Accessing the quadruple aim: Embedding mental health care in medical training

Importance

In order to operationalize the quadruple aim, it is imperative to understand how to best provide mental health services. Medical trainess experience high rates of depression, anxiety, and suicidality during their training; however, barriers often prohibit utilization and access to mental health services.

Objective

This quality improvement project aimed to increase utilization and improve access to mental health services in medical training.

Method

An anonymous Qualtrics survey was used to assess if new pathways had decreased barriers to access and utilization. In addition, a comparision of ultization data was analyized.

Main outcome

In comparing the utilization data of the first three months of the academic calendar year from 2018 to 2019 shows a 42% increase in number of residents/fellows accessing the mental health services. The primary barrier to access is lack of time.

Results

Four primary themes were identified as barriers to care: lack of time, impact of career, confidentiality, and stigma.

Discussion

This project has tremendous importance due to the high national rates of depression, anxiety, and suicidality for residents and fellows. It documents the barriers and need for new ways to outreach and provide direct mental health services which best fit this population.