According to this study, 77.77% of medical students have reported feeling the need for mental health care. This is much higher than the reported prevalence of 44.6% among medical students in India [10]. However, this high prevalence can be referred to as the drastic effect of the COVID-19 pandemic on all sectors of the community [12], especially medical students, who have greater worry about their future and the perceived pressure from their social circle as a source of information and care. More importantly, they fear transmitting the infection to their family that they may have acquired during their medical training and exams.
In addition to this, the loss of loved ones and the transition to online education may both contribute to an increase in levels of stress and anxiety. According to the findings of a longitudinal study that was carried out in China, acute stress, anxiety, and depressed symptoms were rather common among college students during the COVID-19 pandemic. Furthermore, these symptoms exhibited a considerable rise beyond the first stage of the outbreak [13].
Furthermore, females are also 2.7 times more likely than males to feel the need for mental health care. In contrast to a meta-analysis study that includes cross-sectional studies that investigated the distribution of any mental health disorder among Chinese medical students [14], there was no significant difference in gender regarding mental health needs. This significant difference could be due to increased social-cultural pressure on females during their academic years, which puts a tremendous burden on them.
Based on student residence, there is a significant difference between urban and rural students regarding feeling the need to seek mental health care with a probability of 1.9 times more likely in urban students than rural ones. This could be due to loneliness, violence, high crime rates, homelessness, noise and other pollution, traffic accidents, and drug misuse which prevail more in urban regions [15]. On the other hand, in rural areas, the traditional joint family and warm neighborhood may be considered a source of high social support, and it may buffer perceived stress through a support network promoting mental health [16]. However, urban students have higher access to mental health services as the median instrumental total score is significantly lower than rural, in accordance with a previous study [17].
Despite their need for mental health care, only 23% sought professional help. Although this is a lower rate, it is consistent with some studies that indicated varied rates of professional help utilization of 18% and 22.7% in India and the USA, respectively [10, 17]. Some medical schools in the USA, on the other hand, had a higher rate of 42.1% and 33% [18, 19].
Depending on the study results, most of the barriers were instrumental and attitudinal related. Other studies depict that most reported barriers were related to attitude and stigma [10, 20]. While stigma was the highest barrier in some studies [10, 18], our findings identified stigma as the lowest barrier, thus indicating that students are aware of mental health illnesses and no longer ashamed of having such conditions.
Also, all the subscales in this study had a statistically significant correlation with one another (P < 0.001), and this is in accordance with a study that investigated these correlations in India [10]. This is since stigma may have a significant impact on the public’s attitudes toward mental health treatment. For example, the urge to resolve the problem independently, even though it had a high score, could be related primarily to stigma. Likewise, the lack of resources may contribute to opposition to seeking mental health care or an unfavorable outlook toward expert help.
Reported barriers to professional help were different in numerous studies, although the absence of knowledge about accessibility to mental health services and solving the problem by themselves was the most common barriers to care reported by our students, followed by time and financial affords. In Kasam [10], the most prominent one was lack of time, followed by uncertainty about where to find professional help. As reported by Rodriguez [19], convenience, stigma, and concerns about confidentiality were the most common barriers. In Ebert [21], the preference to handle the problem alone, followed by wanting to talk with friends or relatives instead, was rated the most important. And according to Menon [22], lack of time and being unaware as to where to seek formal help were the most common barriers.
So, a continuous effort to improve the accessibility and acceptance of mental health services early in their careers is crucial. Fortunately, the most commonly reported barrier in this study is the lack of information which is the easiest to overcome, and this emphasizes the need of educating students about the available mental health care and where to access it. This can be achieved simply by organizing a committee which concerns about how to access care and raising awareness about mental health problems. Moreover, this educational approach will cover more barriers such as financial costs and the advantages of the services available to the students. Also, the significant positive correlation between all subscales implies that the decrease of instrumental barriers mentioned above would also contribute to the decline of other barriers and vice versa.
