How to fix grad school
In the aftermath of the Chernobyl disaster the increase in cancer incidence rates for the 600,000 inhabitants in the most contaminated areas was estimated to be between 1-5%.1 People are justifiably still afraid of entering the exclusion zone to this day, even after the radiation levels have greatly decreased.
In contrast, being enrolled in a graduate school is associated with a 500% increase in the incidence of depression and anxiety,2 and yet people are rarely seen fleeing universities in terror.
While the above comparison isn’t exactly apples to apples, and the research on graduate school mental illness is still in its infancy, it’s clear that graduate mental health is a major problem3 with a significant public health burden. These numbers also match my personal experience – of my friends in grad school about half were depressed at any one time (myself included), and one ended her life.
The reasons for this are multifarious and have been written about before, but as a quick summary:4
Unbalanced Power Dynamics. In a PhD programs one typically spends 5-7 years working for a single individual, whose subsequent recommendation letter is then the sole arbiter of job prospects post-graduation.
Lack of Structure. Much of grad school work (again, especially in PhD programs) can drag on for years without positive results. Projects, as well as entire programs, often have ambiguous goals and finish lines.
Poor Management. PIs are selected primarily for their scientific acumen. Ability to lead or manage seems to be a secondary consideration and also rarely taught. Workplace culture is often poor, with long hours expected for little pay.
Disillusionment. Science is really hard. Reality has a surprising amount of detail. Many people enter grad school with grand goals such as curing cancer and instead end up spending their entire PhDs elucidating a single novel function of a single protein that is associated with, but not necessarily causative of, a single sub-type of cancer. Other fields have similar problems.
Lack of Prophylaxis. It’s (probably) much harder to cure someone’s depression or anxiety than it is to prevent them from getting it in the first place. Yet the systems in place are almost entirely focused on reacting to mental unwellness, rather than preventing it.
Uncertain Career Prospects. I don’t know exactly what causes this except for maybe the fact that people often don’t get a clear impression of just how much competition there is for the most coveted jobs until after they’ve begun their program.
What might be done?
Make mental health counseling opt-out rather than opt-in. It should be the norm for graduate students to check in with their mental health counselors at least once a quarter.
Take other preventative measures. It would be great to see research on how teaching new graduate students the basics of Cognitive Behavioral Therapy or helping them build a regular meditation practice, affected their graduate school careers.
Put together a mental wellness workbook specific to graduate school. Mental wellness workbooks are surprisingly effective,5 despite feeling strongly reminiscent of 4th grade homework. It would be nice if one existed specifically for grad school and covered things like Impostor Syndrome and The Feeling When All Your Experiments Explode.
Relatedly, bibliotherapy is an effective and low cost form of therapy that would be very easy for graduate schools to implement. Many schools nominally have this, in that they have libraries of therapy-type books in the counselor’s offices, but I doubt this is the optimal solution. A better approach might be to have a large Bibliotherapy-only shelf placed prominently in the front of the library, with individual (handwritten?) book recommendations (like the kind good bookstores often have). The typical graduate program could easily implement this for under $2000, and a dozen or so people-hours.6
Do a better job of promoting healthy culture7 and work/life balance.8 Awareness of the problem and intentionality to fix it from all parties involved could go a long way here. Encouraging hobbies that have consistent positive feedback in proportion to the effort you put in them is a great way to fight burnout. Increasing the amount of consistent positive work-related feedback that students receive with programs such as LabScrum could be very useful too.9
Encourage graduate programs to adopt a Mental Health Bill of Rights. If you’re a member of your progam’s Graduate Student Council, drafting and adopting one of these for your school could be a great way to generate engagement with this topic.
Make graduate programs a better place for women and minorities. There are many ways to do this that have already been covered by many people more qualified to write about the topic than myself, but one simple thing that everyone can do is to be an ally.
Strategic restructuring of PI incentives. A friend told me that Tufts University’s grad program has an interesting rule to the effect that PIs who have had some number of students leave or rotate out of their labs for negative reasons are not allowed to take any rotation students for the following year. There are likely a number of other useful actions that could be taken in this space.
Decrease the rate of incoming graduate students. I think this is one of the more important things that could happen. Fewer students, and more time/money/resources per student could do a lot to change the dynamics of the system. The overall caliber of researchers would increase, job prospects would be better, and it would help equalize the power imbalance between graduate students and professors.
Build a Graduate School Mental Health Index (GSMHI). Globally track graduate student mental wellness in granular detail: at the level of field, graduate school, program/department, and maybe even research lab. Propagate this information to prospective students. If graduate schools were forced to compete for prospective students who used the current mental health quality of a school as a discriminating factor things would likely change much more quickly.
This last point is something I’ve been thinking about for a while. The GSMHI (name is a work in progress!) would basically be the equivalent of the “US News & World Report – Best Colleges” ranking, but for graduate mental health. I’m (slowly) working on setting up a system that would allow grad students to confidentially take mental health surveys, collate the data, and display it in a useful fashion. If you have expertise in this area and would like to help, or just have thoughts on how this could be done better,9 please shoot me a message!
The last thing I want to say is that despite the apparent negativity in this post, my grad school experience was on balance very positive.10 These problems seems mostly structural and overall the scientists, administrators, counselors, and fellow students that I interacted with in my program were wonderful, if sometimes rather complicated, people. I think there are many good reasons to expect graduate mental health to improve in the medium-term future, and I strongly believe this will be positive sum for all involved.
Estimates vary but it seems clear that the cancer incidence rate for this population increased by less than 10%. ⤴
“We surveyed a total of 2,279 individuals (90% PhD students and 10% Master’s students). Respondents were from 26 countries and 234 institutions (Supplementary Tables 1 and 2) and represented diverse fields of study including, biological/physical science (38%), engineering (2%), humanities/social sciences (56%) and “other” (4%) […] Our results show that graduate students are more than six times as likely to experience depression and anxiety as compared to the general population.” Evidence for a mental health crisis in graduate education. Evans et al. Nature Biotechnology, 2018 🔗 — see also: Work organization and mental health problems in PhD students. Levecquea et al. Research Policy, 2017 🔗 ⤴
Graduate students are one of the major drivers of sociological and technological innovation. How much progress is our society leaving on the table if most of them are depressed? ⤴
Much of this is written from the perspective of Life Science PhD programs, which is what I have experience with (as a white male). Most of the points are applicable to non-scientific and/or Masters programs too though. ⤴
Guided Self-Help Cognitive Behavioural Therapy for Depression in Primary Care: A Randomised Controlled Trial. Williams et al. PLOS ONE, 2013 🔗 ⤴
AFAIK there are no studies on prophylactic bibliotherapy which is a shame, because it’s such an easy method to implement. ⤴
One of the most important principles of building a good workplace culture is cultivating an environment of psychological safety. One good way to capture this is with a “No Asshole Rule”. ⤴
See “Counting the costs of casualisation in higher education” (🔗) for a good review of a related topic, workforce casualisation. In the words of one of my friends currently doing her PhD at Cambridge: “I’m doing a lot of extremely time consuming and poorly compensated teaching. In practice, this also means hearing a lot about my students’ struggles, including with mental health. The whole system relies on the fact that we care about our students and will do unpaid labor because we believe teaching/education is important. But I think it takes a toll to know that you’re being taken advantage of.” ⤴
I don’t think we should underestimate how useful something like this could be – getting graduate students early on into an environment rich in short positive feedback cycles could have a massive compounding effect. ⤴ ⤴2
80% Type II fun (my favorite kind), 10% Type I fun, 10% Type III fun, and an additional 10% awfulness. ⤴