Eating disorders mental health literacy in Singapore: beliefs of young adult women concerning treatment and outcome of bulimia nervosa. Early Interv Psychiatry. 2010; 4(1):39-46.
• [39]McCann TV, Lu S, Berryman C. Mental health literacy of Australian Bachelor of Nursing students: a longitudinal study. J Psychiatr Ment Health Nurs. 2009; 16(1):61-7.
• [40]Smith CL, Shochet IM. The impact of mental health literacy on help-seeking intentions: results of a pilot study with first Year psychology students. Int J Ment Health Promot. 2011; 13(2):14-20.
• [41]Vogel DL, Wester SR, Wei M, Boysen GA. The role of outcome expectations and attitudes on decisions to seek professional help. J Couns Psychol. 2005; 52(4):459-70.
• [42]Schomerus G, Matschinger H, Angermeyer MC. Attitudes that determine willingness to seek psychiatric help for depression: a representative population survey applying the Theory of Planned Behaviour. Psychol Med. 2009; 39(11):1855-65.
• [43]Reavley NJ, Yap MBH, Wright A, Jorm AF. Actions taken by young people to deal with mental disorders: findings from an Australian national survey of youth. Early Interv Psychiatry. 2011; 5(1):335-42.
• [44]Jorm AF, Medway J, Christensen H, Korten AE, Jacomb PA, Rodgers B. Public beliefs about the helpfulness of interventions for depression: effects on actions taken when experiencing anxiety and depression symptoms. Aust N Z J Psychiatry. 2000; 34(4):619-26.
• [45]Ajzen I. The theory of planned behavior. Organization Behav Human Decision Process. 1991; 50(2):179.
• [46]University Grants Commission Sri Lanka. Sri Lanka University Statistics 2013. 2013. http://www.ugc.ac.lk/en/publications/1418-sri-lanka-university-statistics-2013.html. Accessed 30th December 2014.
• [47]Leahy CM, Peterson RF, Wilson IG, Newbury JW, Tonkin AL, Turnbull D. Distress levels and self-reported treatment rates for medicine, law, psychology and mechanical engineering tertiary students: cross-sectional study. Aust N Z J Psychiatry. 2010; 44(7):608-15.
• [48]Diagnostic and statistical manual of mental disorders. Author, Washington; 2000.
• [49]National survey on mental health in Sri Lanka. Institute for Research and Development, Colombo; 2009.
• [50]Rosenthal JA. Qualitative descriptors of strength of association and effect size. J Soc Serv Res. 1996; 21(4):37-59.
• [51]Kroenke K, Spitzer RL. The PHQ-9: A new depression diagnostic and severity measure. Psychiatr Ann. 2002; 32(9):509-15.
• [52]Amarasuriya SD, Jorm AF, Reavley NJ. Prevalence of depression and its correlates among undergraduates in Sri Lanka. Asian J Psychiatry. 2015:32–7. doi:10.1016/j.ajp.2015.04.012.
• [53]Langlands RL, Jorm AF, Kelly CM, Kitchener BA. First aid for depression: a Delphi consensus study with consumers, carers and clinicians. J Affect Disord. 2008; 105(1–3):157-65.
• [54]Bond KS, Jorm AF, Kitchener BA, Reavley NJ. Mental health first aid training for Australian medical and nursing students: an evaluation study. BMC Psychol. 2015; 3(1):11. BioMed Central Full Text
• [55]Roberts LW, Hardee JT, Franchini G, Stidley CA, Siegler M. Medical students as patients: a pilot study of their health care needs, practices, and concerns. Acad Med. 1996; 71(11):1225-32.