PhDs & mental health: It’s time to talk

It is common knowledge that there is a mental health crisis in graduate education – and within academia as a whole [1]. Statistically, one in two PhD students will experience a mental health problem at some point during their studies. The percentage of PhD students at risk of having or developing a mental health problem during their studies (i.e., approximately 3-4 years) almost equals the lifetime prevalence of mental health problems in the general population [2].

What is the extent of the problem?

The 2013 survey which examined the mental health of PhD students in Flanders, Belgium [2], found that 51% of PhD students experienced psychological distress. Approximately 30% experienced so many symptoms that they were at an extremely high risk for having or developing a mental health problem. The most commonly reported symptoms of poor mental health were: feeling under constant strain, being unhappy and depressed, losing sleep because of worry, and not being able to overcome difficulties or enjoy day-to-day activities. This risk for PhD students is significantly greater than it is for the highly educated general population, highly educated employees and higher education students [2].

In a similar study of US PhD students, approximately 40% met the criteria for anxiety and 40% for depression – this is six times higher than the US general population. Yet, the levels of help-seeking within this high-risk population are low, with the Nature Graduate Survey identifying that, of the researchers and PhD students who reported feeling concerned about their mental health, only 12% sought professional help [3].

Factors associated with mental health

Mental distress is complex and no single factor can be held accountable. However, several factors have been found to be associated with the increased risk of suffering from a mental health problem.

One of the most important factors is a poor work-life balance. A recent PhDnet survey [4] found that PhD students worked an average of 47 hours per week, with 81% working more than their contractually obligated hours. Worryingly, 75% worked at least one weekend per month and 20% felt that they were not able to take their contractually granted holidays due to their high workload. Finding a good work-life balance is particularly important as long working hours are highly correlated with burnout [5].

The PhDnet survey showed that student-supervisor relationships are also linked to student mental health. Supervision satisfaction is highly correlated with general satisfaction, suggesting that the quality of supervision is related to the overall experience of a PhD student [4]. Fortunately, the survey showed that 72% of PhD students reported being either “very satisfied” or “satisfied” with their supervision. Furthermore, one study showed that having an inspirational supervisor partially offsets the risk of having a mental health problem [2].

Several other factors are thought to be associated with the high prevalence of mental distress in PhD students, however, research is extremely limited. For example, the change from feeling successful throughout your undergraduate degree, to suddenly receiving more critical feedback, can be damaging to your self-esteem. This leads to Imposter Syndrome, which is defined as the persistent inability to believe that one’s success is deserved or has been legitimately achieved [6]. In addition, it is thought that many PhD students would be described as having a Type A personality. Type A individuals are hypothesised to be “high-achieving workaholics”, and are also thought to experience more job-related stress and less job satisfaction [7]. This combination may also increase the risk of having poor mental health.

Financial problems are an additional cause of stress for PhD students, on top of the existing stress from job demands and workload – PhDs are not well paid. If you are fortunate enough to get external funding, this is approximately £14,000 a year, in the UK (slightly more in London). Considering the average hours worked, this works out as below the minimum wage. Part-time jobs can help with financial worries, but this puts you at a much higher risk of burnout. Moreover, PhDs normally take approximately 3-4 years, yet funding often stops after 3 years, meaning the remaining months are unpaid.

How to look after your mental health during a PhD

These statistics can be very daunting when beginning a PhD. But there are several things you can do on an individual level to look after your mental health.

Take the time to look after your physical health – eat well-balanced meals, exercise frequently, even if it is just walking. Get out of the office and go outside for a quick break.

It may help to join a club outside of the University. Meeting other people who are not doing a PhD can be refreshing and a useful way of taking your mind off work. Or get a hobby – anything which will help to create a healthy work-life balance. It’s important to remember that your PhD is not the be-all-and-end-all.

Talking about how you are feeling, particularly if you are struggling, can be an effective way to relieve your distress. Talk to your friends, your family, your peers, and if you feel comfortable, talk to your supervisor. If your supervisor recognises that your mental health is struggling, they can offer advice on the next steps.

If you feel that your mental health is suffering – seek help. The statistics show that PhD students are at an increased risk of having a mental health problem, so if you do feel like you need professional help, it’s quite likely that you do. Most Universities have available counselling and mental health services, or you can visit your GP. There are also several online services or mental health help lines (see the NHS website for a comprehensive list).

What needs to change in the system?

Although there are things you can do to look after your mental health, it should not have to come to that. There needs to be widespread changes within academia itself. If 50% of people suffered from mental distress in any other occupation, fundamental action would be taken. So why does this seem acceptable in academia?

PhD students should be offered more financial support. The length of studies should increase to reduce pressure from the workload. The number of PhD students per supervisor should be reduced in order to prevent supervisors being too far stretched which would allow the development of better quality supervisor-student relationships. Relief courses should be provided by institutes within Universities, and should be made available to all PhD students and academic staff. There needs to be more mental health support provided by Universities. However, this sounds great in theory, but is difficult to implement in practice without government support and widespread changes to the expected workload which is so ingrained within academia.

It’s not all doom and gloom, it seems as though institutions are making some changes to improve the mental health crisis. A couple of weeks ago saw the opening of the first international meeting on postgraduate mental health in Brighton. The two-day meeting aimed to address the fact that many PhD students and postdoctoral researchers are overworked and overstressed, leading to this mental health crisis. The Higher Education Funding Council for England and the UK Research Innovation have given £1.5 million to fund a series of 17 projects, which began in March 2018, aiming to better understand the causes of mental health problems in early-career researchers and what kinds of support their Universities can provide.

However, international data is lacking, most studies have incomplete data or often only apply to an individual University or region. Nature Research suggests that more wide-scale research is needed to understand the extent of the post-graduate mental health crisis and the predictors. It is important that we continue talking about the mental health crisis in academia until fundamental changes are made.

References:

[1] Gorczynski, P., Hill, D., & Rathod, S. (2017). Examining the construct validity of the transtheoretical model to structure workplace physical activity interventions to improve mental health in academic staff. EMS Community Medicine Journal, 1(1).

[2] Levecque, K., Anseel, F., De Beuckelaer, A., Van der Heyden, J., & Gisle, L. (2017). Work organization and mental health problems in PhD students. Research Policy, 46(4), 868-879.

[3] Woolston, C. (2017). Graduate survey: a love-hurt relationship. Nature, 550(7677), 549-552.

[4] 2017 PhD Survey Report (2017), retrieved from https://www.phdnet.mpg.de/42222/PhDnet-Survey-2017-Final-Report.pdf

[5] Hu, N. C., Chen, J. D., & Cheng, T. J. (2016). The associations between long working hours, physical inactivity, and burnout. Journal of occupational and Environmental Medicine, 58(5), 514-518.

[6] Bothello, J., & Roulet, T. J. (2018). The Imposter Syndrome, or the Mis-Representation of Self in Academic Life. Journal of Management Studies.

[7] Kirkcaldy, Bruce D.; Shephard, Roy J.; Furnham, Adrian F. (2002). “The influence of type a behaviour and locus of control upon job satisfaction and occupational health”. Personality and Individual Differences. 33 (8): 1361–1371

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