Issues related to human factor – ergonomics influence the health of the students and contribute to their well-being. Human factor – ergonomics should be considered since the distinction between mind and body or mental and physical health is more artificial than actual. Perturbation in one affects the other; hence, simple steps to alter ergonomics can improve medical students' overall well-being and quality of life.

The purpose of this piece is to provide a perspective on how societal dynamics and changes in India have a bearing on wellness among medical students. Wellness is a dynamic state that is often analyzed in terms of attributes of emotional, mental, physical, and interpersonal/social at the individual level. However, the societal context plays an important role in determining wellness even at this level. The social determinants of wellness would include the individual's location in the social hierarchy, economic, social, and cultural capital that they have access to, and the aspirations and expectations that are placed by the family, peers, and society at large. While this is common to most college-going students, medicine being an elite profession that enjoys high status and seen as providing social mobility, there is increased pressure in terms of competitiveness and performance. These complex interactions result in many challenges for medical students as they negotiate multiple demands – economic, academic, interpersonal, and societal in an institution for a prolonged period of time.

As healthcare workers around the world teeter on the verge of burnout, exhaustion, and mental illness in the wake of the COVID-19 pandemic, this article seeks to discuss the wellbeing of a significant demographic: The medical students. We describe the effects of expectations on medical student wellness, whether regarding themselves, their college experience, their future, the profession, or the people around them. Recognizing these as potential sources of problems and future burnout, we propose possible interventions that could rectify these issues and promote their well-being.

Wellness is a concept of optimal well-being, an essential component for medical students at the personal and professional level. While medical education and healthcare service demand an efficient coping reservoir and resilience, but greater burnout and psychological morbidity is being reported among medical students. Responsibility to address the concerns about well-being lies in medical schools, but there is a lack of awareness and nonavailability of such adaptive resources. In this article, we highlight the concept of wellness and its relevance in the context of medical students, models described in the literature for this purpose, and recommendations for wellness of medical students.

In the recent changes in medical education and health-care systems, stressful work condition and concurrent destabilizing psychosocial dynamics can result in adverse consequences of medical trainee's mental health. This can range from the usual stress in a medical school to distress and long-term burnout emerging into psychological disorders often underrecognized and ill managed. Stigma and poorly integrated available mental health services, administration, peers, and families can be roadblocks to implement an effective campus mental health services. This article also provides a template of student mental health service model in our institution and suggested measures for a holistic professional grooming during medical curriculum.

Mental health issues are common in medical undergraduate students. Various studies have identified depression, anxiety, burnout, and substance abuse, among others, as common problems among this group. Frequent suicides by medical students are a disheartening reality. Despite belonging to the medical fraternity, students find it difficult to approach or access professional help for multiple reasons. In this study, the authors discuss the extent of the problem, available resources, and further efforts that need to be made to improve the provision of care to this group.

Problematic substance use and internet use negatively impact student's well-being. The prevalence of these addictive disorders is high among medical students and is being linked to several medical and psychiatric complications. It also impacts the social fabric of the campus and poses a security hazard to all. Risk factors for these disorders include psychological stress, peer pressure, and a reduced scope for social interactions. Primary preventive programs include health promotion strategies, formulation of a strong campus alcohol and drug policy, and taking steps to reduce drug availability. It is important to create a screening and referral system so that at-risk students can get access to timely interventions. Prevention of excessive internet use to requires focus on pro-social interactions among students and a bigger push for healthy lifestyle for students. At-risk students might require interventions that try to correct cognitive distortions regarding internet use and work on building emotional regulation.

Medical training involves intense academic pressure and competition. Understandably, the prevalence of mental distress and suicidal behaviors is high among medical students. This article discusses the recognition and management of suicidal behavior at an individual as well as service/systems level. At the individual level, identification of common psychiatric symptoms, recognition of suicidal warning signs, adequate assessment, and appropriate referrals can prevent potential suicides. Various strategies have been successfully implemented at the population and high-risk group level. The introduction of technological methodologies may increase the reach of these preventive strategies. Student Wellness Centers can serve a significant role in preventing suicidal attempts and at-risk behaviors.

Objectives and Background: To determine the pooled prevalence of depression among medical students of India by undertaking meta-analysis of published original research studies Materials and Methods: Systematic search was undertaken using PubMed and Google Scholar databases for freely available original articles published between 2014 and 2018 on the subject depression among Indian medical (MBBS) undergraduate students using PRISMA guidelines. Results: A total of 28 original research articles were identified involving 7046 medical students from different medical colleges of India. The median number of students was 284.5 (range, 86–444). All the original research articles had used standardized and validated global screening instruments for identifying depression, and none was based on clinical diagnosis. Meta-analysis of pooled prevalence estimate of depression among medical students in India by random-effects model was 40% (confidence interval [CI]: 32%–47%). Girls had a slightly higher risk of depression than boys (odds ratio = 1.06; 95% CI: 0.81–1.38). There were a total of 16 (57.1%) research articles with the presence of psychiatrist as a co-author and had a pooled prevalence of 39% (95% CI: 29%–49%). The remaining 12 studies without psychiatrist as co-author also reported a nearly similar finding, with prevalence of 44% (95% CI: 33%–54%). On subgroup analysis, it was revealed that the pooled prevalence of depression was 37.9% (95% CI: 22–55), 45% (95% CI: 42–52), and 34% (95% CI: 24–50) in research articles using study instruments Beck Depression Inventory, Depression Anxiety Stress Scale, and other miscellaneous screening instruments, respectively. Conclusion: Within study limitations, the high prevalence of depression was noted among medical students of India and the situation warrants comprehensive management by stakeholders.

Background: Suicide, commonly defined as “an act of self-destruction, initiated and committed by a person who is aware of the fatal outcome and has substantial socioeconomic and cultural influences. The current suicide rate in India is 10.6/100,000 population. Doctors play an active part in the treatment and prevention of patients with suicide attempts, and their therapeutic endeavors may interrupt the ongoing suicidal process. The aims and objectives of this study were to assess the Opinions and Attitudes of the postgraduates of the various clinical departments towards suicide and to find out for any differences among postgraduates of Surgical and Medical groups who manage the consequences of the chosen methods of the suicidal attempts of the patients. Postgraduates of psychiatry were not included. Materials and Methods: It was a cross-sectional study done on various nonpsychiatric postgraduates between October and November 2019 in R L Jalappa Hospital, a constituent unit of Sri Devaraj Urs Academy of Higher Education and Research, who are assessed using structured and validated instruments, the Suicide Opinion Questionnaire, and Attitudes to Suicide Prevention Scale. Results: The majority of both the Surgical and allied science groups with the Medicine and allied science group nonpsychiatric postgraduates had a negative disposition towards suicide attempters and negative attitudes towards suicide prevention strategies and there was no statistical difference among them. Conclusion: There must be training for non-psychiatric specialists towards suicide regularly and change in their respective PG training curriculum towards the approach of patients with self-injurious behaviors.

Background: The various studies globally emphasized that the students from professional courses are subjected to a higher level of stress, anxiety, depression, and suicides. Objectives: The aim of this study is to estimate the prevalence's of stress, anxiety, and depression among medical and engineering students; to assess the source of stressors and coping strategies among them and to determine the association of anxiety and depression between both the fields of students with stress. Materials and Methods: This cross-sectional study was conducted among 319 students from medical and engineering colleges. They were assessed using semi-structured data; depression, anxiety and stress scale-21; coping inventory for stressful situations-21 and sources of academic stress among students. Results: The levels of stress, anxiety, and depression among medical students were found to be 37.27%, 73.37%, and 60.94%, respectively, while that among engineering students were 29.3%, 78%, and 59.3%, respectively. There was significant difference between medical and engineering students, who fall under the category of stress on the basis of age, gender, religion, socioeconomic status, and satisfaction with the academic performance (P < 0.05). The significant differences were also observed between both the fields of students with anxiety and depression (P < 0.05). Conclusion: The stress, anxiety, and depression levels were found to be high among both the groups of students. Academic factors were main source of stressors and both the field of students adopted task-oriented coping strategy a little more to deal with their stressors. Thus, professional students should be provided with appropriate counseling and stress relieving activities to improve quality of life.

Background: Nomophobia refers to an irrational fear of being beyond contact with a mobile phone. Excessive smartphone use can affect physical and mental health of medical students, who already have an increased vulnerability to stress. Coping focuses on resolving the stressful situation and minimizing emotional reaction. This study attempted to understand the correlation between phone addiction and mental health and the coping strategies adopted by the students to handle their stress. Subjects and Methods: This is a cross-sectional study in which the sample was selected by universal sampling. A total of 246 medical students from 2^nd and 3^rd years of undergraduation consented to participate in the study. Nomophobia Questionnaire, Mental Health Inventory (MHI), and Brief COPE scales were administered. Results: The prevalence of nomophobia was 100% and based on the severity, 65.9% of the students had moderate nomophobia. The mean score of MHI was 52.67 with a standard deviation of 8.37. The more common coping styles adapted by medical students were planning activities in advance, positive reframing, and acceptance. A weak negative correlation was present between nomophobia and mental health status. Among persons with nomophobia, those with higher nomophobia scores responded with venting, self-blame, denial, substance use, and self-distraction as coping strategies when exposed to stress. Conclusions: Persons with nomophobia have been identified to have maladaptive coping strategies. Health education strategies should be targeted to youth to prevent harmful effects of this great invention, and workshops on stress and effective coping strategies should be conducted through the academic years.

Context: Varying attitude exists regarding psychiatrists, psychiatric medications, and mental illness among different groups of people. Attitudes are in more of a negative domain when we look from the laypersons' perspective. The study explores medical graduate attitudes in these domains. Aims: The aim was to study the attitudes toward psychiatrists, psychiatric medications, and mental illness among medical undergraduates. Settings and Design: This cross-sectional study was done in a private medical college in India. Subjects and Methods: The study was conducted on medical undergraduate students of a medical college in India. They were asked to fill study forms, which were designed to obtain sociodemographic details and included questionnaires to measure attitudes toward psychiatrists, psychiatric medications, and mental illness. Statistical Analysis Used: The completed forms were subjected to analysis by statistical software SPSS v18. Results: The sample included 596 medical undergraduate students. The study found a statistically significant negative association between age (P = 0.000) and attitude toward psychiatrists; gender (P = 0.014) and religion (P = 0.026) towards psychiatric medications, year of study towards psychiatrists (P = 0.000) and mental illness (P = 0.025). A negative correlation was found between age with attitudes toward psychiatrists (r − 0.273, P = 0.000) and mental illness (r − 0.095, P = 0.020); similarly, a negative correlation was found between year of graduation with attitude toward psychiatrists (r − 0.327, P = 0.000) and mental illness (r − 0.103, P = 0.012). As a preferred branch for postgraduation, only 18.8% were willing to take psychiatry; the willingness increases to 51.5% if no other clinical branch is available. Conclusions: Medical undergraduate students tend to have negative attitudes toward psychiatrists and mental illness in their starting years, but as they progress in their graduation, this tends to change. They have positive attitudes toward psychiatric medications in the later years of their graduation.

Objectives: Variations in work-related stress, anxiety, and physical activity levels have been seen with an emphasis on sex differences. This cross-sectional study was designed to report the gender difference in stress dynamics, trait anxiety, and physical activity and propose a framework for finding out the source causing these differences. Hence, the aim of the study is to find out the comparison of these variables between teachers and students. Methodology: A cross-sectional study was designed which analyzed 120 participants consisting of teachers of assistant professors grade (n = 60) and students (n = 60) from various teaching departments in Guru Nanak Dev University, Amritsar. Further these subjects were categorized into male and female participants. For which, validated questionnaires and methods were used to measure stress and anxiety among these group of participants. Physical activity levels were also measured with a questionnaire focusing on lifestyle. Results: The perceived stress measured by the Perceived Stress Scale-14 and trait anxiety measured by the Self-Rating Anxiety Scale, did not show any significant differences between female participants (37.54 ± 7.27 and 38.85 ± 7.02, respectively) as compared to male participants (37.91 ± 7.11 and 38.14 ± 5.85, respectively). However, higher physical activity expenditure was observed in male students as compared to their female counterparts, which is measured by the International Physical Activity Questionnaire in metabolic equivalent (MET) (3293 ± 1698 and 2234 ± 1674, respectively). Conclusion: Teachers had higher trait anxiety than students. A student shows a higher level of stress and MET values than a teacher. Female teachers showed a higher level of trait anxiety and stress than male teachers but had a lesser value of MET than male teachers. Female students shows greater anxiety level whereas male students shows increased stress level as compared to their respective counterparts. Male students had a higher value of MET.

Background: Life in college and university can be stressful. It was intended to evaluate mental health, specifically depression, anxiety, substance use, and stress among management students to explore the need for support in a campus. Methods: It was a cross-sectional study in the setting of a university campus. Using a questionnaire method, students of the Master of Business Administration course were evaluated for stress, depression, anxiety, and substance use. Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 were used for assessing anxiety and depression. Stress explored through open-ended questions was later categorized. Results: Majority of students (60.7%) reported stress which was broadly course-related and personal issues. Stress was significantly associated with anxiety and depression. Around 36.1% of students had anxiety and 44.2% had depression at a clinically relevant level. The proportion of students reporting wish to die or self-harm ideas nearly every day was 11.5%. Substance use was reported by 18.3%. In contrast to these proportions, only 10% of students acknowledged having mental health problems. Conclusion: Considerable mental health concerns exist in students. The results highlight the need for specific mental health promotion and preventive health actions in a university campus.

The interface of policy and legislation is crucial in making quality mental health care accessible in an effective manner. Shortage of psychiatrists and other mental health personnel in India poses a huge challenge in delivering mental health care. The social context is instrumental in subjecting the mentally ill to human rights violations and discriminations with low awareness, illiteracy, superstitions, denial, and the prevailing social perception of mental illness in India. The enormity of problem requires a multipronged approach supported by a robust policy with specific achievable goals. Mental health policy relies on the legal framework to achieve its goals, and ameliorate the lives of persons with mental disorders. Policy and legislation are two complementary approaches for improving mental health care and services. International developments in mental health care have brought a paradigm shift from “charity-” to “rights-” based approach which is very much reflected in India's first-ever Mental Health Policy, 2014, and the newly enacted Mental Healthcare Act, 2017. This shift entails a “participatory” approach for developing community-based facilities, services, and rehabilitation provisions. An analytical approach has been adopted to gauge the likely outcome of the combined role of this ambitious policy and law in light of existing mental health-care infrastructure and “social context.” An attempt has been made to highlight the main concerns and challenges in effective implementation of new law while putting forth feasible solutions to attain the policy goals. The paper concludes on a note that legal and health measures should work in tandem and eventual convergence be directed toward the best interest of mentally ill persons.

The current paper contextualizes mental health from a human rights-based perspective. It traces the multifarious efforts for realization of human rights of persons with mental illness in the Indian context. Alluding to the stigma and ostracism faced by the individuals with mental illness from their families and communities, the paper discusses the challenges to their care and essential treatment/services and available support. The paper also proposes few eclectic strategies for creation of an enabling and inclusive environment for persons with mental illness.