title: Availability of Emotional Support and Mental Health Care for Pediatric Residents.
abstract: Resident mental health (MH) problems can be associated with reduced empathy and increased medical errors. The Accreditation Council for Graduate Medical Education mandates resident MH support services, but it is unknown if these services are accessible and meet resident needs. We sought to describe the prevalence of anxiety and depression in current pediatric residents in New York State (NYS), and their self-reported use of and barriers to support services.
  
  
  
  We developed an online survey and distributed it to all categorical pediatric residents in 9 NYS programs. Items addressing self-concern for clinical anxiety and depression and use of MH services were pilot tested for content and construct validity. The validated Patient Health Questionnaire-2 (PHQ-2) measured depressive symptoms. Analyses used descriptive and chi-square tests.
  
  
  
  Respondents included 227 residents (54% response rate) distributed across training levels and programs. Many reported "often" or "almost always" feeling stress (52%), physical exhaustion (41%), and mental exhaustion (35%); 11% had PHQ-2-defined depressive symptoms. Some thought that their stress levels raised concern for clinical depression (25%) or anxiety (28%); among these, only 44% and 39%, respectively, had sought care. More women reported physical exhaustion (P < .05). Only 45% of residents reported educational offerings on resident MH; 66% wanted to know more about available resources. Barriers to receipt of services included inflexible schedules (82%), guilt about burdening colleagues (65%), fear of confidentiality breach (46%), and difficulty identifying services (44%).
  
  
  
  Pediatric residents frequently experience MH symptoms, but many do not know about or use support services. Programs should enhance MH support by overcoming barriers and increasing resident awareness of services.
authors.affiliation: Department of Pediatrics, New York Medical College, Valhalla, NY. Electronic address: melissa.cellini@gmail.com.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Cellini
authors.affiliation: Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md.
authors.forename: Janet R
authors.initials: JR
authors.lastname: Serwint
authors.affiliation: Department of Psychiatry, University of Rochester Medical Center, Rochester, NY.
authors.forename: Linda H
authors.initials: LH
authors.lastname: Chaudron
authors.affiliation: Department of Pediatrics, University of Rochester Medical Center, Rochester, NY.
authors.forename: Constance D
authors.initials: CD
authors.lastname: Baldwin
authors.affiliation: Department of Pediatrics, University of Rochester Medical Center, Rochester, NY.
authors.forename: Aaron K
authors.initials: AK
authors.lastname: Blumkin
authors.affiliation: Department of Pediatrics, University of California at Los Angeles, Los Angeles, Calif.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Szilagyi
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology*; D003219:Confidentiality; D003863:Depression / Q000523:psychology; D003866:Depressive Disorder / Q000523:psychology*; D004644:Emotions; D005221:Fatigue; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007396:Internship and Residency; D008297:Male; D005222:Mental Fatigue / Q000523:psychology*; D008603:Mental Health; D008605:Mental Health Services; D009518:New York; D010372:Pediatrics / Q000193:education*; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*
keywords: depression; medical education; mental health; mental health care; residency; stress; well-being