• anxiety
• care seeking
• depression
• help-seeking
• personality
• psychological distress
• social support seeking
• treatment-seeking

• National University of Singapore

• fellow physicians
• graduate medical education (gme)
• medical students
• resident physicians
• spiritual health
• substance addiction
• substance misuse
• substance treatment utilization
• substance use disorder
• substance use policy

• Self-help digital mental health intervention
• burnout
• healthcare workers
• mental health outcomes
• systematic review

• COVID-19
• Help-seeking
• Primary care provider
• Psychotherapy
• Stigma

• Humans
• Intention
• Pandemics
• COVID-19
• Social Stigma
• Psychotherapy
• Primary Health Care
• Patient Acceptance of Health Care/psychology

• Crisis
• Healthcare
• Healthcare workers
• Mental health
• Mixed-methods
• Organizational support
• Well-being

• Humans
• COVID-19/epidemiology
• Psychosocial Support Systems
• Pandemics
• Personnel, Hospital
• Hospitals

• 10430022010011 ZonMw

Medical practitioners’ duties are highly stressful and performed in a particularly challenging and competitive work environment. Stress and burnout among physicians have emerged as a worldwide public health problem in recent years. A high level of distress and burnout can lead to clinically significant behavioral health problems, such as stress-related psychiatric disorders. Mounting evidence shows that physicians have higher risks of insomnia, anxiety, and depression than the general population, especially during the coronavirus disease 2019 pandemic. However, the behavioral health problems of these vulnerable healthcare professionals are noteworthy for being underrecognized and undertreated. In this mini-review, we summarize the current progress of studies on the prevalence and determinants of distress and stress-related psychiatric disorders among phy-sicians and their healthcare-seeking behaviors. We discuss future research directions and the clinical approach that may maximize self-awareness and promote prompt and adequate treatment for clinically significant behavioral health problems of physicians.

• Physician
• Depression
• Anxiety
• Insomnia
• Healthcare-seeking behavior
• Undertreatment

• burnout
• cardiologist
• mental health
• mental health condition
• mental illness
• physician
• well-being

• Anxiety
• Burn out
• COVID-19
• Depression
• Osteopathic physicians

• Competence by Design
• Competency Based Medical Education
• medical education
• resident physician education

Veterinarians have a relatively high prevalence of mental health problems; however, research on professional help-seeking is limited. The main purpose of the present study was to investigate the prevalence of mental health problems and professional help-seeking behaviour for such problems, and the independent factors associated with help-seeking behaviour among veterinarians in Norway.

This cross-sectional study included all veterinarians in Norway (response rate 75%, 70% women). Logistic regression was used to calculate odds ratios (OR) for professional help-seeking for mental health problems. Analyses were controlled for socio-demographic, individual (personality trait reality weakness, SCL-5, attitudes toward mental illness), and work-related factors (work field, job stress).

The prevalence of self-reported mental health problems in need of treatment was 30% (746/2494), significantly higher among women than men (36% vs. 15%). Fifty-four percent had sought professional help, women significantly more often (56%) than men (41%). Among veterinarians with serious suicidal thoughts, 50% (69/139) had sought help. Veterinarians most frequently related mental health problems to work problems (47%), women significantly more often (49%) than men (34%). Factors significantly associated with help-seeking were being female, OR = 2.11 (95% CI: 1.24–3.60), working with production animals, OR = 0.35 (0.13–0.98), public administration, OR = 2.27 (1.15–4.45), academia/research, OR = 4.78 (1.99–11.47) or ‘other’ fields, OR = 2.79 (1.23–6.32), and attitudes toward mental illness, OR = 1.32 (1.03–1.68).

Thirty percent of veterinarians in Norway reported mental health problems in need of treatment, and only half of them had sought professional help. A low degree of help-seeking was also seen among those with serious suicidal thoughts. Being female, positive attitudes toward treatment of mental illness, working in public administration, academia/research and ‘other’ field were associated with more help-seeking, while working in production animal practice was associated with less help-seeking. Interventions to increase help-seeking behaviour for mental health problems among veterinarians are warranted.

The online version contains supplementary material available at 10.1186/s12889-022-13710-y.

• Help-seeking behaviour
• Mental health problems
• Personality traits
• Suicidal behaviour
• Veterinarians

• COVID-19
• anxiety
• depression
• junior doctors
• mental health
• work and social functioning

• COVID-19
• family physician
• healthy lifestyle
• help-seeking
• mental health
• primary care
• resilience

• healthcare students
• help-seeking
• mental health literacy
• parallel mediation
• theory-based construct

Students’ academic persistence is a critical component of effective online learning. Promoting students’ academic persistence could potentially alleviate learning loss or drop-out, especially during challenging time like the COVID-19 pandemic. Previous research indicated that different emotions and autonomy support could all influence students’ academic persistence. However, few studies examined the multidimensionality of persistence using an experimental design with students’ real-time emotions. Using an experimental design and the Contain Intelligent Facial Expression Recognition System (CIFERS), this research explored the dynamic associations among real-time emotions (joy and anxiety), autonomy support (having choice and no choice), self-perceived persistence, self-reliance persistence, and help-seeking persistence. 177 college students participated in this study online via Zoom during COVID-19 university closure. The results revealed that having choice and high intensity of joy could promote students’ self-reliance persistence, but not help-seeking persistence. Interestingly, students who perceived themselves as more persistent experienced more joy during experiment. The theoretical and practical implications on facilitating students’ academic persistence were discussed.

• academic persistence
• anxiety
• autonomy support
• emotion
• joy
• online learning

• Addis Ababa
• COVID-19
• Ethiopia
• Health professional
• Mental disorder
• Prevalence

• Depression screening
• Physician burnout
• Physician help-seeking
• Physician well-being
• Suicide screening

• Depression/diagnosis
• Faculty
• Follow-Up Studies
• Humans
• Internship and Residency
• Surveys and Questionnaires
• Suicide Prevention

Resident physicians (residents) experiencing prolonged workplace stress are at risk of developing mental health symptoms. Creating novel, unobtrusive measures of resilience would provide an accessible approach to evaluate symptom susceptibility without the perceived stigma of formal mental health assessments. In this work, we created a system to find indicators of resilience using passive wearable sensors and smartphone-delivered ecological momentary assessment (EMA). This system identified indicators of resilience during a medical internship, the high stress first-year of a residency program. We then created density estimation approaches to predict these indicators before mental health changes occurred, and validated whether the predicted indicators were also associated with resilience. Our system identified resilience indicators associated with physical activity (step count), sleeping behavior, reduced heart rate, increased mood, and reduced mood variability. Density estimation models were able to replicate a subset of the associations between sleeping behavior, heart rate, and resilience. To the best of our knowledge, this work provides the first methodology to identify and predict indicators of resilience using passive sensing and EMA. Researchers studying resident mental health can apply this approach to design resilience-building interventions and prevent mental health symptom development.

• Applied computing → Life and medical sciences
• Computing methodologies → Artificial intelligence
• Human-centered computing → Empirical studies in ubiquitous and mobile computing
• deep generative models
• mental health
• mobile sensing
• wearable technology

In the face of significant distress among physicians, access to counseling is critical.

An on-site wellness program for physicians-in-training and faculty was assessed by examining (a) were participants representative of those eligible for services and (b) demographic and trainee vs. faculty differences in burnout, distress, suicide risk, and presenting concerns of participants who utilized services.

From 2013–2018, 73% (N = 468; 316 residents/fellows, 152 faculty) of individuals seeking services also consented to research. At intake, participants completed a distress measure (ACORN) and two items from the Maslach Burnout Inventory (MBI), and clinicians categorized presenting concerns and suicide risk. Using Chi-square analyses, participants’ characteristics were compared to physicians eligible for treatment. The association between demographics, faculty vs. trainee status, specialty, and distress, burnout, suicide risk, and presenting concerns was evaluated with ANOVAs and logistic regressions.

Women, trainees, and primary care physicians were more likely to access services. On the ACORN, 63% were in the clinical range (M =1.7, SD =0.6). On the MBI, 36% scored in the clinical range. Clinicians rated 9% of participants with suicide risk. Neither gender, racial/ethnic minority status, nor specialty were associated with distress, burnout or suicide risk. Trainees reported greater distress than faculty (F (1,447) = 8.42, P = .004, ηp2 = .018). Participants reported multiple presenting concerns (M = 3.0, SD = 1.18) with faculty more commonly endorsing work-related issues. Trainees more commonly reported new or worsening psychological symptoms, performance and family concerns.

Two physician groups which often report higher levels of burnout and distress when surveyed, women physicians and residents/fellows, were the most likely to get professional help in an on-site wellness program. Physician wellness programs need to be prepared to address work and personal stressors and different levels of distress and risk.

• cognitive behavioral therapy
• coping
• psychotherapy
• stress

• Mental health education
• Online intervention
• Physician
• Supervisor training
• Workplace mental health

• mental health
• healthcare professionals
• pandemic
• psychological distress
• sars-cov-2

• Anxiety/epidemiology
• Anxiety/prevention & control
• Brazil/epidemiology
• COVID-19
• Depression
• Female
• Health Personnel
• Humans
• Mental Health
• Pandemics
• SARS-CoV-2

• Coronavirus disease 2019
• Help-seeking behavior
• Medical workers
• Mental health
• Severe acute respiratory syndrome from coronavirus 2

• Adult
• Anxiety/psychology
• Anxiety/virology
• Anxiety Disorders/epidemiology
• Anxiety Disorders/virology
• COVID-19
• Case-Control Studies
• China/epidemiology
• Coronavirus Infections/epidemiology
• Coronavirus Infections/psychology
• Depression/psychology
• Depression/virology
• Disease Outbreaks
• Female
• Health Personnel/psychology
• Humans
• Male
• Mental Disorders/psychology
• Mental Disorders/virology
• Mental Health
• Pandemics
• Pneumonia, Viral/epidemiology
• Pneumonia, Viral/psychology
• Sleep Initiation and Maintenance Disorders/epidemiology
• Sleep Initiation and Maintenance Disorders/virology

• anxiety disorders
• depression & mood disorders
• epidemiology
• medical education & training
• mental health

• Cross-Sectional Studies
• Female
• Humans
• Longitudinal Studies
• Male
• Mental Disorders/epidemiology
• Norway/epidemiology
• Stress, Psychological/epidemiology
• Students, Medical/psychology
• Surveys and Questionnaires
• Young Adult

• Norske Legeforening
• Norges Forskningsråd
• Norges Teknisk-Naturvitenskapelige Universitet

There is a growing body of research that shows a significant association between mindfulness and mental health. However, studies on Saudi populations are still in their infancy. Mindfulness is a personal tendency to focus on the present time in a non-judgmental manner, including the interior and exterior experience of feelings and events. The first aim of this study is to examine the relationship between mindfulness, stress, depression, and academic performance in a sample of medical students from King Saud University. The second aim is to explore the potential moderation effects of mindfulness on the impact of stress on academic performance and depression in the study population. This cross-sectional study examined 289 medical students who were selected by a stratified random sampling technique and completed validated online questionnaires measuring mindfulness, stress, and depression. The data were analyzed using SAS version 9.2, and R software was used for graphs. Correlation analysis showed that mindfulness is inversely associated with depression and stress, but not with academic performance. Furthermore, multiple logistic regression showed that mindfulness can predict both depression and stress. We also found that two subscales of mindfulness can moderate the relation between stress and depression: non-judging of inner experience and describing. The findings suggest that a higher mindfulness score is associated with lower depression and stress levels and could buffer against depression in a stressful environment. There is a need for further research to investigate the relation of mindfulness with positive psychological outcomes, as well as experimental trials to examine the efficacy of mindfulness training on improving mental wellbeing in our community.

• Academic Performance
• Depression/psychology
• Female
• Humans
• Logistic Models
• Male
• Mindfulness
• Saudi Arabia
• Stress, Psychological/psychology
• Students, Medical/psychology
• Young Adult

Objective: Although the recently developed mental health literacy scale showed significant score differences between general population and mental health professionals, to this date there is no published scale intended to specifically assess mental health literacy (MHL) in healthcare students. This study constructed a 26-item scale-based measure to assess multiple components of MHL and associated psychometric properties in a sample of medical and public health students of 11 universities in Taiwan. Methods: The development and validation of the scale comprised three phases: measure development, pilot testing (n = 32), and psychometric properties examination (n = 1294). Results: 26 items were generated for five factors: maintenance of positive mental health, recognition of mental illness, attitude to mental illness stigma, help-seeking efficacy, and help-seeking attitude. The scale demonstrated good content validity, internal consistency, and construct validity (factorial validity, convergent validity, discriminant validity, and known groups validity). Conclusions: The findings suggest that the Mental Health Literacy Scale for Healthcare Students (MHLS-HS) is a valid, reliable, and practical tool for identifying MHL gaps in medical and public health students. It has the potential to inform remedial curricular interventions for educators and evaluate intervention effectiveness.

• Mental Health Literacy Scale for Healthcare Students (MHLS-HS)
• health professionals and students
• measurement
• medical education
• mental health literacy
• mental illness stigma
• public health education

• burnout
• pharmacists
• resilience
• suicide

Student life can be stressful and for some students it may cause mental distress. Besides being a major public health challenge, mental distress can influence academic achievement. The main objectives of the current study were to examine associations of mental distress with academic self-efficacy and study progress. A secondary aim was to examine mental health help seeking for students with mental distress. Data was derived from the Norwegian Students’ health and welfare survey 2014 (SHOT 2014) which is the first major survey comprising questions of both mental health, academic self-efficacy and psychosocial factors amongst students. Utilizing these data for a Norwegian region, we found that 749 (31%) of the 2430 Norwegian full-time students under the age of 35 responded to the survey. Symptoms of mental distress were measured using the Hopkins Symptom Checklist (HSCL-25) and academic self-efficacy was measured using a Norwegian version of the General Self-Efficacy Scale (GSE) tailored to the academic setting. Demographic-, social, lifestyle, and study-related variables were included in the analyses. Logistic regression analyses were performed to assess the relationship between mental distress, academic self-efficacy, and academic performance. Seventeen percent reported severe symptoms of psychological distress which is similar to the overall prevalence among students in Norway. Students reporting severe mental distress were four times as likely to report low academic self-efficacy and twice as likely to report delayed study progress compared to students reporting few or moderate symptoms of mental distress. 27% of those reporting severe mental distress had sought professional help whereas 31% had considered seeking help. The study showed that there was a strong association between symptoms of mental distress, academic self-efficacy and study progress. Prospective studies should evaluate whether improved help-seeking and psychological treatment can promote students mental health and ultimately improve academic self-efficacy and study progress.

• academic self-efficacy
• help-seeking
• mental health
• students
• study progress

• Adult
• Burnout, Professional/epidemiology
• Burnout, Professional/psychology
• Cross-Sectional Studies
• Depersonalization/epidemiology
• Depersonalization/psychology
• Female
• Humans
• Internship and Residency/statistics & numerical data
• Male
• Patient Acceptance of Health Care/psychology
• Patient Acceptance of Health Care/statistics & numerical data
• Physicians/psychology
• Physicians/statistics & numerical data
• Retrospective Studies

Nepal is representative of Low and Middle Income Countries (LMIC) with limited availability of mental health services in rural areas, in which the majority of the population resides.

This formative qualitative study explores resources, challenges, and potential barriers to the development and implementation of evidence-based Comprehensive Community-based Mental Health Services (CCMHS) in accordance with the mental health Gap Action Programme (mhGAP) for persons with severe mental health disorders and epilepsy. Focus Group Discussions (FGDs, n = 9) and Key-Informant Interviews (KIIs, n = 26) were conducted in a rural district in western Nepal. Qualitative data were coded using the Framework Analysis Method employing QSR NVIVO software.

Health workers, general community members, and persons living with mental illness typically attributed mental illness to witchcraft, curses, and punishment for sinful acts. Persons with mental illness are often physically bound or locked in structures near their homes. Mental health services in medical settings are not available. Traditional healers are often the first treatment of choice. Primary care workers are limited both by lack of knowledge about mental illness and the inability to prescribe psychotropic medication. Health workers supported upgrading their existing knowledge and skills through mhGAP resources. Health workers lacked familiarity with basic computing and mobile technology, but they supported the introduction of mobile technology for delivering effective mental health services. Persons with mental illness and their family members supported the development of patient support groups for collective organization and advocacy. Stakeholders also supported development of focal community resource persons to aid in mental health service delivery and education.

Health workers, persons living with mental illness and their families, and other stakeholders identified current gaps and barriers related to mental health services. However, respondents were generally supportive in developing community-based care in rural Nepal.

• Community mental health
• Patient support groups
• Severe mental disorders
• Stigma
• Task shifting
• mHealth

Psychosocial job stressors, such as low control and high demands, have been found to influence the health and wellbeing of doctors. However, past research in this area has relied on cross-sectional data, which limits causal inferences about the influence of psychosocial job stressors on health. In this study, we examine this relationship longitudinally while also assessing whether the relationship between psychosocial job stressors and health is modified by gender.

The data source was seven annual waves of the Medicine in Australia: Balancing Employment and Life (MABEL) survey. The outcome was self-rated health (measured using the SF-12), and key exposures reflected job control, job demands, work-life balance variables, employment arrangements, and aggression experienced at work. We used longitudinal fixed and random effects regression models to assess within and between-person changes in health.

Excessive job demands, low job control, feelings of not being rewarded at work, and work-life imbalance were associated with higher within-person odds of poorer self-rated health. Gender differences were apparent. For female doctors, work arrangements and work-life imbalance were associated with poorer self-rated health whilst task-based job stressors were associated with poorer self-rated health in male doctors.

These results suggest the importance of addressing adverse working environments among doctors.

Not applicable.

The online version of this article (doi:10.1186/s12913-017-2554-z) contains supplementary material, which is available to authorized users.

• Employment
• Health
• Job stress
• Medical doctors
• Medicine
• Work

• Examination
• Medical students
• Mental health
• Support

• Female
• Health Services Accessibility/statistics & numerical data
• Help-Seeking Behavior
• Humans
• Interviews as Topic
• Male
• Patient Acceptance of Health Care/psychology
• Patient Acceptance of Health Care/statistics & numerical data
• Qualitative Research
• Schools, Medical
• Stress, Psychological/psychology
• Stress, Psychological/therapy
• Students, Medical/psychology
• Students, Medical/statistics & numerical data
• United Kingdom

• Training
• emergency medicine
• healthcare professionals
• intervention
• mental health
• prevention
• suicides

• Adaptation, Psychological
• Attitude of Health Personnel
• Clinical Competence
• Emergency Medical Services/standards
• Health Care Surveys
• Health Knowledge, Attitudes, Practice
• Health Personnel/education
• Health Personnel/standards
• Humans
• Lithuania
• Risk Factors
• Suicide Prevention

• Emotional problems/support
• Physician well-being
• Suicide

• Academic Medical Centers
• Burnout, Professional/diagnosis
• Burnout, Professional/psychology
• California
• Depression/prevention & control
• Education, Medical, Graduate
• Faculty, Medical
• Humans
• Internship and Residency
• Medical Staff, Hospital/psychology
• Mental Health Services
• Surveys and Questionnaires
• Suicide Prevention

• Adult
• Burnout, Professional/prevention & control
• Health Promotion
• Humans
• Internship and Residency
• Program Development/methods
• Psychiatry/education

• suicide
• medical
• education
• residency
• prevention
• web-intervention

• Adult
• Aged
• Anxiety/epidemiology
• Case-Control Studies
• Depression/epidemiology
• Female
• Humans
• Male
• Middle Aged
• Patient Acceptance of Health Care/psychology
• Physicians/psychology
• Prevalence
• Registries
• Retrospective Studies
• Risk Factors
• Sleep Initiation and Maintenance Disorders/epidemiology
• Specialization
• Taiwan/epidemiology

• HEALTH SERVICES ADMINISTRATION & MANAGEMENT
• MEDICAL EDUCATION & TRAINING
• MENTAL HEALTH
• PUBLIC HEALTH

• help seeking
• medical education
• mental health literacy
• stigma
• suicide

• Alcohol Drinking/epidemiology
• Alcohol Drinking/psychology
• Commerce/education
• Cross-Sectional Studies
• Depression/epidemiology
• Depression/psychology
• Education, Medical
• Female
• Humans
• Male
• Patient Acceptance of Health Care/psychology
• Patient Acceptance of Health Care/statistics & numerical data
• Sex Factors
• Stress, Psychological/epidemiology
• Stress, Psychological/psychology
• Students/psychology
• Students/statistics & numerical data
• Students, Medical/psychology
• Students, Medical/statistics & numerical data
• Sweden