Rather than a problem, mental health is an opportunity for the scientific community to create healthy and empowering working conditions. Mathias Schroijen tells us how Eurodoc aims to raise awareness and advocate for independent research on mental health among early-career researchers in Europe in order to provide preventive policies and share good practices.
The development of doctoral candidates into autonomous and critical early-career professionals lies at the heart of doctoral training. This development typically takes place in flexible and self-managed working conditions, which ideally encourage them to manage their own individual career development. However, a recent study in Belgium (Leveque et al., 2016 and 2017) has shown worrying figures on the prevalence of mental health problems in doctoral candidates, when compared to a similar cohort of highly educated individuals from the general population. Approximately 40% reported feeling under constant strain, while 30% reported feeling unhappy and depressed. Similar observations have been made at the University of California in the United States (University of California Graduate Student Well-Being Survey 2016) and the University of Leiden in the Netherlands (van der Weijden et al., 2017), with comparable high reports of anxiety and depression. Despite such consistent findings, these results are limited in scope and we do not know how prevalent such issues are in doctoral candidates across Europe, what the exact causes are, and how to tackle these issues effectively.
Mental health is a top priority for the European Council of Doctoral Candidates and Junior Researchers (Eurodoc) and as such we aim to raise awareness of mental health issues, facilitate research funding on mental health issues, train and support early-career researchers, and finally provide policy recommendations and examples of good practices. Two exemplary initiatives are noteworthy from within the Eurodoc network. Firstly, the Polish Association of Doctoral Candidates (KRD) has undertaken the initiative to evaluate mental health among doctoral candidates in Poland using David Goldberg’s General Health Questionnaire (GHQ-28). Secondly, the Association of Italian PhD Candidates and PhDs (ADI) is currently collecting information in collaboration with the psychological consulting centres within the Italian universities.
Preliminary results from KRD confirm that doctoral candidates in Poland feel exposed to high pressure in a competitive environment which requires them to develop very specific, complex, and demanding skills. Between 40% and 50% of all respondents have reported feeling exhausted, overworked and overwhelmed by their responsibilities. Forty-six percent have felt the need to improve their health condition and 34% reported a strongly reduced enjoyment of ordinary daily life. A minority has even reported feeling “worthless” as a person (14%), to have thought about their own death (7%), or to have experienced suicidal thoughts (6%). ADI is currently working on a protocol for a multicentric study to evaluate the mental health conditions of doctoral candidates working in Italy. In addition, they are now trying to raise awareness on mental health issues and to identify possible risk factors for researchers. Several meetings with doctoral candidates, postdoctoral researchers, and the wider academic community are scheduled to take place in the coming months to openly discuss these issues and come up with practical positive solutions.
We can hypothesise a wide array of factors that may individually or collectively lead to the development of mental health issues in doctoral candidates. Examples include a lack of career prospects in academia, the doctoral candidate-supervisor relationship, imposter syndrome, poor institutional support, the publish-or-perish mentality, working conditions, funding pressure, isolation, mobility, lack of social support, high teaching load, and work-life balance. For a better understanding of these risk factors, we will focus on four important challenges which most early-career researchers are confronted with.
A first challenge is the observation that many doctoral candidates feel ill-prepared and highly uncertain when facing the transition in their professional career to the non-academic labour market. Moreover, their training remains primarily focused on an academic career, a career which doctoral candidates themselves continue to desire and often deem as the superior career path when compared to career opportunities outside of academia. A second challenge is the taboo surrounding work-related stress and mental health issues in academia. Doctoral candidates are expected to work independently and to be able to deal with the high demands of academic life. Those who are stressed or facing mental health issues often do not dare to tell anyone because of the potential risk of jeopardising their academic career by being deemed unsuitable for academia. A third challenge is the support needed for doctoral candidates who admit that they are experiencing difficulties. Many institutions have counsellors for students and staff, but most do not have specific counsellors who are trained for the particular issues that doctoral candidates face during their research. Finally, doctoral candidates often struggle with the feeling that, besides their publications, many of their other tasks (lab management, administrative tasks, team management, student guidance, science vulgarization, etc.) often remain poorly recognised.
Factors such as a lack of professional perspective, social isolation, non-supportive working environments, and a lack of recognition are potentially causal factors for the development of mental health issues. However, the problem is that we do not have systematic data to make evidence-based and effective policies. For Eurodoc, our priority is thus to raise awareness and advocate for independent research on mental health issues among doctoral candidates in Europe in order to develop proper solutions and preventive measures. In light of this, we deem it crucial that there are adequate health support structures in place to support doctoral candidates, that doctoral candidates find inspirational leadership and guidance along with satisfactory and constructive work relations, and that doctoral candidates can optimally develop themselves in both their scientific expertise and their career prospects outside of academia.
A supportive network of inspirational mentors and sustainable resources for continuous self-development are likely positive factors in preventing and alleviating mental health issues. We strongly encourage the scientific community to look at mental health as an opportunity instead of a problem. Scientific breakthroughs and major innovations are built on human capital, on individual scientists’ creativity, resilience, perseverance and curiosity. As these qualities require a healthy mind, mental health acts as a barometer for the quality and potential of our scientific work. Actions to better understand and improve mental health allow the scientific community to re-think and re-design the conditions under which science is practised. This is our opportunity to create empowering working conditions in which scientists are able to develop and reach their full potential. Even minor actions can make the difference: actively keep an eye on your colleagues, reach out if you think there are issues, and take care of yourself and each other.
With contributions by Mateusz Kowalczyk (Medical University of Lodz/KRD), Giulia Malaguarnera (University of Catania/ADI), Gareth O’Neill (Leiden University/Eurodoc), and Ewelina Pabjańczyk-Wlazło (Lodz University of Technology/KRD).organisation
All views expressed in these articles are those of the authors and do not necessarily reflect those of EUA Council for Doctoral Education. If you would like to respond to this article by writing your own piece, please see The Doctoral Debate style guidelines and contact the CDE team to pitch your idea.
While questions of mental health and wellbeing are present in society in general, universities have a unique responsibility to protect students, doctoral candidates and staff from the causes of mental health issues and promote their wellbeing. Doctoral candidates, in particular, are at risk as they are under great pressure to succeed, may be enrolled in a programme in a country that is not their own, and may not know where to find help as many resources are addressed to “students”, and not doctoral candidates.
In addition, there is a lack of solid information on the topic and terminology surrounding the issue may be unclear and require a conceptional revamping. This contributes to slow progress in the debate. That is why EUA-CDE has gathered some of the best experts from our community across Europe to talk about mental health and wellbeing in The Doctoral Debate. The authors of our articles have provided explanations, shared perspectives and experiences, as well as recommendations.
Katia Leveque and Anneleen Mortier from Ghent University clear up the conceptional confusion by addressing the difference between mental health and wellbeing, explaining why this distinction is so very important. Barbara Dooley, CDE Steering Committee member, shares perspectives from the institutions regarding the overall relevance of the topic and suggests how to tackle it. Janet Metcalfe and Sarah Nalden from Vitae talk about what is being done in the UK and what other institutions across Europe can learn from this experience. And Mathias Schroijen from Eurodoc shares a view from the side of doctoral candidates and describes the issue from different national contexts in Europe.
At EUA-CDE we feel that it is important to openly discuss this issue and we will be happy to receive feedback on these articles from the CDE community. We are looking forward to your perspectives and experiences and we hope you enjoy and learn from this month of reading on mental health and wellbeing on The Doctoral Debate.Read more
Over the next few weeks, The EUA-CDE Doctoral Debate will focus on the mental health and wellbeing of doctoral students and the importance of addressing this issue from an individual, institutional and societal perspective. Wellbeing and mental health tie in with the traditional focus of EUA-CDE regarding the professionalisation of doctoral education in Europe, in that there is an institutional-level responsibility to provide support and training for early-stage researchers.
Manuela Schmidt and Erika Hansson of Kristianstad University in Sweden propose a student-centred approach to meeting the needs of doctoral students, which will lead to the enhancement of doctoral students’ wellbeing as a long-term goal in order to improve it, as well as better productivity.
To put mental health into context, it is important to start with some key definitions such as mental health, mental disorder and resilience. Resilience is key to navigating the stress and uncertainty that doctoral students can encounter. The following definitions are taken from The Lancet Commission on global mental health and sustainable development:
“Mental health: The capacity of thought, emotion, and behaviour that enables every individual to realise their own potential in relation to their developmental stage, to cope with the normal stresses of life, to study or work productively and fruitfully, and to contribute to their community.
Mental disorder: Disturbances of thought, emotion, behaviour, and relationships with others that lead to substantial suffering and functional impairment in one or more major life activities, as identified in the major classification systems such as the WHO International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders.
Resilience: The capacity of individuals to adapt to adversity or stress, including the capacity to cope with future negative events.”
Epidemiological research worldwide has indicated a concerning growth in the prevalence of mental health issues, particularly among young adults - indicating negative psychosocial, educational and vocational consequences at the individual level, as well as a weighty social and economic cost. This is shown in the work of Patrick McGorry, Professor of Youth Mental Health at the University of Melbourne in Australia and Executive Director of Orygen, The National Centre of Excellence in Youth Mental Health.
Coupled with this is the widespread and increasing prevalence of psychological morbidity among higher education students, representing a neglected public health issue, which holds major implications for campus health services and policy development. Recently there has been an increased focus on the mental health and wellbeing of doctoral students globally with organisations in the UK, the USA and across Europe acknowledging the mental health challenges experienced by graduate research students.
Many universities have well developed services for undergraduates but provide little or no structured information regarding accessing available resources for their doctoral community. Part of the issue with regard to doctoral candidates lies with their status. In some universities, doctoral candidates are considered students. In others they are considered employees with a contract and, in another category, the doctoral candidate is treated as an academic in the institution whilst also completing his or her doctorate. These very differences can lead to confused pathways of care for doctoral candidates when they encounter mental health difficulties.
The very nature of the doctoral experience could increase the risk of psychological distress. For some doctoral candidates this experience includes: poor supervision, conflict with supervisor or supervisory team, financial stress, lack of sleep, poor diet, balancing the need to work and conduct doctoral research, if not funded. Additional pressures include: completing the doctorate within a specified timeframe and external pressures, such as publishing, funding, career prospects, etc. - none of which are going away any time soon.
This is echoed in a recent Vitae report listing the following additional factors affecting postgraduate researchers’ wellbeing: lack of clarity with regard to what is expected as part of the research process, limited feedback on progress and expectations of high achievement and high workloads. It is a combination of risk factors rather than any single risk factor that can result in, or exacerbate, mental health issues among doctoral students.
The following reflection from a doctoral candidate captures many of the issues that published studies report. “The research environment itself can be a negative one, with little or no support for students struggling with mental health issues, particularly depression or anxiety. Even the day-to-day stresses of struggling through a difficult research project is often unsupported by facilities within the department, or even other researchers, and no information regarding accessing available resources within our higher education institutions.”
Doctoral students are very important to the research output of a university system and as such supporting them is key to strategic missions. Therefore, universities need to look beyond risk factors and focus on constructive solutions. To ensure that doctoral students are supported, universities need to take both a top-down and bottom-up, solution-focused approach. At the top, universities need to develop institutional-level structures, policies and practices to provide clarity to all involved in doctoral education.
Research points to the supervisor as key. Supervisor training should include how to identify when a doctoral student is struggling, having a constructive conversation and signposting them to appropriate support. Supervisor training should include not only good practice in supervision and feedback, but also mentoring more broadly on career pathways and where they fit within the organisational structure, areas that many doctoral students struggle with.
At an individual level, doctoral candidates themselves need to be made aware of the signs of mental health difficulties and seek help early to ensure a good outcome. Seeking help and timely intervention have consistently been shown to lead to better outcomes.
At a broader system level, institutions need to provide appropriate training for all relevant staff with roles in the wider mental health support system to understand the needs of doctoral students. Furthermore, institutions need to develop an evidence-based approach by mapping demand and systematically collecting empirical data to understand when and how to support the doctoral community.
World-class research asks for healthy and supportive work environments that allow researchers to flourish. The organisational benefits of high levels of wellbeing and good mental health in employees are well-known: better performance, less turnover, less absenteeism, less presenteeism and more organisational commitment. However, compared to the non-academic sector, universities are lagging far behind in terms of investments in the wellbeing and mental health of their doctoral researchers and academic staff. This lag is unfortunate as the European Union explicitly acknowledges that mental health is a key resource for the EU’s success as a knowledge-based society.
Is this due to a lack of need in academia? When exploring social media, the emerging picture suggests a pressing need: academics provide testimonies of stress, depressions, anxieties, addictions, burnout, suicidal ideation and suicides. According to some, the frame of “a mental health crisis in academia” is warranted.
As a reaction to the increasingly voiced concerns about wellbeing and mental health of academics on social and other media, more and more universities in Europe have put wellbeing on their policy radar, either as a totally new policy objective or as a policy objective in need of higher priority. In several universities, surveys and monitoring devices are set up, and prevention and action plans are developed or extended.
In the light of these recent developments, we call for some caution in the framing of “wellbeing” and “mental health” as these concepts refer to delicate and sensitive issues. When setting up programs, universities mostly use the framing of “wellbeing”. The terminology “mental health” is expressed far less, which might be related to the stigma and taboo surrounding it. Contrary to “mental health”, the use of a broad umbrella concept such as “wellbeing” has shown to ease the mobilisation of a critical mass of management support for initiating and adopting action programs. In addition, it might also ease the acceptance of action programs by those for whom they are developed. As categorising well-meant initiatives under the “wellbeing” umbrella has merits for its mobilising capacities, accurate reflections on term usage is in place. We’ll just initiate a few reflections.
First, in many European countries, the concept of wellbeing has no official definition. Across Europe, the conceptualisation of wellbeing differs. The European Agency for Safety and Health at Work identified as many as 11 different terms in use to describe wellbeing at work. General wellbeing at work might cover physical and mental wellbeing, psychosocial issues and the working environment. At a very high level of generalisation, all conceptualisations of wellbeing refer to an individual’s positive evaluations of his or her life, as it includes positive emotion, engagement, satisfaction, and meaning. Such broad definitions enable the understanding of wellbeing, but offer no clear guidelines for research, policy or action.
Second, as for the concept of mental health, definitions vary depending on cultural differences, subjective assessments, and competing theories and paradigms. Depending on the definition, there is an assumption of a certain level of pathology. Differences in the level of pathology refer to differences in “normal” or “non-clinical” mental health status versus “abnormal”, “pathological” or “(sub-)clinical” ones. Depending on the conceptualisation, another terminology is used to indicate mental health: “distress”, “issues”, “problems”, “disorders”, “illness”, “disease”. One consequence of this lack of agreement on the conceptualisation of mental health, is that the same concept, for example “depression”, might refer to very different levels of pathology, ranging from a single, transient and normal depressed feeling, to a severe, chronic and psychiatrically diagnosed depressive disorder. Needless to say, this might lead to miscommunication, misunderstanding, the hollowing out of concepts and the downplaying of severe emotional pain and suffering as a simple feeling of sadness.
Third, within occupational wellbeing research, researchers have mostly studied job outcomes (e.g. job satisfaction, absenteeism) and health outcomes (e.g. depression, emotional exhaustion) independently. Most studies have focussed on the causes of the outcomes, not on the interrelatedness of the outcomes themselves. Many people assume (often implicitly) that job and health outcomes are highly correlated. For example, many people assume that high job satisfaction is highly and positively linked with general mental health. But existing empirical evidence shows that the correlation is not as strong as usually assumed. As a consequence of the assumption, some organisations wipe out the possibility of mental health problems in their work force, using the argument that everyone is happy with their jobs, as their satisfaction surveys show. Another consequence of some assumptions made about the interrelatedness of outcomes, is that well-meant action programs might succeed in triggering desired effects in one outcome, while simultaneously triggering undesired effects in another outcome. To illustrate: an initiative aimed at reducing absenteeism might be very effective in lowering absenteeism statistics but might simultaneously trigger higher levels of presenteeism in the organisation, especially when underlying problematic working conditions are not adequately addressed.
In sum, universities that aim at efficient and effective management programs that support doctoral researchers and academic staff to flourish, might benefit from thorough reflection on how wellbeing and mental health are explicitly and implicitly conceptualised within their organisation. On top of that and more importantly, they should reflect on the (potential) consequences of these conceptualisations in terms of individual vs organisational responsibility, and in terms of approach. When work stress is reformulated in terms of a pathology or disease, it will trigger a different approach than framed in terms of psychosocial stress. The first will bring clinical psychologists, psychiatrists and medical specialists to the front stage, the latter will bring in human resources managers, job coaches and organisational change managers. The framing of wellbeing and mental health at work is not at all innocent: the concepts are real in their consequences. Nomen est omen.Read more
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