Evidence map›Paper›PMID 41663173›Full record

SynthesisBMJ open2026

Effect of medical school initiatives on help seeking for mental health problems among medical students: a systematic review and meta-analysis.

Amy E Manley, Rachel Perry, Paul Moran, Sarah Dawson, Lucy Biddle, Jelena Savović

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Amy E ManleyPopulation Health Sciences, University of Bristol, Bristol, UK Amy.Manley@bristol.ac.uk.ORCID http://orcid.org/0000-0001-6972-1963
Rachel PerryPopulation Health Sciences, University of Bristol, Bristol, UK.ORCID http://orcid.org/0000-0001-5874-3016
Paul MoranPopulation Health Sciences, University of Bristol, Bristol, UK.ORCID http://orcid.org/0000-0002-9257-8699
Sarah DawsonPopulation Health Sciences, University of Bristol, Bristol, UK.
Lucy BiddlePopulation Health Sciences, University of Bristol, Bristol, UK.
Jelena SavovićPopulation Health Sciences, University of Bristol, Bristol, UK.ORCID http://orcid.org/0000-0002-2861-0578

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesMany medical students with mental health problems do not seek help. However, it is unclear what medical schools can do to promote help seeking. We sought to establish the effect of medical school initiatives on help seeking for mental health problems among medical students.

designA systematic review and meta-analysis of studies published between 2013 and 2023. DATA SOURCES: MEDLINE Ovid, EMBASE Ovid, PsycINFO Ovid, Web of Science, ERIC, BEI and Education Abstracts. ELIGIBILITY CRITERIA: Studies that assess the effect of an intervention delivered by a university or healthcare organisation on medical students' attitudes towards help seeking or their help-seeking behaviour for mental health problems. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently screened studies for inclusion and extracted data. Risk of bias was assessed using Cochrane Risk of Bias 2 (for randomised controlled trials (RCTs)) and Risk Of Bias In Non-randomized Studies of Interventions (for non-randomised studies). Studies were grouped according to intervention type. Meta-analysis was conducted using random-effects models. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluations.

resultsThe evidence from the meta-analyses was of very low to low certainty. Improvements in help seeking were noted in the meta-analyses of pre-post studies investigating the effect of interventions with a lived-experience component (five studies, n=492, standardised mean difference (SMD) 0.62, 95% CI 0.33 to 0.91, p<0.001); of educational interventions (two studies, n=260, SMD 0.38, 95% CI 0.01 to 0.74, p=0.04); and of interventions to improve access to services (two studies, n=1120, OR 1.80, 95% CI 1.12 to 2.88, p=0.02). Effects on help seeking diminished over time. The meta-analysis of three pre-post studies (n=677) evaluating the effect of clinical clerkships found no benefit on personal help-seeking attitudes (SMD 0.21, 95% CI -0.08 to 0.51, p=0.16). Meta-analysis of controlled studies comparing different approaches did not find superiority of face-to-face lived-experience interventions over active control interventions.

conclusionsOverall, the evidence is of very low to low certainty, due to the serious risk of bias in the included studies, most of which used uncontrolled pre-post designs. Interventions with a lived-experience component may improve medical students' help-seeking attitudes. Standard clinical clerkships did not appear to impact personal help seeking, despite multiple previous studies suggesting they reduce stigma, suggesting barriers to help seeking extend beyond stigma and mental health literacy in this student population. Further high-quality research, particularly RCTs with long-term follow-up, is needed to firm up the evidence base in this area. PROSPERO REGISTRATION NUMBER: CRD42024319771.

Indexed as

Help-Seeking BehaviorMental DisordersPatient Acceptance of Health CareSchools, MedicalStudents, MedicalHumansMEDICAL EDUCATION & TRAININGMENTAL HEALTHPSYCHIATRYSchools, MedicalStress, PsychologicalSystematic Review

Identifiers

PMID41663173
PMCPMC12887498

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.