What To Do About The Graduate Student Mental Health Crisis
A study of depression and anxiety among graduate students has found that 39% of its survey respondents “scored in the moderate-to-severe depression range.”
The study, “Mental Health Crisis in Graduate Education: The Data and Intervention Strategies,” by Teresa Marie Evans (UT Health San Antonio), Lindsay Bira (UT Health San Antonio), Jazmin Beltran-Gastelum (St. Mary’s), L. Todd Weiss (Kentucky), and Nathan Vanderford (Kentucky) and another study showing high rates of depression among graduate students, “Work organization and mental health problems in PhD students,” by Katia Levecque (Ghent), Frederik Anseel (Ghent), Alain De Beuckelaer (Radboud), JohanVan der Heyden (Scientific Institute of Public Health, Brussels), and Lyddia Gisle (Scientific Institute of Public Health, Brussels), are discussed today in an article at Inside Higher Ed.
Self-selection bias may have inflated the numbers in both studies, but even discounting them by half would leave the rates of depression they found among graduate students strikingly higher than the 6% found in the general population.
What to do about this? Colleen Flaherty at IHE reports:
The authors suggest that institutions follow a successful National Institutes of Health program “train the trainer” model, in which faculty members and administrators are trained by mental health professionals to recognize and respond to students’ needs, providing referrals as needed. The same model could be used by career development professionals to train faculty members to help today’s Ph.D.s compete in the “vast and ever-changing job market,” they added.
Perhaps less simple, the study advocates a “shift in the culture within academia to eliminate the stigma [surrounding mental health issues] and ensure that students are not reluctant to communicate openly with their faculty advisors.” The authors do note that many in academe have spoken out about their own struggles. Yet, they say, fears of not gaining tenure or otherwise being judged by colleagues remain.
The paper also pushes for work-life balance, which it acknowledges is “hard to attain in a culture where it is frowned upon to leave the laboratory before the sun goes down,” especially in an ever-competitive funding environment. Faculty and administrators must nevertheless “set a tone of self-care as well as an efficient and mindful work ethic” to move the dial, they say.
Some readers may recall philosopher Peter Railton’s Dewey Lecture at the 2015 Central Division Meeting of the American Philosophical Association (APA), in which he discussed his experience with mental illness and called for more openness about it, as well as the “Philosophy and Depression” post in which many philosophers answered Railton’s call. There have also been discussions of mental illness in the interviews conducted at Discrimination and Disadvantage, for example, this one with Audrey Yap (Univ. Victoria).
In an effort to elaborate on how to pursue any of the three strategies discussed above for responding to high rates of mental illness among graduate students, or alternatives to them, those who have had positive and negative experiences, at the levels of institutional policy or interpersonal interaction, are invited to share their views about what has helped and what hasn’t.
Edgar Degas, “Two Dancers Resting”
Well, for starters, universities need to fund and staff adequate mental health care. Changing the department climate is an important step, but if grad students can’t actually use any of the resources that are supposedly available, the problem’s not going to get solved. An anecdotal example:
At my institution, the subsidized student health insurance plan (the only one that’s affordable for a grad student not relying on a partner’s insurance) gives most of its mental health benefits in low-cost trips to the university’s counseling center. In most cases, the person you see at the counseling center will be a trainee – *another graduate student*. Many of these people are great, but because they’re graduating and getting jobs, turnover is high and the quality is hit-or-miss. If you do get a good rapport with a particular counselor and they’ll be around for a while, good luck getting in to see them regularly: at a university with 50,000 students, the counseling center is always operating at maximum demand. If you need something beyond the counseling center (like, you know, medication) you can expect the costs to start climbing in a hurry. Also, the benefits in the student health insurance are dictated by an unpublicized university committee with no effective grad student representation. This arrangement unsurprisingly results in new benefit cuts every year, most of which are ALSO unpublicized until you try to use the benefit you had last year and find out it’s no longer covered.
So yeah. Having a more forgiving environment in your department won’t be a lot of help if your grad students can’t effectively access professional treatment.
Agree entirely! At my institution, the upper administration has been slowly stifling the counseling center so those beleaguered folks have to accomplish more with less. It is quite maddening to see, especially when we have graduate students who face some serious mental health challenges. So, training for faculty is good, but necessary is to refund the counseling center.
I’m a grad student at a major public university, and this is very true of my experience. I exhibit depressive symptoms as well as (clinically defined) obsessions which I’ve been treated for in the past, but enertering grad school made these come back with a vengeance. I tried to seek help from the counseling center, but they had a several-months-long waiting list for sessions, so they referred me to a clinical practice outside the university. Ultimately, because of bad insurance reasons, I couldn’t afford sessions there, and it had already been weeks since I scheduled my ‘pre-screening’ where the referal had taken place. So I gave up, as I imagine many do when they’re trying to get help. Many grad students, if thet end up seeking help, probably end up slipping through the cracks like I did.
I don’t find it at all implausible that there is a mental health crisis in graduate education. But the Evans et al survey that gives that 39% figure is not at all convincing as evidence for that. It is a *self-report* survey, and it is extremely easy to see reasons why students with mental health issues would be much more likely to respond to it than students without.
Justin alludes to this when he mentions “self-report bias”, and notes that even if the numbers are inflated by a factor of 2 then the rate of mental health issues would still be much higher than in the general population. But that “factor of 2” is (I take it) pulled out of the air. If the numbers are inflated by a factor of 6 by self-report bias, then the graduate-student rate of mental health issues would be about the same as the general population. Is a factor of 2, or a factor of 6 (or a factor of 10) more plausible? I have no idea, and neither does anyone else – unless they’re already starting with some antecedent assumptions about the level of mental health issues in graduate students, in which case the survey is moot as evidence for that level.
Just in case you’re skeptical that self-report effects could be as dramatic as all that, just look at the subject mix in the research. Only 2% of respondents are engineers, but the graduate population in the US is around 9% engineers (source: http://cgsnet.org/graduate-enrollment-and-degrees) and I think is if anything higher in other countries. So it looks as if engineers are only 1/4 to 1/5 as likely as average to reply – and that’s a self-report effect with no obvious causal origin.
I should say that Justin’s post links to the abstract, and I can’t find an online copy of the original paper, so I’m going on the abstract. It’s possible that the bulk of the paper addresses these issues, though I’m skeptical, not least because the abstract doesn’t engage with the evidence for nonrandom sampling coming from the subject mix. And the other paper Justin links looks less obviously problematic from its abstract, though I can’t right this moment access a copy so as to look more thoroughly.
Yes, the “factor of 2” was pulled out of the air, as part of trying to acknowledge the self-report problem with the survey. I appreciate you pointing out that this may be more problematic than I first thought.
Would it be too meta for us to talk about how shit like this is supremely unhelpful? (Don’t worry, I’m outtie. Given the direction of the discussion at even this early stage, I’m not at all inclined to share. Thanks for trying, though, Justin.)
I am strongly in favor of universities (and indeed everywhere else) taking mental health issues seriously. But it makes a huge difference as to how we take them seriously whether mental health issues are dramatically *more severe* in the graduate-student population (in which case it’s an urgent matter to understand why it is and whether it is a consequence of changeable factors about grad school in particular) or whether graduate-student mental health issues are simply a playing out in a familiar context of a general health issue. (And I take it that’s part of the point of the OP, since it puts data front and center.)
Shorter version: if there is no graduate student mental health crisis, asking what to do about it may be unwise.
When you get taught to think critically about the world, especially if you study philosophy, it’s enough to make anyone depressed. Since graduating from philosophy at the age of 58 I have been overwhelmed by a nihilistic view of life. What is the point etc. I struggle to break through. Before graduating I aspired to some sort of spirituality but that has been educated out of me.
Right–Dan Weijers (http://www.danweijers.com/) has some cool work that indicates philosophers are less happy than non-philosophers (https://www.youtube.com/watch?v=7xi0cWSibus see 27:30 or so) and makes some suggestions for happiness-inducing behaviors that philosophers are not typically good at (e.g. “positive relations with others,” see 49 minutes or so and later of https://www.youtube.com/watch?v=7xi0cWSibus ).
If indeed grad school is causing depression, one answer seems pretty obvious: stop taking on so many grad students. Fewer grad students means means fewer new PhDs, which means less competition, which means that we don’t have to spend every waking minute trying to get another CV line, publication, or whatever. It’s all well and good to talk about changing the “culture” of grad departments, but that just seems obviously to ignore the larger problem.
The problem, I suspect, isn’t that too many professors spend too much time at the department/lab. (I actually think it’s kind of funny that the problem here is believed to be grad students feeling they need to work long hours like their professors rather than go home and play with their puppies.) The problem is basically natural selection: if a few grad students work harder and devote themselves more to their discipline, they’ll be more likely to get jobs (generally speaking). And so the job market becomes more competitive, even if every department encourages its grads to take it easy and not work too hard. So we all learn that we need to spend the 5-7 years going all-out as much as we can, if we want better than a 10% chance of success.
Unless the job market is fixed (either by increasing demand or decreasing supply), this is a problem that will not be fixed.
Some people are depressed because they have mental health issues.
But many people are depressed because their situation sucks. And yes, grad school can suck. In which case, the solution is not “help them with more mental health services,” but rather ” deter them from going to grad school in the first place.”
Of course, some of them are (or could be, or would be) good philosophers. So what? It’s not like we have so few would-be philosophers (or other grad students) in the world that we need to encourage a group of miserable folks to stay there.
Given that the human genome hasn’t changed in the last 30-40 years, it would seem likely that the unprecedented rates of mental illness among students is situational. We might ask ourselves what we are doing to make young people so miserable. We might also ask how we are acculturating young people to handle/cope with challenge, difficulty, and failure.
I suspect the answers will not be flattering to us and will challenge and even undermine what have become pedagogical and parenting common wisdom.
Relatedly, have a read of Jeff Schmidt’s comprehensive analysis in “Disciplined Minds”. Includes survival tips drawn from US army (!)
https://www.amazon.com/Disciplined-Minds-Critical-Professionals-Soul-battering/dp/0742516857
I’m a graduate student in the physical sciences at a major research university in the US. I’ve struggled with depression. I’m much better now after about a year of therapy, which I was lucky to obtain at a very low price because of my university insurance.
A key thing I learned during therapy, which helped me significantly, was to stop browsing the Internet compulsively. It ate up all my time, leaving me with a sense of meaninglessness, and impeded my research, which compounded the depression . Graduate students are particularly prone to Internet abuse because they don’t work with well-defined clear-cut tasks and no one is looking over their shoulders. So it’s easy drift off clicking on website after website before you find that your entire day or week or month has disappeared and you having achieved nothing of lasting value. This is profoundly painful feeling.
I’m not saying that this was sufficient to fix my depression; I learned other important skills, like letting go of perfectionism. But the consequences of this one behavior were so dramatic that my therapist encouraged me to contact someone in the psychology department and write up a paper on it. I haven’t done that, but I think the Internet browsing hypothesis requires more exploration.
+1 on the value of avoiding the internet (and/or social media) for mental health. Although I don’t have any true mental health issues, I noticed that not only would Facebook easily eat up tons of my time, but I would end up much grouchier after using it. It was not making me better as a person; it wasn’t helping me get work done; it wasn’t making me happy. Now I go on for about 30min once/week to catch up on notifications. Not long enough to get involved. Same now for Reddit, as well. The only thing I still use is Twitter, and that’s mainly for news purposes. My days are much better, and more productive, now.
Further, my hypothesis—that Internet browsing is a significant contributor to the graduate student mental-health crisis—makes a clear prediction: This crisis is relatively new and it started after the widespread adoption of the Internet. I did some quick searches on Google Scholar but I could not find any good data on graduate student mental health prior to, say, 2000.
If anyone can find any long-time-period data on this topic, that’d be great. Independent of my hypothesis, it seems like we need to understand how recent this phenomenon is (if these studies do hold up).
I think internet abuse is a symptom that in part compounds the damage. Many grad students already lack a feeling that their work is meaningful or going somewhere, and I believe this often manifests itself in writing being an extremely painful process. At least it was in my case: It not only took effort, which is normal, but it was literally torture to get the right formulation on the page, and probably because it felt pointless.
And if that is the case, then internet abuse is a tried and tested evasive strategy. This clicking from website to website to checking your email and back basically simulates goal-directed activity, which you undertake instead of the painful work; but that activity is empty because there are no meaningful goals to be achieved and you don’t progress on what you’re actually supposed to do. And when you realize that, it feeds into the guilt and pain of writing. Disabling the internet and blocking routes for evasion is a crucial thing, but I believe it’s equally important to tackle the root cause: Grad students need to find ways to experience their own competence: that they work is meaningful and going somewhere. And that’s only possible through feedback from other people, i.e. a constructive and genuinely interested supervisor and: teaching.
I think a big problem with grad school is that it can be very hard to experience one’s work as meaningful, especially given uncertain job prospects and often neglectful supervision. Apart from better training supervisors (although it’s also a character issue, and many supervisors are too much on their own research egotrip to recognize the value in training their students in a way that they feel their work is going somewhere), one major factor that made a huge difference for me is this one: Teaching.
I started out in a programme that was research-only: three years of complete discretion in how to spend your time, no teaching obligations, only a little bit of course work. Seems luxurious, but it actually was hell. My supervisor wasn’t really interested in my project, so I was more or less left alone to cope. The lack of external structure to my week (I was too inexperienced to impose a sensible structure on my time myself, such as mimicking a 9-5 work day and having a strict separation between work & leisure times) and the lack of constructive feedback of any kind made me feel I was just swimming without ever seeing land. Unnecssary to say, I didn’t do very well and–in retrospect–would say that I was probably borderline burnt-out most of them.
I then decided to change programmes, and am now in a programme with a teaching requirement. And it made a huge difference to (a) have an externally imposed structure to my week that also restricts what other time I have left to work on the thesis, (b) to have that immediate experience of my own competence in dealing with the students. I think this latter aspect is the most crucial one. I think teaching hugely improved my general mood and well-being, and I have a sense of purpose now in regard to my work. Even writing feel so much easier and pleasant compared to earlier, where every paragraph was literally torture. I don’t think that having more writing experience alone explains that.
So, my advice: Let them teach.
This is also a good reason to present at conferences. It gives you an external deadline, gets you feedback on your work, allows you to build some community with other philosophers who you can be excited to see at the next conference, and—especially if you’re working on a more niche issue—gives you a chance to talk to the other people working on that specific issue.
I wrote about some of my relevant experiences during graduate school (and immediately afterwards) in this post: https://samirchopra.com/2015/02/27/of-therapy-and-personal-and-academic-anxieties/
That piece does not directly address the question raised by Justin, but I wanted to put it out there by way of just contributing hopefully, even if only a tiny bit, to a more open discussion about these matters.
Having a more open-minded conception of what counts as good work will probably help deal with this problem. My stress is increased by the fact that my papers are not considered good enough unless there is a certain degree of surveying of the literature, but I do not always wish to survey the literature: sometimes I just wish to make an argument concisely. Some philosophers have gotten away with the latter (e.g. Gettier with his famous 3-page paper on JTB account of knowledge), but grad students have their work scrutinized are controlled more than faculty, so wrong norms are imposed upon us to a greater extent with little we can do about it. These norms can also increase the amount of time grad students must work on papers, which plausibly increases stress as someone may feel forced to do work in which they have lost interest.
Also academic bullying and exclusion are issues that are almost not at all addressed. Many of the cultural change-makers in academia have focused, wrongly in my opinion, on social justice and the climate for minorities, rather than the general culture and how well people treat one another. I propose dedicating resources to making departments more pleasant places in general, whether it’s by more plants, nicer furniture, art, etc. in the department spaces, or more leisure activities, or orientations where grad students engage in activities with one another to cultivate a sense of friendship and relaxation, or more accountability for bullying (including cyber-bullying and the abuse of disciplinary resources [e.g. Title IX] to attack people one dislikes), etc.
Couldn’t agree more with this comment about bullying. It’s a huge problem in my experience. Also unaddressed cronyism / conflicts of interest in a program (and the profession generally) are a great sapper of morale amongst the younger and less powerful.
Suspect an unacceptable number of our grad students actually have some form of PTSD
I’m a graduate student at a well-regarded philosophy department. I’ve personally seen a lot of anxiety and depression in my fellow students which largely stems from them being overloaded with aissgnments and readings. The problem is not so much that there is a lot of work, per se, but that this work interferes with their ability to socialise, to have weekends, to relax, to sleep, to pursue relationships, to address non-academic problems or exigencies in their life or to do other things that affect their mental health.
It appears that lecturers often have little sense of how demanding the workload is which they place on students, and they often have a misguided faith that their expectations are appropriate or that, if they are not, students will go out of their way to tell them. Even when many of the students find the workload unreasonable and extremely difficult to manage, they more often than not will choose to not voice their concerns to their lecturers out of fear that they will be seen as incompetent, that they will displease the lecturers or that the lecturers will not do anything.
Lecturers need to actively seek feedback about how students are finding aspects of their courses, rather than just assuming that they instantly have their courses structured perfectly. They need to remove barriers to hearing feedback from students, even if it means creating anonymous channels of communication like anonymous online surveys *during courses*. And they need to recognise the reticence students often have about doing anything that might be seen as complaining in a way which identifies them.
That at least might be a step in the right direction, even if it’s not sufficient.
I’ve often wondered if mental health problems seem overrepresented among graduate students, not just because grad student work can be destructive, but also because grad students are better-than-average equipped with the concepts necessary to identify this destruction *as* a mental health problem.
I doubt I’m the only person who was diagnosed with a mental health problem in grad school but subsequently realized I’d had the disorder all my life. Part of the delay in diagnosis was that grad school was the first context to be so demanding that I couldn’t handle my health on my own and needed other forms of support, so definitely part of the issue was the nature of grad student work. But part of it was that it never previously occurred to me that my problem was a *mental health issue*, rather than just a personality quirk (“I’m just not the kind of person to whom so-and-so task comes naturally”) or a character flaw (“I’m bad at such-and-such task because I’m lazy”).
For all its many flaws, the academy was a place where I had access to the vocabulary and the empirical psychological research that let me see my problem for what it was. I can imagine that in other contexts I’d be undone by the same mental health issues but decide that the problem was my character or my personality, checking “No” on any “History of mental health issues?” questions on any survey I got.
This is obviously sheer anecdata, and counterfactual anecdata at that – I don’t want to underestimate the average non-grad student’s access to mental health-relevant concepts. But I wonder if society-wide erosion of the stigma around mental health issues would not only, in the long term, lower that 39% grad-student number by improving mental health for everyone, but also, in the short term, raise that 6% total-population number by improving mental health *self-awareness* for everyone.