Pre-existing mental health problems in medical students: a retrospective survey

Background: The undergraduate medical course is demanding. Each year, a small number of students 'struggle', for academic or other reasons. Recent studies at Nottingham reported anecdotal evidence that those who struggle disclose a much higher incidence of psychological distress than those who do not struggle. Aims: The study aimed to assess whether a group of students with mental health problems were more likely to have a pre-admission history of similar problems. Methods: Three year-cohorts of medical students were classified as struggling or not on the course, and whether they disclosed mental health problems during their course. The Nottingham Occupational Health Service carried out a confidential review of pre-admission health questionnaires. Results: Students who struggled on the course and disclosed mental health problems were more likely to have a relevant pre-admission history. One third of those with a positive history disclosed a further significant episode. Conclusions: Existing pastoral care mechanisms may need to be enhanced in order to identify and support potentially vulnerable students.