title: Depressed medical students' use of mental health services and barriers to use.
abstract: OBJECTIVE
  Depression is an underrecognized yet common and treatable disorder among medical students. Little is known about the rate of mental health service use by depressed medical students. This study sought to determine the level of mental health service use by depressed medical students and their reported barriers to use.
  
  
  METHODS
  In the spring of 1994, a one-time survey of 194 first- and second-year medical students was conducted in the School of Medicine at the University of California, San Francisco. Outcome measures were self-reported use of counseling services, barriers to use, suicidal ideation, and depressive symptoms as measured by the 13-item Beck Depression Inventory (BDI).
  
  
  RESULTS
  Twenty-four percent (n = 46) of the medical students were depressed by BDI criteria. Of the depressed students, only 22% (n = 10) were using mental health counseling services. The most frequently cited barriers to using these services were lack of time (48%), lack of confidentiality (37%), stigma associated with using mental health services (30%), cost (28%), fear of documentation on academic record (24%), and fear of unwanted intervention (26%).
  
  
  CONCLUSIONS
  These data demonstrate that depression among medical students may be undertreated. Medical schools can assist depressed students by addressing issues such as the stigma of using mental health services, confidentiality, and documentation. Early treatment of impaired future caregivers may have far-reaching implications for the individual students, their colleagues, and their future patients.
authors.affiliation: Student Health Services, University of Pennsylvania School of Medicine, Philadelphia, 19104, USA.
authors.forename: Jane L
authors.initials: JL
authors.lastname: Givens
authors.forename: Jennifer
authors.initials: J
authors.lastname: Tjia
mesh_terms: D000328:Adult; D003219:Confidentiality; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D013337:Students, Medical; D013997:Time Factors