|Year : 2014 | Volume
| Issue : 2 | Page : 104-105
Barriers to service utilization among medical students
Vikas Menon, Siddharth Sarkar
Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education & Research (JIPMER), Puducherry, India
|Date of Web Publication||29-Dec-2014|
Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education & Research (JIPMER), Puducherry - 605 006
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Menon V, Sarkar S. Barriers to service utilization among medical students. Int J Adv Med Health Res 2014;1:104-5
The study of medicine has been found to be associated with considerable stress among its students. Previous researchers from India have found that significant percentage of medical students suffer from different expressions of psychological morbidity due to this stress in the form of substance usage and depression. , Prevalence rate of syndromal depression specifically in this group has been found to be from 45.3%  to 71.3%.  This is about 6-8 times the rate in the general population which is reported to be 7.9-8.9/1000 population as per a frequently referenced meta-analysis from India.  This makes it amply clear that medical students experience increased psychological morbidity when compared to the general public.
Appropriate management of psychological health issues in this population is important to restore their academic pursuits and effective participation in patient care activities. However, it has been observed that many medical students do not seek appropriate treatment and tend to self-medicate or seek informal prescriptions and help from peers or colleagues.  This puts the students in a paradoxical situation, wherein despite availability of treatment at close quarters, they are not able to get necessary help. It also implies that there are unmet needs for services among this group. In such a scenario, it is imperative to know the barriers which prevent students from accessing appropriate health care and taking recourse to potentially harmful avenues like self-medication. Very little information is available on why medical students hesitate to seek professional help for their health issues in general. Few Western studies have concluded that barriers to health care seeking among medical students include worry related to future dealings with the doctor they would consult and the cost of treatment. , The limitations of existing literature include studying only those students who seek help (which makes the sample non-representative), lack of validated scales to assess help-seeking among medical students, and non-response bias. To the best of our knowledge, there is no published literature on this question from the Indian subcontinent. It is conceivable that help-seeking trends may differ across cultures and, hence, needs to be investigated in detail. To cite an example, many government and private medical institutions in India offer their entire range of services free of cost to the students and, hence, financial considerations may not be that pressing. Of more concern to the students may be the fear of exposure of their problem among peers and even the counselors themselves which may affect their self-esteem. The issue of confidentiality, therefore, assumes significance. It is also, at least theoretically, plausible that barriers to seeking health care for physical and mental health issues may differ and need to be assessed separately.
The implications of studying the barriers to health care seeking among medical students can be quite profound. Such studies would provide unique perspectives into student perceptions about the health care delivery system and preferred modes of accessing care, based on which recommendations could be made to the concerned institute or policy makers. If some barriers are encountered and endorsed frequently, steps may be taken to address them with the ultimate goal of improving the well-being of medical students. It would also provide valuable insights and targets for action that may be applicable to the broader student population. An example would be the introduction of anonymous helplines for student-related issues, depending on their perceived need for confidentiality and anonymity. Our initial effort at addressing this issue has been to survey whatever literature is available and develop a questionnaire that identifies the issues and concerns among medical students when it comes to accessing services for their health issues. Through this, we wish to sensitize the teaching community as well as provide actionable inputs to the administration. Obviously, there is a need to undertake such studies across the length and breadth of the country to identify locally prevalent hurdles. As teachers of health professionals, we hope this critical gap in existing literature will be addressed sooner than later.
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