As a PhD student with mental health challenges, I sometimes question whether my experience is the same as my peers. Did they look for a supervisor who understands mental health?  Do they see themselves reflected in resources about ‘caring for your mental health’ and ‘self-care for students’?

Don’t get me wrong, entering a PhD and being me has been remarkably rewarding. I have a supportive environment to explore my ideas, where my strange questions can lead to insightful conversations. I’ve met peers who not only accept and encourage me but challenge my conceptualization of the world and my approach to research. I have a supervisor who sees value in my perspectives and believes in me. When applying to ÐÓ°ÉÔ­´´, I was even exposed to . In essence, it feels like my potential in defining myself as an academic is limitless. While I’m still waiting for this to come crashing down (I’ve heard this happens in second year), I can’t help but think it’s the contrast between the supportive spaces I’ve found and the concessions I’ve had to make that makes my disappointment sting all the more.

At times, it can feel like the very institution of academia doesn’t accept me, and that even with acceptance, inclusion isn’t guaranteed and support is strictly rationed. For example, despite publishing an article on , ÐÓ°ÉÔ­´´â€™s counselling services aren’t set up to provide long-term support – which automatically necessitates that I seek support off campus. In order to pay for therapy, I’ve had to label myself on provincial and school documentation as having a disability (regardless of whether I identify as that). While I’m grateful for the support that’s offered, the process of being forced into a label has sucked.

While writing this, the qualitative researcher in me couldn’t help but see the underlying theme in my experiences – the disconnect between the people and the system. My social and academic environments are ones of support and collaboration, where being me is a strength. How, then, have our institutional processes and policies not caught up?

These systemic barriers probably won’t change anytime soon (or maybe they will, and I’d be thrilled to be wrong here) but here are steps that prospective and current PhD students can take to protect or maintain their mental health based on my own experience:

Prospective students:

1. Include what you need (for your mental health) as a criterion in your search for the perfect supervisor or school.
2. Have open conversations with your potential supervisor about mental health. See if they are open to using different approaches to support you.
3. See if you can speak to a current graduate student about their experience. This can help you get a feel for the lab culture, and if it would be a supportive and inclusive environment.

New students:

1. Get registered with your university accessibility services as quickly as you can. Your disability coordinator can help you navigate OSAP and the NSLSC.
2. Think about moving your health information to Health Services on campus. This can be helpful for coordinating your services and setting up a comprehensive circle of care.
3. Pay attention to when bursaries open and close at your university. There are usually programs or bursaries that are specifically for helping people with disabilities.
4. See if you qualify for any of the awards .
5. Be open with your supervisor. It’s not all sunshine and daisies and sometimes they can suggest strategies to help you cope.
6. Establish your support network prior to entering the program. Your supervisor isn’t your therapist, and it can be easy to cross boundaries and over-share if you don’t have solid supports in place prior to starting the program. Further, I’ve found it hard to connect with peers if they don’t share similar life experiences and have relied on my friends more than ever.

The items in this list came from hours wading through blogs and Reddit treads (which, frankly, are often gloomy) and conversations with other folks who have been there, done that. As such, this isn’t a prescriptive list outlining the steps to success for PhD students with mental health concerns, but rather steps that have been helpful for me so far. I hope these lists might even slightly reduce the amount of labour necessary for our participation in academia. At the heart of it, I write this because, at the end of the day, we belong here.

Mel Edwards is a first year PhD Student in the Spatial Determinants of Health Lab. Her research interests include the use of e-mental health to support underserved populations in rural communities

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It has been an absolute pleasure to work as a part of the Spatial Determinants of Health lab over the past summer. Through the I-CUREUS award, I was able to work with Dr. Paul Peters and an MSc student, Maria Tovar Hidalgo, on a scoping review that examined oral health inequities within rural regions of Canada. The goal of this research was to assess how rurality can affect oral health experiences and outcomes in comparison to urban areas. The research also aims to contribute interventions which have improved poorer oral health outcomes within similar rural communities in countries like Australia, Sweden, and Norway. My work on this project primarily focused on conducting a literature search and extracting subsequent data which would be included in the scoping review.

Before this experience, I had only performed literature reviews for my health science courses and over the summer I was able to familiarize myself with research tools, such as , and gain a practical understanding of how policy research is composed. I quickly learned that every step within the process of synthesizing data is thorough, and that collaboration is key when it comes to being successful within health research.

I was fortunate to have joined a lab in which I was able to not only collaborate with Maria as often as I had but one in which we could discuss our research within lab meetings and troubleshoot any issues or challenges that might have come up within all of our various research projects. Dr. Paul Peters also maintained a lab environment that prioritized the success and wellbeing of all researchers. I was overwhelmed with the number of resources available at the beginning of the summer that would help me navigate health research and the tools he supplied to encourage better mental health management. I am grateful to have had such a supportive lab and mentor as part of my first research experience.

Some interesting things that I learned within my lab were how to adjust and calibrate a search string so that the resulting literature would become increasingly relevant to what I was searching for. As well, I learned about a multitude of comorbidities within oral health, a field that I was not very familiar with before this project, and about the innovative ways in which oral health could be improved, down to the fluoridation of drinking water. I went into this lab with some understanding about how rurality and access to care can affect health outcomes, however, I was challenged to learn about an entirely different field of public health than what I was exposed to within my classes. Through my participation in this research, I familiarized myself with the scope of oral health within the context of effective health policy development.

This experience allowed me to develop my critical thinking, organization, and time management skills. I was also exposed to a variety of research questions when going through published articles which I am inspired to pursue within my later career. I hope to apply these skills within my future in healthcare and to find many more opportunities as enriching as my time within this research lab.

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The approach to health research in ÐÓ°ÉÔ­´´ Health Sciences is multi-disciplinary. While this descriptor is oft-used in higher education I think it’s very apt for our Department. We are a small group who together manage a growing suite of programs that provide training at the undergraduate, professional, and post-graduate levels. Our expertise is incredibly varied and includes genetics, virology, developmental endocrinology as well as social psychology, community health, and data analytics.

To make this work we have adopted a perspective that recognises multiple ways of ‘knowing’ and doing science. Some of our work is in ‘wet labs’ while other work is within communities and with individuals. Sometimes this works, and sometimes we get pushback from outside where others might not understand the nature of health research.

To respond to this I created a short Twitter thread on the “hierarchies of evidence” based on the foundational work of Marc Petticrew and Helen Roberts, .

The fundamental premise of this work is that the method one employs in health research is dependent on what question is being asked.

One wouldn’t run a survey when asking “how innate immune responses are regulated by metabolic programming?” Conversely, one wouldn’t set up a randomized control trial when asking “What physician recruitment and retention strategies have been effective in rural Canada?”

This goes back to the fundamentals of science. Early social science theory was heavily influenced by the physical sciences and was highly positivist (see ).

However, we have transitioned to recognising that society doesn’t operate by a set of definable rules, where there is one ‘right’ answer to social problems.

In health research, we recognise that much of what we do interacts on multiple levels. There is not one way of  about health, health systems, or public health.

Back to our Department and what we’re attempting. I feel that we are a truly unique addition to the Canadian health education landscape. We provide a foundational Bachelor’s of Health Sciences where students are provided in-depth, advanced learning and hands-on research experiences in health sciences, from the social, biomedical and environmental determinants of health perspectives. We augment that with a course-based graduate program that considers health across the science, technology, and policy domains. In addition, we have a growing cohort of research-based graduate students in our MSc and PhD programs.

It comes down to a matter of perspective though. We are firmly grounded in the philosophy that a multidisciplinary and integrative approach is necessary to understand and address health issues.

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This article has some great food for thought regarding university student success, retention, and attraction. In too many universities the focus has been (primarily) on marketing and recruitment, on the administrative side. I’ve seen many studies showing the relative growth of administration costs compared to teaching costs.

“I offer a simple hypothesis in response: Many of our problems — retention, class attendance, educational success, student happiness and well-being, faculty morale — might be ameliorated by ratcheting down the bureaucratic mechanisms and meetings and hiring an army of good teachers. If we replaced half of our administrative staff with classroom teachers, we might actually get a majority of our classes back to 20 or fewer students per teacher. This would be an environment in which teachers and students actually knew each other.”

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