Gender diversity in the Journal of Mental Health – how are we doing and what do we need to do?

The #MeToo campaign questioned sexual behaviour stereotypes and is calling for better behaviour from men. This has not just been highlighted by high profile court cases, but also by recent job losses in the science field, many of which go unpublicised. One that did hit the headlines was the foolish assertions of Nobel Laureate Sir Tim Hunt at the World Conference of Science Journalists in 2015. He said, in front of a large audience, “Let me tell you about my trouble with girls. Three things happen when they are in the lab. You fall in love with them, they fall in love with you, and when you criticise them, they cry.” Incensed by this dismissal of their contribution to science, many women took to the Twittersphere with the hashtag #distractinglysexy attaching their photos wearing gumboots, gas masks and all-in-one overalls. Sir Tim lost his honorary position at University College London and his credibility.

It is another 5 years down the line since Sir Tim Hunt’s assertion, so we are asking whether the position of women in Science, Technology, Engineering and Maths (STEM) has changed or even improved? There is some room for optimism coming from the 2019 statistics produced by Women in STEM in the UK campaign (WISE: https://www.wisecampaign.org.uk/). There are now one million women in the STEM workforce, almost double that 10 years ago. Girls are also taking more STEM subjects at school and beginning to outperform the boys in many of them. So, the future may be looking much rosier with a current, and likely future, workforce being more equal. But, and it is a big but, there are still issues concerning women’s chances of progressing a science career. We know that a gender pay gap exists and may be getting larger (at least 10% in the UK according to the University College Union (U.C.U.) 2017) and that there are still far fewer women professors even in the mental health topics covered by this journal which generally have more women involved. So perhaps it is time to take another look at our own institutions and even our own journal.

Why is it important? This is not a rhetorical question. Of course, we need to make the STEM community more equal but not just for moral and ethical reasons. We are now beginning to recognise that women have been important STEM contributors and have much more to contribute. For example, those who coded the first computers were nearly all women, but today the number of women in the tech industry is stuck at a low 16% and has been for 10 years. Key scientific discoveries, like sex being determined by chromosomes, were a breakthrough made by a woman, Nettie Stevens. Why don’t we know about her? Because a man was credited with making the discovery, and still is in some recent textbooks, although Wikipedia has the correct version. In 2019 the second woman to win a Nobel Prize, and one of the youngest of any to win, shared the title with two other men, one of whom was her husband. One newspaper headline referred to the laureate, Esther Duflo, as a wife only, which diminished her name recognition as well as implying that her prize was the result of hanging on to her husband’s coattails. To add more fuel to this argument we also know that men judge publications from male authors to have “greater scientific quality”, even when authorship gender was randomly attributed (Knobloch-Westerwick et al., 2013). We know that more diverse scientific groups improve the quality of research especially in medicine. Nielsen and colleagues (Nielsen et al., 2017) examined one and a half million medical papers and discovered that when women are the lead or senior authors there is more attention paid to gender and sex related factors. This is important as STEM science affects all our lives by having an impact on government policy and even on the health treatments developed.

Many changes are needed to reverse the undervaluing of women’s contribution to STEM science. One way is to have women in higher academic positions because they provide role models for aspiring younger women. The dominance of men in the STEM subjects (Moss-Racusin et al., 2012) has long been recognised. Initiatives like the Athena SWAN in the UK (https://www.ecu.ac.uk/equality-charters/athena-swan/) have coveted silver and gold awards that now have monetary value in terms of being able to apply for some government grant schemes, such as ones from the National Institute for Health Research. This scheme demands that universities demonstrate equality schemes and lists the areas they are interested in. But one not yet covered is gender inequality in publication authorship which provides the clearest illustration of women’s part in scientific discovery. We know that gender inequality persists as globally women account for fewer than 30% of STEM authorships despite being a larger percentage in the workforce (Lariviere et al., 2013).

Career progression in academia requires publications and successful grant applications which are closely linked. Grant funders are keen to identify who is likely to deliver, especially on more prestigious or more financially rewarding grants, and publications are a measure of success. In the UK, the system for allocating resources to universities, the Research Excellence Framework rates, by peer review, publications of academic staff over the previous 5 years. These quality ratings contribute to the overall score for a university which then determines monetary support. Publications are therefore not only valuable for individuals’ careers, but in the UK, also to universities in direct monetary terms. Is this a level playing field for women? Unfortunately, it isn’t. Several studies have shown that the odds are stacked against women’s publications particularly when reviewers are not blind to author gender (Budden et al., 2008; Roberts & Verhoef, 2016). Given this evidence it is surprising that double blind peer review is not the norm.

We wondered about our own statistics and whether there was an opportunity for the Journal of Mental Health (JMH) to take stock and consider whether we need to make changes to prevent bias. So, we have looked at the gender of authors in our 2019 volume. Here we defined gender as either men or women, based on data gained via their affiliated university or organisation. We know that in our field there is a convention that authors that are important for the paper are usually first or last. First authorship generally denotes that the study was run and written by them, and last author position usually denotes a senior academic who guided and may even have found the resources to carry out the study. This is not the case for all studies, but we had to make some assumptions. We do, however, know that progression in STEM careers in topics covered by JMH depend on similar rules.

Table 1 shows the bare facts. We have more women as first or last authors than men (54% vs 42%), a fact that was pleasing (e.g. Aschbrenner et al., 2019; Faithfull et al., 2019; Harrington et al., 2019; Khalid et al., 2019; Mulfinger et al., 2019; Weir et al., 2019). But as we investigated the data further, we find that women are more likely to be represented as first or sole authors (68%) and men to be positioned as last author (57%). There was also a difference in who was shared first and last author positions. Papers with women as first authors were more likely to have a man as the last author (42%) but only 10.5% of papers with men as first authors had a woman as the last author. These data suggest that a gender bias still exists and perhaps reflects the current state of our STEM subject. We may have more women scientists, but they are less likely to be the senior author and tend not to be the supervisor or guide for more junior men.

Luckily at JMH we do have double blind peer review so no reviewer would have been making a judgement on the worth of the paper using the author gender and this may contribute to our lack of gender bias. However, JMH covers STEM topics where more women are employed, so we do not know whether there is hidden discrimination as we have not investigated the author gender of those papers rejected – that is for another year.

Table 1. Gender by type of author.

Gender	First author	Last author	Total
Male	18 (27.3%)*	36 (57.1%)	54 (41.9%)
Female	45 (68.2%)**	24 (38.1%)	69 (53.5%)
Not known	3 (4.5%)	3 (4.8%)	6 (4.6%)
Total	66	63	129

*includes one male sole author.

**includes two female sole authors.

In conclusion, JMH has been successful in at least balancing the gender of authors. But clearly the author position still reflects the gap in career progression. Gender diversity is important – women are half the world – but it is not the only type of diversity we need to consider there is also ethnicity and now that gender is not a binary concept it is harder to identify this author attribute via publication. The JMH has emphasised the inclusion of people who use mental health services as authors (Byrne et al., 2019; Pinfold et al., 2019; Robertson et al., 2019; Robotham et al., 2016; Webber et al., 2014) and we have been successful on our editorial board, in our editorials (Carr, 2020; Sweeney & Taggart, 2018; Wykes et al., 2019) and in the types of research we accept (Farr et al., 2019; Happell et al., 2019b; Happell et al., 2019a; McCabe et al., 2018; Mulfinger et al., 2019). We want to continue to encourage these papers and particularly those led by service users. This is very difficult to measure as some people do not want to publicise their mental health status. Our plan is to discuss these issues with our publisher to see if we can collect some data that will enable us to see if we are meeting our goal of a level playing field for all.

Disclosure statement

No potential conflict of interest was reported by the author(s).