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Health and Medicine

Carolina leads study on support needs for diverse student population

Beka Layton, Alli Schad and UNC School of Medicine colleagues published a study in eLife on mental health disparities among biomedical graduate and medical students from historically excluded groups.

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For several years, university professional development experts have raised concerns about the mental health of students, trainees and staff across universities. The COVID-19 pandemic and a period of heightened reckoning and protests about systemic racism in the United States in 2020 have exacerbated these concerns.

To gain a better understanding, UNC School of Medicine researchers used annual survey data from hundreds of biomedical graduate and medical students at UNC-Chapel Hill to focus on measures of depression, anxiety, hazardous alcohol use, problems related to substance use, and suicidal ideation. These data were collected in 2019 and 2020, and were analyzed by type of training program, race/ethnicity, gender, sexual orientation, and survey year.

The findings, published in the open-access journal eLife, indicated significant differences for rates of depression, anxiety, and suicidal ideation. Biomedical doctoral students showed greater incidence than medical students. Historically excluded students (e.g., people of color, women, LGBQ+ trainees) showed greater incidence compared to their peers.

“Of note, mental health remained poor for biomedical doctoral students in 2020 and declined for those belonging to historically excluded populations,” said co-first author Beka Layton, director of professional development programs for UNC Training Initiatives in Biological and Biomedical Sciences in the School of Medicine’s Office of Graduate Education. “The high rates of depression, anxiety, and suicidal ideation reported suggest that the structure of medical and biomedical research training environments need to continue to be improved and support for mental health increased.”

The study, titled “Equity, Diversity and Inclusion: Mental health in medical and Ph.D. students during the 2020 COVID-19 pandemic and racial protests,” highlights the challenges biomedical graduate students face – challenges exacerbated by racial inequities and belonging to other historically excluded groups.

Layton is the principal investigator on the NIGMS R01 grant titled, “SCISIPBIO: Training the Next Generation of Scientific Leaders – Professional Development, Mental Health, & Mentoring,” which allowed her and colleagues to conduct this study.

Co-author Jean Cook, chair of the Carolina Department of Biochemistry and Biophysics, has been advocating for providing more mental health resources for graduate students for years, especially during her tenure as associate dean of graduate education.

Co-first author Alli Schad, UNC School of Medicine director of student wellness at the time of the study, has been advocating for and directly supporting graduate student mental health for six years, from both in and outside of the academy. In fact, Schad and Cook were featured in Science in 2019 for their groundbreaking approach to providing graduate mental health support. Nonetheless, evidence suggests that more support is needed and should be a priority going forward.

Co-author Debra Ragland, assistant director of diversity affairs in the OGE and the NIH-funded Initiative for Maximizing Student Development at the time of the study, has supported trainees across the biomedical pipeline, from undergraduate research experiences through graduate training. She similarly recognizes the stress that the academic environment can cause.

Together, the work of these co-authors varies from administration and staff support through mental health practitioners, and their conclusion is the same: academic trainees in the biomedical and medical sciences encounter challenges and stressors that call for mental health support, especially for those who face systemic barriers due to historic underrepresentation by race, ethnicity, gender, or sexual orientation.

“While this is not a comprehensive list, it is important to acknowledge the systemic barriers that these groups have faced and continue to face in biomedical training and education,” Schad said.

“The impact of COVID-19 has only exacerbated these effects,” Ragland added. “Our current study has shed light on the importance of providing support for and creating transformational change in academic education and training programs to better support trainees.”

Particularly, the authors examined the impacts for people of color, women, and LGBQ+ identifying individuals. The incidence of depression, anxiety, and suicidal ideation for biomedical and medical trainees, and for these historically excluded groups particularly, suggest that more efforts are needed.

The authors hope that this work joins the call of others in creating more visibility for those struggling with mental health challenges. This work may help administrators, staff, and faculty help recognize the need for support in these areas and can help students normalize these experiences in realizing they are not alone.