Graduate students need more mental health support, study highlights

There is a mental health crisis in graduate education, and research institutions need to take action to address it. That’s the take-home message from a global survey of Ph.D. and master's students published today, which adds to the meager but growing literature on the subject and corroborates anecdotal evidence and discussion about the topic from recent years, including a number of personal tragedies and numerous testimonials and concerns expressed on social media and elsewhere. The new results “hopefully [add] to a conversation that might … result in a cultural change,” says co-author Teresa Evans, a career development office director and lecturer at the University of Texas Health Science Center in San Antonio.

The new online survey data—2279 responses, mostly from Ph.D. candidates based in 234 institutions across 26 countries, 40% of whom are in the biological and physical sciences and engineering—unveil “strikingly high rates of anxiety and depression” among the graduate population, the authors write in the Nature Biotechnology paper. Based on clinically validated questionnaires, 41% of respondents showed moderate to severe anxiety and 39% moderate to severe depression, both of which are more than six times the prevalence found in studies of the general population. The researchers also found significant variation by gender. About one-third of male respondents reported experiencing each condition, compared with approximately 40% of female participants and more than half of the 42 transgender and gender-nonconforming respondents.

The data also suggest that a perceived supportive relationship with one’s principal investigator (PI) and healthy work-life balance correlate with better mental health, the authors write. Approximately half of the students with anxiety or depression reported not having supportive relationships with their PIs, as measured in a variety of ways, including whether the students feel valued, whether their PIs have a positive impact on their mental well-being, and whether they feel that their PIs are assets to their careers. More than half of respondents with anxiety or depression didn’t feel that they had a good work-life balance.

“These data and others call for a major need for institutions to create programs to help solve these issues,” says co-author Nathan Vanderford, an assistant professor at the University of Kentucky in Lexington. In the paper, the authors encourage institutions to see mental health as an essential component of the skillset that is necessary for successful career development. Their recommended actions include increasing awareness of mental health issues among students, facilitating access to dedicated support, training PIs to spot struggling students and refer them to appropriate resources, and encouraging PIs to promote work-life balance by leading by example.

The study provides fresh and generalizable evidence that “there is probably a serious problem with mental health in academia,” writes Frederik Anseel, a professor at King’s College London who co-authored a study published last year showing widespread risk of mental health issues among Ph.D. students in Belgium, in an email to Science Careers. He does note, however, that the study is subject to some of the caveats that skeptical institutions and policymakers have raised about similar studies, including his own. Specifically, the data may be skewed as a result of predominantly attracting respondents with personal experiences of mental health issues, and they don’t investigate the causality between perception of a nonsupportive academic environment and mental health. Nonetheless, by going beyond single countries or institutions, the new study suggests that the prevalence of mental health challenges among graduate students “probably has something to do with how academia is organized as an industry, how we train people, how we manage people, and how careers develop,” Anseel says.

On a more positive note, there are signs that institutions are working to improve the situation. Universities worldwide have started to acknowledge that mental health issues are common in academia, and they have begun to look for ways to better support their students and staff, Anseel says. Since he and his co-authors published their paper, they have been receiving three or four invitations per week from institutions to present their findings and help set up monitoring and prevention practices, he adds.

Wendy Ingram, who co-founded a well-being and mental health peer support network when she was a graduate student at the University of California (UC), Berkeley, after a dear friend in her program died by suicide due to depression, agrees that “more academic institutions are taking steps to tackle mental health issues,” she writes in an email to Science Careers. For example, in the fall of 2017 UC Berkeley set up a satellite counseling service specifically for Ph.D. students, and last month Johns Hopkins University released a 51-page report looking into measures to better support student mental health and well-being on campus.

However, all too often initiatives are “small and homegrown or based in individual departments,” says Ingram, who is now a postdoctoral fellow at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland. More also needs to be done for students who may experience additional challenges in the workplace and beyond due to their minority status, including LGBTQ+ students and women, she says. For real change, she would like to see “creation of a culture that is about prevention and intervention, not crisis response and stigma.”

Institutions have an important role to play, writes Gail Kinman, a professor at the University of Bedfordshire in the United Kingdom, in an email to Science Careers. Her work has found evidence of psychological distress among university staff, and she welcomes the new study’s addition to the literature. PIs should also better support students by appreciating their personal circumstances and highlighting the need for work-life balance for a sustainable career, she adds. But “supervisors may well be experiencing high stress and mental health problems themselves,” Kinman notes, adding that “academics alone cannot and should not take responsibility for the mental health of their students.”

That’s part of why it is important for students to take charge of their situation. “If you are concerned about your mental health, take action at an early stage. Contact your counseling service to discuss options,” Kinman says. She also encourages students to nurture their mental health by engaging in self-care, taking time to recover after intense spells of work, setting boundaries between professional and private life, showing compassion and forgiveness toward themselves, and establishing a social support network.

Evans also emphasizes that students who are not currently struggling with mental health can be proactive and put themselves in a good position for when the going may get rough. “In everybody’s life there are ups and downs and unexpected turns, and the struggles can become very real very rapidly,” she says. “It is very important to know who you can turn to and … build that team of people now so that you have them.”