Barriers to Seeking Mental Help and Interventions to Remove Them in Medical School during the COVID-19 Pandemic: Perspectives of Students

Medical students are at increased risk for psychological morbidity but the majority of those with mental health problems do not seek professional care. We aimed to uncover the viewpoints of medical students regarding barriers and facilitators to using university mental health services and their attitudes and preferences towards online counselling. Four semi-structured focus groups were conducted (n = 26, mean age = 21.8, +/- 1.88, 73% males). After reaching data saturation, interviews were audio-recorded, transcribed and content-analysed by two independent coders. Intrapersonal barriers emerged to be perceived low risk, excessive self-reliance, lack of belief in the effectiveness of service, lack of openness. Interpersonal factors were the following: assumed long waiting list, insufficient provision of service information, fear of exposure, and not being familiar with the counsellor and the process. Extrapersonal barriers such as insurance problems, the number of available sessions, adverse sociocultural attitudes, fear of stigmatisation were identified. Students suggested that the university should provide psychoeducation and routine screening, apply social marketing and stigma reduction campaigns, improve information flow, and offer not only personal but also online video counselling to target removing these barriers. The results provide a reference for the redesign of mental health services to facilitate their access by students. Implications and limitations are discussed.