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In the US, 1 in 5 adults experiences a mental illness. Over 9.8 million adults and youths have serious suicidal thoughts, and LGBTQ+ communities experience an even greater burden of mental health disparities. Mental illness is often recognized late by providers, which prevents timely and effective treatment.


We estimated the frequency and response of healthcare trainees asking about mental health using video-recorded standardized patient interviews conducted by third-year medical students (M3s). Standardized patients are trained to give out specific health history information only when prompted by the student. Students had 30 minutes to complete new patient interviews in a primary care setting.


Among a sample of 38 M3s, 60% discussed mental health for an average of 1.3 minutes. Only 26% of these students followed up about a mental health treatment plan. After the mental health disclosure by patients, students responded, "I am sorry to hear that" (30%), frowned (22%), or offered support and resources to the patient (17%). Not all trainees elicited whether a patient identified as LGBTQ+ or connected patient identity with mental health support.


We document how mental health histories may not be identified in primary care settings. Many disclosures were also prompted by providers asking about previous hospitalizations rather than mental health specifically. We thus recommend routine mental health history intake for new patients establishing care. Trainees may benefit from comparing interpersonal skills, like empathetic responses between providers and patients, and connecting LGBTQ+ patient identity and terminology to support patients' mental health needs.

Publication Date

Spring 2020


Mental Health; LGBTQ+; Medical Education; Medical Students; Past Mental Health History; MERA


Medical Education | Mental Disorders



Prevalence Of Mental Health History Intake By Medical Trainees