The importance of mental health support for graduate and medical trainees: You are not alone

By Kristin G. Anderson and Jennifer M. Stinson

When I started graduate school, a friend introduced me to the blog Hyperbole and a Half, a series created by comedian/artist/blogger Allie Brosh. Many of her posts are light-hearted, entertaining stories from various stages of her life:

Dog from Hyperbole and a Half blog Alot from Hyperbole and a Half blog Image from "This why I'll never be an adult"(Images above from: “Dog”, “The Alot is better than you at everything”, and “This is why I’ll never be an adult”)

For me, though, some of her most thought-provoking posts address issues related to mental health. Allie has a greater legacy than her cartoons: her readers feel like they are not alone.

Many of Allie’s stories reference, directly or indirectly, heavy topics, like burnout (“This is why I’ll never be an adult”), mood disorders (“Sneaky hate spiral”), social anxiety (“The awkward situation survival guide”), and depression (“Adventures in Depression” and “Depression Part Two”). She makes the subject matter relatable by weaving in humor. Her fans—including graduate school me—echo her experiences and thank her for reflecting their feelings.

Early and often, peers and mentors in graduate school consistently said “this is going to be hard.” I was prepared to feel tired, stressed, and overwhelmed from time to time, but I wasn’t prepared for anxiety, self-doubt, imposter syndrome, burnout, isolation, and depression. A new study from Nagy and colleagues (Nagy et. al. CBE-Life Sciences Education, 2019) found that 49.3% of biomedical graduate students met criteria for a mental health disorder in the past year, which is about twice the rate in the general population (Kessler et. al. Arch Gen Psychiatry, 2005). This reinforces what has been a growing concern in graduate studies: these issues are relatively widespread in biomedical graduate student education and are linked in part to people leaving graduate school.

Nagy et al. found a correlation between the students who experienced at least one bout of anxiety, depression, or another clinically diagnosable mental health concern and those who thought about dropping out. Then, they went on to demonstrate that a current clinical mental health diagnosis (but not a lifetime history of a mental health diagnosis) and functional impairment due to a mental health concern could both predict graduate school burnout. These results—and other studies—paint a concerning (but treatable!) picture of overwhelmed and burned out biomedical graduate students who are silently suffering as they work toward their degrees. Many factors contribute to this trend, including isolation and loneliness (Barreira et al., 2018).

It is crucial to provide support because graduate school—and science in general—is hard. And yet, stigma continues to be a major barrier in receiving adequate support (Evans et al., Nature Biotechnology, 2018). Students generally feel they are unable to be honest with their academic team regarding issues of failure, burnout and mental health (Hunter et al., International Journal of Doctoral Studies, 2016). Typically, students who are seeking mental health treatment actually report lower levels of depression and anxiety than their peers (Barreira et al., 2018), presumably because they have a source of support. Nagy et al. found that graduate program climate and research training environment were significantly associated with both burnout and the severity of depressive symptoms. This presents a clear point of intervention for graduate programs and stresses the importance of creating a departmental culture that actively works to reduce stigma and promote access to care.

Where do those services and supports come from? If you are struggling, or would like more information, here are a few places you can go (please note, these links are specific to the University of Washington and the Seattle region):

  1. Your University Counseling Center. Some universities, like the University of Washington (UW), offer free opportunities to talk confidentially with therapists. Some even offer same day appointments. While some may not be equipped to provide long-term one-on-one services, many have the ability to write referrals for therapists who will accept your insurance.
  2. Your University Mental Health Clinic. Some people may need support with medication, which requires a prescription from a psychiatrist. At UW, the Hall Health Mental Health Clinic provides these services.
  3. Counseling/Therapy Group, geared toward graduate students. These often require an intake appointment, are run by professionals, and are specifically coordinated (e.g. only one person from each graduate program) so that the participants can have privacy and speak openly.
  4. Crisis resources. UW Crisis Clinic (1-866-427-4747). 24-hour crisis line (1-866-4CRISIS). The Trevor Project (1-866-488-7386).
  5. Community-based resources. Sound Mental Health.
  6. In-person workshops. Here is a list of workshops held by UW in the fall of 2019.
  7. Online Resources, including Apps and Podcasts.
  8. Disability resources. Alliance for people with disabilities. The ARC.


Barreira, P., Basilico, M., & Bolotnyy, V. (2018). Graduate student mental health: Lessons from American economics departments (Working paper).

Evans, T.M., Bira, L., Gastelum, J.B., Weiss, L.T., and Vanderford, N.L. (2018) Evidence for a mental health crisis in graduate education. Nature Biotechnology, 36, 282-284.

Hunter, K. H., & Devine, K. (2016). Doctoral students’ emotional exhaustion and intentions to leave academia. International Journal of Doctoral Studies, 11, 35-61.

Kessler et al. “Lifetime prevalence and age of onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.” Arch Gen Psychiatry. 2005. 62(6):593-602.

Nagy et al. “Burnout and mental health problems in biomedical doctoral students.” CBE-Life Sciences Education. 2019. 18(2)

Where to find mental health resources for graduate students? (2018, May 3) Retrieved from