Opening the Dialogue on Mental Health in Grad School for MIAW

Inside Higher Ed's GradHacker blog posted about mental health yesterday in response to Mental Illness Awareness Week (MIAW).  Turley, who posted the blog, stated,

"I think that mental health issues are the biggest barriers to success among graduate students."

I have to agree.  I've stated on here numerous times that by the time we get to grad school, we are pretty much intellectually equal.  Time management and stress-management are the areas which either sink us or let us have success.  This is particularly true in times of high-stress such as comps!

I thought the post was well-done and brought up some important suggestions worthy of review.  And, since it is, MIAW and a large portion of this blog is devoted to helping those dealing with mental illness in graduate school, I thought I would tie this all together with a post about dialogue.

The suggestions Inside Higher Ed offered were mainly about dialogue.  I think this is an important point of note.  Why?  Well, as I posted about in "How to Talk to People with Mental Illness", a large part of the "puzzle" of "dealing" with the problems associated with mental illness are associated with stigma and a lack of awareness about resources.  I have been very open with my own struggles with bipolar disorder and how it has been the biggest challenge I have faced in grad school.  I have tried to show that most people deal with mental illness or face hardships associated with stress or anxiety in grad school whether it be prior to comps or specifically during the comps process.  Likewise, because I am a survivor of sexual assault and have also tried to be open about this, I have talked about the importance of being aware of the process of dealing with survivors and what comes "next" in the process of healing.  Most importantly, I have tried to open the dialogue on here and twitter in hopes that people would realize they aren't alone.  This was my most popular post this year.

I think people are starting to become aware on the blogosphere and on twitter of the reality of how prevalent mental illness is in grad school.  As I've said before, it's rather important to put this all into perspective.  I can think of few people who haven't seen a counselor.  And, in my opinion, most people who haven't seen one here, probably could have benefitted from seeing one at one time or another.  Whether it is just a "rough patch" or a legitimate disorder that needs to be diagnosed, the "treatment" is the same.  Thus, it doesn't matter what we call it.  Everybody's got something.  That's a thing I think we should emphasize.  While I deal with sometimes unique situations due to OCD, PTSD, and bipolar disorder, most of what I have been through is pretty relatable and standard grad school "fare" that is associated with stress and anxiety that MOST will experience in their time here.

That's why the GradHacker article is a good one, I think. It recommends three things:

1. "Graduate departments need to openly acknowledge the problem."2. "Academic advisors should receive training on preventing, recognizing, and addressing mental health issues in their students (and themselves too!)."3. "Graduate programs should offer (or even require) courses or workshops that teach yoga and mindfulness techniques."

Starting with number 1, I agree.  My department is not awful about this but there have been teachable moments here that I think have gone undiscussed.  In two instances, a grad student basically was a danger to themselves and another person.  I was the target of such a situation when a student basically became obsessed with me, stalked me, and then threatened to hurt themselves when I refused to help them do their homework. The student was eventually asked to leave the program for poor performance and the DGS reached out to this person.  He was more than helpful suggesting resources but the student either did not pursue them or did not get the preferred results.  In another instance, another student stalked a fellow cohort member, was a danger to herself, and the DGS admitted to WALKING her over to a hold.  Again, good for him.  He does look out for us.  However, in both instances, no more further discussion was called for.  These were moments the administration of the department could have used to bring us together, offer up resources, and possibly bring in a person from mental health to have a more open discussion.  Still, at least the administration hasn't ignored the problem here and is more than willing to LISTEN and help.  That's huge.

Number 2 is something I feel strongly about as a future academic and as a current grad student.  I do not doubt that my advisor is one of the best ones here as far as helping with this problem.  As I posted here, she has taken a personal interest in the unique problems facing female students trying to balance it all - school, life, and society's conflicting expectations. If I went to her looking for resources, I bet she would be able to help and would actively try.  However, I know others have not received the same level of support from other advisors or in other departments.  When a guy I was dating awhile ago admitted that the lack of sleep due to terrible lab hours was making him feel completely out of touch with reality, his advisor basically told him to suck it up.  We've talked since he graduated and got a job with a much better work-life-balance and he said that the last year here was the worst year of his life thus far.  The strangeness of being in a foreign country, having no time to even sleep or eat, and having no friends took its toll.  He now sees a therapist and is feeling much better.

I have talked about the need to be aware of resources for both general stress and anxiety and for sexual assault crisis.  We are faced with problems that our students bring us even as grad students.  I make myself aware of the mental health and counseling resources on campus as well as the sexual assault crisis resources.  This particular school has EXCELLENT resources.  If I was advising grad students in the first semester of grad school or teaching an introductory seminar, I would like start that first seminar or meeting off with a general overview of what stress is like in grad school, that it is "the norm" and that how you deal with it is what matters.  I wish more people did this.  The more open we are about the problem - not just in closed-door settings - the more likely we are to solve the problem.

In regards to number 3, I agree with the idea of offering mental health seminars or cohort meetings for first year grad students.  This is proactive.  If a counselor was brought in once every other week for drop-in meetings and open discussions with a cohort in a conference room somewhere, good techniques could be gained in dealing with stress and anxiety.  Likewise, students would not feel as isolated.  Eventually, if you manage to get through semester one, you will realize that everyone is dealing with the same damn thing.  But you have to get there first!

The counseling and mental health centers on campus offer a variety of stress-mangement, sexaul assault recovery, and mindfulness resorces here that I think are very valuable.  However, few are grad-student specific.  Because I am aware of stigma and the perceptions of undergraduates as well as my age, I am reluctant to join any group that is not grad-student specific. It would be a conflict of interest to have a student or future student in there.  But hey, at least some grad-specific things exist and there are sexual assault survivor groups, which is more than I can say for my undergraduate school.  And, there, everything cost a lot of money.  Here, 90% of these resources are free and if they aren't, they take insurance.  Indiana did not take any form of insurance, which was a huge barrier to poor grad students seeking treatment, I'm sure.

All in all, I look forward to having more dialogue on this blog in the future (in the comments) and on twitter.

Big takeaways that I think we should focus on is that we need to provide resources to students before things get hairy.  Provide the resources to deal with stress and anxiety first rather than just react to the problem.  And as future academics or current academics, we should be aware of what resources are available and work actively to smash stigma.

Sexual Assault: as a research topic and as a practical discussion

I usually stick to a few key topics around here: academia, mental health, and bikes.

But today, things are going to be a bit different because I can't avoid talking about the inherent need to discuss rape and sexual assault a it's implications in our society.

Why?  Well, most importantly, I study the way that bureaucracies deal with sexual assault.  Secondly, I've actually had to help a student make a referral about a sexual assault my first year here.  Third, it's a huge problem in society and one that has affected me personally.

A recent discussion started on a blog I frequent.Jezebel ran a story about Whoopi Goldberg and Serena Williams's misguided comments about the Stubbenville case.  It just shows how crazy rape culture because women are parroting this dialogue.  Rape effects women unfortunately all too often.  Vassar College has some important statistics about the prevalence of rape among college-aged women.  By college, 1 in 4 women has been sexually assaulted.  I was one of them so, yes, I have a horse in this fight.

Let me define what this means. Rape and sexual assault are basically ALL situations where consent was not had and sexual advances were made.  Assault is a wider definition than rape and covers more bases but, essentially, it's advances without consent either way.  There is no "rape rape", there is no "legitimate rape".  There is just rape.  No consent = rape.  Why does this seem to be so hard for people to understand?

There are two main problems that I have with Goldberg and Williams's reasoning.

1. The normative "should have". The "women should protect themselves by no dressing provocatively and drinking too much" idea of covering your drink and altering your behavior to stay safe!  These women alleged that the victim in question should have better protected herself.  It's something that is said generally, but especially of college-aged women who are "date raped".  This means drinking, roofies, and being assaulted by a person you know, generally.  There are two big problems with this line of reasoning.  The first is that when you trust people, you tend to let them in and you don't expect them to, I don't know, rape you?  And if that person wants to hurt you, they will likely do it - regardless of "precautions".

There is another problem with the "protection" aspect.  Victims tend to blame themselves.  They don't need victim blaming.  Do you NOT think that this victims has played the decisions in her mind over and over and over again regarding that night?  She likely has.  And, despite taking any other precautions, these guys would have either found a way to hurt her in a different manner or would have hurt someone else.  The thing is, if someone wants to hurt you they will.  The self-blaming feelings after rape are awful to deal with.  The student in question that came to me was feeling all of the same.  A friend took advantage of her at a party and she wasn't sure where to go.  Two weeks after the fact, she broke down and told me this was why her last paper was awful.  I directed her to the very well-equipped sexual violence response center on campus but I knew how she felt.  The evidence was gone by then.  People would ask her why she had waited, why she had drank so much, and criticized even what she was wearing.  All I could do was hand her resources and be as supportive as I could without crossing that instructor-student line.  I tried to be compassionate above all.

What happened to me was far less-intense but similar.  A friend hurt me.  I was younger than my student and younger than the person in question.  It was reported to school officials but they did nothing.  I never told my parents the whole story out of shame.  I blamed myself for not "doing more" but it happened at school in a situation where I was sure I would get detention if I left.  I didn't want to talk to anyone about it for a long time and didn't even have the words to describe it because I was too young to really have that vocabulary.  The Stubbenville victim is a child.  She faces similar problems.  Blaming her for "not doing enough" only makes the situation worse.


2. Putting the onus on women excuses men from their own guilt.  Going back to those Vassar numbers, 84% of men that actually committed rape (most of it was actually date rape, remember) claimed it wasn't.  What does this tell us?  Well a couple of things.  The first is that people, in general, don't understand what constitutes rape or sexual assault.  We tell women how to avoid rape but we never tell men how to avoid RAPING women.

I will never forget talking to a man from RWAMREC, the Rwandan Men's Resource Center, a non-profit that educates men AND women in Rwanda about the roles involved in sexual violence and encourages men to step up and be masculine in positive ways.  Basically, they have a campaign that says men need to recognize what rape is and to stop when consent isn't there.  I oversaw a number of meetings and talked to a number of Rwandan bureaucrats at the center charged with policing sexual and domestic violence reports.  The number one misconception found among average people and bureaucrats was simply their lack of knowledge about what WAS rape.  These people were well-meaning but facing the exact same problems we do here in the U.S.   Was it "rape-rape" or what?  My conclusion was that these issues were leading to bureaucratic discretion being unintentionally used to thwart the intended way of implementation and enforcement of the Gender-Based Violence Law passed by the Parliament years before.  Rwanda is making great strides in this aspect but it faces the global problems of stigma.

A similar organization in the United States also deals with this problem.  Men Can Stop Rape also gives tools to educate people on what constitutes rape and teaches men about consent.  Rape culture hurts men AND women.  The problem won't be solved until we educate everyone.


So, how does this affect what I do on a daily basis?

Well, it affects my students - male and female - as I said before.  It doesn't help women because they end up getting assaulted on a regular basis on college campuses.  It doesn't help men because it doesn't inform them of what constitutes rape.  Don't take this to mean that I think all men are prone to raping or hurting women.  Absolutely not.  But when you live in a culture where it's considered okay to have sex with a totally incapacitated person despite that meaning that consent no longer exists, it means we aren't doing enough to educate people about what rape is.  And college, based on culture, parties, etc, seems like a place ripe for this sort of misconception to cause problems.  Sexual assault has serious consequences far beyond the immediate.  PTSD, depression, and panic attacks are common with survivors.  Reliving that experience is common.  That can lead to students dropping out, doing poorly, or suffering unnecessarily.  We need to improve mental health resources on all campuses.  My undergrad did a pretty poor job of coping with sexual assaults.  I can gladly say that my current place of study has made HUGE strides to deal with the problem.  It's nowhere near perfect but the administration has been very adamant about dedicating resources and personnel to address the problem.


So, think about how this matters and what you can do to help?
1. Be educated about what constitutes rape.
2. Don't perpetrate myths and when you see them - speak out.  Especially you guys out there.  When men get involved, it makes the message of what rape is clearer to men in your social circle and sets a good example for future generations of guys.  Be a trend setter and get your hands dirty, ladies and gents.  Don't let people think this is okay.
3. If a student or friend comes to you, know about the resources available.  Be supportive but don't make demands about what they should do.  I.E. if they don't want to go to the authorities, the best thing you can do is give them their options and support whatever choice.  Legal recourse is a really scary matter and isn't the right choice for everyone at that moment.  Remember, you aren't the one who was assaulted so you can't know how you would feel in that instance.  Things are not simple.
4. Press for more resources and education on campus. 
5. Get involved with feminist organizations that pursue similar goals.  Volunteer at the rape crisis center, a women's shelter, or participate in the Vagina Monologues to raise awareness.
6. Be mindful of how your words affect others in both positive and negative ways.  Don't make rape jokes.  Don't assume things about victims or blame them.  Realize that if you are surrounded by 4 women, one of them has probably been the victim of an assault.  Your words carry weight.
7.  Small things make a big difference.  One defense of a Stubbenville victim or someone similar may make my day and make me feel like I can go on to share my story with others.  It has only been through the kindness and acceptance of others that I have been able to find some peace and confidence in relating my experience to others.  Sharing experiences helps others.  Not everyone can do it and it's not something everyone will necessarily want to do but small statements of support, even indirectly, give me a lot of hope for the future.

When You Get Hit with A Dissertation Topic

So, I go to my advisor's office with a paper idea for both publication and for her class this semester that she has indicated is a really good idea.  It's about gun control, which is something political scientists rarely ever tackle.  It's a comparison across states.  She tells me that's good, but that she doesn't want me to do that.  She wants me to choose a policy area that I will do my dissertation on and do a comparative study.

Ummm... wow.

So, I'm a second year.  She says I should decide early and then make it work.  So, I go home and cry.  Why would she put this pressure on me now?  It's too early.  She even admitted she hasn't told anyone else this, just me.  Because she wants to push me and feels like I have potential to figure it out now and just "do" it.

Fuck.

I don't know what to do.  I went in circles all Friday and Saturday.  There were tears.  I screamed into a pillow.  I ingested an entire bottle of wine and then set out the next morning to go to a local coffee shop just to sit and watch a blank screen until I found something.  The problem was that there was NO seating anywhere except those damn barstools that my 5' frame cannot cope with.  I went to the second hope and it was randomly closed.  Fuckity fuck.  I drove all around town to find something, feeling the whole time that the world was against me.

I was terrified until I had an idea.  I ran to the library like my legs were on fire.  No one has written on this - no one.  It's perfect, right?  And I can get TWO papers out of this because it qualifies for another class, too.  Yes!

Now I can just hope she doesn't shoot it down.  It would help me with grant applications for Canadian studies, too.  It's just hard.  And now I'm on an upswing mood-wise.  It frustrates me to no end that anytime I can be this creative, I am on a mood upswing.  Now, I'm not sleeping and am working nose to the grindstone all day.  Seeing the shrink tomorrow in hopes that I can adjust my meds and get back to where I need to be.

Now I know why people with mood disorders are artists, great thinkers, and inventors. I am so, so creative when I am hypomanic. And it leaves me with little incentive to control it because I always feel great until the crash.  I've had enough now, though, that I am terrified of them and want to control that mood.  That means tuckering myself out exercising, forcing myself to eat right, and taking meds that knock me out in hopes I get to sleep.  It needs to stop!

How to Talk to People with Mental Illness

Okay, another soap box post.

A favorite blog of mine has a set of posts entitled "social minefield".  I think this would appropriately be put underneath such a title.  Why does it matter?  Well, at least half of the grad students I have known suffer from mental illness.  I am one of them.  I was diagnosed with unipolar depression at age 19 and OCD shortly after.  I was diagnosed my first year of grad school with bipolar II, which wasn't a surprise.  I have a history of it on my mother's side of the family and while it sucks, I doubt you would really ever notice.  I'm pretty stable.  Copious amount of therapy and the appropriate regimen of meds has led me to lead a pretty normal life.

The other reason that this matters?  Students, just like normal people, have mental illnesses.  Plenty of them do.  They probably won't tell you that they have them, but you should be sensitive to the needs of your students.  In fact, being diagnosed with a mood disorder in your late teens/early 20s is very likely.  This is the time of frontal lobe development and the time when you are most likely to see this occur.  My diagnosis at age 23 and my symptoms, which appeared up to a year earlier, was textbook.  You may see students also exhibiting strange behavior, a  lack of concentration, or saying that they are completely stressed. Tell them that it is normal and refer them to a stress relief center on campus.  Most colleges have these sorts of groups on campus.  Mine has them almost every day of the week - for free.  Others, like my undergrad, charge a nominal fee and have regular meeting times.  You don't have to say, "I think you have a mental illness" because they may just be overwhelmed and lack study skills, but especially if they have had a recent loss or are dealing with other issues and confide in you about this, know the resources.

The thing I stress most, however, is that you don't offend people.  You see, people like myself have mental illnesses.  Yes, normal, productive members of society can suffer.  You may make jokes about "being OCD" or may make fun of me for freaking out over a door not being locked properly.  It's one ritual I may always have.  It's painful for me and I don't need an audience.  I legitimately believe that things will burn down when I don't lock the door properly.  Yes, it sounds crazy - because it really is - but I have no control over these thoughts.  My brain just likes to screw with me sometimes.  Don't make jokes about self-harm, eating disorders, or how you want to kill yourself.  People who have been there or have been personally effected by suicide don't like it.  My sister saw two suicides and one attempt within her first year of college.  She really gets upset by these jokes, despite not suffering from a mental illness.

Why does this matter?  Well, there are several reasons:
1. People who have suffered and are back "on track" and in therapy, taking their meds, exercising, etc to help themselves may find themselves feeling badly about taking their meds and doing the things that help.  Stigma can be a powerful barrier to treatment.
2. People who have a mental illness should feel safe.  They shouldn't be made to feel ashamed.  Part of the problem with mental illness is that it IS stigmatized.  You can work to change that by making every space a safe space.
3. You never know who has been effected by mental illness - either by their own struggles or by those of others.  I am very effected by not only my own contemplation of suicide but also the multiple attempts of people around me which left me reeling.  I never attempted and never ever had a plan, but the thought that there was no hope was all around.  Many people have felt that way once.  Trivializing it doesn't help.  So, be careful always.  You don't know who is listening.

How do I improve the situation?
1. Don't trivialize the struggles of mental illness.  Being OCD is not like an episode of Monk.  Cutting yourself is not just something emo kids do.  Eating disorders are no something you wish you had.  You aren't clinically depressed because you had a shitty day.
2. If someone has a mental illness, be supportive, but don't assume anything.  They will tell you what they are comfortable telling you.  Don't assume that they are somehow "crazy" or "fragile" unless they tell you.  I am a pretty normal human being.  I get A's.  I study just as hard as everyone else.  I deal with some trials and tribulations, but I don't ask for sympathy.  I learned something when I case managed for Medicaid.  You need to give empathy, not sympathy.  This is true here.
3. If a student or colleague comes to you, be aware of the resources available.  Don't say, "I think you need to see someone."  Say instead, "I know stress can be overwhelming.  Have you tried these stress relief workshops?  I hear they really work."  If you are talking to a friend and really care about them, you can offer to go with them to the stress relief thing or agree to hold their hand while they wait for a therapist.  Be aware of what is there, share it in a supportive and non-judgmental manner, and then let the person do what they will with it.  Empathize.  Don't judge.
4. Be aware that mental illness can be crippling and it is time consuming to take care of - just like any other illness.  I work on it all the effing time.  That said, it's not any different than having a physical illness.  I have several other chronic conditions that are pretty bad to deal with and they are very similar to mental illness as far as coping goes.  Most people have dealt with this sort of condition at least once in their life.  Think of how you felt and how you wanted to be treated and do unto others as you wanted to have done to you.

As an academic - hell, as someone who comes into contact with people - you should be aware of mental illness.  People have the ability to change stigma.  Just as was done with diseases like breast cancer and AIDS  in the past, we can help bring this to the forefront.  It's just especially important because of the age of students you deal with and the fact that academics have a higher incidence of mental illness than the general population.

Just some food for thought.