Developing a Framework for Mental Health Disclosure Decision-Making Among Medical Students: A Qualitative Pilot...

Area of Science:

• Medical Education
• Psychiatry
• Qualitative Research

Background:

• American medical students report higher rates of depression, anxiety, and psychological distress compared to the general population.
• A significant majority of medical students do not seek professional help for these mental health conditions.
• Disclosure of symptoms or diagnosis is a critical prerequisite for seeking mental health support.

Purpose of the Study:

• To explore the decision-making processes involved in mental health disclosure among medical students.
• To develop a preliminary framework for understanding how medical students decide whether to disclose mental health concerns.

Main Methods:

• Conducted semi-structured qualitative interviews with 20 medical students from nine US institutions.
• Utilized Constructivist Grounded Theory (CGT) for iterative analysis, including focused and theoretical coding.
• Interviews were audio-recorded, transcribed, and analyzed to develop a conceptual framework.

Main Results:

• A framework was developed, identifying three key factors influencing disclosure decisions: Assessing Anticipated Outcomes, Evaluating Priorities, and Determining Appropriate Recipients.
• Two moderating variables, Disclosure Goals and Severity and Type of Symptoms, were identified as impacting students' perspectives on outcomes and recipients.
• The findings underscore the intricate nature of mental health disclosure decision-making in this population.

Conclusions:

• Mental health disclosure among medical students is a complex process influenced by multiple factors.
• Future interventions should consider student perspectives on disclosure recipients and communication strategies.
• Understanding these complexities is crucial for improving mental health support and well-being initiatives for medical students.