Fees protests take mental toll on medical students: study
Long after the student-led #FeesMustFall protests ended, many students still suffer the emotional turmoil of their impact, with new research showing that a significant number of medical students who were directly affected by the uprisings were at an increased risk of depression and anxiety.
The study, which surveyed almost 500 medical students from the University of Cape Town, found that more than a third (36.4%) of students had symptoms above the cut-off for depressive disorder, and a quarter (25%) had clinical depression.
Researchers found that just under half, or 46%, of medical students from this university are at risk of anxiety disorders, with one-fifth (20.5%) having been diagnosed as having anxiety disorder and 25% with depressive disorder.
Almost half (45.5%) of the surveyed students were those who underwent a contingency “mini-semester” course as a result of postponement of classes during the peak of the protests in 2016. In January 2017, secondand third-year students had to take part in a six-week “catch-up” on teaching and assessments to make up for the two months of forfeited teaching the previous year.
The student-led protest movement, which began towards the end of 2015 and ended in 2017, demanded a stop to student fee increases, as well as an increase in government funding of universities. It affected most SA universities and is deemed to be the largest student protest since the end of apartheid in 1994.
The study, which appears in the current issue of the South African Medical Journal, also shows that female trainee doctors are more likely to suffer from depression and anxiety than their male counterparts, while female students are four times more likely to have anxiety disorders than males.
Clinical students from the fourth to sixth years showed decreased symptoms of depression compared with their juniors in the first to third years who took part in the catch-up exams, and who were twice as likely to have depressive and anxiety symptoms than their counterparts who didn’t take part. Just over a quarter of the 473 students who took part in the survey received psychiatric medication, with 16% on depression medication, while 12% were treated for anxiety.
Despite the depressive symptom burden in medical students, many students seemed to be under-treating their mental illness, with only 58% of those with depression on treatment. Only 66% of those diagnosed with anxiety were on treatment.
Medical students from UCT also showed higher levels of depressive and anxiety symptoms than their counterparts from the University of KwaZuluNatal, which had a 15.6% prevalence of these symptoms, the University of the Free State (26.6%), and Pretoria University, which reported 14.9% of depression and anxiety symptoms among its medical students.
Co-authors and final-year medical students at UCT, Stefan van der Walt and Wakithi Mabaso, attributed this marginal increase to the death of the health faculty dean, Prof Bongani Mayosi, who committed suicide in 2018 following a battle with depression.
“We acknowledge that it is unclear whether these findings represent true differences or may be attributable to differences in measurement tools on the impact of the death of dean of faculty of health sciences at the University of Cape Town,” they wrote. They said his death could have led to increased rates of depressive or anxiety symptoms at the time of the study.
The two researchers said there was a need for further research into the careers of these medical students since junior doctors were particularly vulnerable to mental illness.