In 2013, when Wendy Ingram was a fourth-year graduate student in the department of molecular and cell biology at the University of California, Berkeley, a classmate became severely depressed, took a leave of absence from the program, and eventually committed suicide. Ingram and her friends were more than shocked. “We were devastated, and we were frustrated,” says Ingram, now a postdoc at Johns Hopkins University. “We saw gaps in care and gaps in knowledge and gaps in understanding of what would have been helpful things to do.”
Spurred by that heartbreaking loss, Ingram and eight classmates in UC Berkeley’s Molecular Cell Biology (MCB) program created the MCB Graduate Network. The graduate student–led group organizes students-only discussions targeted to each year of graduate training, where seasoned students talk with less-advanced colleagues about navigating the big milestones of that year, such as picking a lab or taking a qualifying exam. The program’s organizers also facilitate a mentorship program, in which new students meet with two upper-year students at least once a month during the fall of their first year. Plus, the group maintains a website that includes a list of resources available to MCB students in a variety of areas: mental health, physical health, personal and legal support, career development, and financial concerns.
Like many organizations promoting graduate students’ mental health around the US, the MCB Graduate Network is run by and for students with support, but minimal involvement, from faculty and staff. But there are calls to expand the institutional footprint in this arena. Anecdotal evidence from mental health practitioners and students, and, more recently, research findings, reveal that depression and anxiety are unusually prevalent among graduate students. And momentum is gathering among institutional administrators and principal investigators to respond by offering better and more-appropriate support to their trainees.
“There always will be mental health concerns” for graduate students, Brianne Howard, the director of academic support at the University of British Columbia (UBC), tells The Scientist. But institutions can help, she says, by combining a proactive approach—that is, finding out what the stressors are and trying to mitigate them—with efforts to make sure that faculty and staff are ready to act when students are really struggling.
Understanding the extent of mental health problems among students
In 2017, Frederik Anseel, a psychologist at King’s College London, and colleagues compared mental health data from more than 3,500 PhD students in Belgium to those of people in the same age group with similar educational backgrounds who were not in graduate school. They found that half the PhD students had experienced recent psychological distress, and a third were at risk for developing a psychiatric disorder such as depression. There were twice as many mental health problems among the PhD students as in the control group.
That difference surprised Anseel. He explains that, starting grad school, PhD students in Belgium tend to make a bit more money than their counterparts who choose to work outside academia, and that, typically, highly educated individuals have lower instances of mental health problems. “Normally, you would expect the opposite pattern because these [students] are very highly educated people earning a good salary,” he says.
But such findings are no surprise to Maggie Gartner, a psychologist who retired in January from her role as executive director of student counseling services at Texas A&M University. She has worked in counseling centers since 1984—often with graduate students, both individually and in groups. Gartner explains that one of the big issues graduate students face—and one she has seen throughout her career—is the expectation to excel in a variety of roles. “They are pulled 20 ways from Sunday,” she says. “They try to do their best in one area, and that means it’s not as good in another area because they just can’t give it enough time.”
It’s a professional duty to recognize stress and mental health among people we supervise.—Phil Buhlmann, University of Minnesota
As Anseel and his team looked into the factors associated with mental health status in the student population, they identified multiple areas of concern. Although the observational study could not determine causative factors, researchers found that worries about the competitive academic job market, poor career prospects, lack of control, inadequate support from colleagues, work-life imbalance, and a difficult supervisor-student relationship were all linked to psychological distress.
That last factor can be particularly difficult, says David Sacks, a psychologist with a private practice in Nashville, Tennessee, who has frequently seen problems arise in this area during his work with graduate students. Until June, he also counseled students and postdocs in biomedical research at Vanderbilt University. When a conflict arises between a mentor and a trainee, whoever is called in to mediate tends to defer to the faculty member because they have more power, he says, meaning students’ needs often go unaddressed and patterns of mistreatment are likely to continue.
Combined, all the sources of graduate school stress build up into emotional adversity that can affect student performance, Sacks adds. “Very rarely do people fail due to not being intellectually gifted enough to do the work,” he says. “It’s coping with rejection. It’s balancing the things you have to give up and sacrifice. It’s focusing too much on the outcome rather than the process because the reward is so far off in the future.”
Since Anseel published his results in the May 2017 issue of Research Policy, students from around the world have reached out to him to comment on the similarity of their experiences to those described in the paper, suggesting the findings apply far beyond the study population. But other groups’ research also indicates that some segments of the graduate student community are much more likely to experience mental health problems than others.
For a 2018 study, a group of researchers from around the US recruited more than 2,200 graduate students through social media and email to take a survey that included clinical scales for both anxiety and depression. Of the respondents, 41 percent reported scores indicating anxiety and 39 percent scored as depressed. Female trainees were more likely to be depressed and anxious than their male colleagues, while transgender and gender-nonconforming participants had the highest rates of anxiety and depression.
The study helps “showcase the support that is needed for [female and transgender graduate students] in academia,” says study coauthor Teresa Evans, an assistant professor of pharmacology at the University of Texas Health Science Center in San Antonio. She adds that the 2018 study only skims the surface of the mental health differences among groups of graduate students, an area that needs more research, especially into the root causes. A recent consensus study report from the National Academies of Science, Engineering, and Medicine points to the role of sexual and gender harassment, which disproportionately affects women and transgender individuals, and also calls for more research.
How administrations are taking steps to provide support
As evidence of mental health problems in graduate students piles up, several institutions have begun complementing the work of student organizations by making changes that are designed to improve the school environment.
One of the researchers spearheading such efforts is chemist Phil Buhlmann of the University of Minnesota Twin Cities. When he started as the director of graduate studies in his department six years ago, he made it his mission to support graduate student mental health department-wide—a move that was strongly supported by his colleagues. “It’s a professional duty to recognize stress and mental health among people we supervise,” Buhlmann says. What’s more, faculty “really care about their graduate students. They take pride in graduate students who do well, so they want to help.” Students and faculty can consult with Buhlmann, who now serves as a mental health advocate, when they have a concern, and he typically directs them to the right resources on campus.
There needs to be a bigger push to make [graduate student mental health] a priority.—Nathan Vanderford, University of Kentucky
Graduate students in the chemistry department also collaborated with Buhlmann and the university’s health services to develop a survey, which they conduct every two years to assess graduate students’ mental, social, and physical health. Buhlmann and the students recently published a study describing this project in the Journal of Chemical Education, in the hopes of helping other students and faculty who want to improve graduate student well-being.
Administrators are making similar efforts at other institutions. In the past five years, universities around the US have announced task forces—generally composed of administrators, faculty, staff, and students—to monitor and make recommendations about undergraduate and graduate student mental health.
In 2016, one such task force, at Johns Hopkins University in Baltimore, conducted listening sessions and a mental health survey of more than 2,300 students. The following year, the group issued draft recommendations, soliciting feedback from university students, faculty, and staff; last February, they released a final report. Task force co-chair Daniele Fallin of the Johns Hopkins Bloomberg School of Public Health says that such reports help identify barriers to improving mental health. At Hopkins, “it was very clear that we needed better awareness of what’s available, so that people can be better coaches and advisors to their own graduate students,” she says.
UBC’s Howard, meanwhile, along with Susan Porter, the dean and vice provost of graduate and postdoctoral studies, is working with the university’s counseling services to address the immediate mental health needs of graduate students. They are currently testing two programs: one to help departments identify and alter parts of the training process that tend to present mental health challenges to students, and another to provide counseling specifically for grad students. Porter and Howard have also worked to offer mental health support at atypical locations—the university library or hospital, for instance—so that graduate student teaching assistants can avoid uncomfortable encounters with their students at the normal counseling service sites. Off campus, grad students have access to 24/7 counseling services via phone or video chat that they can use when they’re doing fieldwork or learning a technique in a lab abroad.
Despite these initiatives, university involvement in graduate student mental health varies widely, and there is little in the way of a unified effort to address the issues across the academic spectrum. According to a survey of graduate deans conducted by the Council of Graduate Schools (CGS), an organization of about 500 institutions in the US and Canada, many administrators have concerns that their universities are not doing enough and that faculty might not be as prepared as other staff to direct students in crisis to appropriate resources. Porter and others, meanwhile, emphasize the ongoing need for long-term cultural change to improve the mental health environment in grad schools.
Nonetheless, interest in possible solutions is building, says Hironao Okahana, who led the survey and is the CGS associate vice president of research and policy analysis. The council has convened two meetings with sessions on graduate student mental health within the last year to facilitate connections among people working with students, and organizers are planning another such session for the council’s annual meeting in December.
The University of Kentucky’s Nathan Vanderford, a coauthor of the 2018 study, says that funding organizations, such as the National Science Foundation, could also make a difference by requiring attention to graduate student mental health, in the same way they’ve made training in responsible research conduct mandatory for recipients of training grants. “There needs to be a bigger push to make [graduate student mental health] a priority,” he says, “because institutions are going to continue doing what they’re doing unless they’re motivated to do something else.”
How you can support grad studentsCheck in: If you suspect someone is struggling with a mental health issue, don’t stay silent, says Emily O’Hara, a licensed independent clinical social worker at the University of Minnesota Twin Cities. “We get asked the question all the time from faculty and staff, ‘What if I say something, and it makes it worse?’ [But] if you see something, say something, and worry less about saying the right thing.”
Listen: According to Maggie Gartner, former executive director of student counseling services at Texas A&M University, the most supportive faculty “listen to their graduate students. They give them time, and that’s a precious gift because faculty don’t have that much time either.”
Destigmatize help-seeking: David Sacks, a psychologist in Nashville, Tennessee, compares graduate mental health support to that provided by a sports coach. “No one talks about the stigma of getting a coach to help with your strength and conditioning. It doesn’t mean you’re admitting you’re physically weak when you hire a personal trainer,” he says. “We figure this is something you do if you want to maximize your potential.”
Monitor mental health in your program: “You need to have a monitoring system because often otherwise you just have anecdotes and isolated events, and you have no idea how stressful the environment is,” Frederik Anseel, a psychologist at Kings College London, tells The Scientist.
Consult the experts: Mental health professionals are eager and willing to speak with faculty or staff members who have concerns about a student, says Gartner. “I don’t know a counseling center director who does not encourage consulting.” She tells faculty and staff, “Yes, you should call me. We will help you deal with the situation.”
Abby Olena is a freelance science journalist based in Carrboro, North Carolina.