EUA Council for Doctoral Education

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Developing an evidence-based approach to supporting the mental health of doctoral candidates

06 December 2018 | Barbara Dooley

Universities need to follow a solution-based approach to adequately address mental health and wellbeing among doctoral candidates. This includes providing appropriate support structures and developing an understanding of the diverse reasons that lead to such challenges for doctoral candidates. EUA-CDE Steering Committee member Barbara Dooley shares her perspective regarding the overall relevance of the topic and how to tackle it.

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.