A Discussion on Graduate Student Wellness

Join three Duke experts on student mental health and wellness: Mike Boyce, Ph.D., Associate Professor of Biochemistry and Cell Biology; Yan Li, Psy.D., licensed psychologist and Associate Dean of Graduate Programs; and Nancy Zucker, Ph.D., Professor in Psychiatry and Behavioral Sciences, as they discuss the unique stressors that graduate students face today, the psychosocial components of stress and cultural pressures, and how graduate students can support their own well-being through resilience building and community resources at Duke.

Transcript

Mike
Hi everyone. My name is Mike Boyce, I'm an associate professor of biochemistry and of cell biology in the School of Medicine here at Duke, and I'm joining you today for a discussion on mental health and wellness and the unique stressors that graduate students face. So, joining me are two of my colleagues: Yan Li, who's the Associate Dean of Graduate Programs in The Graduate School, and Nancy Zucker, who is a professor in psychiatry and behavioral sciences, two experts on this topic. Over the past couple of years, Drs. Li and Zucker have held several workshops for faculty and staff in The Graduate School discussing student wellness. I attended one of these workshops and benefited from it. So, Yan and Nancy, I'm really looking forward to this discussion with both of you.

Yan
Thank you for hosting this discussion, Mike.

Nancy
Thanks so much for inviting me, and absolutely.

Mike
My pleasure. Thanks for being here, both of you. Before we get started, maybe we could hear a little bit more from each of you about your experience and work in the sort of student mental health realm. Nancy, maybe you'd like to start.

Nancy
Sure. So, you know, as you mentioned, I'm a professor in, you know, psychiatry and behavioral sciences, but I'm also the Director of Graduate Studies for the Department of Psychology and Neuroscience. And it's kind of been blending those two worlds that has kind of brought me here just watching graduate students struggle with mental health issues and trying to figure out how best to help them. And so entered into lots of discussions about this with Yan, and started thinking about what are some key tools that we can share with the community that might be helpful.

Mike
That's great. Yeah.

Yan
I serve as the Associate Dean of Graduate Programs and Director of University Center for Exemplary Mentoring. I'm also a licensed psychologist with over 20 years of clinical experiences in university mental health. So, before stepping into my current role I served as a staff psychologist at Duke CAPS for over a decade, and also spent three years as the Associate Dean for Student Affairs and Director of Counseling and Psychological Services at Duke Kunshan University. And, at Duke, wellness is such a key pillar of The Graduate School and also the Graduate Student Affairs mission, and we really recognize the student success is not just about academic performance, it's also about well-being, belonging and building a sustainable foundation for long-term personal and professional growth. And Mike, we also need to hear about you and your new role in The Graduate School.

Mike
Yeah. Thank you for bringing that up. One reason I'm participating in this discussion today is that I'm honored to have been selected as the next graduate school Graduate Faculty Fellow. So, this is a fellowship offered by The Graduate School and the Office for Faculty Advancement together that'll give me an opportunity to work closely with graduate school leadership and administration and work on special projects in particular. I'm really excited to participate in events like this as part of that position. Working in the wellness space, I'm also a Director of Graduate Studies, like Nancy, and, you know, sort of helping support students with not just their academic but also well-being concerns is important to me as well and I was really happy to help with this podcast episode for that reason. So, thanks to both of you. I do have a few questions. Maybe I could start off with the first one here. And speaking of being a DGS or Director of Graduate Studies, I think it's so valuable that both of you have both an academic role—as a DGS or a dean, and also a clinical role as a sort of a subject matter expert in the mental health space. And it would be great to hear, you know, your combined perspectives on those two roles from, from the following questions. First, I was going to ask if we could maybe establish a little context for folks who are listening. Why is this even an important conversation in the first place, graduate student mental health? And why is it important to be talking about this now? Maybe Yan, you, if you don't mind starting for the first question?

Yan
Yeah, absolutely. This is such a timely and essential conversation. A growing body of research has highlighted what many in academia always feel: graduate students are facing a mental health crisis. One widely cited study, “Evidence for a Mental Health Crisis in Grad Education,” found that graduate students are over six times more likely to experience depression and anxiety compared to the general population. So, at Duke, two thirds of our graduate students are between the age of 22 and 28, so the majority of them are Gen Z, and they're the first generation of digital natives. They grew up with smartphones and social media as constant companions, which research has linked to increased anxiety and mental health concerns. Most also completed their undergrad education during the height of the COVID-19 pandemic, adding layers of disruption and uncertainty to their academic paths. And so, the 2024 CCAPS (Counseling Center Assessment of Psychological Symptoms) data from the Center for Collegiate Mental Health shows that Duke graduate students top five concerns are academic distress, social anxiety, generalized anxiety, depression, and generalized distress. So, understanding these concerns is critical to providing timely and effective support. And also, a joint survey conducted in December 2023, by The Graduate School and Trinity School, which Nancy, actually, we did this project together, and we reviewed the top stressors, including also career uncertainty, writing pressure, financial strain, academic workload, and family- or partner-related stress. So, those findings are really aligned with the CCAPS data and highlight how academic and personal demands interest to affect graduate students' well-being.

Mike
Wow yeah, such a significant and timely topic. Nancy, did you want to add anything on that particular...?

Nancy
Yeah. I mean, you know, Yan did such a brilliant job of kind of summarizing the immense kind of list of stresses on grad students. I think, you know, one thing that I would give it also is just, kind of mentorship context. You know, when I got my certificate for being 25 years at Duke yesterday, and when I — (Mike: Congratulations!) — Oh, thank you, thank you! When I, you know, when I think about kind of the mentorship I was when I started, the personal boundaries between grad students and faculty were quite different, you just did not bring personal stuff to work, you did not discuss personal stuff. And so, if I believe if my students had struggled with mental health issues, you know, something that was just kind of not paid attention to, and so I feel like the landscape in terms of that has changed dramatically. And so, all the issues that Yan mentioned, while always having been present, are more of a focus of, of kind of a holistic approach to graduate student wellness than they were when I started. So, I think that that's also just important to highlight.

Mike
Certainly, important for those of us who’ve maybe been in these roles for a while to keep that in mind, how it's evolving. That seems like a good segue into the next question that I was going to ask, which is about the challenges that grad students face today. There's academic ones, of course, like there have always been, but there's more than that, as, as both of you just alluded to in your, in your answers to the previous question. And these are not things that can simply be addressed with mindfulness or wellness routines only, I think — not that those aren't necessarily helpful components, but not a silver bullet. So, maybe you could start with you, Nancy. How would you say we could best go about supporting some of these additional needs?

Nancy
Yeah. And I think, you know, one of the things that the current moment is making us reflect on is kind of the meaning of, the meaning and value of science. Right? And, you know, people enter into graduate school because they have something passionate that they want to devote their life to pursuing and to have this kind of feeling that that pursuit is, is not valued, you know, by the community, you know, on the one hand, it could be just, you know, complete existential crisis of profound proportions, but also, it can just be a moment to reflect with humility on how do we do a better job of making people understand what academia is, and how our benefit to society and how do we do a better job of bridging with communities and increasing the impact of our work? So, I think it's just a real moment for meaning and definition, and exploration is a way to just kind of find meaning in the current situation.

Mike
Sounds like those strategies might address the environment that graduate students exist in sort of on a systemic level. Yeah. Yan, anything you wanted to add to that?

Yan
Yeah. So, you know, in graduate school is really a time, a lot of stress to graduate student are going to encounter a lot of stress and also constant changes. So, during this graduate school, it's very easy to feel like the control we once had is slipping away. And so, the structure of academia can feel unpredictable and high stakes for many of our students, and especially international students and first gen students, or those from underrepresented by background. There are real external factors at play, such as visa restrictions, financial insecurity, imposter syndrome, unclear expectations, and limited access to mentorship. And like Nancy mentioned earlier, those are not imagined stressors and those are structural realities. So, acknowledging them is very crucial and essential to prevent students from internalizing those external structure barriers as personal failure of effort or ability. And then at the same time, nurturing a sense of empowerment and have a sense focus on things that they can control. And, and then also, finding, you know, the meaning and the values of why they are here, even at The Graduate School to start with and then keep going back to that, that why and that value is going to be such an important anchor to face the stress, the self-doubt, and then also external, environmental barriers that they cannot control.

Mike
Yeah. Thank you. And I know you sort of just mentioned how external forces or circumstances could disparately impact students who belong to different groups, for example, underrepresented groups. So that's maybe a good entree into my next question. Cultural differences, you know, and that can be defined in many different ways I think, could influence how best to approach wellness, right, for anyone in particular, for grad students, and we have a diverse, group of graduate students here at Duke from all kinds of different cultural backgrounds — half of our graduate students are international, just as one example. And, you know, therefore, perhaps a one size fits all list of resources or approaches is not going to work for all or even most of our students. So maybe Yan, I think it's your turn to start first with this question. Do you want to say a little bit more about how cultural differences influence how we approach wellness for graduate students in particular?
 
Yan
Absolutely. So, for international students from collectivist cultures, which emphasize group goals, interdependence and community over individual desires, there's often a strong emphasis on fulfilling family or societal expectations. So, success is really viewed not just as a personal achievement, but as something that reflects the entire group, family, community, or even country. So as a result, a student's sense of agency may be more relational out of respect for hierarchy, duty and interdependence. So even when support is available, students might quietly endure stress, believing it's their responsibility to manage it alone. So, I come to this not just as an administrator, but as someone who lived it. So, I was a first-generation college student from a humble working-class family and later a Chinese international student. I came to this country for my graduate degree. So back then, wellness, wasn't even on my radar. I was just trying to survive. And I was not kidding. I struggled academically when I first came to this country. I was under constant financial pressure and worked three jobs to cover tuition and living expenses. So, I got a C in my first semester of graduate schoolwork, and I was at risk of being dismissed from the program. I was terrified, what made it worse is a professor told the entire program that I was taking advantage of others because I had borrowed a classmate’s notes and said that I should at least pay them for it. So, as you can imagine, I felt shamed and humiliated and deeply isolated. So, at the time, I assumed it was entirely my fault and that I wasn't smart enough, didn't deserve to study abroad, or I didn't work hard enough. So, I was also the first international student the program ever admitted. And that was back in early 2000s — there wasn't a lot of international students in this country, not from China, for sure, so all this added to my sense of not belonging. So, I didn't have the language support, and that sense of disconnection and helplessness, really kind of gradually eroded me and my confidence and made it difficult to believe that I had the power to change my circumstances. And that took years to rebuild in terms of a sense of confidence and belief in myself. So, I was fortunate to make it through my master program, thanks to the incredible support of my family, friends and a mentor outside of my program who believed in me and stood by me along the way and helped me reconnect with my purpose and inner strength, the values and meanings that why I was here at that time. So that experience really profoundly shaped how I approach graduate student well-being today. I want students to know that what they are feeling is valid. Yes, the system is complex. This society is complex and can be harsh, but they are not alone. So, we need to acknowledge the real structural challenges students face. That's what I think.
 
Mike
Wow, thank you so much for being so open about your own experience and challenges. It really makes your current accomplishments even more impressive than I already thought they were. It also occurs to me that, I mean, everything you just said is so important for graduate students to hear, but also for faculty to hear. I think, you know, often faculty, it doesn't occur to them, or perhaps they're too busy to take a moment to realize that students might be facing the kinds of circumstances that you just described. So, thank you so much for that. Nancy, would you like to add anything on the topic of cultural differences and wellness?

Nancy
No, just wonderment at Yan's vulnerability and strength, and I just think that that's just such a beautiful thing to share. I agree with you, Mike, about the importance of sharing that story and just emphasizing the importance of us being willing to hear the narratives of our students. Right, so that they really feel seen and understood to increase that sense of connection that Yan mentioned was essential for getting through that period.

Mike
So true. Yeah. Well said, thank you. Next question for you first, Yan. What would you say is the most important piece of advice that you would give to graduate students who are interested in improving their resilience, stress tolerance, mental wellness?

Yan
Yeah. So, to me, I think know what truly matters to the students, to you, to, you know, for us in terms of values. So, when we are clear on our values it becomes so much easier to stay grounded during difficult times and so also, graduate students, I really hope you invest in yourself and get to know your strengths. Make your decisions based on your values, not fear. And so, when the external noise starts to overwhelm you, pause and ask, do I really want to spend my precious time and energy on this? Or would I rather focus on what truly matters, which is family, community, health, learning, growth, or whatever that is important.

Mike
Thank you. Nancy?

Nancy
I love that answer. And I think I would say, you know, to work on your sense of connection with others and, you know, I think that we underestimate the value of accompanying people, which is a term that I got from... I've been finishing up David Brooks’s ‘How to Get to Know a Person,’ which is just a great, great book. And he mentions kind of this value of just accompanying, whereas, you know, there's people in our lives that we, you know, we interact with on what feels like more superficial levels every day. You know, it could be our lab mates, it could be the person whose parking spot is next to yours, and that gradually kind of, you know, day by day, you're getting to know these people, their habits, their interests, and to begin and to take some risks about asking the people around you questions that help you get to know them better and to know their story and their why, and to just really increase the depth of these connections in ways that feel safe for you personally, but that just make you feel more connected in the various groups in which you're a part of.

Mike
Thank you. I love both of those answers. I'm going to offer one additional one, just maybe in closing. So, I've been a faculty member working with grad students for more than 12 years and a DGS for about five now, and I feel like a common mistake especially that new graduate students make I would say is not asking for help when they should, or not as soon as they should. This is not only restricted to the topic of mental health, you know, it could apply to academia or academics rather, or other realms. But I think it's equally applicable to wellness, physical, mental health. You know, there's a lot of good people at Duke, and resources to support students when there are challenges, but they don't necessarily come and knock on your door. Sometimes it's necessary to take the first step and ask for help from somebody that you trust. Maybe it helps some people to hear that, in my opinion, you know, as somebody who is admitting and mentoring and graduating students that I think they should ask for help more often and sooner. I think that's what faculty and staff who want to help graduate students would prefer. So, if you can, don't be afraid to do that.

Nancy
Yeah, I love that.

Mike
That is a wonderful thought to close on, I think. So, with that, I think I'd like to thank both of you for this discussion. As we said, such an important and also timely topic. Really appreciate your insights from both of you. Just a reminder to people listening, graduate students listening, you can access an updated list of wellness resources on The Graduate School’s website. To do that, you can go to gradschool.duke.edu/wellness, or you can reach out to Graduate Student Affairs (GSA) or Yan Li by emailing grad-gsa@duke.edu. Thank you for listening.