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University campuses are hotbeds of mental health concerns, including among graduate students. But the demand for counseling services often outstrips capacity, according to a 2018 report.

At the University of North Carolina (UNC) in Chapel Hill, students seeking mental health support are frequently referred to providers off campus. “It’s not that they can’t get treatment; they certainly can. … But it’s also not easy to set up,” says Jean Cook, an associate dean of graduate education at UNC who oversees the university’s biological and biomedical sciences Ph.D. program. Students have to arrange transportation, and for grad students there’s an added layer of complexity because they may have to explain why they need to take multiple hours out of their day to travel to an appointment off campus, she adds.

To get around that issue and to provide more specialized help for graduate students, Cook helped spearhead a novel solution: In 2017, UNC’s medical school hired Alli Schad—a mental health counselor who is entirely dedicated to serving biomedical Ph.D. students and medical students. At first, administrators thought that they’d see a surge of pent up need that would taper off over the course of a few months, Cook says. But the demand didn’t subside, so in April the school hired a second counselor.

Science Careers spoke with Schad about what her job entails and what she’s learned about the mental health needs of Ph.D. students. This interview has been edited for clarity and brevity.

Jean Cook, PhD
Jean Cook, PhD, Associate Dean for Graduate Education, Professor of Biochemistry & Biophysics and Pharmacology

Q: What are some of the more common mental health issues that you see?

A: I work a lot with students who are experiencing anxiety and depression, as well as students who are concerned about their peers’ mental health and how to support them. When I started the job, I did a needs assessment—which involved surveying our biomedical Ph.D. students about their issues and what kind of support they wanted—and found that, of the 195 who responded, 56% of our students were experiencing anxiety and 59% were suffering from depression.

I haven’t taken a look at the top reasons students come in, but I can tell you about certain themes that come up. One is concerns with PIs [principal investigators]—for instance, how to deal with different personalities and how to navigate expectations, set expectations, or clarify expectations.

Grad school can be challenging because it’s so different from the undergraduate experience. When you’re an undergrad, the path is really laid out for you; it’s clear what you have to do next to meet your goals. When you embark on a graduate program, it’s a lot more ambiguous and students sometimes struggle because they don’t have a set timeline.

Another big one involves learning how to navigate having a professional life and a personal life. There’s this implicit or explicit notion in academia that you must be working all the time. It’s not uncommon for students to be in the lab 60 hours a week, but it’s important to be able to take a break. They’re not automatons; they’re not just data producing machines. They’re human beings. And there’s so much more to life than work.

What I tell them is: When we take time to address other parts of our life that feed us—that bring us joy, that bring us contentment, that bring us a sense of peace—we can more fully show up for work, and we can be more OK with working when we’re there. I’m a huge fan of being able to hit the pause button and attend to other things that are important in your life. I think it’s absolutely vital.

Q: Why do you think it’s helpful to have someone in your position—someone who is embedded within a graduate program?

A: One reason is accessibility. We were intentional about putting my office in a location that’s very convenient to students, so they can just pop in, and it doesn’t take a lot of extra time away from their day. I think that makes a big difference.

I’m also really familiar with the program. I know what students are experiencing at different points of their education, and what the main triggers are for stress. A generalist provider might have amazing counseling skills, but they might not understand the demands of grad school or where Ph.D. students can go to find extra help. For instance, if a student is grappling with what career they want to pursue, I’ll point them to the office of graduate education’s career resources; someone else might not know they exist.

I’d also say: Why not invest in people who are admitted to a program? When students are healthier mentally, they’re more likely to finish their program and to engage with their work and be more productive. I would dare to say that, in the end, hiring someone like me would probably save a program money.

Q: Some students may be hesitant to see a counselor because of potential stigma. Do students ever worry about seeking help from someone who is in their building, or who they might otherwise see at work? Is that ever awkward?

A: My office is tucked away in a little spot where people essentially won’t be outed—they won’t feel as if they’re seen; we were very careful about that. At the same time, people know me through things other than individual counseling, such as leading workshops and meeting with faculty and staff. When I walk down the hall, students almost always say hi. But of course, the work that I do is confidential, and it’s important that it remains confidential. So if students avoid eye contact, which sometimes they do, that’s totally OK too. It’s up to them.

Q: What advice do you have for readers who might be on the fence about whether they should go see a counselor, who aren’t sure whether their particular issue is serious enough to merit seeking outside help?

A: If you think maybe you should see a counselor, go ahead and see a counselor. Give it a chance and see if it’s a good fit. There’s really nothing to lose in that, and it’s better than suffering through something alone.

Mental health has been stigmatized. But one thing that I have found helpful is when people go back to their labs after meeting with me and talk to other people about it. And then there’s this snowball effect, where their lab mates come and meet with me to seek support. I think that’s helpful for changing the culture of addressing mental health.

Q: You mentioned that you meet with faculty members as well. What do you discuss with them?

A: Part of my job is to advocate on behalf of student mental health. Sometimes it takes an outsider to bring awareness to see what’s happening within one’s home. And I have been welcomed at the table to provide feedback, as well as to make suggestions.

When we think about supporting student mental health, it’s important to not just put the burden on the student and say there’s something wrong with your mental health; we’ll give you the support to address it. That’s great—but it’s also important to think about the culture that we’re perpetuating. Our mental health isn’t just something in and of us—it comes from the environment we’re in and the experiences that we have.

Having conversations is a good way to change culture. For instance, the high work demands that are part of science have been long standing, and they speak very much to the dedication of scientists. But I also wonder: At what cost? Part of my job is to open up conversations about those kinds of things, to ask, “Do we have to perpetuate a culture that negatively impacts the mental health of people within the system? Or is it possible to make small changes to better support people?”

Story courtsey of Katie Langin, the associate editor for Science Careers. July 11, 2019.