Mental health among Thai medical students: Preadmission evaluation and service utilization

Background and Aims Mental illness among medical students is common. Identifying at-risk students can be beneficial in terms of prevention and treatment. This study examined the association between preadmission mental health evaluation and mental health service utilization among Thai medical students. Methods The authors collected data from all first- to sixth-year students at one university hospital and three affiliated hospitals during the 2014 to 2019 academic year (n = 1642). Preadmission mental health was evaluated using the Thai Mental Health Indicators 66 (TMHI-66) questionnaire. Data from mental health service utilization included the dates of service and the clinical diagnosis. Data were analyzed using Cox regression, adjusted for sex, hometown, and affiliated hospital. Results The prevalence of poor mental health was found to be 3.7% based on TMHI-66 results. The proportion of all students who sought mental health services was 8.3%, and they were mostly diagnosed with depressive disorder (3%), adjustment disorder (1.9%), and anxiety disorder (1.9%). Students with positive TMHI-66 results were more likely to seek out services at the faculty counseling center for one or more mental health problems (Hazard ratio [HR] = 2.11, 95% CI 1.11-4.04, P = .024). Conclusion Preadmission mental health was found to be associated with mental health service utilization. Depressive disorder was the most frequent mental illness among Thai medical students utilizing the faculty counseling services. Still, the number was far lower than the reported prevalence of mental disorders due to various reasons. Further studies are needed to investigate risk and protective factors for mental disorders to better promote mental health and encourage mental health service utilization in targeted students throughout medical education.