Mental health of students is a recurrent theme of late (e.g. see here). It was a key theme of research that Barbara Fogerty-Perry (Otago Polytechnic), Gemma Piercy Cameron (University of Waikato), and I did, looking at the impacts of the pandemic on tertiary students in New Zealand. Our sample was mostly made up of undergraduate students. However, students undertaking independent study, such as PhD students, may be more of a worry. Doctoral study can be a lonely and isolating experience.
So, I was interested to read this recent substack post by Scott Cunningham on depression, anxiety, and suicidality among economics PhD students. The post is based on two studies: (1) this meta-analysis of mental health among PhD students (in all fields, and worldwide), by Emily Satinsky (Massachusetts General Hospital) and co-authors (including Scott Cunningham), published in the journal Scientific Reports (open access); and (2) this forthcoming paper in the Journal of Economic Literature (will be ungated when published, but for now there is an ungated earlier version here), by Valentin Bolotnyy (Stanford University), Matthew Basilico, and Paul Barreira (both Harvard University), on mental health among economics PhD students.
Cunningham's post is difficult to excerpt, since there is a lot of detail in it. However, here is one part:
Students are our in our care and therefore we bear a certain amount of responsibility to these mental health struggles. It is likely that these mental health struggles are endogenous, not only to the students own choices, but to our personal and collective choices as well. They are young, they are working hard, and their struggles are often unknown to the very people, like advisers and friends, who might be in a position to help. The first step is to learn more about the pervasiveness of these problems. I encourage you read these two papers with curiosity and an open mind.
I encourage you to read the whole of Cunningham's substack post, and follow up with the research articles if you are interested. Since Cunningham does such a good job of summarising the two articles, I'm not going to repeat the effort here, other than to note these key statistics from the Bolotnyy et al. paper:
We find that 17.7% of students are experiencing moderate or severe symptoms of depression, 17.6% are experiencing such symptoms of anxiety, and 24.8% are afflicted with one or the other. These rates are 2 to 3 times the national prevalence, but are similar, if not lower than, estimates produced by other studies of graduate student mental health...
The takeaway from that is that the situation is bad in economics, but potentially no worse in economics than in other fields of PhD study. Bolotnyy et al.'s study is based on eight high-ranked PhD programmes (Columbia University, Harvard University, University of Michigan, Massachusetts Institute of Technology (MIT), Princeton University, UC Berkeley, UC San Diego, and Yale University). It would be interesting to see if the situation was as bad at lower-ranked, less selective institutions. It could be better, or it could be worse - it depends on whether positive selection of students on the basis of academic performance negatively selects them on measures of mental health. It also depends on the extent to which the pressures of PhD study cause worse mental health (neither of the cited studies can help with that, since they are cross-sectional and so only show correlations). It also depends on how resilient PhD students are, and how that correlates with academic performance (and neither study addresses resilience).
Clearly, there is more to learn on this topic. It was instructive to learn that, from the Satinsky et al. meta-analysis, there has not been a study of PhD student mental health in New Zealand (at least, not one that measured depression or anxiety), and only a couple in Australia. Given that the New Zealand model of PhD study, with little coursework and students working on a single, large research project (or several, smaller, inter-connected projects), differs substantially from the US model, it may be that there are differences in the consequences for PhD student mental health. Again, mental health among New Zealand PhD students could be better, or it could be worse. Perhaps the coursework component creates a cohort of colleagues that PhD students connect with, who can help them through their studies, improving mental health outcomes. Or, as I said at the outset of this post, perhaps the solitary research project approach is intensely isolating and worsens mental health. Either way, the current pandemic, where international PhD students are commencing their New Zealand PhD while still overseas, distant from supervisors, peers, and more senior PhD students, is going to be incredibly challenging, both in terms of work and mental health. I really worry for the two PhD students who I have who are currently in this position (and hope that the borders open soon to let them get over here into what is a, if not fully supportive, at least less isolating, environment).
Anyway, coming back to the research papers that Cunningham discusses, Bolotnyy et al. make six recommendations that are worth considering:
First, we recommend that department leaders raise awareness of mental health issues among graduate students, raise awareness of available mental health resources, and encourage students to take their mental health and the health of their peers seriously...
Second, department leaders could use their platform to encourage students to invest in building friendships with their peers and to actively avoid prolonged isolation...
Third, improving student-faculty advising relationships can help students identify promising directions for research and bounce back better from setbacks... Some departments have started connecting students early on with faculty who volunteer to advise students in the pre-research years. Such advising relationships, established outside of the dissertation committee structure, may provide students with faculty support that does not come bundled with consequential evaluation...
Fourth, relatedly, we recommend instituting policies that help advisers ensure that students are not falling through the cracks and are progressing with their projects. In programs where the advising structures are more diffuse, field-specific meetings among faculty to discuss student progress could be a good way to do this...
Fifth, with so few students finding meaning in their work, we think it would be useful to actively encourage students to pursue research questions they find meaningful and socially valuable...
Sixth, departments could partner with campus mental health services to experiment with different approaches to mental health treatment. Some departments have experimented with peer support groups and "Let's Talk" programs that make campus mental health professionals available for drop-in hours close to the department...
I absolutely agree on raising awareness, encouraging students to build friendships and peer networks and to engage with staff members other than their supervision team on a regular basis, and building better links between academic programmes and mental health services (this applies at all levels of study). Regular meetings of PhD supervisors might be helpful in some circumstances.
Two of the recommendations (#3; and #5) strike me as a little problematic though. In relation to having non-supervisors "provide students with faculty support that does not come bundled with consequential evaluation", we should recognise that this type of emotional labour is more likely to fall on the shoulders of female faculty members, potentially exacerbating gender differences in workload and research performance. There needs to be mechanisms in place to ensure that doesn't happen, before this recommendation will be feasible to implement. Also, there needs to be clear expectations about professional boundaries, to avoid other problems arising (the Bolotnyy et al. paper has a whole section on sexual harassment, for example).
In relation to pursuing research questions that are meaningful and socially valuable, those research questions are unfortunately often not valued as highly within the field as questions that are less meaningful but more publishable. This is a problem that will be most difficult to address, as PhD students who have aspirations of tenure and/or a position at a high-ranking institution will continue to prefer to study research questions that are publishable in the top journals. It would require the top journals to be more open to other research questions, or are-organisation of the journal publishing model (see Maximilian Kasy's recommendation in this post, for example).
PhD student mental health is clearly a major problem. These studies (and Cunningham's post) have highlighted just how bad the problem is. However, we still need to know more, and to develop (and test) potential solutions.
[HT for the Cunningham post: David McKenzie at Development Impact]
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