Support mental health in higher education on World Mental Health Day

Despite efforts to reduce negative or discriminatory attitudes toward mental health in the broader community, learners in medical schools across Canada continue to be silenced by stigma, says Dr. Aliya Kassam, PhD.

Kassam is the founder of the Wellness Innovation Scholarship for Health Professions Education and Sciences (WISHES) education lab at the Cumming School of Medicine (CSM), a grassroots initiative working to promote the well-being of learners by reducing stigma related to illness, while promoting diversity and inclusion to create a safe culture at the CSM.

“Mental distress among students of the health professions is a growing public health concern that has far-reaching negative consequences,” says Kassam, an associate professor in the Department of Community Health Sciences and a member of the O’Brien Institute for Public Health at the CSM.

“Medical students suffer from rates of mental illness higher than the general population but very few seek treatment,” says Kassam.

Stigma, concerns about the impact on career progression, and systemic and structural barriers  are some of the reasons students don’t seek help, she says.

Once medical students reach residency, mental distress is common.

Compared with physicians, residents in Canada have a 48 per cent increased risk of burnout, 95 per cent increased risk of depression and 72 per cent increased risk of suicidal thoughts, says Kassam.

Future doctors shape culture of health care

It can be particularly important, and impactful, then, to address the stigma around mental illness with medical students and promote a sense of holistic well-being at the individual, programmatic and systemic levels for learners.

“Attitudes early on in training are more open to change but tend to harden as students advance through medical school and residency,” says Kassam.

“As future doctors, they will be influential in shaping the culture of health care, and their responses (or lack of responses) to incidents of stigmatizing behaviour or attitudes will model for others what physicians and other health-care providers and policy-makers consider to be appropriate behaviour.”

Researchers at the WISHES Lab are exploring the important role that systems, such as medical schools and health-care systems, can play in supporting well-being.

“We want to have a positive impact not just on the individuals that make up our community but on the systems that influence wellness for all of us,” says Kassam.

Establishing formal programs that reduce stigma and improve access to wellness and advocacy services in medical schools are interventions that have been associated with lower rates of depression and suicidal ideation, says Kassam.

“Medical schools should consider learner well-being a key component of medical education because how we train our health-care providers ultimately impacts public health and patient care,” she says.

• Access learner wellness resources 

Understanding the role of equity, diversity and inclusion in medical education

Kassam, who leads the Equity, Diversity and Inclusion (EDI) portfolio at the O’Brien Institute, says that mental health and EDI are closely connected.

“If a learner feels stigmatized because of mental health concerns, gender identity, race, ability and any other equity-deserving characteristic, this leads to a sense of isolation and lack of belonging which has a profound impact on mental health and all aspects of well-being,” says Kassam.

An EDI needs assessment, led by Kassam, is underway at the CSM, which will target the education and advocacy needs of learners and faculty alike.

The results will be used to develop curricula and policies to help change the culture of medical education at CSM and ultimately health care in the future.

Mentorship for mental health

Mental health and well-being concerns on university campuses are on the rise. Dr. Lorelli Nowell, PhD, says participating in mentorship could be a part of the solution.

When mentorship is meaningfully integrated into campus culture it provides a host of evidence-backed benefits, says Nowell, who studies the role of mentorship in higher education and health care.

“Mentorship can address mental health challenges through creating a sense of community, developing stronger collegial work and social relationships, and providing a means for giving and receiving emotional support,” says Nowell, an assistant professor in the Faculty of Nursing and a member of the O’Brien Institute.

In part due to the COVID-19 pandemic, students and faculty in higher education are reporting higher rates of mental health challenges such as social isolation, loneliness, anxiety, and depression, alongside overwhelming academic demands. Nowell says:

The need for mentorship may never have been greater. 

Mentoring relationships in higher education can include students, postdoctoral scholars, faculty, academic leaders, and others who seek to grow and develop personally and professionally and can include both formal and informal connections.

In addition to supporting their mental health, those who engage in mentorship also have higher levels of productivity, feel a greater degree of satisfaction in their education and careers, and have greater levels of career success and advancement, says Nowell.

Nowell, lead of the mentorship and leadership portfolio at the O’Brien Institute, says she is grateful for her personal mentorship experiences.

“As a frontline nurse, graduate student, postdoctoral scholar, and now as an assistant professor I have been so grateful for my exceptional mentors, and I continue to have meaningful and valued relationships with them.”

'Best part of my career'

She says mentorship relationships have encouraged her to grow, develop, and push the boundaries of what is possible.

Today, Nowell rates mentoring students as one of the best parts of her career.

“Day to day, providing mentorship for my students and peers has become the most satisfying and rewarding part of my academic work,” she says.

Mental distress and the stigma associated with it have serious consequences, and doctors, faculty, and students, are not immune, says Dr. Katrina Milaney, PhD, associate scientific director for population health at the O’Brien Institute.

“We know that the WISHES Education Lab and mentorship initiatives will have a positive impact on multiple levels," says Milaney. "The O'Brien Institute mission is to advance public health through research excellence, so we are pleased to champion the important research our members are leading,” she says. 

UCalgary students and faculty interested in mentorship can contact their department, faculty or institute to learn more about the numerous mentorship programs and opportunities available at the university.