When new doctors have suicidal thoughts, online therapy can help

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The research involved about 200 medical interns – residents in their first post-graduate year, which is often one of the most intense periods of doctor training. It often involves 80-hour weeks and overnight hospital shifts dealing with multiple medical crises.

An earlier study of 740 interns found that suicidal thoughts increased almost four-fold during the first three months of residency, said Dr. Constance Guille of the Medical University of South Carolina in Charleston.


Her research group led both studies.

Sarah Dalechek, a first-year psychiatry resident at that university, said her program requires two month-long rotations of 16-hour overnight shifts in an emergency room. She said she became very depressed but had little time to seek help.

The study involved interns at Yale University and the University of Southern California. It used a free online program developed at the National Institute for Mental Health Research at the Australian National University in Canberra. Overall, 12 percent of interns who got online therapy said they had thought about suicide during the year, versus 21 percent of the interns who received four weekly emails with information on depression and where to seek help.

After accounting for initial group differences that could increase chances for depression and suicidal thoughts, the researchers calculated that interns who got the sessions were 60 percent less likely to have those thoughts than the other group.

The online program included sessions about how to put feelings of stress or despair into perspective. For example, a poor test grade or bad performance evaluation might lead to feelings of “I’m not good enough,” but the lessons encourage more positive thinking about “how many exams have you passed, to put this failure in a more accurate light,” Guille said.

Guille said medical students and residents tend to be high-achieving perfectionists, but that they need to learn “you can’t always be perfect in medicine, you have to figure out how to deal with failure.”

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