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.
I was a grad student at UM over a decade ago. Not great memories of the climate there for mental health. Much of my impression derived from offhand comments by key faculty, who might read this blog, so I won’t go into specifics. They weren’t malicious: they came from other cultures with different expectations about what was normal v. weird. They didn’t realize my experiences fell into the weird camp, and it took me a while not to feel really messed up.
Subtle institutional cues matter too. I remember suggesting to a revered senior prof that grad students get feedback on our prelims. He said, “It’s not our job to give you feedback. It’s only our job to judge you.” I had a metastatic case of imposter syndrome at the time and wanted more feedback on how to improve. This was disappointing. I remember the University also had language in their grad student materials that implied mental health was solely in the service of productivity, which was dispiriting, but that’s also just capitalism and I was lonely.
I run my own lab now and try to be extremely careful about the messages I send, but I am probably messing up a bit too. On the PI side, I have great sympathy for the need to produce on grants/contracts. To avoid demanding too much of grad students, I now almost exclusively budget for and hire more senior/permanent researchers for my lab’s core work. (Bizarrely, I have trouble finding enough! Most PIs I know do too!)
As an aside, mental health support for faculty (by which I mean the insurance plans and their coverage, and how promptly they review requests for out of network care) is also subpar. Those four-session employee counseling programs are awful. (I was advised to take up yoga when on the receiving end of deeply inappropriate behavior, and the counselor revealed the names of other recent clients/faculty.) I advise my trainees to look off campus for good therapists.
Thanks for posting on such an important topic! While there are still many problems with my uni around mental health support, one thing I love is that they provide free “Mental Health First Aid” training to staff and students http://www.mhfainternational.org/index.html.
It’s really popular among students as it gives you the tools/ability to recognise and support people going through tough times. Now our challenge is convincing faculty to give it a go!
I get really confused when these mental health efforts are just aimed at students. Mental health does not get magically better when you become a postdoc or a faculty member – the concerns continue and may even get worse due to increased demands, higher expectations (but confusing/ambiguous/amorphous expectations), and isolation. Further, if postdocs and faculty feel better about themselves and feel mentally healthier – they will be better able to create positive environments — and will be better mentors.
It’s almost like providing support for a child, but doing nothing to support their siblings or parents — if the entire system isn’t improved, the child will not be any better off.
In the category of small but subtle barriers – add ‘fear of the unknown at the counseling center.’ Students – undergrad and grad, and especially those from backgrounds where mental health care was not readily available or accessed – have little information about what to expect and what protections they have when seeking help. A quick and simple video showing what happens when someone arrives – stressing, e.g., that all the student employees are trained in confidentiality procedures, that no one will see your computer intake data except the counselor, that no one (law schools, your PI, your parents/partner, ANYONE) will find out that you went there – on the website would address a lot of the concerns I saw when I was there as a GSI. *I* could answer most of those questions and describe the intake procedure because I’d been through it. That alone got 2-3 students to go over; I walked a couple more over myself. But many of them, especially international students and students from backgrounds without ready access to the white-collar privilege of mental health care, have no idea what happens there or what protections they have. One of my classmates thought they were going to put wires on his head and shock him. Even now, in my capacity as a PhD student coach and mentor, I see a TON of misconceptions about using the counseling center.
My first advisor was generally unaware of my mental health issues; I think I told him when I was first diagnosed because I was taking a class with him and my performance was erratic as I adjusted (or didn’t) to meds. But he was old and retiring and didn’t really seem to care. My mentor up and moved to an Ivy shortly after my diagnosis, and left her entire research project literally on my office doorstep while I was teaching my first solo (summer compressed schedule) course. My second advisor was a little more aware of the ups and downs because they affected my deliverable schedule to him, but he didn’t seem to care one way or another so long as I had a plan to graduate. “Benign indifference” is not the best advisor approach, but it kept the ball firmly in my court with how much I wanted to disclose and when. He allowed me to graduate on my own timeline, so long as I arranged my own funding, and that was probably the biggest help.
I’m glad to see UM tackling this really crucial issue. The institutional and structural components require concerted effort from the top down as well as bottom up. Students can’t do it alone; it requires the protection of tenure and administrative hierarchy to force cultural changes.
One thing we hear repeatedly from students and faculty alike is that CAPS is not a trusted resource. There is a hesitancy to contact them either directly as a student or as a referral from faculty to students. They feel it is ineffective and not worth their time or energy. I know that CAPS is making an effort but how to do we help improve the perception and get students to use the resources?
Do you think the same concerns apply to the embedded CAPS counselors? In the conversations I’ve had, I’ve heard good things about the embedded counselor model, but much more mixed things about regular CAPS. So, one thing that seems worth exploring is expanding the embedded counselor program.
Thanks for following up. I’ve asked my students and they DO feel that the embedded counselors are much better! They said they don’t feel like everyone knows about them. It’s a reminder to me to make sure I’ve specifically added this to the list of things I highlight for my students! They said they’d like to see more embedded services!
Thank you for doing this work! It is so important and truly needed. Wanted to share that PSU created an online Canvas course for faculty advisors. It’s geared toward academic advising but I think something similar could be developed at U-M for faculty advisors of graduate and undergraduate students. Feel free to contact me if you want to discuss this idea further.
Thank you very much for sharing this!
Another resource I recently heard about that sounds great is CIMER at Wisconsin:
I like that it includes curricula for both mentors and mentees.
CIMER looks cool. That reminded me of another new resource geared for faculty advisors in STEM fields. The guide may be focused on undergraduate advising but still worth reviewing: https://www.aspirealliance.org/national-change/national-change-resources/faculty-advising-guide
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I am a Medical Assistant at UHS and would love to be involved in helping identify ways to better serve our student patient population in regards to mental health. Please let me know how I can be of service!
Sorry typo in my email!