Referring PhD students to counseling is treating the symptoms, not the disease

If we want to support students with mental health issues in academia, we need to do more than just refer them to counseling.

— crazy mama, PhD (@crazygradmama) November 13, 2015

I went off on a bit of rant on Twitter yesterday, starting with the sentence above.  Around about the 7th or 8th tweet, I realized that I needed to work this up into a full-fledged blog post.  So here we go.

Two things set off this rant.  The first was reading the latest in a long line of articles about the mental health problem in grad school.  Don’t get me wrong, it’s a fine article, and the more people talk about this, the better.  However, like many of its predecessors, it focuses on access to counseling and other mental health care as the solution.  That’s absolutely important, and so is emphasizing the message that it’s OK to seek treatment.

But offering counseling and antidepressants is just treating the symptoms.  If my toddler woke up with a dangerously high fever, I would give him Tylenol to bring it down, but I’d also take him to the doctor, where the cause of his fever would be evaluated and treated.  If all the kids at his daycare came down with the same serious illness, the staff would give us all information about how to get them treatment, but they’d also clean the heck out of everything and assess whether their hygiene policies needed changing.

Along those same lines, we need to talk about why anxiety and depression are so prevalent among PhD students.  As the links above describe, graduate school causes mental health issues in many students, and exacerbates existing issues in others.  We need to make sure that those students who are suffering feel comfortable asking for help, but we also need to fix the system that’s causing this psychological epidemic in the first place.

I’m sure there are people out there who think that this is just how a PhD has to be, and sure, pushing yourself to your intellectual limits is always going to be hard.  But don’t you think people would do better—be more productive, produce better work—if the system didn’t function in a way that made them miserable?

The second trigger to my rant was a discussion that took place at a gathering of female postdocs and PhD students in my department.  It was a meeting to chat with last week’s (female) colloquium speaker.  Based on who organized this particular meeting, I suspected that any advice might tend toward the useless kind, but I went anyway.  (There were donuts, what can I say?)

The organizer and the guest of honor were both the kind of postdoc that the department likes to bring in to tell all us PhD students “how to succeed:” people who’ve won an especially prestigious postdoctoral fellowship, the kind that will get their resumes placed at the top of the pile in faculty searches.  These people tend to be extroverted, assertive, even cocky; in grad school, they did “groundbreaking research” and somehow managed to publish a half-dozen first-author papers.  Be like these people, goes the message, and you too can be successful and awesome.

This is the mold.  This is the person the system says you have to be.  There’s an underlying assumption that it’s possible, if you just work hard enough, for everyone to become this person—and that if you don’t, it’s because you didn’t try hard enough.

Which brings me back to why I’m not OK with “make counseling more available and less stigmatized” being presented as the full solution for poor mental health among PhD students.  It relieves the system of the burden of change and puts it on the individual students.  There is something wrong with you, says the system.  Go get that taken care of, and when you’re all fixed up, come back and fit yourself into our mold.  

Let me end with a personal example, in hopes of further clarifying my point.  One of the pieces of advice we always get is to talk to lots of faculty who aren’t your research advisor.  Make yourself seem more awesome.  Cultivate people who can write letters of reference for you in the future.

The problem with this advice isn’t its content.  Networking is an important skill that will serve you well in just about any occupation, and fundamentally, people won’t learn about your research unless you tell them about it.  No, the problem with this advice is that it’s universally delivered from the perspective of a confident, gregarious extrovert: “Just go talk to professors!”

I’m a shy introvert with major social anxiety—it’s incredibly difficult for me to “just go talk” to anyone, much less someone who’s presented as an evaluator and an important part of my career.  Talking to someone—taking up their time—makes me feel like I’m being a huge imposition.  These are my issues to overcome, and they do require real mental health care.

But you know what else would really help?  A system that acknowledges that this is hard for me.  A system that is just the tiniest little bit more encouraging of these kinds of interactions.  That reassured me that I’m not doing something dramatically wrong and weird and awkward when I knock on a professor’s door and ask to chat.  That doesn’t treat every discussion about research as an evaluation of me, designed to make the questioner look good.  And above all, a system that doesn’t assume that I’m a bad researcher just because I don’t fit the mold.