As I’ve written about before, I am chairing a task force for Michigan’s Rackham Graduate School that is focused on graduate student mental health. We started our work last summer, and have spent the past several months especially focused on identifying needs. This was done by evaluating what others have found; in one-on-one conversations with graduate students, mentors, and mental health professionals; and by hosting a couple of town halls. This post summarizes the major themes that emerged out of these conversations.
Theme 1: Access to care & other resources
One of the most common things we heard is that people don’t know what resources are available or, if they do know about particular resources, they don’t know which one is appropriate for a particular situation. This was a dominant theme, and resonated for me: I’m much better connected on these issues than many of my colleagues, but there have been some times in the past year where I felt really unsure of who was available to help with a particular issue.
Other dominant themes were: there aren’t enough counselors available through the campus counseling services, and the short-term care model that the counseling center uses makes it so people have to start over with a new provider quickly or simply don’t start the process in the first place. Add to that that students sometimes have to call long lists of providers in the community before they can find one who works for them, and access to long term care is clearly an issue. On top of that, the $25 copay for mental health care is a major burden for many students.
A less common item, but a very important one, related to this theme relates to policies related to a leave of absence. It is possible for students to take a leave of absence, but how to go about doing so, and whether it’s possible for students to still receive a stipend during that time, is not clear to many students and faculty. There also was feedback that it can be hard for students to re-enter their program after taking a leave.
In addition, some students previously have not had access to any or sufficient healthcare, or have experience with healthcare in a very different context (e.g., in a country with a very different healthcare system). These students can use more support figuring out what is available and navigating the system.
Finally, I heard from people who found themselves (or their students) unable to access care (and other resources) when traveling for field work or some other extended, work-related travel.
Theme 2: Mentoring and navigating the mentoring relationship
Both faculty and students want more training for advisors related to graduate student mental health. Faculty feel unsure of how to reach out to a student they have concerns about, who they can receive support from if they have a concern, and about how to accommodate student mental health concerns. One thing students emphasized was that they want advisors to receive more training in how mentoring can influence student mental health.
To me, there are some things here that seem like they can be relatively easily addressed, including making sure mentoring plans are more widely used (and useful), and creating formal mechanisms for diffuse mentoring (such as cohort-based mentoring).
But there are also some really challenging issues. As some examples: I spoke with students who had felt unable to report problematic mentors because they feared they wouldn’t get a letter of recommendation that they needed to get their next position. I spoke with advisors who fully supported students who took substantial time to address mental health concerns but, as a result, hadn’t made progress on a grant and now had no data for a renewal and could no longer pay other people in the lab (or, similarly, who were left scrambling to cover teaching responsibilities). It also became clear that there are many cases where there is an advisor who is genuinely trying to figure out to support a student, and a student who is equally genuinely trying to figure out how to make the advising relationship work, but where the overall relationship has broken down. One thing that is very clear is that there are a lot of complicated situations that are not captured by the simpler narratives that a) mentors don’t care about their students and just view them as cogs in a machine, or b) on the flip side, that students today are coddled and need to suck it up. There are some really hard, sticky situations out there. We won’t be able to address all of them. But I’m hoping we can improve things overall.
Another thing related to this theme that has come up is that we need more support for difficult conversations (for both faculty and graduate students!) It reminded me of something that has come up repeatedly in terms of health care reform: some of what is essential to improving patient outcomes is having everyone empowered to have difficult conversations. (This is summarized in Grenny et al.’s Influencer, among other places.)
Theme 3: Department/programmatic requirements, expectations, and culture
There were several things that came up related to departments or graduate program requirements, expectations, and culture. This included:
- A need to have different definitions of success and different paths to success, including multiple options for major PhD milestones. Some of this work made me think of this resource by Price & Kerschbaum about creating supportive environments for faculty with mental health conditions. In that, they write “Tanya Titchkosky (2011) argues that disabled faculty are “unexpected types” in university culture: that is, the culture is not set up to expect them, and so they must individually figure out how to negotiate their access needs.” And “A powerful move in creating a welcoming climate for faculty with mental disabilities is simply to indicate, through policy and everyday practice, that they are expected.”
- We need true support for work-life balance. As one example: I talked to students who said that their department says they support work-life balance, but then assign hundreds of pages of reading per week for a required course.
- Related to the previous, we must address problematic aspects of department and campus culture, including chronic overwork, a culture of expected perfection, discrimination, and hostile environments (especially for students from marginalized groups).
- Students wished that discussions of mental health and wellness were more a part of the culture of departments, and that they were addressed more explicitly in graduate courses. (A couple of UMich Economics professors addressed this head-on in a grad econ course this semester. It sounds like it was very well-received.)
- We need structures that reduce isolation and promote a sense of community. Community is really important to well-being and mental health, but it can be hard to develop that sense of community.
- There is a need for true support at the department level for students who are interested in non-academic careers.
Theme 4: Training and resources for individual students
While I get frustrated when conversations about graduate student mental health are dominated by what I think of as “self help for graduate students” (that is, by suggestions that graduate students should do more yoga or exercise more, ignoring the larger systemic issues that need to be addressed), I also realize that many students would benefit from trainings and resources related to things that they can do individually, including for things like mindfulness and resiliency training. So, we’ve been looking into evidence-based resources that are available to students (or might be made available).
Theme 5: A few things that don’t fit neatly into the previous themes
Helping students deal with imposter syndrome emerged as a theme particularly in smaller conversations with students. Going along with this is perfectionism, where some students feel that any mistake will reveal them as a fraud and/or ruin their career; this can be particularly acute for students from minoritized groups.
We also have spent a lot of time (including with help from graduate students at a town hall) thinking about what a mental health ally program might look like. Among other things, key take homes were: there need to be multiple allies per department, some of whom need to be people who are not mandatory reporters, and all of whom receive training related to confidentiality.
Another thing that clearly resonated with a lot of us on the task force was something that one graduate student brought up at a town hall: there are things that seem like a silly, small barrier but that are actually a big deal. This student talked about how the lack of a towel service at the rec center makes it harder to work out in the middle of the day, to the point where exercise often just doesn’t happen. I hadn’t been thinking about towel service at the rec center as something we might consider, but it makes a lot of sense – there’s really strong support for exercise as something that supports strong mental health.
There can be some unique needs for students who spend extended time off campus (e.g., for fieldwork), including related to access to care (as discussed above), but also related to isolation, mentoring, and additional financial strains that can occur as a result.
Not all students are the same (obviously!)
Finally, at the risk of stating the obvious, not all students are the same and therefore not all students will be equally impacted by the different factors discussed above, or by different possible changes. Vanderbilt’s Mental Health Bill of Rights & Responsibilities states:
In caring for the mental health of all of its students, Vanderbilt University commits to consider and support the unique needs of its students, including but not limited to: students of color, international students, LGBTQI students, students with disabilities, military veterans, students who are first-generation college students, survivors of trauma, and students from underrepresented religious and socioeconomic backgrounds.
When we are evaluating potential changes we might recommend, the task force has been charged with considering students from each of those groups (and we’ve added on a couple of others to the specific list: parents, and students in recovery).
Have we missed something?
The issues we found above are generally supported by other studies or reports (e.g., this and this and this and this). I think we’ve identified the major issues that we might have some control over (though, at present, I’m not sure if we actually have control over all of them). If you think we’re missing something, I’d love to hear it. (Truly!) I’d also love to hear about things that address the issues raised above! We’re interested in things that have been developed specifically for graduate students, but also in things that might map over from other areas (e.g., business).
We’re considering a variety of potential recommendations that will hopefully address some of the issues described above. In a future post, I will lay out both why the number of recommendations we make will be relatively small, and why we’ll often end up piloting things at a small scale first.