Effectiveness of universal programmes for the prevention of suicidal ideation, behaviour and mental ill health in medical students: a systematic review and meta-analysis.
Study Goal
The researchers aimed to evaluate the effectiveness of universal interventions, particularly mindfulness-based approaches, in reducing mental ill health, suicidal ideation, and behavior among medical students.
Results Summary
Relatively brief mindfulness-based interventions showed short-term effectiveness in reducing anxiety, depression, and stress in medical students, but effects on suicidal ideation and behavior were undetermined. There was limited evidence of long-term benefits, and organizational-level stressors were largely unaddressed.
Population
Medical students
Effective Dosage
Not specified
Duration
Varies (brief interventions, exact duration not specified)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
relatively brief interventions designed to reduce stress; most commonly using mindfulness-based or guided meditation approaches | no change | depression, anxiety and stress | medical students | limited evidence | limited evidence of an effect | #1 |
relatively brief, individually focused, mindfulness-based interventions | decrease | anxiety, depression and stress | medical students | in the short term | may be effective in reducing levels | #2 |
interventions specifically designed to address suicidal ideation | neutral | suicidal ideation | medical students | - | effects remain to be determined | #3 |
interventions specifically designed to address suicidal behaviour | neutral | suicidal behaviour | medical students | - | none investigated the effectiveness | #4 |
curriculum-level changes | neutral | - | medical students | - | five investigated the effects | #5 |
QUESTION: A growing body of work suggests that medical students may be particularly at risk of mental ill health, suicidal ideation and behaviour, resulting in recent calls to develop interventions to prevent these outcomes. However, few reviews have synthesised the current evidence base regarding the effectiveness of these interventions and provided guidance to improve future intervention efforts. STUDY SELECTION AND ANALYSIS: The authors conducted a systematic review to identify studies of any design reporting the effectiveness of any universal intervention to address these outcomes in medical students. Embase, MEDLINE and PsycINFO databases were searched from their respective start dates until 1 December 2017. FINDINGS: Data from 39 studies were included. Most investigated the effectiveness of relatively brief interventions designed to reduce stress; most commonly using mindfulness-based or guided meditation approaches. Only one implemented an intervention specifically designed to address suicidal ideation; none investigated the effectiveness of an intervention specifically designed to address suicidal behaviour. Five investigated the effects of curriculum-level changes. Overall, there was limited evidence of an effect for these programmes at both the postintervention and longest follow-up assessment on depression, anxiety and stress. CONCLUSIONS: Relatively brief, individually focused, mindfulness-based interventions may be effective in reducing levels of anxiety, depression and stress in medical students in the short term. Effects on suicidal ideation and behaviour, however, remain to be determined. There has been a significant lack of attention on organisational-level stressors associated with medical education and training.