Seeding Change within Medicine: Geisel’s Revolutionary Approach to Student Mental Health
It’s no secret that medical school is extremely demanding, creating high levels of stress among students. Nationally nearly one-third of medical students report symptoms of depression and related illness, and one in ten have considered suicide. These higher-than-average rates persist throughout residency and physicians’ careers—and have a direct impact on quality of life, productivity, and patient care, according to several studies. At the Geisel School of Medicine, surveys of MD students have found that they are not immune from these issues.
Thanks to a $2M gift from a Dartmouth College alumnus and his spouse, Geisel has launched Healthy Students, Healthy Physicians, a new comprehensive mental health and wellness program that prepares Geisel graduates to meet the stresses and challenges of their profession without sacrificing their own health.
“This gift is allowing Geisel to launch a truly revolutionary program that sets our medical school apart as a model for other institutions,” says Matthew Duncan, MD, MED’01, an assistant professor of psychiatry at Geisel and leader of the program.
“We hope the generosity, vision, and leadership of these donors will inspire others to support this pioneering program,” says Duane Compton, PhD, dean of the Geisel School of Medicine. Launched in late 2019, the program is a top priority for Geisel, has a fundraising goal of $5 million, and is part of The Call to Lead campaign.
Healthy Students, Healthy Physicians provides and continues to plan a variety of training and supports, including mental health screening, increased access to individual and group counseling, and wellness and resiliency programming—all at no cost to students. Geisel MD, MD-PhD, and MD-MBA students can utilize the program, and it will be available to students from The Dartmouth Institute for Health Policy and Clinical Practice by 2021. Fundraising to further expand these offerings is ongoing. Duncan notes that while general awareness of mental health issues has improved, they remain highly stigmatized in the field of medicine. A program like Healthy Students, Healthy Physicians is a vital step in ending that stigma.
“We want to create a community in which developing resilience is part of physician training and seeking mental health care is seen as a sign of strength and not a personal weakness or professional liability,” says Duncan. “This gift will help plant the seeds of cultural change within the practice of medicine.”
Fast, Free Support
Tailored to medical students’ unique schedules, the program offers flexible hours for individual and group counseling in two locations near the Geisel campus, as well as video and phone appointments. Students who call the dedicated Geisel Counseling phone line to schedule a non-emergency appointment are guaranteed a response within 48 hours, and offered a first appointment within seven days. Counseling is available throughout students’ entire time at Geisel with no limits to number of appointments and no billing hassles.
In August 2020, a licensed mental health counselor with experience in race-based trauma and the mental health impacts of structural racism joined the Healthy Students, Healthy Physicians counseling team. “Students from underrepresented minority groups often face additional stressors, especially in predominantly white academic communities and health care systems,” says Duncan. “Our new counselor has joined a task force of faculty, staff, and students focusing specifically on the mental health needs of our underrepresented minority students and, later this fall, they will set forth a proposal for expanded workforce and programming to meet these needs.”
Another resource that will soon be available to students through Healthy Students, Healthy Physicians is the Interactive Screening Program (ISP), a 27-item questionnaire that screens for stress, depression, alcohol and drug abuse, and eating disorder symptoms. Used by more than 25 medical schools and more than 120 higher education institutions, the ISP helps students understand if what they’re feeling is normal stress or something more serious. Counselors receive the encrypted results and can engage with the student—who remains anonymous—to give an assessment, open a dialogue, and point the student to additional resources as needed.
“Many of our students are experiencing common life or school-related stressors that are resolved through a supportive approach or coaching,” explains Duncan. “For those who meet the diagnostic criteria for a formal mental health disorder, counseling is most useful and appropriate. The ISP is one more tool we can use to identify the students who could benefit from any of these types of help.”
Resilient Future Physicians
Other Healthy Students, Healthy Physicians offerings include Mental Health First Aid Training that teaches students, faculty, and staff how to identify, understand, and respond to signs of mental illnesses; wellness and resiliency workshops, seminars, and electives on topics such as mindfulness, meditation, and cognitive behavioral therapy; and a stigma reduction workgroup to increase discussions about mental illness among physicians and the importance of seeking help.
With philanthropic support from additional donors, Geisel hopes to broaden services to the program. A dedicated psychiatrist could provide assessments, medication management, and continuity of care to Geisel students. A neuropsychologist could provide neuropsychological evaluations—tests that are essential to students in need of reasonable accommodations in order to have equal access to the academic environment.
In the meantime, program data and survey results gathered since the program launched demonstrate a high level of satisfaction among students. One hundred medical students have received confidential counseling through the program so far, and a vast majority indicated that they are very likely to recommend Geisel Counseling to a classmate. Healthy Students, Healthy Physicians leaders will continue to measure the program’s success through the use of anonymous surveys and confidential reporting.
Duncan sometimes uses an athletics analogy to explain the importance of mental health supports for medical students. “If you recruit a top athlete, you provide them with athletic trainers and supports to help them keep their bodies in peak physical condition. Likewise, we want to provide medical students with mental health supports and resiliency training to help them navigate the stresses of medical school and perform at their very best throughout their careers—which benefits everyone, especially their patients.”