How to Make Grad School More Humane

There's a mental-health crisis among graduate students, and it bears particularly hard on those with disabilities. Fixing it requires specific mental-health supports—and broad cultural change.
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Rebecca (all names have been changed) had just started her graduate program studying planetary science, or "rocks in space" as she calls it, at the Massachusetts Institute of Technology. Within two minutes on the phone with her it's obvious that she is, as they say in Cambridge, wicked smart. Being smart wasn't enough, though, to convince her doctors or professors to take her needs seriously when she started getting sick. She says that her symptoms began with abdominal pains that gradually got worse, followed by rectal bleeding. "Who teaches you how to talk about that?"

MIT is "a rough, unpleasant place on a good day," Rebecca says, and as her symptoms worsened, she says she didn't get much help. She went to a campus doctor who kept insisting that she was bleeding from supposed anal sex, even after he found inflammation over 40 centimeters into her intestine. She felt like she couldn't talk to anyone.

Rebecca was concerned. "My adviser was watching me" struggle in class, she says. She was worried they thought she was "just lazy.'" Finally, she went on medical leave, left town, found a new doctor, got the correct diagnosis (colitis), and got treatment. As she improved, she flew back to MIT to meet with her adviser and plot a course back to the program. "I [had] short hair and was very skinny," she says, "and my adviser looks at me and says, 'Oh, you really were sick.'"

Graduate school can be brutal place, even when advisers listen to and support their students in times of need. A single professor can potentially end a graduate student's career, or make a situation so miserable that to remain causes trauma. But graduate students are vulnerable in multiple senses of the word, not just when victimized by predators and other bad actors. They are expected at once to act as pre-professional apprentices while still needing to write papers and get good grades. In many fields, including history, pressures have intensified as funding opportunities diminish and tenure-track jobs are increasingly rare. In 2014, Jill Yesko, then a graduate student in geography, described graduate school as "a broken system that disenfranchises half of all doctoral students and endorses a corrosive academic ecosystem that dishonors scholarship at the expense of what is essentially academic hazing." She's right. Graduate students are asked to work faster, teach more, publish immediately, and somehow keep reading and learning while wrestling with the knowledge that they can do everything right and still end up having to choose between poorly paid adjunct work or leaving the profession that they worked so hard to join.

Now add disability to the mix.

Last year, I spent weeks talking to current and former graduate students with unmet disability-related needs. Some have tried to arrange formal accommodation through their universities' disability resource centers. Others avoided seeking accommodations for a variety of reasons, including the lack of a medical diagnosis, a lack of trust in university bureaucracy, or a sense that disability services were, at best, organized around the needs of undergraduate students—not for those pursuing years-long work in advanced study. In all cases, students spoke about the challenges of trying to learn in an environment that seemed to maximize anxiety by design rather than by accident.

Take Maria, who studies literature at an elite private school. She experienced a traumatic brain injury the same week that she got accepted to graduate school. Over direct message, she says that it took two years to find proper treatment and that she's been "piecing myself back together throughout the program." Since the injury, Maria has experienced "print disability, fatigue, what is essentially ADHD, depression, and [post-traumatic stress disorder], with a few other quirks, like occasional catatonia."

Maria sought accommodation through her university's disability center, but says they basically scoffed at her. "The idea of actually giving me the prescribed accommodation of time-and-a-half on exams was treated as almost a joke, and something we'd only talk about if I didn't manage to pass my [intensive language] exam," she says. "A psych person at campus health services asked me if it wasn't perhaps 'all in your head.' Never mind that I was there for a head injury—so, whether psych or physically scrambled, YES, it was definitely in my head."

Florence, a graduate student who identifies as an "Aspie" (an informal term for what used to be diagnosed as Asperger's Syndrome, now considered part of the autism spectrum), tells me that when she sought accommodations as a master's student over a conflict with a professor, she got called in to a meeting with the professor and the chair of the department. Florence writes over email:

I went to the disabilities department and requested an advocate, as I tend to cry when frustrated and it makes it hard to communicate my points. They refused to send someone, even as a silent observer. So I sat through a meeting with my department chair and professor, both berating me, while I cried for 45 minutes. I've since learned the disability office's refusal to provide an advocate was highly illegal, and I should have pursued it, but I had no idea at the time.

As a Ph.D. student, Florence avoided disability services when it came to course work but did receive help from disability services when adopting a cat as an emotional support animal, despite a university policy against pets. Florence writes: "Once I got to my doctorate, I was very aware that even though accommodations are available, you are not encouraged to take them, and that needing help for your disability can do damage to your reputation."

Suzanne is a veterinary student. She tells me over email that veterinarians and students have a disproportionately high suicide rate. Suzanne isn't currently at risk, but she has had depression since she was 16 and is on the autism spectrum. She says that her campus pays a lot of lip service to mental illness awareness, but that the community isn't truly supportive. "One poignant example," she writes:

The day before my final exams, I was called into a meeting with the beloved class coordinator and the school counselor (whom I had confided in previously). The coordinator proceeded to try to coerce me into withdrawing from the program (despite satisfactory grades and good feedback from hospital clinicians), citing points that made it clear the counselor had disclosed some of our discussions to him without my consent. I was told [the class coordinator] was [making these recommendations] for my own good. I left the meeting in tears, feeling particularly violated by the counselor.

Meanwhile, Suzanne notes that her graduate work is exhausting and unremunerated and says that faculty members just seem to shrug off the mental-health burden it imposes. "A lecturer told us that class and clinical rotations would make us depressed and that we should just 'get over it,'" Suzanne says.

Michelle, a literature student at a public university in the American West, found herself in a department that explicitly prided itself on supporting the mental-health needs of students—but it turns out the department hadn't built a system in which students would feel safe disclosing their needs. "They never seemed to acknowledge how terrifying it can be to go to the head of your department and say, 'Hey, I'm anxious literally all the time and also I'm so stressed out that I want to die and actively think of killing myself like once a month,'" Michelle writes over email. "It was so bad during my second semester that I started cutting myself. Not a single soul at my university knows this, since I showed up to teach and attend class the next day."

Today she is teaching middle school in the Midwest, at a school where "the principal has been immensely supportive of my mental-health issues, to the point that I didn't even have to request the accommodations I needed. It's amazing how much someone actively checking in on you can do for a person who's often too terrified to ask for help."

These examples are not isolated incidents. To my knowledge, we don't have comprehensive data about the rates of disability, broadly construed, in graduate school in this country. Still, there have been a number of major studies on mental health and graduate school, and the results are terrible. A working paper published in November of 2018 by three Harvard University professors based on a survey of 500 graduate students in economics found that econ students were three times as likely as the population average to experience moderate to severe symptoms of depression or anxiety. Eleven percent experienced suicidal ideation. The authors conclude their study with detailed recommendations that any department could enact: They advocate "continuous engagement," by which they mean regular check-ins by mentors with their students. They also want to prioritize responding to sexual harassment (which mostly, the authors find, is perpetrated by graduate students against other students), making coursework more relevant to research, and providing confidential avenues for students to safely give feedback on advising. Most of all, they suggest: "Destigmatize conversations about failures, big and small. Destigmatize getting help."

The Harvard report followed on a study last spring published in Nature Biotechnology that sampled 2,279 graduate students, 90 percent of whom were Ph.D. candidates, across multiple fields from humanities to physics and engineering, representing 26 countries and 234 institutions. The authors found that "graduate students are more than six times as likely to experience depression and anxiety as compared to the general population." It's a "mental health crisis," the authors write, one requiring both specific mental-health supports and broad cultural change.

The people I talked for this story also emphasize cultural change more than constructing new medicalized systems of support. Maria, for example, loves her adviser. "She's worked with me and with my health and abilities," she says. "This has meant looking for situations and assessments that play to my strengths; written over oral [assessments], for example. It's meant patience as I sometimes go for stretches without seeming productive (and beating myself up plenty already), and then accommodating sudden barrages of work from me without breaking stride. Some of it's been blunt talk about what I will have to deal with, with others. What I will have to hide."

That kind of attitude remains rare among faculty. For many mentors, graduate school still functions as a weeding-out process to determine who's fit to join the professoriate and who isn't. That was likely never an acceptable or moral way to run things, but it's certainly no longer sustainable in the current context of academic employment. If most students won't land the professorial jobs of their dreams, graduate school has to become more satisfying, and more healthy, while you're there. Instead, 50 percent of all graduate students drop out of Ph.D. programs. The combination of lack of supports for people with all kinds of disabilities, students who are multiply marginalized by other factors, and the overall punishing culture of academia that causes burnout is driving away smart people who just want to learn at the highest level possible.

Let's end graduate school as boot camp. In her 2014 essay, Yesko described graduate students as victims of "dysfunctional graduate departments, toxic faculty, and the Navy Seal-like brutality of the Ph.D. process." We aren't training Ph.D.s for armed aquatic insertion into hostile territory. We can afford to make our programs humane.

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