Supporting students to support peers : a qualitative interview study

Background: High rates of psychological distress and suicidal ideation are experienced by medical students globally. Medical students are reluctant to seek support due to perceived stigma and fear of negative impact on their career trajectory. In medical programs, peers are likely the first to recognise signs of a medical student in distress. Aim: This study sought to understand how medical schools could better support peer support strategies. Methods: Medical students at two Australian medical schools were invited to participate in semi-structured telephone or face to face interviews. Participants were recruited from wellbeing interest groups and the general cohort. To ensure anonymity, students were interviewed by researchers from the other, interstate, medical school. Interview recordings were transcribed. Identifying details were removed from verbatim transcripts by the interviewer, then independently analysed by another researcher for emergent themes. Results: Participants readily identified numerous causes for distress in peers. Being in frequent and direct contact increased awareness of their peers' wellbeing and facilitated identification of any distress. Mental health (MH) stigma and confidentiality concerns were seen as barriers to open MH peer discussions. Despite this, friendship groups were seen as the primary form of support. Participants readily identified strategies for medical schools to facilitate peer support. Formalising peer support, however, generated mixed responses. Conclusions: Our findings confirm that students are well placed to identify and support peers in distress, but not all students support formal peer support roles. Future research is needed to confirm findings and explore the acceptability of suggested strategies.