We’re obviously concerned with people’s dental health here at the UCSF School of Dentistry. But how much do we think about people’s mental health?
I’m not talking about the well-established link between dental health and mental health, although I’m always happy to have that conversation. What’s on my mind is the mental health of our students—and more broadly that of our residents and other learners—who are under so much pressure to excel, and who are at a particularly vulnerable age for mental health challenges.
Research has shown that most mental illness becomes symptomatic by the age of 14 and nearly 90 percent peak during a person’s 20s. That differs from other chronic diseases, which typically develop in the 50s. Almost all our students are in their 20s—when the risk of anxiety, depression, maladaptive coping mechanisms, suicidal ideation, and substance abuse are at their highest.
The students’ school life contributes to the problem. In addition to the academic and clinical demands, there can be overwhelming financial pressure, anxiety about keeping up with peers, and a culture that often demands high achievement without being understanding of mistakes. This puts the brain health of health professional students at greater risk compared to their peers.
We’re also still dealing with fallout from the pandemic, which caused an increase in anxiety and other mental and behavioral health issues that have not gone away.
Universities have a unique responsibility to their students. We’ve invited them into this environment and we need to lay the groundwork for their success.
Brain Power
Every day that I have the opportunity to work with the students in our professional schools, I am struck by their skills, knowledge, and compassion. The brain power this emerging generation of leaders possesses consistently impresses me. Protecting brain health is important for us as individuals and also for society at large.
UCSF offers a range of services to support students and others who might need help. Student Health and Counseling Services gives students a place to get assistance for the unique set of pressures in their lives. Psychological counseling, medical clinics, COVID-19 resources, stress and depression screening, and spiritual support are among the services available.
I think we could go even further. Is it time for universities to ensure students know how to take care of their mental health by making it part of their education? A multifaceted curriculum could address student health through course content, wellness electives, learning communities, or required resilience/mindfulness experiences.
Better Sleep
Over the course of an intensive education program, students may become conditioned to function with just a few hours of sleep. Long hours are part of the student lifestyle during health professional education, and staying up late to keep pace with rigorous academic demands is part of the culture.
While they may perceive that they are still performing at their best, the students’ insufficient sleep has been shown to have a negative effect on academic performance and overall health.
Even more concerning, research shows that sleep deprivation is a significant contributor to depression and other brain health disorders.
I wish I could give a homework assignment: Tonight, get a good night’s sleep! No yawning in class or clinic tomorrow!
The Importance of Taking Action
There is strong evidence that interventions can help not only treat but also prevent some brain health conditions. In many cases, the earlier the intervention, the more effective it is in minimizing individual suffering and costs to society. The McKinsey Health Institute, an arm of the global consulting giant, posits that “mental and substance-use disorders are highly treatable and often preventable,” and investing more in tackling these conditions could add years to people’s lives—and “life to their years.”
I’ve been pleased to see that members of Gen Z—the cohort born after 1996, including most of today’s students—have a more nuanced approach to mental health than previous generations. The shame and stigma associated with depression and anxiety in earlier generations are not shared by these young students. Many famous people their age, including athletes like Simone Biles and Naomi Osaka, have been open about their struggles with mental health, and it has been heartening to see that they were met with great public support.
This positive environment creates an opportunity to address brain health directly with our students.
Worthy Goals
One important aspect of brain health is positive mental health, which is highly related to perceived self-efficacy, autonomy, competence, and the ability to realize one’s intellectual and emotional potential.
Good brain health means more than just the absence of disease. It also includes overall cognitive functioning, resilience, and a state of well-being in which individuals feel able to cope with the normal stresses of life, realize their abilities, work productively, and contribute to their communities.
These seem like professional activity goals we should develop in our graduates.
