'Screen medics' mental health'

July 4, 2003

Psychiatrists say universities need screening procedures to identify trainee doctors with mental-health disorders amid fears that many hide problems that pose risks to patients, writes Anna Fazackerley.

The Royal College of Psychiatrists, which has established a working party to look at the problem of identifying and treating mental illness in universities, looks set to call for a more uniform system of screening for depression at the start of medical degrees.

Medical schools require students to declare any mental illness, but the Council of Heads of Medical Schools admits that some may not do so for fear that it could harm their application. Recurring mental illness can force a student to abandon their medical degree.

Charlotte Feinmann, a member of the RCP working party, told The THES: "You're making such an enormous investment financially and personally in students, it is better to recognise that they might not be able to cope earlier rather than later."

A recent survey found that almost 30 per cent of doctors had a minor psychiatric illness, compared with 20 per cent of the general population.

Michael Powell, executive secretary of the CHMS, said a history of mental illness would affect a student's fitness to practice as a doctor. "That would be looked at seriously in terms of whether they complete the course," he said.

Key figures in medical schools agree that depression, which is on the rise among students generally, often goes undetected.

Mark Berelowitz, the sub dean for student welfare at the Royal Free and University College London Medical School, said: "It is not clear what we should do if someone comes to us after three years and says, 'I've been depressed for as long as I can remember.'"

If a student develops a mental illness while pursuing a medical degree, General Medical Council guidelines state that it is their duty to recognise that they are unwell and to seek treatment.

Such cases will usually be reviewed by the school's fitness-to-practice committee, which will often recommend time off for treatment. If someone is not fit to practice in the long term, the school cannot graduate them.

A student in a medical school that The THES cannot name for reasons of confidentiality had recovered from a past psychiatric episode but then suffered a severe relapse on the course.

The head of the school said: "The committee decided it was appropriate to exclude him from the course, and we helped him to find a place on another course."

Alan Cumming, director of undergraduate learning and teaching at Edinburgh College of Medicine, said: "We take these issues more seriously than we did before. But if you're asking 'do we have intimate knowledge of all our students' mental welfare?' we can't claim that."

Some doctors insist that screening for mental-health disorders would be ineffective and could be seen as discrimination.

Lizzie Miller helped found the Doctors Support Network to support doctors and students with mental-health disorders. She said: "I had bipolar disorder, and I am a better doctor for of it. I wouldn't have been picked up by screening medical students, and nor would someone like Harold Shipman."

Dr Miller is calling for better education about depression. She said: "When I was a houseman I would wake up in the morning and think 'Shall I kill myself today?' But I would look round at everyone else and they seemed to be feeling the same so I thought it was normal."

Doctors' Support Network: 0870 7650001


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