As the head of student government at Duke University School of Medicine in Durham, North Carolina, Sujay Kansagra had witnessed several of his fellow students dealing with depression. “I knew it was a big problem,” he said. “People were feeling isolated.” So Kansagra came up with an innovative way to provide emotional support to depressed students while shielding their identities. With the help of Caroline Haynes, Duke's associate dean for medical education, he arranged an online forum to give students a safe place to talk and to help them “realize they aren't alone and that there are a lot of resources available.” Students posted messages anonymously. Although the postings were reviewed by a psychiatrist in Duke's student counseling service, the administration was not privy to the forum, which received more than 100 postings and more than 1000 hits during its planned 10-day existence in April 2005.
According to Kansagra, “people had a lot to say about fighting with depression and [feeling] that medicine in general sees mental illness as a weakness and not an actual disease. People felt the need to hide it . . . because we are taught that we are the healers and not the ones with problems.” The pilot project led to open discussions about mental health, and in the subsequent week, Haynes, a psychiatrist, made two referrals for depression counseling. “This was a fabulous first step,” she said. “People felt that their concerns were normalized and validated. . . . It started a conversation that many people are hesitant to start.”