Medical Student Utilization of Mental Health Services: Mixed Method Analysis of Factors That Impact Where Students Seek Treatment.

OBJECTIVE: Medical students are disproportionately affected by mental health conditions. It is therefore crucial to improve access to care for this population. To do this requires an understanding of where students seek treatment and what guides this decision. The goal of this study was to examine what motivates students to seek care based on a survey of medical students at the Michigan State University College of Osteopathic Medicine (MSUCOM). METHODS: All medical students at MSUCOM were offered a survey that inquired about demographics; if they had sought mental health treatment, and if so, where they had sought treatment (internal vs. external to the institution); if they had not sought treatment, where they would prefer to seek treatment; and what factors influenced these decisions. This survey was conducted before the COVID-19 pandemic. RESULTS: A total of 354 students (25.3%) completed the survey. Of these, 167 (47%) sought mental health care during medical school, 108 of whom (65%) sought care internally in the institution, and 59 of whom (35%) sought care externally (eg, in the community). Statistically significant factors that influenced students' decisions to seek care internally at their training institution included concerns with confidentiality (OR=0.24, 95% CI: 0.12, 0.49), convenience (OR=2.29, 95% CI: 1.19, 4.40), trust/comfort with provider (OR=2.01, 95% CI: 1.02, 3.97), age (OR=0.56, 95% CI: 0.43, 0.73), and year of medical education (OR=0.49, 95% CI: 0.35, 0.67). CONCLUSIONS: As medical schools increase the internal availability of mental health services for their students, these results highlight the importance of ensuring confidentiality and accessibility of services. As more than 1 in every 3 students seeking care preferred external resources, it is important for medical schools to also provide information on community resources.