Peer responses to psychologically distressed tertiary students: the detection of distress and the helping behaviours of student colleagues from medicine, compared to psychology, law and mechanical engineering students.

Medical students experience elevated levels of psychological distress and they are reluctant to seek professional help for mental health problems. They are also reticent to notify authorities about colleagues experiencing psychological distress. Yet, young people are more likely to seek help from peers than from any other source and we know very little about the help that these peers provide to their distressed colleagues. The current research explored medical students’ approaches to colleagues experiencing psychological distress: firstly, to determine whether they notice the distress of colleagues; secondly, to explore what determines consideration to intervene and help colleagues; and thirdly, the range of helping behaviours provided. Comparisons were made with students from other professional tertiary disciplines. Students from all six years of an undergraduate medical course were compared with convenience samples from Psychology, Law and Mechanical Engineering at The University of Adelaide. Students were recruited for one of three studies which employed a variety of measures, including the Kessler Measure of Psychological Distress (K10), a Retrospective Helping Behaviour Instrument (RHBI) and a Hypothetical Helping Behaviour Instrument (HHBI). Psychological distress (as determined by the K10) among the disciplines surveyed (N = 949) was 4.4 times that of age-matched population normative data. Despite this high rate of distress, students consistently rated the distress of their colleagues as significantly lower than the colleagues’ own self ratings. All disciplines were equally inaccurate in detecting the distress of their colleagues. Analysis of hypothetical helping behaviours, in response to a vignette, indicated that medical students offered more help to non-medical students than they did to fellow medical students; however, the quality of help delivered to fellow medical students was superior. Non-medical students offered more help to medical students than they did to students from their own discipline, but the quality of help they offered did not change between the two disciplines. Analysis of the mixed method RHBI indicated that discipline had an effect on the types of help provided to distressed colleagues, the reasons for and for not helping a colleague, and general helping concerns. Three main types of help were provided: social support, academic assistance and therapeutic assistance. Medical students from Year 3 onwards offered a diverse array of helping behaviours, whilst law and mechanical engineering students primarily offered academic support. Help was considered more frequently than it was actually given and reasons for and against providing help were associated with belief or doubt about the benefit of helping, positive or detrimental effects for the helper, the closeness or lack of friendship with the helpee, and confidence to help. This research has improved our understanding of the mechanisms that produce helping behaviour. It has also provided a rich inventory of the type of help offered by the medical students and by other tertiary students. This knowledge is crucial in the development of effective approaches to assisting distressed students, particularly in regards to the theoretical and practical development of peer support programmes. Peer support programmes take into account young peoples’ preferences to speak to peers. Peer support programmes that build on the students’ existing behaviours and resources (those behaviours identified in this research) have an increased chance of acceptance and validity. Such programmes may offer a viable adjunct to formal support services and, more importantly, may have far reaching effects in breaking down the stigma of mental health problems within professions such as Medicine.Thesis (Ph.D.) -- University of Adelaide, School of Population Health and Clinical Practice, 200