Training as a Psychiatrist When Having a Psychiatric Illness

Factors influencing career preference in mental health among nursing students and intern nurses in Dar es Salaam, Tanzania

Worldwide, the prevalence of mental health, neurological, and substance use (MNS) disorders has been on the rise and remains a significant leading cause of disease burden. Sub-Saharan Africa (SSA) shares a fair burden of MNS with depressive disorders being the most prevalent in this region. A huge treatment gap for MNS exists, with lack of appropriate human resources and expertise for service delivery being one of the key barriers. Pre-service and in-service training plays a vital role in developing human resource for mental health. However, low or lack of career interests in mental health has been documented among students. A cross-sectional study was conducted between April and May 2021 to determine factors influencing career preference in mental health among nursing students and intern nurses at Muhimbili University of Health and Allied Sciences (MUHAS) and Muhimbili National Hospital (MNH) respectively in Dar es Salaam, Tanzania. Sixty-eight (68) nursing students at MUHAS who had covered the mental health nursing course and 83 intern nurses who had rotated at the MNH Psychiatry and Mental Health department participated in the study using consecutive sampling. A pre-tested structured self-administered questionnaire was used to collect data, followed by analysis with version 25 of the Statistical Package for the Social Sciences. The Chi-square test and logistic regression were performed to determine factors associated with career preference. One third (33.1%; n = 50) of participants had career preference in mental health nursing. Living with a person with mental illness (adjusted odds ratio [AOR]: 4.350; 95% CI: 1.958, 9.664; p <0.001), awareness of possible career advancement in mental health (AOR: 16.193; 95% CI: 2.022, 129.653; p = 0.009), awareness of possible income generation in mental health career (AOR: 6.783; 95% CI: 2.295, 20.047; p = 0.001), and satisfaction with psychiatric working environment (AOR: 6.753; 95% CI: 2.900, 15.726; p <0.001), were significantly associated with career preference in mental health. Low mental health career preference among university nursing students and intern nurses jeopardizes the future of the mental health nursing profession and may complicate the already existing shortage of human resource for mental health. The higher learning institutions, health facilities, and the Ministry of Health may need to take deliberate actions to ensure that interest to pursue a career in mental health is built among students and interns. Further research is needed to provide more insight into how the psychiatric working environment affects career preference in mental health.

Attitude Towards Suicide and Help-Seeking Behavior Among Medical Undergraduates in a Malaysian University

OBJECTIVE

The attitude of medical personnel towards suicide may influence the outcome of suicidal-patients management. This study aimed to determine the attitudes of medical undergraduates towards suicide and its association with their help-seeking behavior.

METHODS

A cross-sectional study involving 290 medical undergraduates was conducted in a Malaysian university. The questionnaires on the attitude towards suicide and general help-seeking behavior were used as research instruments.

RESULTS

The mean age of the participants was 22.4 years. Participants who did psychiatry posting indicated a greater tendency to agree on suicide as a way of communication (p = 0.008) than those who did not. Participants previously diagnosed with a psychiatric illness indicated a greater ability to understand and accept suicide (p < 0.001) as well as a greater tendency to agree on the normality of suicide (p = 0.019) than those without a previous diagnosis. Those who attended a suicide prevention program also indicated a greater tendency to agree that loneliness and avoidance could be triggers to suicide (p = 0.037) than those who did not. No correlation was found between the "attitude towards suicide" and "general help-seeking behavior" variable.

CONCLUSION

Education programs in suicide prevention and management need to be incorporated early into the undergraduate medical curriculum to cultivate a more positive attitude towards suicide and help-seeking behavior.

Programs and Resources to Alleviate Concerns with Mental Health Disclosures on Physician Licensing Applications

This article considers concerns about the presence and phrasing of questions on physician licensing applications related to mental health, substance abuse, and leave from practice. These questions may discourage physicians from seeking appropriate treatment due to fear of stigmatization, public disclosure, and career effects related to licensing or credentialing concerns. Accessible and affordable resources and programs are needed to allow physicians to seek treatment in a non-punitive, confidential manner. The authors discuss how some state medical boards have taken steps to address barriers that prevent licensees from seeking help and review the work of the Federation of State Medical Boards Workgroup on Physician Wellness and Burnout, which addressed concerns about physician wellness, burnout, and suicide prevention. Physician health programs also have begun to intervene in areas related to mental and physical health and are providing confidential and professional support. Additionally, medical schools, hospitals, and medical societies have increased their focus on mental health by implementing programs and offering resources to help students and physicians improve their overall health. Raising awareness about the importance of physician wellness has inherent value to physicians and the public and ultimately contributes to patient safety and the health of our nation.