We Need to Talk about Mental Health for Graduate Students

    03/11/2018

    As I sat in at a small church group last Friday evening listening to people discuss their anxieties and their struggle to find meaning, two people started talking about their emotional stress stories of dealing with failed experiments in their laboratories.  One person recounted a near mental breakdown at one point and how they cried in that moment of despair.  Another described a feeling of loneliness when pushed to over work at the bench.   Both were biomedical scientists in the early stages of their careers perhaps facing turmoil with their thesis advisors and within the academic system. During my drive back home I pondered about how I could relate to their situation. I remember feeling the same way when I was in graduate school and during parts of my postdoc.  It also echoes what I have been hearing for years at career development meetings and online in science careers columns.

    I don’t consider myself as someone who has endured extraordinary hardship.  From a high level perspective I have had it relatively easy, having gone through graduate school and an early career in academia without suffering too much stress. I always had plenty of support from my mentors and my family.  Indeed there were times when I felt challenged and depressed towards the end of my PhD studies, while rushing to finish up my dissertation, but this is just what every graduate student goes through in some way or another.  However, I have seen the toll that graduate school takes on people who have not been as fortunate as me or who lacked the network of emotional support.  For many young academics, especially those who are the first generation of their family to attend graduate school, it is important to find support when dealing with emotional turmoil while they undergo technical and personal challenges.

    In March this year, Nature Biotechnology published a report of mental health and clinical anxiety in over 2,000 graduate students in PhD and Masters programs covering everything from biological/physical sciences to humanities and the social sciences.  The results showed that graduate students were six times more likely to experience depression and anxiety than the general population.  39% of graduate students were scored as moderate to severely depressed compared to just 6% in the general population.  Up to 56% of students sampled disagreed with the statement, “I have a good work-life balance”. Up to 50% of those in the anxiety/depression group disagreed with the statement that their PI or advisor provided “real” mentorship or support while only 36% agreed with the statement.  Furthermore, the report provided strong data to show women and transgender students are under increased risk of depression and anxiety compared to men.

    It has long been known that people with higher level graduate degrees are more susceptible to depression and feelings of alienation.  Only recently, however, has this been recognized as a crisis and has anyone attempted to address the issues from a national and institutional level.  The NIH introduced the “Broadening Experiences in Scientific Training (BEST)” award program within the NIH campus at the Office of Intramural Training and Education.  This has helped broaden the career aspirations of scientists within their campus.  NIH grants now include mandatory sections for mentors to address how they will help trainees better develop their careers.  Certain training grants, such as the K - grants mandate principle investigators (PIs) to serve a minimum of 75% professional effort on research, development and mentoring.  Many local institutions have graduate school programs that try to help with professional development by introducing individual development plans (IDPs), something that has been offered by Science for a number of years now.  At the postdoctoral level I was intimately familiar with the National Postdoctoral Association.  I personally worked at setting up nationally recognized Postdoctoral Associations during my training to introduce career development at my old school - admittedly without much success!

    However, all of these institutional groups still fall short when it comes to solving the mental health crisis.  At issue are two things that, in part, are a reflection of our changing society.  The first is the problem of modern work culture.  The second is economic turmoil that has led to geopolitical division.  I will focus on the former, since the latter requires an altogether different blog – suffice to say it has resulted in a manifestation of nationalism and alternative facts that denigrate everything we strive for in knowledge development. 

    The academic system is built on the backs of many hard-working junior scientist who serve a few prominent PIs in order to drive innovative research.  In the old days an academic career was straight forward.  At the end of a productive graduate school and postdoctoral training, one was able to attain a tenure track faculty position in a university as a full professor.  Today, the sheer number of people graduating with a PhD has saturated the job market while research funding, especially within academia, has shrunk, without even accounting for rising inflation.  The guarantee of finding meaningful employment as a tenure track faculty, doing globally impactful research is simply a lie.  It is therefore difficult for career development institutions that work under the NIH and within universities to fundamentally challenge the academic culture that feeds them.  Thus, many graduate students and postdocs in their early career fall through the cracks of emotional support during times of need.

    Shortly after the mental health report was published, hundreds of scientists contacted Nature to contribute their personal stories.  One individual, Robbie Hable, a PhD student in engineering, wrote about how he was hospitalized for depression in graduate school.  He then mentioned finding out about the Cheeky Scientist Association (CSA), created by Isaiah Hankel. The CSA provides a platform for PhD students and postdocs to support each other both technically and emotionally as they look for jobs in industry, transitioning out of academia.  On their forum there is a common thread of success stories which researchers post during the interview and transition process designed for encouragement, often during times of rejection.  In the UK there are national frameworks set up, such as #stepchange, which works to improves mental health of faculty and students in higher education.  There are also mental-health charities, such as Student Minds which seek to help students psychologically.

    For those who are open to the idea, there is always sanctuary in religion, if all other methods seem out of reach.  This may seem counter-intuitive to many people in higher education STEM fields, myself included, who come from atheist families with secular upbringings.  What use is God and a chronicle of bizarre miracles if you champion intellectual philosophers borne out of the enlightenment era to rationally explain your problems?  Religion, however, as I have discovered in recent years, brings with it a form of comfort and community not offered by university or secular institutions.  There are therapeutic stories such as in Mark 4:38-39, Jesus calms the storm in the Sea of Galilea and asks his disciples to stay calm, have faith in him. These stories have a remarkably calming effect on one's personal nature in times of stress. In fact it is often the small bible study groups and communal potlucks that bring nourishment to those who suffer the most.  Deep friendships and bonds can form when people come together to discuss major questions of life – why are we here? / where are we going?.  When one focuses on those big issues, all other life worries tend to seem trivial.  At a time when nations have become protectionist and when political divisions have grown ever larger, religion may yet see its return as a key player for unity.

    That is not to say that joining a religion or even joining a cult is the be all and end all to the mental crisis currently faced by graduate students.  Those staunchly opposed to religion may find relief in therapy or simply in school counselling.  A secular movement named "The School of Life", started by the outspoken atheist philosopher, Alain de Botton, has in recent years gained traction around the world. The School of Life provides an endless slew of fascinating videos on Youtube which dish out advice to those searching for meaning in life while going through crises. Each video is designed to teach you a part of a wider curriculum of life lessons that include love, marriage, relationships, philosophy, history, art and psychotherapy. Alain de Botton's radical idea that high art and culture can replace God when it comes to soothing a troubled person's soul may seem elitist and too out of reach for most of us. However, between his famous lectures on why you will marry the wrong person and his books on how to choose a job you love much of his philosophy deals with the same issues the church originally had to do: how to face mundane life problems and how to go on in life in spite of massive emotional setbacks.

    The consequences of not seeking help can often be devastating.  The University of Iowa, where I am currently located, bears a painful memory of what happens when graduate student mental illness is not treated quickly.  In 1991, a student named Gang Lu, shot and killed four faculty and a postdoc in the Physics department before committing suicide.  His main grievance was that he was pasesed over for a departmental prize in particle physics and, potentially, not being able to stay on in America.  His problem of deteriorating mental health had been noticed by colleagues for some time but no one took action.  The killing at the university sent shockwaves across the US.  It has even been dramatized by Hollywood into a movie (Dark Matter, starring Meryl Streep). Not surprisingly, after 27 years, the events of that day still echo in the back of people’s minds. 

    Interestingly, it has been the local church community, not the university itself, that has gathered together every few years to commemorate this tragedy and move towards healing people from their emotional wounds.  That contrasts with my experience of living in larger metropolitan areas where people often have more choice from secular help groups and charities. Ultimately, there are a multitude of ways for people to seek help in times of mental hardship.  As the crisis of mental illness in graduate students enters into our collective consciousness it will come down to both a matter of personal responsibility and of social institutional support to seek a solution before things spiral out of control. 

     

    References

    Evans TM, Bira L, Gastelum JB, Weiss LT, Vanderford NL, Evidence for a mental health crisis in graduate education. Nature Biotechnology 36, 282-284 (2018):
    https://www.nature.com/articles/nbt.4089

    Nature Career Feature, May 2nd 2018: Feeling overwhelmed in academia? You are not alone, Chris Woolston:
    https://www.nature.com/articles/d41586-018-04998-1

    #Stepchange initiative:
    https://www.universitiesuk.ac.uk/stepchange

    Student Minds Charity:
    https://www.studentminds.org.uk/

    The Cheeky Scientist Association: https://cheekyscientist.com/

    Jesus calms the storm by Ludolph Backhuysen: https://www.artbible.info/art/large/903.html

    The School of Life by Alain de Botton: https://www.theschooloflife.com/

    Dark Matter movie starring Meryl Streep and Ye Liu: https://www.imdb.com/title/tt0416675/

    Scream painting by Edvard Munch: https://www.edvardmunch.org/the-scream.jsp