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Primary Submission Category: Mental health/function
Mental Health and Substance Use Among U.S. Medical Students Following the Dobbs v. Jackson Women’s Health Organization Decision.
Authors: Alaxandria Crawford, Parvati Singh,
Presenting Author: Alaxandria Crawford*
The U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization changed the national landscape of abortion care. For medical professionals, this decision may have introduced unique stressors, including concerns about providing evidence-based care, legal risks, uncertainty about clinical training, and the future of reproductive care practice. These challenges may have been particularly salient among medical students and trainees. We examined whether the Dobbs decision preceded adverse mental health outcomes among medical students in the U.S., from Fall 2018 to Winter 2025.
We retrieved data on mental health outcomes among medical students from the Health Minds Study – Student Survey database, a repeated cross-sectional nationally representative survey of college students in the U.S. We defined our exposure as the timing of the Dobbs decision, defined as pre-Dobbs (through Winter 2022) and post-Dobbs (Fall 2022 onward). Binary outcomes included: clinical depression, clinical anxiety, suicidality, non-suicidal self-injury, and substance use. We conducted difference in difference analysis using (survey-weighted) logistic regression models. The interaction between the Dobbs indicator (referent = pre-Dobbs period) and medical student status (referent = all other students) served as the main coefficient of interest.
Overall, we observed no change in any of our 5 outcomes pre- versus post-Dobbs across all students. However, medical students exhibited higher odds of adverse mental health outcomes, relative to all other students, following the Dobbs decision. These included clinical depression (OR=1.41; CI:1.16,1.72), substance use (OR=2.10; CI:1.70,2.59) and non-suicidal self-injury (OR=1.34; CI:1.06,1.69). We failed to reject the null for clinical anxiety (OR=1.12; CI:0.94,1.34) and suicidal ideation (OR=1.02; CI:0.74,1.40).
The Dobbs decision preceded increased clinical depression, self-harm, and substance use among medical students in the U.S.