# Mental health burden and service barriers among medical and health sciences students: prevalence and determinants from a cross-sectional analysis

## TL;DR

Medical and health science students experience high levels of depression, anxiety, and stress, with gender, age, and location as key factors, and barriers like stigma and cost limiting their access to mental health services.

## Contribution

This study identifies demographic and academic determinants of psychological distress and barriers to mental health services among medical students in Saudi Arabia.

## Key findings

- Female students reported significantly higher depression, anxiety, and stress scores than male students.
- Urban-dwelling students had higher anxiety scores compared to rural students.
- Academic factors like major, year of study, and GPA were strongly linked to mental health service barriers.

## Abstract

Medical and health sciences students face significant academic, clinical, and social pressures that increase their risk of psychological distress. Prior studies report elevated levels of depression, anxiety, and stress in this group. Barriers to accessing mental health services such as stigma, confidentiality concerns, limited awareness, and fear of negative consequences further compound this risk. Understanding the prevalence, determinants, and service barriers is essential for developing effective support systems.

To determine the prevalence and determinants of depression, anxiety, and stress among medical and health sciences students at Batterjee Medical College, Saudi Arabia, and to identify barriers limiting their access to mental health services.

A cross-sectional study was conducted among 384 students using a self-administered online survey. The Depression Anxiety Stress Scales-21 (DASS-21) assessed psychological distress, while the Barriers to Mental Health Services Scale-Revised (BMHSS-R) measured perceived obstacles to seeking help. Data were analyzed to identify prevalence, associated demographic and academic factors, and barriers to mental health service utilization.

Depression, anxiety, and stress (DAS) were evaluated using validated DASS-21 subscales demonstrating excellent internal consistency (α > 0.88). The total BMHSS score showed significant associations with academic factors, including major, year of study, and GPA (p ≤ 0.01). Gender was a strong predictor of psychological distress, with female students reporting significantly higher mean scores across all DAS domains (p ≤ 0.000439). Age was significantly associated with anxiety and stress (p ≤ 0.024). Students residing in urban areas reported higher anxiety scores than those in rural regions (p = 0.029). These findings identify gender, age, and residence as key demographic risk factors requiring targeted interventions.

The study found a high prevalence of depression, anxiety, and stress among medical and health sciences students, with demographic and academic characteristics emerging as significant correlates. Intrinsic barriers, such as stigma and self-reliance, and extrinsic barriers, including accessibility and cost, further limited help-seeking and compounded psychological distress. These findings emphasize the need for comprehensive institutional mental health strategies and longitudinal research to enhance student wellbeing.