Exploring Mental Health in Academia

Social media platforms receive significant scrutiny, often vilified for driving humans apart and creating a sense of "disconnectedness" in the real world. Unarguably there’s a level of truth to this notion.

However, for one community, social media – and one platform in particular – are helping to create a pertinent conversation.

The community? Research and academia.

The conversation? Mental health.

"I do think Twitter makes it easy for people to freely and openly discuss mental health, and the frequency of #MentalHealth and #MentalHealthAwareness tags is indicating that this is in fact true," OpenAcademics tell me.

OpenAcademics is a Twitter account that has been created with the aim of promoting a healthier academic culture. A representative of OpenAcademics says, "We are mostly highlighting diversity and inclusion, equality and mental health by creating an environment where people can share and discuss, to let them know that they are not alone."

I've witnessed many individuals utilizing these platforms as an outlet to share their personal experiences with mental health in academia. Their stories are often raw, stripped back and emotive. Their words add force to the growing voice that demands change and corroborates the notion that academia is facing a mental health crisis.

Exploring the extent of the (global) problem

A plethora of research has cast a spotlight on the gravity of mental health issues in academia.

In their study Work Organization and Mental Health Problems in PhD Students, Levecque et al (2017) surveyed 3,659 Belgian doctoral students from a variety of universities and disciplines.¹ Fifty one percent self-reported having at least two mental health issues (such as depression, anxiety), 40% reported three or more, and 32% reported at least four. The research also found that mental health problems are higher in PhD students (from a variety of disciplines) compared to other populations.

Liu et al (2019) surveyed doctoral students in China and found that 41.2% of doctoral students demonstrated symptoms of mild depression, 23.7% mild-moderate, and 20% moderate-severe anxiety symptoms.²

The Advanced HE’s annual Postgraduate Research Experience Survey (PRES) of over 50,000 postgraduate researchers incorporated new wellbeing questions for 2019. The full report is available online, and reveals "striking" levels of anxiety within the population – only 14% reported that they had low anxiety.

The journal Nature runs a global annual survey for doctoral researchers. The survey had over 6,000 respondents in 2019 and featured a question exploring mental health. Thirty-six percent of the survey participants said that they had sought help for anxiety or depression caused by their PhD studies. Chris Woolston's commentary piece, aptly titled PhDs: the tortuous truth expands on the survey findings.

Data from the Nature PhD Survey 2019.

"We all have mental health"

"We all have mental health". If you're familiar with the work of Mark Freeman, you'll be well acquainted with this statement, but it's one I think is important to reiterate.

The pathophysiology of mental health disorders is complex and remains somewhat unknown to medical professionals. Whilst research depicts the contribution of both environmental and genetic contributions, a causal correlation has not been proven. The aim here, therefore, is not to assume that studying for a PhD directly inflicts a mental health disorder on an individual.

Rather, I wanted to explore why academia and research can be hard on an individual's mental health, speaking directly with the individuals and organizations that are championing mental health discussions in this space, and highlight areas where we're perhaps falling short and could improve.

"Graduate school is a notoriously challenging environment"

"Graduate training is hard for so many people’s mental health because of the inherent loneliness, competition, and high-pressure environments people face. We are often away from our support systems, can’t always confide in our colleagues, can’t relate to old friends, and may feel that we are constantly three steps behind where we should be," Susanna Harris tells me.

Harris is a PhD candidate in microbiology at the University of North Carolina in Chapel Hill. She is also the Founder and CEO of PhD Balance, a volunteer-led organization that hopes to empower graduate students to build their personal and professional resilience. "Our vision is that the most difficult but common conversations are talked about openly and often; we discuss mental illness, work-life balance, harassment and discrimination, burnout, career development, and more."

She explains how many of the stories that PhD Balance have received follow a similar trend: ”I’d dealt with mental health concerns in the past, which were exacerbated in graduate school. I was ashamed and scared, but eventually got help and now feel better prepared to tackle this huge challenge.” Harris encourages readers to look at the organization's Instagram page [@PhD_Balance] where a list of personal stories are available to read.

The points she raises are echoed by Christina (Tina) Del Carpio, a PhD student in Ecology and Evolutionary Biology who also runs the blog The Anxious PhD Student: "Graduate school is a notoriously challenging environment for mental health wellbeing. I think the hardest part for me has been transitioning to seeking professional care in the context of my university’s large and slow-moving bureaucracy. Appointments at our student counseling and psychological services are limited to only six visits per year."

Long-hours culture: quantity over quality?

Del Carpio also raises a point that is highlighted in the 2019 Nature survey – long hours culture: "I’ve encountered people who still hold on to models of academia where you can only be successful by working long hours and weekends. I’ve even been told by a faculty member at my university that if I’m not willing to do so, I need to find a different career."

The Nature survey found that 27% of respondents spend 41-50 hours on their PhD programme per week and 25% report that they spend 51-60 hours. The participants that reported spending 41+ hours a week on their PhD, 85% were dissatisfied with their hours worked. Data from the Office for National Statistics suggests that average number of hours worked by an individual in the UK per week typically range between 36-37 hours. It therefore seems that many PhD students are at the risk of working significantly longer.

Data from the Nature PhD Survey 2019.

OpenAcademics say, "Unfortunately, the academic culture for some reason is blindly looking at quantity of hours rather than quality. Expectations to work long hours and weekends can be difficult to handle as an early career researcher." How can we look to change this seemingly ingrained perception that more hours equal more success? Del Carpio comments: "I’ve been able to seek out communities and support networks within academia that do validate my decisions to prioritize my mental health while ignoring those who don’t."

"I changed the culture in my graduate lab by working smarter, not harder," OpenAcademics add. "My advice would be to find a good supervisor and mentor, surround yourself with people who are understanding and realize the importance of work/life balance."

"You don’t have to check your identity at the door to be a successful scientist"

In my personal experience, identity, "Who am I with this disorder?", can become a point of focus when experiencing a mental health condition. Prior to starting my career, I completed a degree in neuroscience. Whilst studying, I experienced severe anxiety that became debilitating. And so, I decided to seek help from my institution. I distinctly recall attending a Monday morning counseling session 9 am until 10 am, where I'd discuss the struggles I'd been facing in the previous week, most often in tears. For me personally, these sessions were a helpful form of therapy and an outlet to discuss what I was going through.

Once the clock struck 10 am I'd have to walk over to the library to resume work on my dissertation, or perhaps attend a meeting with my supervisor, or a lab session.

I felt split in two. I was a hardworking, budding scientist that was the first-generation in my family to study at university, and I was striving to really make something of myself. I was also a young woman that was trying to learn coping mechanisms so that I could get through day-to-day life with an anxiety disorder. For a while, I hid this from my peers, tutors and institution. Why? Well, at the time I didn't think that I could be both of these people. I feared that my credibility as a scientist could be brought into question if people knew that I was unwell.

Del Carpio eloquently discusses the concept of identity in academic environments: "As scientists, we want to see the world and our work through an objective a lens as possible. But it’s unreasonable to expect that our personal identities and experiences don’t impact our work."

She wants to share her experiences as a PhD student whilst also acknowledging the human side of being a student that isn't always publicly shared: "I try to break down the false image that neurodiverse people can’t pursue science unless they can fully compartmentalize their personal lives from their work. I want other early career researchers to know you don’t have to check your identity at the door to be a successful scientist."

On the topic of identity, I feel it's imperative to pause here and acknowledge a phenomenon that, unfortunately, many readers may be acquainted with – impostor syndrome. Whilst impostor syndrome is not a clinically diagnosable syndrome, it is being increasingly recognized as a contributor to an individual's sense of mental wellbeing, and there is fluidity between some of the characteristics associated with impostor syndrome and the symptoms of mental health disorders. In fact, 16% of respondents to the 2019 Nature survey ranked impostor syndrome as a concern, and it was categorized as a "top concern" for respondents in North or Central America.

"Impostor syndrome is rampant in higher education because, whilst there are wonderful aspects of higher education, there are aspects that fuel self-doubt not only in faculty but also in staff," says Valerie Young, PhD, an internationally-known expert on impostor syndrome.

She adds: "When you look at STEM, people in creative fields and artistic fields such as writing are more susceptible to impostor syndrome because they are being judged by subjective standards. There are people in jobs that are professional critics that have to judge their work. But then also in medicine, or technology for example, these fields are rapidly changing and updated, and so you might feel that you can never keep up to date."

If you want to know more about impostor syndrome, or are experiencing feelings of impostorizm, The American Psychological Association offers several tips to try and overcome these beliefs on their website, and our article discusses helpful advice from experts.

Stigma

Unfortunately, individuals that suffer with a mental health condition are often challenged two-fold. First of all, they are confronted with the symptoms of their disorder and the impact it can have on their life. Secondly, they face stigma.

Our modern-day society is often perceived as one of growing acceptance, understanding and empathy. A place where there is no room for shame surrounding mental health disorders. Perhaps this is true of certain places and to certain extents. But, as Del Carpio explains, stigma is yet to be completely eradicated:

"Mental health diagnoses are seen with significant negative stigma in the US and even more so in some cultural groups including Latinx communities."

Harris agrees, and emphasizes that stigma can be a barrier for individuals seeking help: "Mental illness is still so stigmatized that people can’t discuss it without fear of retribution. At the low end of studies, one in four grad students are dealing with mental health concerns. We know only about 50% of adults will ever receive treatment for their mental illness. So, at least one in eight students are struggling without help."

But how exactly do we fight stigma? In a comprehensive article, Reducing the stigma of mental illness, H. Stuart says that: "Decreasing mental illness-related stigma and the hidden burden of mental illness worldwide will take a concerted global effort."³ The organization See Me provides a list of helpful suggestions for ways that, as individuals, we can help to eliminate stigma surrounding mental health issues on a day-to-day basis.

Del Carpio adds a suggestion: "I think one of the best ways to battle this stigma is to talk frankly about our experiences. By having these transparent conversations, we can make others facing mental health difficulties feel less isolated and more likely to seek out mental health care."

"We are far from where we want to be"

It's only over recent years that the lid has really been lifted on the extent of poor mental health in academia. The increasing awareness can be attributed to the brave individuals that are speaking out about their own personal experiences, and the published research that has endeavoured to gather quantitative and qualitative evidence when exploring the issue.

This poses one question. The research and the data are there – so are institutions working with it?

I ask Harris whether she felt the current frameworks in place to support graduates are sufficient: "Wow, this is a hard one. While I do think many, many people around the world are working diligently to address these issues, we are far from where we want to be." She continues, " No environment is perfect, but if academia holds itself to the highest standards (as we often claim) we need to be more honest about the reality of how many are struggling without access to support."

Of the 36% of survey participants that said they had sought help for anxiety or depression caused by their PhD studies, one-third of these individuals sought help from a resource other than the institution at which they were studying.

In 2019, the 1^st International Conference on the Mental Health & Wellbeing of Postgraduate Researchers was held in Brighton, UK, on Mental Health Awareness Week.

Describing the rationale behind the conference, Dr Jane Creaton, University of Portsmouth, and Paul Roberts, University of Sussex, said: "There’s a well-worn trope when talking about doctoral study – it’s all a matter of survival. Undertaking a doctorate, we’re told, is a battle. A battle won, not by the smartest, but the most resilient. We believe this view is fundamentally wrong and it's time for us to change the conversation. "The event was a sell-out, and a sequel to the conference will take place later this year.

Time for change in research culture

It's hoped that calling for a change in conversation will in turn lead to an overall change in research culture, as the problem in academia doesn't end when finishing a PhD. The necessity for this change was recently highlighted in the largest ever survey into experiences of research culture by the Wellcome Trust.


Video credit: The Wellcome Trust.

The full results of the comprehensive report are available to access online, but to summarize, the key findings include:

• Poor research culture is leading to unhealthy competition, bullying and harassment, and mental health issues
  
  
• The system favors quantity over quality, and creativity is often stifled
  
  
• Researchers are passionate and proud about their work, but have concerns about job security

Jeremy Farrar, Director of Wellcome, said: “These results paint a shocking portrait of the research environment – and one we must all help change. The pressures of working in research must be recognized and acted upon by all, from funders, to leaders of research and to heads of universities and institutions."

Open Academics add, "Academic working culture can make it difficult to cope with every day “musts”. I feel like academia is getting more and more demanding, where journals are requiring more than ever, which translates to professors putting more pressure on students to “get things done”. These professors have, in my experience, no or only limited training in dealing with mental health issues."

Undoubtedly, there is so much more to say. There are many contributing factors to poor mental health in academia that are beyond the scope of this piece. It's clear that the research space needs to both protect, encourage and inspire individuals currently in academia and those considering a future career in academia. It's clear that now is the time for change.

"We need an environment where you feel like you can admit that you are stressed, that your mental health is suffering, and where it is allowed to say “no” when the workload is too high."

– OpenAcademics

Getting support

If you're experiencing mental health problems or need urgent support, there are lots of places you can go to for help:

•  Time To Change website (UK-based)
  
  
•  United Global Mental Health lists national helplines
  
  
• Mental Health America provides a list of US resources

OpenAcademics, Susanna Harris – PhD Balance and Christina Del Carpio – The Anxious PhD Student, were speaking to Molly Campbell, Science Writer, Technology Networks.

References:

1.       Levecque et al. (2017). Work organization and mental health problems in PhD students. Research Policy. https://doi.org/10.1016/j.respol.2017.02.008.

2.       Liu et al. (2019). Prevalence and associated factors of depression and anxiety among doctoral students: the mediating effect of mentoring relationships on the association between research self-efficacy and depression/anxiety. Psychol Res Behav Manag. doi: 10.2147/PRBM.S195131.

3.       H. Stuart. (2016). Reducing the stigma of mental illness. Global Mental Health. DOI: 10.1017/gmh.2016.11.