Graduate students face unique pressures as a part of the typical doctoral experience, including isolation in projects of indeterminate length, disproportionately little pay for excessive amounts of time and effort, and supervisory relationships that can result in the success or failure of a graduate degree.

Graduate students also bear the increased responsibilities of adulthood, such as copious amounts of debt from student loans, providing spousal and/or family support, and the foreknowledge of an uncertain career trajectory following graduation.

Graduate students suffer high rates of mental health issues. A survey of graduate students at the University of California revealed that approximately 50% of graduate students suffer from some form of mental illness [1]. Up to 87% of graduate students report feelings of anxiety, 68% feelings of depression, and up to 19% of cases report suicidal ideation [2].

Even students without clinically significant levels of depression or anxiety experience symptoms that hinder their work and quality of life.

Lisa Brandes, the assistant dean for student affairs at Yale University, expands on the issue: “the stress and structure of a graduate program can exacerbate their issues or [overwhelm] their coping skills” [3].

These challenges of graduate school result in frequent occurrences of burnout, loss of productivity, and attrition. It is imperative for graduate students to have access to a safe space in which appropriate support and professional assistance is available. Unfortunately, such spaces are often difficult to find, for both intrinsic and extrinsic reasons.

Intrinsic Issues

Normalcy of Stress

Stress and fatigue exacerbate mental health issues. Many academics consider both as quintessential parts of the graduate school lifestyle, thus colleagues may not identify anything amiss when a student reports symptoms of depression or anxiety.

Another student provided one graduate student the following advice: “Everyone has some kind of breakdown during [their] PhD; it is nothing to worry about” [4].

Given the normalization of depression and anxiety within the graduate school community, many students are left isolated with their symptoms and without support.

Stigma: By Self and Others

Students with mental health issues are often treated differently than students without. Stigma is not limited to the uninformed public, but it is also shared by well-trained professionals, even those in mental health disciplines [5,6].

Given the already arduous and competitive nature of working towards a doctorate, students strive to avert any additional challenges. Thus, disclosure to administrators or other avenues of potential support is often avoided at the cost of one’s mental well-being.

Furthermore, stigma toward mental illness also exists in the mind of the afflicted individual. Students may internalize feelings of incompetency or self-blame [5,6].

Internalized stigma may get in the way of the student’s ability to make an accurate self-assessment of the need for care, leading to low motivation for self-advocacy. This can further impair the likelihood of obtaining help.

Supervisory Infantilization

While the relationship between students and their supervisors would ideally be one of support and care, in many cases they are not. Data support this common experience, with supervisor-student challenges being reported as strong contributors to high rates of PhD student attrition [7].

Derogatory attitudes from supervisors include “infantilization” (e.g., a student being treated as less mature than they are), feelings of compulsory benevolence (i.e., the belief that people who have a mental illness require excess levels of personal care), and general avoidance of the student [8]. Confronting these issues reinforces students’ assumptions and fears, leading them to avoid self-disclosure.

Extrinsic Issues

Relationship Mismatch between Client and Therapist

The match between therapist and client is crucial, both in terms of treatment success and to prevent premature termination of the relationship [9]. Unfortunately, finding the right match can be difficult. In many cases, a graduate student seeking therapy is placed with a trainee, and therapy sessions can reflect more of a peer support session than true counselling.

In other cases, the counselor is unfamiliar with particular challenges that accompany the life of a doctoral student. The student may be forced into unhelpful levels of self-disclosure, hampering the treatment progress.

Access to Care and Excessive Wait Times

Generally speaking, those with mental illnesses receive fewer medical services and insurance benefits than those not labeled this way [10,11].

Independent of this more general issue, while many schools strive to support mental wellness, lack of funding means that it can take a great deal of time, sometimes up to weeks, in order to obtain an appointment with a therapist.

Dr. Mark Sinyor, a researcher at Sunnybrook Hospital in Toronto, ON, spoke of the struggle: “The demand often far exceeds the services available. This is an issue because sadness, anxiety and hopelessness are often features of mental illness that can be reinforced by a wait” [12].

Closing Thoughts

Graduate students face unique issues as a student population. They are a more mature group than undergraduates, with greater responsibilities but fewer supports.

While not necessarily more likely to experience mental health issues than any other student population, the unique factors inherent to the graduate experience, such as the normalization of stress and anxiety, stigma, and supervisory infantilization, aggravate existing mental health problems.

Additionally, there are issues independent of the graduate school experience that compound these issues, such as a relationship mismatch between client and therapist and the availability of mental health care services. More research is required, both for graduate students as a special population, and into solutions to the pervasive lack of mental health supports. In the time being, graduate students must work together to reduce stigma and promote mental health awareness.

Finally, graduate students must pressure overseeing bodies, such as university administrations and government policies, to aid the resolution of these critical issues.

References

[1] Joel Dimsdale and Michael Young. (2006). Student Mental Health Committee – Final Report (2006). Retrieved from http://regents.universityofcalifornia.edu/regmeet/sept06/303attach.pdf.[2] Cassandra Willyard (2006). Need to Heal Thyself? Retrieved from http://regents.universityofcalifornia.edu/regmeet/sept06/303attach.pdf.[3] Jessica Kohout and Marlene Wicherski (2009). Graduate Study In Psychology: Faculty and Student Data. Center for Workforce Studies, APA.[4] Melonie Fullick. (2011). My grief lies all within” – PhD students, depression and attrition. Retrieved from http://www.universityaffairs.ca/opinion/speculative-diction/my-grief-lies-all-within-phd-students-depression-attrition/#comment-157.[5] Brockington, I. F., Hall, P., Levings, J., & Murphy, C. (1993). The community’s tolerance of the mentally ill. The British Journal of Psychiatry, 162(1), 93-99.[6] Corrigan, P. W., River, L. P., Lundin, R. K., Wasowski, K. U., Campion, J., Mathisen, J., … & Kubiak, M. A. (2000). Stigmatizing attributions about mental illness. Journal of Community Psychology, 28(1), 91-102.[7] Golde, C. M. (1998). Beginning graduate school: Explaining first‐year doctoral attrition. New directions for higher education, 1998(101), 55-64.[8] Corrigan, P. (2004). How stigma interferes with mental health care. American psychologist, 59(7), 614.[9] Zane, N., Sue, S., Chang, J., Huang, L., Huang, J., Lowe, S., … & Lee, E. (2005). Beyond ethnic match: Effects of client-therapist cognitive match in problem perception, coping orientation, and therapy goals on treatment outcomes. Journal of Community Psychology, 33(5), 569.[10] Desai, M. M., Rosenheck, R. A., Druss, B. G., & Perlin, J. B. (2002). Mental disorders and quality of diabetes care in the veterans health administration. American Journal of Psychiatry, 159(9), 1584-1590.[11] Druss, B. G., & Rosenheck, R. A. (1997). Use of medical services by veterans with mental disorders. Psychosomatics, 38(5), 451-458.[12] Charlotte Arnold, Vjosa Isai, and Katie Raskina. (2015). Mental Health Report: Students who need help left waiting for counselling services. Retrieved from http://ryersonian.ca/students-who-need-help-left-waiting-for-counselling-services/.