The University of California medical system is falling short when it comes to mental health resources for medical students; it’s not taking care of its own caretakers.
To deal with the overwhelming amount of stress their jobs require, medical students often first turn to family for comfort. However, family can only help so much, leaving physicians-in-training with very few options to alleviate their stress.
At UCLA, the most obvious source of help would be Counseling and Psychological Services. Unfortunately, while CAPS is a great resource for most students, programs specifically for medical students are nonexistent. There is a vast difference in experience between medical students and undergraduates, and these groups have differing counseling needs. CAPS, however, is currently not equipped to handle these differences.
The sole reliance on CAPS at various medical schools is unrealistic and has thus far been unsuccessful. Data from 2014 indicates the UCLA medical student body is made up of around 745 students, out of which only about 14 percent make use of mental health services at CAPS. These numbers, provided by UCLA, are low in comparison to the high stress medical students endure throughout their medical career.
Some schools have developed programs to complement existing mental health resources and have made them better for medical students. For instance, UCSF has created the Medical Student Well-being Program, offering medical students who are always on the go next-day appointments as well as flexible hours that work around their schedule. Meanwhile, UC Berkeley has developed a satellite program that encourages communication by providing mental health professionals specific to departments that students can identify with.
UCLA needs to be more proactive in tackling the serious problems of burnout and depression in its medical school by following UCSF’s and UC Berkeley’s models. By providing the medical student body with more targeted programs, students will be able to better their lives and preserve their sanity before it’s too late.
The reason CAPS is not effective as the sole program serving the mental health needs of medical students is that it forces students to wait long periods before being seen, while also juggling their schedules in hopes of squeezing in inflexible appointment times. Not improving access to mental counseling can harm students who are distressed and require mental assistance as soon as possible.
In efforts to prevent this, UCLA has had talks about implementing a satellite program along with CAPS, but it’s barely in its beginning stages. Only one meeting has been carried out about this matter.
“We are not there yet,” said Dr. Margaret Stuber, assistant dean for career development and well-being at the David Geffen School of Medicine. “It’s something that we have started talking about. The medical school always had some services that we offer in parallel with CAPS so that there is another way of dealing with (the issue of mental health).”
However, the parallel services with CAPS are obviously ineffective, given that UCLA’s mental health services have a UC Student Association mental health grade of a C+. Even when there are two doctors available to see students at the medical school – Paula Stoessel, who screens students, and Bruce Kagan, who treats them – their duties are completely isolated from CAPS. This means students can be prescribed conflicting treatments because there is no mutual conversation between the medical school and CAPS.
Surprisingly, the answer to UCLA’s problem might come from UC Berkeley, which doesn’t even have a medical school.
The school has established satellite locations throughout the campus where there are mental health providers doing clinical and outreaching consultation work. This means one person is stationed in a department or school and can tailor services to students within that school.
The duties of these mental health providers are clear and focused. Their work is mainly geared at providing services to the needs of specific groups, allowing them to host appropriate workshops and provide more effective individual counseling.
Jeffrey Prince, director of counseling and psychological services at UC Berkeley and the director of student mental health at UCSF, said that there are about 10 satellite locations within Berkeley. In those locations, each psychologist offers drop-in counseling, also known as “Let’s Talk” hours, which, unlike therapy sessions, do not require mass amounts of paperwork to begin a formal counseling relationship.
This program not only offers a quick opportunity for students to check on their mental health status, but also fosters a closer relationship between a staff member and a student, ultimately encouraging students to seek more formal counseling if necessary.
Giving medical students the opportunity to speak with someone who is familiar with the culture of medical school is vital because mental health professionals who are cognizant of medical school calendars can reach out to students during times when they know students will be prone to high levels of stress.
Yet this doesn’t seem to be happening at other top UC medical schools.
Thankfully, there are also programs other than UC Berkeley’s that UCLA and others can learn from. While UCSF is not an “ordinary” university, because of its sole emphasis on professional schools, it can still act as a template for how schools can provide better support to their medical students.
Vittorio Comelli, a UCSF psychologist, works closely with medical students at UCSF by providing a mental health program that is geared solely for their needs. Comelli is the assistant director of the Medical Student Well-being Program, which, unlike other mental health programs at UC’s, is constructed specifically to serve the mental health of medical students.
This program has a 15-year history and was made to offer medical students services where they could be seen and helped quickly. Comelli spends the majority of his time either speaking with medical students or trying to reach out to them.
“Medical students who come into the Medical Student Well-being Program have one-third more satisfaction with their mental health compared to national numbers,” said Comelli. “We are only focused on them. We are very intimately connected to their professional lives.”
By implementing similar programs as the ones at UCSF and UC Berkeley, UCLA can cultivate a mindset focused on mental wellness that is geared specifically for medical students.
Granted, there are costs associated with establishing a program of similar size and caliber. However, the resources are there. According to documents from the UC Office of the President, Ronald Reagan UCLA Medical Center makes $2.25 billion in revenue, $100 million of which is profit.
UCLA can implement the changes gradually, and should not use a lack of funding or space as an excuse. By locating a small amount of profit every year to create and develop mental health programs, the university will benefit from its investment.
Having better geared programs for medical students that are reachable and timely can have a great impact on student wellness. UCLA medical school as well as other schools need to expand outside of CAPS and think more about their professional school population.
There is no such thing as offering perfect mental health resources to all students, but there is a lot of room for improvement. Providing a point person at every major school within a university who focuses on mental health services can be a step closer to fixing this broken system.
The majority of the UC system is currently hoping everyone will fit into one mold, but they simply can’t. Our future doctors deserve better.