Psychological counselling service for medical students: an increasing need

Mental health problems are common in college students (more than 30% of first-year students had a mental disorder; Alonso et al., 2018) and have an early onset that typically preceded the beginning of the academic experience and predicted a lower academic performance (Auerbach et al., 2016). However, mental health problems are often untreated, and the access rate to counselling services is generally low, ranging from 2% to 10%; previous research (Karp et al., 2018) have reported a higher access rate (16%) in a cohort of USA medical students. As part of a wider in-progress longitudinal study, we assessed the access rate of three cohorts of Italian medical students (n=385) during the 6-years course. Then we compared the psychological symptoms reported at the beginning of the first year (assessed with SCL-90-R) with the symptomatology reported when they accessed the counselling service. Nearly the 30% (n=104) of the first year medical students report a clinical level of psychological symptoms and their access rate along the six-year course was the 12% (n=45) in comparison with the 1% of access rate of the general university population. The majority of the students request a consultation between the third and the sixth year (70%), while only two students accessed the service during the first year. The severity of psychological symptoms of students accessing the counselling service is higher in comparison to other medical students yet at first year. Medical students have a higher access rate to psychological counselling services and their psychological symptoms at first year are predictive of future access to the service. A tailored approach could be developed to recognize at-risk students and increase early access to counselling services.