Psychological support for students

Interview with Magdalena Łazarewicz, Ph.D., Study of Health Psychology, Medical University of Warsaw

How much do students of the Medical University of Warsaw need the help of the University Psychological Clinic?

Magdalena Łazarewicz, Ph.D.: There is a great deal of interest in the help provided by the clinic. When information about the launch of the clinic for all students of the Medical University of Warsaw appeared on the Medical University of Warsaw website in February 2018 (previously, since 2014, consultations had only been available for international students), nearly 60 people approached us within three days with a request to arrange a psychological consultation. This year, the same happened when we resumed our activities after a short break. Annually, 250 students contact the clinic on average, and eventually, about 200 students benefit from the clinic’s short-term assistance. This represents just over 2% of the total number of students of the Medical University of Warsaw. About 15% of the people consulted at the clinic are international students. However, it seems that these figures do not yet reflect the absolute need for psychological support, especially now - during a pandemic. We are constantly trying to reach students with information about the existence and operation of our clinic so that everyone knows where to turn for help. In the early stages of the pandemic, during the lockdown and remote learning period, we provided online consultations. We currently operate hybrid: stationary at 14 Litewska Street and online.

There is much talk about the fact that young people are increasingly experiencing mental health crises. Does this also apply to students?

M.Ł.: Research shows that the proportion of teenagers who have mental health problems has increased significantly over the past decade or so. Both in Poland and worldwide. Similar unfavourable changes are observed among students. Some studies even show that they experience mental crises more often than secondary and primary school students. However, students - already young adults - are much less talked about in this context. Meanwhile, they and other young adults were the groups that fared worst in the first phase of the pandemic.

What might this be due to?

M.Ł.: Above all, it seems, this is due to the drastic changes in lifestyle that the pandemic has forced upon us have been most severe for them. Studying is a period not only of intensive intellectual development but also - and perhaps above all - a period of forming one’s own identity and trying to build close relationships. Many young people study outside their hometowns. Independence comes with many challenges. However, losing newly gained freedom, independence, liberty, and a new lifestyle can be even more difficult. For many students, returning home during the pandemic meant re-entering uneasy family relationships and returning to the role of a child. This situation limits development towards adulthood. 

Has the situation returned to normal after the restrictions were lifted and the university returned? 

M.Ł.: Many students have adapted well to the new reality, to this new normal. However, there remains a significant group of students who require additional support. With the return to full-time education, new challenges have arisen, involving the need for increased social activity. Not everyone is coping equally well after the pause caused by the pandemic. Students come to our clinic with symptoms characteristic of social anxiety, although before the pandemic, they had no problems expressing themselves in class and participated actively in student life. We also work with students grieving the loss of a loved one or experiencing survivor guilt. They suffer from loneliness and a sense of being misunderstood by others, who often play down the dangers of COVID-19. 

What other problems do students come to the clinic with?

M.Ł.: Currently, we primarily work with students with mood disorders. The lowered mood is expressed by sadness, lack of drive, problems with concentration, and motivation to learn. Many students who come to us experience anxiety. Some of these are associated with academic stress, most often due to lowered self-esteem and feeling high pressure of expectations from parents and the environment. Sometimes this pressure is real, sometimes imagined. Students also often talk about problems related to peer groups, romantic relationships, and family homes. Students with addictions (to alcohol, but also computer games or gambling) and eating disorders also come to the clinic.

Are medical students more vulnerable to mental health crises and mood disorders than students in other majors?

M.Ł.: Pre-pandemic research indicates that it does. Medical students have more mental and emotional problems than students in other disciplines. Very worryingly, however, they are less likely to seek help with them.  Thanks to the ongoing longitudinal study COVID-19 Experienced by Students”, I will soon also be able to answer the question of how the emotional state of medical students looks and changes in the pandemic compared to students in other disciplines. More than 4,200 students participated in the first phase of the survey conducted in spring 2020. This is the second time we have studied student health and functioning during the winter 2021 pandemic. This is now the third time we have collected data from them.

How does your clinic work? Can it be used in the short or long term?

M.Ł.: When a person comes to us, we try as soon as possible to arrange an appointment for the student to see a psychologist of their choice. We immediately sign up for three 50-minute visits on dates indicated by the person at weekly intervals. These three meetings for one person are the basic scope of our activities. During this time, we identify the problem and decide whether we can help within these three meetings or whether longer work is needed. After the first consultation, it is sometimes apparent that the student needs long-term therapy or psychiatric consultation. We then focus primarily on finding a place where he can get help and motivate him to enter therapy. Sometimes we extend our meeting cycle by several sessions. This applies firstly to those who are most in need of help and for whom, for various reasons, we are unable to find therapy outside our centre within a short period of time. Secondly, situations where we see that we can complete work on a particular problem faced by a student in a short period of time.

Who are you able to help during the three consultations, and who needs further therapy?

M.Ł.: It depends on the severity of the symptoms and the type of problem the student is presenting with. I mentioned that students most often come in because of lowered moods. If someone feels a substantial loss of vitality and has suicidal thoughts, this signals that he or she needs psychiatric consultation and therapy outside our centre. If, on the other hand, the symptoms are less severe, then during our meetings, we can develop tools to help the student cope better on their own. Our few meetings are also usually sufficient as support for coping with crisis situations or as psycho-education. However, it is certainly not enough, for example, for people with personality disorders, obsessive-compulsive disorders or those struggling with eating disorders. Here we focus on building motivation to participate in psychotherapy.

Do you offer only individual consultations or workshops as part of your clinic’s operation?

M.Ł.: We plan to run support groups and personal development workshops. Young people badly need such activities, meetings, gaining knowledge about mental health. Both within the clinic’s operations and in the activities carried out by the Health Psychology Study. We place great emphasis on the personal development of the students. We would like to help them make the most of their studies and contribute to making it a time for them to develop and spread their wings. It would be great if medical students graduate and enter the profession in the best possible mental shape because they will face very responsible tasks and many challenges in the future. 

How do I make an appointment?

M.Ł.: Detailed information on enrolment is available on our website link. At present, you have to select matching dates for three appointments with the same therapist from a calendar available on the website. You then send this application to my email address and wait for feedback. This way of enrolling is about to change: from the new semester, we are introducing electronic enrolment. We hope to make the system more student-friendly.  

Interviewed by Iwona Kołakowska, the Medical University of Warsaw