ABSTRACT
A significant, if relatively small, body of literature provides a picture of PGR mental health and wellbeing, and key factors influencing this. However, little has been written on interventions, practices and changes to institutional support for PGRs, how these impact on wellbeing, and what factors influence their success. This paper summarises and synthesises research that has evaluated interventions or institutional changes aimed at supporting PGR mental health and wellbeing. A rapid systematic review methodology identified 21 papers, which evaluated interventions or practices to support PGR wellbeing, gathering data from 1066 students, 33 staff members (mainly supervisors) and 11 recent graduates. The papers included were diverse but limited and therefore did not offer strong evidence for the effectiveness of specific approaches. However, they provided valuable insight, which we conceptualise in a model of approaches to enhancing PGR wellbeing before exploring barriers to implementation of interventions, and recommendations for research, policy and practice.
1. Introduction
Student mental health and wellbeing is a source of increased interest and concern, within the UK and internationally (Brown Citation2016; Carter et al. Citation2017; Papadatou-Pastou et al. Citation2017; Hughes et al. Citation2018). The literature on this topic has highlighted how institutions have shifted practice to accommodate student need for mental health services (Lusk and Fearfull Citation2015), but that significant barriers to accessing support remain (Cage et al. Citation2020). Moreover, the focus of increased interest has largely remained on undergraduate students and, to a lesser extent, postgraduate taught students. Postgraduate Researchers (PGRs) have largely been overlooked, although there is now a body of literature that provides a picture of PGR mental health and wellbeing setting out a range of key factors influencing this (Metcalfe, Levecque, and Wilson Citation2018; see also Stubb, Pyhältö, and Lonka Citation2011; Levecque et al. Citation2017; Barry et al. Citation2018; Schmidt and Hansson Citation2018; Waight and Giordano Citation2018). This review does not set out to describe this literature on PGR wellbeing, but to capture literature exploring how to address PGR wellbeing. Clearly these two literatures are closely related, hence we summarise the main factors identified as relevant to PGR wellbeing in , although, this is not intended to be exhaustive.
Table 1. Factors impacting PGR mental health and wellbeing.
Notwithstanding the insights captured in , mental health and wellbeing remain relatively underexplored (Sverdlik et al. Citation2018), in comparison to research examining attrition and dropout from postgraduate research and how to address this (for example, Wright and Cochrane Citation2000; Skopek, Triventi, and Blossfeld Citation2020). For example, a recent review looking at factors contributing to PGR success explicitly excluded studies analysing wellbeing outcomes, which were considered not related to success (Salinas-Perez et al. Citation2019). Yet factors that impact on wellbeing are likely to have a significant effect on dropout (Schmidt and Hansson Citation2018), and vice versa, since progress in study has been identified as contributing to psychological health (Barry et al. Citation2018).
Moreover, mental health issues are known to be prevalent in graduate students in comparison to the general population, and many of those leaving Ph.D. programmes explicitly cite anxiety and depression (Kendal and Waterhouse-Watson Citation2020). The status of PGRs’ wellbeing is crucial to their development and progression and therefore to the health of the UK higher education sector (Metcalfe, Levecque, and Wilson Citation2018). Schmidt and Hansson (Citation2018) argue that alongside standard measures of academic progress, measures of wellbeing should be incorporated throughout a course of Ph.D. study because of the potential costs of attrition due to poor wellbeing. Beyond the psychological costs to the individual, the potential financial, creative and research activity loss is substantial (Guthrie et al. Citation2017; Barry et al. Citation2018; Mackie and Bates Citation2019). Consistent with the wider literature on wellbeing in the workplace, the wellbeing of PGRs and their self-efficacy also has an important effect on their motivation and productivity (Guthrie et al. Citation2017; Barry et al. Citation2018; Sverdlik et al. Citation2018; Sverdlik and Hall Citation2020). Those who do progress through postgraduate research despite the challenges can still be impacted, and this experience may also set up expectations and habits for their future academic careers. The normalisation of the ‘pressure’ of postgraduate research could be further compounding the issues of mental health and wellbeing since the expectation of a stressful working environment can lead to under-reporting of problems (Metcalfe, Levecque, and Wilson Citation2018). The recent nature of much of the literature on PGR mental health and wellbeing reflects an expanding field of research, but may also point to a growing problem. At the same time, this attention has increased knowledge and awareness, identifying a wider of range salient factors and greater detail in understanding what influences PGR mental health and wellbeing and how this varies between individuals (Mackie and Bates Citation2019).
In summary, whilst the literature on PGR mental health and wellbeing remains relatively small, there is now a body of work that provides a good understanding of the relevant factors impacting on wellbeing, and their effects. There is also a general awareness within institutions, and across the Higher Education sector, of the need for action, and a plethora of practical interventions and recommendations for changes to institutional practices (UUK Citation2015; Hughes et al. Citation2018; Metcalfe, Levecque, and Wilson Citation2018). There is however a significant gap in understanding how successful (or not) interventions and institutional changes have been, and why. There is very little literature addressing this question, and a disconnect between identified stressors, who they affect and how they are interrelated (Mackie and Bates Citation2019).
The current paper addresses this gap in two ways. First, it presents the findings of a rapid review to summarise and synthesise research that has evaluated interventions, institutional changes or practices aimed at supporting PGR mental health and wellbeing. Second, the paper explores potential reasons for lack of effectiveness of different interventions, drawing on ideas from the field of policy analysis to propose a simple framework for revealing barriers to implementing interventions in practice.
We sought to identify literature that evaluated practices that supported PGR mental health and wellbeing in addition to studies explicitly identified as evaluations of a planned intervention. The review addressed the following key question:
What is the effectiveness of different interventions, practices and institutional arrangements in supporting PGR mental health and wellbeing?
It is important to recognise that some literature tends to use the terms ‘mental health’ and ‘wellbeing’ quite interchangeably (see for example, Metcalfe, Levecque, and Wilson Citation2018 and Carter et al. Citation2017). This conflation is problematic because mental health issues affect a smaller subset of the population and refer to specific problems, whereas wellbeing is a broader term which has relevance for the population in general (Barkham et al. Citation2019). While an important distinction, we did not apply a specific definition or restrict our analysis to either term because we wanted to maximise the amount of literature gathered by the review, and we expected the literature base to be small. We adopted a broad conceptualisation, in line with the approach set out by the World Health Organisation, whereby mental health and wellbeing are seen as overlapping (WHO Citation2005). This does not assume that good mental health and good wellbeing are the same (see Galderisi et al. Citation2015 for a discussion) but does recognise that both were relevant to the aims of our review.
The paper proceeds as follows. Section 2 outlines the methods of the review. We then present the results of the review in section 3 before discussing the implications of the review findings for research, policy and practice in section 4. Section 5 sets out the framework for understanding barriers to implementing interventions and applies it to an example from Section 3.
2. Methods
This rapid review adopted systematic review methodology that was applied in a short time frame to synthesise relevant material (Grant and Booth Citation2009). As the review was aimed at informing work within a larger university project to improve PGR wellbeing it needed to be completed quickly and systematically to inform project decisions (Khangura et al. Citation2012). Systematic review methods call for structured searches using keywords associated with the research question that are then systematically screened to identify relevant publications. Findings from these publications are then synthesised. Rapid reviews follow a similar but streamlined process (Tricco et al. Citation2015), therefore they tend to be less comprehensive in their search strategy and interpretations of the findings captured are necessarily more tentative (Khangura et al. Citation2012).
To establish if the review was necessary we conducted initial searches for existing review-level studies prior to carrying out searches for the review itself (Cooper et al. Citation2018). These searches only identified one study, exploring mental health in the research environment generally rather than focussing on PGR experiences (Guthrie et al. Citation2017). Although this rapid evidence review was not peer reviewed, it did look at interventions and their effectiveness, highlighting the weak and small evidence base evaluating interventions (Guthrie et al. Citation2017; Ch. 5). None of the interventions identified explicitly targeted PGRs. However, this is a field that is rapidly expanding and several reviews have been published, after the searches for this current review paper were completed (Schmidt and Hansson Citation2018, Sverdlik et al. Citation2018; Mackie and Bates Citation2019). These reviews predominantly concentrated on factors influencing mental health and wellbeing rather than interventions, as discussed above; although Mackie and Bates (Citation2019) did include five intervention studies in their scoping review, evaluation was not their focus.
Search terms and strategy
Search terms were used to identify studies by their population, or sample and outcomes. These terms were intended to identify a broader range of studies than we would include in the review, applying exclusion criteria throughout the screening process to screen out irrelevant studies. The searches applied terms relating to the population and phenomenon of interest – PGR students and mental health and wellbeing (see supplementary material for full search terms). Following the inclusive approach to mental health and wellbeing set out in the introduction, we sought studies that evaluated interventions, practices and institutional arrangements in relation to wellbeing or mental health outcomes as defined by the studies themselves.
Results were then combined and duplicates removed. We also issued a call for evidence, and searched organisations’ websitesFootnote1 that were thought likely to return relevant case studies. These methods did not produce any additional material related to our research question beyond those papers already identified through searches of the academic databases. The searches were completed in June 2018, but because of the amount of recent research in this area (Mackie and Bates Citation2019) the initial search results were supplemented with results from updated searches in August 2019, as detailed in the search flowchart ().
Figure 1. Flowchart of search process.
The search results were screened for relevance by both authors, first by title, then abstract according to the criteria detailed in . All articles deemed eligible were screened again as full papers, and any disagreements between authors at the title and abstract stage were discussed and resolved. Any full papers rejected were double checked by the second author and the remaining titles were then retained, and relevant data extracted and synthesised. Some additional papers were identified through references and expert adviceFootnote2 as well as updating the search. This took the total number of studies included in the review to 21.
Table 2. Inclusion/exclusion criteria.
Quality assessment and evaluation of evidence
Quality appraisal of individual studies was guided by a tool developed for reviews where a diversity of methods is included both within and between studies (Pluye et al. Citation2009). Whilst this quality assessment informed our appraisal of the strength of the evidence, we do not provide specific quality ratings of the findings of individual studies. However, we do discuss the limitations of the evidence gathered by the review in final part of the findings section. We provide a narrative synthesis to ‘tell the story’ of the findings of studies captured in the review (Popay et al. Citation2006), this synthesis was developed from the data extracted from all studies included in the review. The data extraction itself was guided by a uniform approach in order to glean relevant information from each study.Footnote3 The data extraction provides the basis for which summarises the effects of approaches to enhancing PGR wellbeing and also the narrative synthesis outlined in the findings. The narrative synthesis was then drafted by the first author and reviewed and discussed with the second author. Considering the literature on PGR wellbeing and through discursive and iterative development of the narrative synthesis between the authors a model of approaches to supporting PGR wellbeing was conceptualised. This model is underpinned by the findings of studies included in the review, which set out a range of ways in which PGR wellbeing can be influenced by interventions, practices and institutional arrangements.
Table 3. Map of approaches and outcomes supporting PGR wellbeing.
3. Findings
Summary of included studies
Most included studies evaluated a relatively small population of PGRs and a clearly defined programme or intervention aimed at improving wellbeing in a general sense. Some studies addressed informal practices or institutional arrangements rather than interventions per se, and looked at other important outcomes for PGRs, such as degree progress or professional development. In total the studies included gathered data from 1066 students, 33 staff members (mainly supervisors) and 11 recent PGR graduates. However, a large proportion of this number (N = 594) came from one large study that surveyed students at a UK university to understand how they used student services to support mental health (Waight and Giordano Citation2018), and from one other study surveying PGRs (N = 142 respondents) at a large chemistry graduate school in the US (Mousavi et al. Citation2018). Across the studies, a range of methods were applied to evaluate mechanisms for supporting PGR wellbeing, but the majority adopted a qualitative approach (12 studies), 5 studies used a mixture of methods and 4 studies applied a purely quantitative approach to evaluation. The favouring of qualitative methods is not surprising given the relatively small average sample size of studies included (N = 25.8 excluding the study with largest sample (Waight and Giordano Citation2018)).
Of the four studies using just quantitative methods, three used longitudinal designs (Wright, Citation2006; Marais et al. Citation2018; Mousavi et al. Citation2018) one qualitative study also used a longitudinal design (Williams, Thakore, and McGee Citation2017), but most were cross-sectional. The fourth quantitative study included used a randomised control design (Barry et al. Citation2019), but the study follow-up period was short and it relied on a convenience sample, both factors that weaken the methodological approach. All included studies sampled PGRs and some also included staff perspectives (Green and Bowden Citation2012; Howells et al. Citation2017). One study, also sought views of recent graduates along with current PGRs who they mentored (McConnell, Geesa, and Lowery Citation2019; see also Geesa, Lowery and McConnell Citation2018), whilst another sampled views of current students, recent graduates and staff (Hobbs et al. Citation2015). Not all studies took place in the UK higher education sector, although many did. Eight studies were undertaken at institutions in the UK and Ireland, seven from Australia, two from New Zealand, three from the United States and one study at a French university. Within the 21studies included in the review some focussed exclusively on the experiences of international students (Lee Citation2017; Mason and Hickman Citation2019; Chatterjee-Padmanabhan and Nielsen Citation2018) or minority groups (Williams, Thakore, and McGee Citation2017).
Approaches to enhancing PGR wellbeing
The findings from the review are synthesised as , a model that outlines four broad types of approach to supporting PGR mental health and wellbeing. maps out how the different papers identified in the review correspond with and specifies the main outcomes identified as being relevant to PGR wellbeing or mental health.Footnote4 Each of the four broad types is discussed in more depth in the following sections which comprise a narrative synthesis of the data extracted from included studies, which we subsequently discuss as a whole alongside the limitations of the evidence captured in the review and implications arising.
Figure 2. Approaches to enhancing PGR wellbeing [graphic: see acknowledgements].
![Figure 2. Approaches to enhancing PGR wellbeing [graphic: see acknowledgements].](/cms/asset/10b697a2-215f-4350-ac07-ffddf386bce0/cshe_a_2020744_f0002_oc.jpg)
1. Relationship between PGRs and their supervisors
The structure and quality of the working relationship between PGRs and their supervisors has long been identified as a key causal factor influencing PGR wellbeing (Mackie and Bates Citation2019, 569–71). Three studies directly addressed the relationship between PGRs and their supervisors (Gurr Citation2001; Green and Bowden Citation2012; Howells et al. Citation2017).
The interventions utilised tools to enhance communication and transparency, such as a tool to align supervisory style with PGR need (Gurr Citation2001), encouraging gratitude practices to improve the supervisory relationship (Howells et al. Citation2017), that had other benefits also. Increased confidence was expressed by students participating in some interventions (Gurr Citation2001; Howells et al. Citation2017), which enabled students to develop more autonomy and access more support if needed (Gurr Citation2001). The studies also highlighted the multiple ways in which supervisors can provide support, underlining emotional support as an important supervisory role, although one not typically expected from supervisors (Green and Bowden Citation2012). A fourth study explored the role of group supervision in enabling students to draw on each other as resources for critical reflection, learning and emotional support, whilst also creating a sense of belonging in a group of professional doctoral students (Hutchings Citation2017). Experiencing supervision as a group facilitated PGR community, another important aspect of the conceptual model, and also raises the possibility of a different mode of supervision with implications for PGR wellbeing.
2. Psychological and emotional resources
The independent nature of postgraduate research can create isolation and presents challenges for self-motivation and self-management, highlighting the need for PGRs to develop resilience to thrive and progress. Five studies evaluated programmes explicitly aimed at building these psychological or emotional resources. The large-scale study by Waight and Giordano (Citation2018) sought to comprehensively evaluate the extent to which students were aware of and accessing student services to support these psychological resources. The study underlined the importance of mental health services outside of university and informal sources of support, such as family friends and peers, with participants identifying the focus groups of the study itself as useful for sharing experiences and building resilience (Waight and Giordano Citation2018; see also Mousavi et al. Citation2018).
The four studies that evaluated programs designed to improve psychological resources showed reduced anxiety (Marais et al. Citation2018), reduced stress (Kearns, Gardiner, and Marshall Citation2008), improvements in depression and psychological capital (Barry et al. Citation2019), as well as fewer wellbeing problems and better course retention (Wright Citation2006). A cognitive behavioural coaching intervention aimed to combine cognitive skills for managing emotionally destructive behaviour with practical time and work management skills. The study argued that the psychological or emotional dimension needs to be embedded in PGR training (Kearns, Gardiner, and Marshall Citation2008), which is consistent with studies included in the review that highlighted how doctoral training can also address PGR anxieties. A more comprehensive mental health initiative was examined by Mousavi et al. (Citation2018), who highlighted its collaborative nature. The initiative brought PGRs, faculty leadership and professional health services together to bring about a cultural change in the graduate school, to the point where mental health was openly discussed and embedded in departmental activities. This example of a holistic approach to developing psychological resources was embedded in a cultural change in the community around PGRs, demonstrating the impact of interventions beyond the individual level.
3. Personal and professional skills
Developing a sense of academic identity, career progression and development of personal and professional skills are key to PGR wellbeing and successful PGR study generally. The eight studies in this area evaluated different practices and initiatives to support personal and professional development, with several evaluating coaching or mentoring schemes for PGRs (Mason and Hickman Citation2019; Williams, Thakore, and McGee Citation2017; Lane and De Wilde Citation2018; McConnell, Geesa, and Lowery Citation2019). The investment of time and effort for mentors and coaching can be significant (Mason and Hickman Citation2019), and they may not always have the skills or knowledge that those they are supporting are looking for (Williams, Thakore, and McGee Citation2017; McConnell, Geesa, and Lowery Citation2019). In general though, these approaches were valued by those being mentored or coached and those providing guidance who experienced this as development (McConnell, Geesa, and Lowery Citation2019). Mentoring was also shown to help build PGR community, for example by pairing new students with current PGRs, developing peer groups and facilitating social events (Mason and Hickman Citation2019; Williams, Thakore, and McGee Citation2017; McConnell, Geesa, and Lowery Citation2019).
Coaching sessions can also offer a neutral space to help resolve issues in the relationship between supervisors and their students (Williams, Thakore, and McGee Citation2017; Lane and De Wilde Citation2018) having a positive effect on supervisory relationship, another key influence on PGR wellbeing. The coaching and mentoring programs captured in the review were focused on helping students to develop personal and professional skills enabling the development of competencies and problem solving abilities (Janson and Howard Citation2004; Marchand Citation2017). However, they also had an impact on wellbeing in other ways, helping students to overcome isolation (Hobbs et al. Citation2015) and anxiety (Chatterjee-Padmanabhan and Nielsen Citation2018). Practices in this area of the PGR model support students ability to complete their study through the development of skills and this is indicated in some of the studies included, but the studies also highlight their role in developing community and dealing with issues associated with supervisory relationships. Some of the studies did note the demands of development, in terms of being a mentor or participating in training that was not necessarily relevant or valued. Therefore, sensitivity to individual training requirements and benefits is important.
4. Community
Developing the PGR community in institutions is key. This can be achieved through shared working space, social events, group training programmes and online platforms. Several studies identified the formation of PGR communities as important for wellbeing, although not all of these set out to explicitly achieve this. The creation of community can establish mechanisms for sharing tacit knowledge, and a repository of resources that could be useful for coping and succeeding in Ph.D. study (Janson and Howard Citation2004; Bennett and Folley Citation2014). Emotional support as well as practical problem solving of issues related to PGR experience were key outcomes (Hutchings Citation2017; Lee Citation2017; Mason and Hickman Citation2019; McPhail-Bell and Redman-MacLaren Citation2019). Mechanisms for the creation of community may be particularly important for International students who might have limited social networks at the host institution and face cultural challenges (Lee Citation2017; Mason and Hickman Citation2019), particularly in managing their relationships with supervisors. The studies evaluating mechanisms for peer support and advice highlight the role of these in emotionally supporting mental health and wellbeing, but these mechanisms also facilitated sharing of skills and strategies for success in PGR study, assisting professional and personal development.
Discussion and limitations
The evidence synthesis indicates four broad approaches to supporting PGR wellbeing that act as key focus points for activities. However, there are many overlapping elements. Studies looking at how supervisory relationships can be strengthened to improve PGR wellbeing also underlined that these relationships can support personal and professional development, help to develop psychological resources, and PGR community depending on how supervision is structured and experienced. Similarly, the outcomes that follow from a coaching programme are not necessarily different to those arising from a student-led community of practice.
The literature on Ph.D. supervision underlines various ways it can impact PGRs negatively (Mackie and Bates Citation2019) particularly in the early stages of Ph.D. study where a change, uncertainty or conflict between supervisors can have a marked impact (Cornwall et al. Citation2019). International students may face particular challenges in establishing good relationships with supervisors (Elliot and Kobayashi Citation2019), as may marginalised groups who experience challenges to Ph.D. study more acutely (Mattocks and Briscoe-Palmer Citation2016). Therefore, the studies in the review that built trust, appreciation and communication between supervisors and PGRs demonstrate an important route to positive student-supervisor relationships, which is a protective factor for wellbeing (Hazell et al. Citation2020). Poor communication, cultural insensitivity or excessive criticism can damage supervisory relationships and PGR mental health (Li and Seale Citation2007). Therefore, supervisors’ role in developing PGR students, in a holistic sense, alongside supporting academic development and eventual completion is an important consideration (Åkerlind and McAlpine Citation2017). Whilst international students may benefit from a personalised, holistic style of supervision (Egan et al. Citation2009), the review showed that PGR students also draw support from many other sources. Peer support, wider PGR community and coaching programmes offer spaces to resolve or cope with issues arising from within supervisory relationships.
Those interventions and practices that enable peer support and PGR community also help to address isolation and loneliness that can be experienced by Ph.D. students (Cornwall et al. Citation2019). The review highlights that this issue can be addressed in a number of ways, including informal practices of support (e.g. through email correspondence (McPhail-Bell and Redman-MacLaren Citation2019)), formalised mechanisms (e.g. mentoring programmes (Mason and Hickman Citation2019; Williams, Thakore, and McGee Citation2017)) and more indirectly (e.g. through shared professional skills programmes (Hobbs et al. Citation2015)). The presence of social support is protective of PGR wellbeing (Hazell et al. Citation2020) and whilst the Ph.D. may be regarded as an individual journey the presence of a supportive community to cope with emotional strain is important (Collins and Brown Citation2020) and can be developed by group supervision (Hutchings Citation2017) and other practices as evidenced by the review. Social support is not just important for PGR students, but also in the transition to postdoctoral research career (Vekkaila et al. Citation2018). The independent nature of Ph.D. study demands attention to how to support that combats isolation can be built into this experience and online communities can play a role, as evidenced by one study in the review (Bennett and Folley Citation2014).
Online resources can also be a helpful source of information utilised by students (Papadatou-Pastou et al. Citation2017; Waight and Giordano Citation2018) enabling them to practice ‘self-care’ to maintain wellbeing (Hazell et al. Citation2020). The inclusion of studies that demonstrated approaches to develop psychological resources for PGRs is in line with literature highlighting resilience and perseverance as core competencies for Ph.D. students (Durette, Fournier, and Lafon Citation2016) and individual interventions building psychological resources were shown to be effective in the review. However, studies also argued for the need to embed these capabilities into professional training (Kearns, Gardiner, and Marshall Citation2008) and supervision (Green and Bowden Citation2012), highlighting that supporting PGR wellbeing in a general sense and adopting practices that support PGR progression are also likely to benefit mental health and resilience (Kendal and Waterhouse-Watson Citation2020).
The qualitative nature of much of the data made it difficult to identify explicit outcomes that are distinguishable from one another. Many of the studies talked about wellbeing in broad terms, using terms like confidence and support. Several studies in the review evaluating different approaches identified increased confidence as an important outcome related to wellbeing (Gurr Citation2001; Mason and Hickman Citation2019; Chatterjee-Padmanabhan and Nielsen Citation2018; Lane and De Wilde Citation2018). This finding is in line with previous research that highlights increasing confidence as an important aspect of personal and professional development in PGR study (Mowbray and Halse Citation2010). Recent research has also identified the value for PGRs in both giving and receiving support (Vekkaila et al. Citation2018) reflecting the utility of approaches that involve mentoring or PGR community building. It was also clear that many of the approaches do not necessarily address wellbeing problems explicitly but are actions that may be considered good institutional practice and thereby contribute to wellbeing. They are likely to assist with timelier thesis submissions, fewer withdrawals, and better academic outcomes, which can be considered important for wellbeing as well as reducing mental health concerns.
In general, the different approaches evaluated were diverse, with a wide range of methods applied and small average sample sizes. Moreover, the evaluations were typically cross-sectional and often provided subjective accounts of the effectiveness of different mechanisms for supporting PGR wellbeing. These characteristics meant it is difficult to generalise from the findings of the review or appraise whether specific approaches are particularly effective. Despite not being able to offer generalisable evidence for the effectiveness of different approaches to supporting PGR wellbeing, the data captured in the review are rich, and can usefully inform approaches to supporting PGRs. Furthermore, the review also suggests that a narrow conceptualisation of wellbeing or mental health may actually be limiting in considering how best to support PGRs. Many of the included studies highlighted ways in which informal support mechanisms can be strengthened and individual resilience can be developed outside of formalised wellbeing interventions or mental health support services. The review does point to the continued value of dedicated mental health and wellbeing services, notably those supporting psychological resources, alongside broader approaches that support PGR wellbeing in the four key areas identified. However, the review also highlights that the evidence base is still relatively small and the methodology adopted by studies identified in the review limits the extent to which we can say with certainty approaches to PGR wellbeing and mental health are effective or not.
The field of research and literature on PGR wellbeing is developing apace and this is adding important insight to our understanding of this issue and its implications for the research sector. PGRs are an important cohort, particularly for the future of the research sector and also in terms of their academic output and contribution to research teams (Levecque et al. Citation2017). The experience in undertaking a Ph.D. is also formative of their research career more generally since it involves training researchers to fit into their future working environment (Bégin and Géarard Citation2013). If this experience is normalised as stressful then this is likely to set up harmful expectations and habits for research careers (Cornwall et al. Citation2019), thus influencing the experience of work in the sector more generally. Whilst wellbeing should be an important consideration in and of itself, it also has a bearing on productivity, as the wider literature on workplace wellbeing confirms (Whitman, Van Rooy, and Viswesvaran Citation2010; Oswald, Proto, and Sgroi Citation2015).
The rapid nature of this review and methodology applied, alongside the rate at which literature on the topic is expanding means the review is unlikely to have captured all relevant information available. However, a paper identified in our searches was also recommended to us by its authors as a result of our call for evidence, suggesting our search strategy and terms had produced valid results. Universities themselves are also likely to hold valuable information evaluating practices that is not available as published research, either as grey literature or in academic outlets. The PGR cohort, which is typically quite small and varied in each institution presents challenges to undertaking more extensive quantitative research to understand the effects of particular practices and interventions. Researchers and practitioners will need to select appropriate techniques and combine methods where necessary. Although the review did identify quantitative studies, and one large survey, in particular, there are limitations to what these kinds of approaches can tell us about practices at a more micro level. If PGR numbers continue to grow then quantitative methods may become more applicable, however, the review emphasises the worth of qualitative studies, which remain valuable for capturing rich data of subjective experiences, particularly those of students themselves.
4. Implications for research, policy and practice
This review has uncovered a wide range of practices that can support wellbeing that can be regarded as good institutional practices for universities to adopt developing a conceptual model that can be a useful basis for these practices. We highlight five particular recommendations for action by individuals and HE institutions and explore how potential barriers to implementing actions can be overcome in the following section.
First, the studies captured in the review underline the benefits of developing PGR community using a range of methods adapted to specific contexts, this may include cohort training programmes and student-led initiatives. Where initiatives are student led, some institutional support is likely to be required, and institutions need to be wary of asking too much of students. Collaborative approaches where faculty and students work together can reach beyond the PGR community to improve the culture of a school or department more widely and be effective in supporting wellbeing, particularly if they draw on professional mental health staff (Mousavi et al. Citation2018). Opportunities for PGR students to meaningfully inform department or university-wide initiatives need to be considered.
Second, virtual communities can be complementary to the development of shared space and activities and connect PGRs at a broader level of community, but if relied on solely may not generate the same support. Online support and social media platforms can provide support but are not comprehensive, and online spaces can potentially be negative for wellbeing. Awareness of online support may be limited, and trusted public health services may be preferred. Therefore, universities should make efforts to understand what sources of online support PGRs access and use, and what may be most helpful.
Third, dedicated mental health support services are important, but interventions that facilitate personal development and build resilience are likely to be useful preventative strategies. Moreover, these are an important aspect of academic and professional development that will support PGRs as they transition into early career researchers. Institutions need to consider how their practices support PGR wellbeing alongside staff and other students. The wellbeing of early career researchers and post-docs is also important, particularly given competition for academic roles and the pressures on successful Ph.D. graduates seeking to develop their career (Levecque et al. Citation2017; Hayter and Parker Citation2019).
Fourth, pay particular attention to the quality of the supervisory relationship. Institutions and individual departments should consider how to embed emotional support in supervisor training and the development and use of tools/strategies to manage and improve the supervisory relationship. This may necessitate additional support for supervisors and localisation of support services.
Finally, peer support and mentoring are important sources of good mental health and professional development, but also demand resources and commitment from individuals and may require specialised knowledge/skills. They can in some cases create a burden on mentors. The impact on all PGRs participating needs to be considered. Universities could consider facilitating peer support through professional development and training to encourage buy in from PGRs and others.
5. Understanding barriers to implementing interventions
The review above has helped formulate practical recommendations, but there remain key questions for those addressing PGR mental health and wellbeing in the higher education sector. Despite the depth of knowledge about the factors affecting PGR wellbeing and awareness amongst institutions and policy makers of the need to act on mental health, gaps remain in terms of successful action (Mackie and Bates Citation2019). While the recommendations above suggest potentially useful mechanisms for improving PGR wellbeing, the success of actions also depends on their prioritisation and integration with current processes, and arrangements that shape how organisations and individuals carry out their work. Following mainstream scholarship in political studies (e.g. Peters Citation2012), we argue that institutional contexts bound and shape how new initiatives play out in practice.
Different institutions, decision-making processes, sectors and decision support tools must work to different time frames, different objectives, different capacities, different analytical processes and different boundaries. Successful wellbeing and mental health interventions can be frustrated or altered at any of these points. Therefore, having ‘sufficient understanding’ of wellbeing problems, or using examples of ‘best practice’ from elsewhere, does not necessarily mean that this knowledge will be used to successfully transform practice. The contextual factors that affect transfer of ideas between political systems are familiar to scholars of political studies – see, for example, the overviews by Knill (Citation2005) and Benson and Jordan (Citation2011). In the case of wellbeing interventions in higher education, lesson-learning, sharing good practice and building networks around ideas and interventions are all important, but it is also critical to understand factors that shape HE organisations’ abilities to successfully take this knowledge forward and address wellbeing problems.
In this final section of the paper, we do two things. First, we propose a simple theoretical framework for understanding where barriers to successful implementation of interventions may arise. Second, we combine this with the approaches to enhancing PGR wellbeing that arose from our review () to propose a model for addressing barriers at the intervention, department, or university level. Drawing on research by Russel and Turnpenny (Citation2020; see also Russel, Turnpenny, and Jordan Citation2018) about challenges faced when attempting to embed knowledge in the natural environment in policy-making, and adapting it to PGR wellbeing, we propose a three-level framework for understanding where barriers to successful implementation of interventions may arise. Such barriers can occur at the individual, organisational and wider social and political level and whilst it is possible to explore barriers individually or at one particular level, they should not be considered as discrete. Clearly, the wider social and political context has an impact on how and why HE institutions approach PGR wellbeing and mental health, which in turn will influence how individuals themselves perceive and access interventions, below we provide a summary and examples of barriers at the different levels in the context of PGR wellbeing.
The individual level includes the behaviour of individuals involved in decision-making and intervention design and implementation, and also the individuals with mental health/wellbeing needs – and the resource and other constraints upon them. Barriers here might include limited awareness, understanding, time, or money; and scepticism about how interventions add to or complement existing practices and ideas. The organisational level includes organisational procedures and management structures, how knowledge and ideas are transferred, norms and incentive structures. Barriers may include fragmented and conflicting requirements across different university functions and decision-making levels, differing ideas about the type of intervention to be deployed – and whose ideas are most influential; and weak leadership. The social and political context includes broader societal and political values, norms and goals and relations between HE and other organisations. Barriers at this level can manifest in different ways, such as competing for underlying societal values, business and political priorities about what is important, and differing demands emerging from them – which may not be aligned with or may take priority over PGR wellbeing. Values, such as maximising student numbers, minimising resource use, world class research, financial survival, may be explicitly expressed or implicitly assumed. There may also be different conceptions of wellbeing and associated causes of poor mental health. For example, some may believe problems are mainly caused by individual lack of resilience, while others may look to a social conception of wellbeing.
The above examples of barriers at the three levels are not intended to be exhaustive or necessarily relevant in every instance. However, they can inform a framework to address barriers and examine actual practice in combination with approaches to enhancing PGR wellbeing () and the practical recommendations of the review. Given the limited size and scope of the intervention literature on PGR wellbeing and mental health, consideration of potential barriers by those working in the sector at the outset of planning actions is likely to be important. Barriers could be addressed in different ways, for example, through a facilitated discussion workshop, including appropriate representatives of PGRs, academics, professional services, students’ union and senior leaders. A workshop could integrate the planning of a particular intervention/s with identification and consideration of barriers to determine actions, but addressing barriers effectively is likely to require continued consultation and adaptation. In above, using the example of an intervention to improve the supervisor-PGR relationship, we show how the approaches to enhancing PGR wellbeing might be combined with the barriers framework through consultative workshops to more effectively lead to successful action.
Figure 3. Combining approaches to PGR wellbeing with barriers framework.
Conclusion
Whilst universities are beginning to attend to wellbeing more strategically and are undoubtedly mindful of growing needs in relation to student wellbeing more generally, PGRs are a group that can be overlooked, as neither wholly staff nor conventional students. This combined with the particular nature of postgraduate research means that this is an at-risk population. Failure to attend to PGR wellbeing and the wellbeing of those working in the research sector more generally may result in losses to scientific advancement, significant costs and limit the supply of talent in the research workforce. The conceptual model we build from reviewing the literature on interventions and practices that support PGR wellbeing can form the basis of a more strategic approach that is also likely to improve retention and completion times. The review suggests that institutions need to be able to strike a balance between dedicated services for wellbeing and mental health and wider culture and climate that underpins wellbeing for PGRs. Thought also needs to be given to potential barriers to implementation of particular interventions and how barriers to PGR wellbeing can be overcome at individual, organisational and wider social/ political levels. Finally, the above analysis makes clear that PGR wellbeing cannot be separated from the working conditions and practices in the higher education sector generally and the wider labour market. Meaningful action to improve PGR mental health and wellbeing needs to be considered within that context.
Supplementary Material
Download MS Word (37.2 KB)Acknowledgements
This review was compiled as part of the ‘Courage’ project at UEA andwas supported by the Office for Students and Research England [Grant Number P4, previously administered by the Higher Education Funding Council for England (HEFCE)]. We would like to thank all those involved with the project that contributed to the development of the review and have given feedback on the review as well as those who provided feedback during a presentation at the 1st International Conference on the Mental Health & Wellbeing of Postgraduate Researchers. We would particularly like to thank you Matthew Sillence (UEA) for his support in searching for studies for the review and Tarnia Mears (UEA) for developing the graphic of the PGR wellbeing model.
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No potential conflict of interest was reported by the author(s).
Additional information
Funding
Notes
1 Organizational websites were: Student minds; NUS; Universities UK; HEFCE; Advance HE (formerly Higher Education Academy); Higher Education Policy Institute; UK Council for Graduate Education; Vitae; Times Higher Education
2 See acknowledgements for details of experts contacted for potentially relevant sources.
3 See supplementary material for data extraction guidance and detailed summary table of papers included, which is available by emailing the first author
4 More detailed summary information of studies included in the review is contained in supplementary material.
5 This organisation has now been replaced by The Office for Students and Research England.
References
- Åkerlind, G., and L. McAlpine. 2017. “Supervising Doctoral Students: Variation in Purpose and Pedagogy.” Studies in Higher Education 42 (9): 1686–98. DOI: 10.1080/03075079.2015.1118031.
- Barkham, M., E. Broglia, G. Dufour, M. Fudge, L. Knowles, A. Percy, A. Turner, C. Williams, and SCORE Consortium. 2019. “Towards an Evidence-Base for Student Wellbeing and Mental Health: Definitions, Developmental Transitions and Data Sets.” Counselling and Psychotherapy Research 19 (4): 351–7. DOI: 10.1002/capr.12227.
- Barry, K. M., M. Woods, A. Martin, C. Stirling, and E. Warnecke. 2019. “A Randomized Controlled Trial of the Effects of Mindfulness Practice on Doctoral Candidate Psychological Status.” Journal of American College Health 67 (4): 299–307. DOI: 10.1080/07448481.2018.1515760.
- Barry, K. M., M. Woods, E. Warnecke, C. Stirling, and A. Martin. 2018. “Psychological Health of Doctoral Candidates, Study-Related Challenges and Perceived Performance.” Higher Education Research & Development 37 (3): 468–83. DOI: 10.1080/07294360.2018.1425979.
- Bennett, E., and S. Folley. 2014. “A Tale of two Doctoral Students: Social Media Tools and Hybridised Identities.” Research in Learning Technology 22: 23791. DOI: 10.3402/rlt.v22.23791.
- Benson, D., and A. Jordan. 2011. “What Have we Learned from Policy Transfer Research? Dolowitz and Marsh Revisited.” Political Studies Review 9: 366–78. DOI: 10.1111/j.1478-9302.2011.00240.x.
- Bégin, C., and L. Géarard. 2013. “The Role of Supervisors in Light of the Experience of Doctoral Students.” Policy Futures in Education 11 (3): 267–76. DOI: 10.2304/pfie.2013.11.3.267.
- Brown, P. 2016. The Invisible Problem?: Improving Students’ Mental Health. Higher Education Policy Institute.
- Cage, E., M. Stock, A. Sharpington, E. Pitman, and R. Batchelor. 2020. “Barriers to Accessing Support for Mental Health Issues at University.” Studies in Higher Education 45 (8): 1637–49. DOI: 10.1080/03075079.2018.1544237.
- Carter, M. A., P. Pagliano, A. Francis, and M. Thorne. 2017. “Australian University Students and Mental Health: Viewpoints from the Literature.” International Journal of Innovation, Creativity and Change 3: 1–25.
- Chatterjee-Padmanabhan, M., and W. Nielsen. 2018. “Preparing to Cross the Research Proposal Threshold: A Case Study of two International Doctoral Students.” Innovations in Education and Teaching International 55 (4): 417–24. DOI: 10.1080/14703297.2016.1251331.
- Collins, J., and N. Brown. 2020. “Where’s the Validation? Role of Emotion Work and Validation for Doctoral Students.” Higher Education Research & Development 41 (2): 1–14. DOI:10.1080/07294360.2020.1833315.
- Cooper, C., Booth, A., Varley-Campbell, J., Britten, N., and Garside, R. 2018. “Defining the Process to Literature Searching in Systematic Reviews: A Literature Review of Guidance and Supporting Studies.” BMC Medical Research Methodology 18 (1): 1–14. DOI: 10.1186/s12874-018-0545-3.
- Cornwall, J., E. C. Mayland, J. van der Meer, R. A. Spronken-Smith, C. Tustin, and P. Blyth. 2019. “Stressors in Early-Stage Doctoral Students.” Studies in Continuing Education 41 (3): 363–80. DOI: 10.1080/0158037X.2018.1534821.
- Durette, B., M. Fournier, and M. Lafon. 2016. “The Core Competencies of PhDs.” Studies in Higher Education 41 (8): 1355–70. DOI: 10.1080/03075079.2014.968540.
- Egan, R., D. Stockley, B. Brouwer, D. Tripp, and N. Stechyson. 2009. “Relationships Between Area of Academic Concentration, Supervisory Style, Student Needs and Best Practices.” Studies in Higher Education 34 (3): 337–45. DOI: 10.1080/03075070802597143.
- Elliot, D. L., and S. Kobayashi. 2019. “How Can PhD Supervisors Play a Role in Bridging Academic Cultures?” Teaching in Higher Education 24 (8): 911–29. DOI: 10.1080/13562517.2018.1517305.
- Galderisi, S., A. Heinz, M. Kastrup, J. Beezhold, and N. Sartorius. 2015. “Toward a new Definition of Mental Health.” World Psychiatry 14 (2): 231–3. DOI: 10.1002/wps.20231.
- Geesa, R. L., K. Lowery, and K. McConnell. 2018. “Mentee Perspectives of a First-Year Peer Mentoring Program for Education Doctoral (EdD) Students.” International Journal of Doctoral Studies 13, DOI: 10.28945/4148.
- Grant, M. J., and A. Booth. 2009. “A Typology of Reviews: An Analysis of 14 Review Types and Associated Methodologies.” Health Information & Libraries Journal 26 (2): 91–108. DOI: 10.1111/j.1471-1842.2009.00848.x.
- Green, P., and J. Bowden. 2012. “Completion Mindsets and Contexts in Doctoral Supervision.” Quality Assurance in Education 20 (1): 66–80. DOI: 10.1108/09684881211198257.
- Gurr, G. M. 2001. “Negotiating the” Rackety Bridge"—a Dynamic Model for Aligning Supervisory Style with Research Student Development.” Higher Education Research & Development 20 (1): 81–92. DOI: 10.1080/07924360120043882.
- Guthrie, S., C. A. Lichten, J. Van Belle, S. Ball, A. Knack, and J. Hofman. 2017. Understanding Mental Health in the Research Environment: A Rapid Evidence Assessment. Santa Monica, CA: RAND Corporation. https://www.rand.org/pubs/research_reports/RR2022.html.
- Hayter, C. S., and M. A. Parker. 2019. “Factors That Influence the Transition of University Postdocs to non-Academic Scientific Careers: An Exploratory Study.” Research Policy 48 (3): 556–70. DOI: 10.1016/j.respol.2018.09.009.
- Hazell, C. M., L. Chapman, S. F. Valeix, P. Roberts, J. E. Niven, and C. Berry. 2020. “Understanding the Mental Health of Doctoral Researchers: A Mixed Methods Systematic Review with Meta-Analysis and Meta-Synthesis.” Systematic Reviews 9 (1): 1–30. DOI: 10.1186/s13643-020-01443-1.
- Hobbs, Burroughs, and McGloughlin. (2015). “Improving Formal Research Training: Developments at NUI Maynooth, Ireland.” GeoJournal 80 (2): 197–201. DOI: 10.1007/s10708-014-9588-0.
- Hobbs, Burroughs, and S. McGloughlin. 2015. “Improving Formal Research Training: Developments at NUI Maynooth, Ireland.” GeoJournal 80 (2): 197–201. DOI: 10.1007/s10708-014-9588-0.
- Howells, K., K. Stafford, R. Guijt, and M. Breadmore. 2017. “The Role of Gratitude in Enhancing the Relationship Between Doctoral Research Students and Their Supervisors.” Teaching in Higher Education 22 (6): 621–38. DOI: 10.1080/13562517.2016.1273212.
- Hughes, G., M. Panjwani, P. Tulcidas, and N. Byrom. 2018. “Student Mental Health: The Role and Experiences of Academics.” University of Derby, King’s College, London, Student Minds. Available on-line at http://www.studentminds.org.uk/theroleofanacademic.html.
- Hutchings, M. 2017. “Improving Doctoral Support Through Group Supervision: Analysing Face-to-Face and Technology-Mediated Strategies for Nurturing and Sustaining Scholarship.” Studies in Higher Education 42 (3): 533–50. DOI: 10.1080/03075079.2015.1058352.
- Janson, A., and L. Howard. 2004. “The Odyssey of Ph. D. Students Becoming a Community of Practice.” Business Communication Quarterly 67 (2): 168–81. DOI: 10.1177/1080569904265421.
- Kearns, H., M. Gardiner, and K. Marshall. 2008. “Innovation in PhD Completion: The Hardy Shall Succeed (and be Happy!).” Higher Education Research & Development 27 (1): 77–89. DOI: 10.1080/07294360701658781.
- Kendal, E., and D. Waterhouse-Watson. 2020. “I’ma Unicorn, ask me how! What the Rise of ‘Quit Lit’and ‘Staypieces’ Says About Higher Education and Academia.” Studies in Higher Education, 1–12. DOI: 10.1080/03075079.2020.1770714.
- Khangura, S., K. Konnyu, R. Cushman, J. Grimshaw, and D. Moher. 2012. “Evidence Summaries: The Evolution of a Rapid Review Approach.” Systematic Reviews 1 (1): 1–9. DOI: 10.1186/2046-4053-1-10.
- Knill, C. 2005. “Introduction: Cross-National Policy Convergence: Concepts, Approaches and Explanatory Factors.” Journal of European Public Policy 12 (5): 764–74. DOI: 10.1080/13501760500161332.
- Lane, L. G., and J. De Wilde. 2018. “The Impact of Coaching Doctoral Students at a University in London.” International Journal of Evidence Based Coaching and Mentoring 16 (2): 55–68.
- Lee, S. 2017. “Peer Support for International Doctoral Students in Managing Supervision Relationships.” Journal of International Students 7 (4): 1096–103. DOI:https://doi.org/10.32674/jis.v7i4.194.
- Levecque, K., F. Anseel, A. De Beuckelaer, J. Van der Heyden, and L. Gisle. 2017. “Work Organization and Mental Health Problems in PhD Students.” Research Policy 46 (4): 868–79. DOI: 10.1016/j.respol.2017.02.008.
- Li, S., and C. Seale. 2007. “Managing Criticism in Ph. D. Supervision: A Qualitative Case Study.” Studies in Higher Education 32 (4): 511–26. DOI: 10.1080/03075070701476225.
- Lusk, C., and A. Fearfull. 2015. “Supporting Students in Higher Education: Results and Recommendations Following a Paradigm Shift Within a Scottish Ancient.” Studies in Higher Education 40 (6): 1107–27. DOI: 10.1080/03075079.2014.881338.
- Mackie, S. A., and G. W. Bates. 2019. “Contribution of the Doctoral Education Environment to PhD Candidates’ Mental Health Problems: A Scoping Review.” Higher Education Research & Development 38 (3): 565–78. DOI: 10.1080/07294360.2018.1556620.
- Marais, G. A., R. Shankland, P. Haag, R. Fiault, and B. Juniper. 2018. “A Survey and a Positive Psychology Intervention on French PhD Student Well-Being.” International Journal of Doctoral Studies 13: 109–138. DOI: 10.28945/3948.
- Marchand, T. 2017. “Action Learning in Postgraduate Research Training.” Action Learning: Research and Practice 14 (1): 83–95. DOI: 10.1080/14767333.2017.1282637.
- Mason, A., and J. Hickman. 2019. “Students Supporting Students on the PhD Journey: An Evaluation of a Mentoring Scheme for International Doctoral Students.” Innovations in Education and Teaching International 56 (1): 88–98. DOI: 10.1080/14703297.2017.1392889.
- Mattocks, K., and S. Briscoe-Palmer. 2016. “Diversity, Inclusion, and Doctoral Study: Challenges Facing Minority PhD Students in the United Kingdom.” European Political Science 15: 476–92. DOI: 10.1057/s41304-016-0071-x.
- McConnell, K., R. L. Geesa, and K. Lowery. 2019. “Self-reflective Mentoring: Perspectives of Peer Mentors in an Education Doctoral Program.” International Journal of Mentoring and Coaching in Education 8 (2): 86–101. DOI: 10.1108/IJMCE-07-2018-0043.
- McPhail-Bell, K., and M. L. Redman-MacLaren. 2019. “A Co/Autoethnography of Peer Support and PhDs: Being, Doing, and Sharing in Academia.” The Qualitative Report 24 (5): 1087–105.
- Metcalfe, J., K. Levecque, and S. Wilson. 2018. Exploring Wellbeing and Mental Health and Associated Support Services for Postgraduate Researchers. Cambridge: Vitae, The Careers Research and Advisory Centre (CRAC) Limited.
- Mousavi, M. P., Z. Sohrabpour, E. L. Anderson, A. Stemig-Vindedahl, D. Golden, G. Christenson, K. Lust, P. Bühlmann. 2018. “Stress and Mental Health in Graduate School: How Student Empowerment Creates Lasting Change.” Journal of Chemical Education 95 (11): 1939–46. DOI: 10.1021/acs.jchemed.8b00188.
- Mowbray, S., and C. Halse. 2010. “The Purpose of the PhD: Theorising the Skills Acquired by Students.” Higher Education Research & Development 29 (6): 653–64. DOI: 10.1080/07294360.2010.487199.
- Oswald, A. J., E. Proto, and D. Sgroi. 2015. “Happiness and Productivity.” Journal of Labor Economics 33 (4): 789–822. DOI:10.1086/681096.
- Page, T., A. Bull, and E. Chapman. 2019. “Making Power Visible: “slow Activism” to Address Staff Sexual Misconduct in Higher Education.” Violence Against Women 25 (11): 1309–30. DOI: 10.1177/1077801219844606.
- Papadatou-Pastou, M., R. Goozee, E. Payne, A. Barrable, and P. Tzotzoli. 2017. “A Review of web-Based Support Systems for Students in Higher Education.” International Journal of Mental Health Systems 11 (1): 1–20. DOI: 10.1186/s13033-017-0165-z.
- Peters, B. G. 2012. Institutional Theory in Political Science: The New Institutionalism. 3rd ed. New York, USA: Bloomsbury.
- Pluye, P., M. P. Gagnon, F. Griffiths, and J. Johnson-Lafleur. 2009. “A Scoring System for Appraising Mixed Methods Research, and Concomitantly Appraising Qualitative, Quantitative and Mixed Methods Primary Studies in Mixed Studies Reviews.” International Journal of Nursing Studies 46 (4): 529–46. DOI: 10.1016/j.ijnurstu.2009.01.009.
- Popay, J., H. Roberts, A. Sowden, M. Petticrew, L. Arai, M. Rodgers, N. Britte, K. Roen, and S. Duffy. 2006. “Guidance on the Conduct of Narrative Synthesis in Systematic Reviews.” A Product from the ESRC Methods Programme Version 1: 1–93. DOI: 10.13140/2.1.1018.4643.
- Pyhältö, K., A. Toom, J. Stubb, and K. Lonka. 2012. “Challenges of Becoming a Scholar: A Study of Doctoral Students’ Problems and Wellbeing.” International Scholarly Research Network Education 7: 1–12. DOI: 10.5402/2012/934941.
- Russel, D., and J. Turnpenny. 2020. “Embedding Ecosystem Services Ideas Into Policy Processes: An Institutional Analysis.” Ecology and Society 25 (1): 1–10.
- Russel, D., J. Turnpenny, and A. Jordan. 2018. “Mainstreaming the Environment Through Appraisal: Integrative Governance or Logics of Disintegration?” Environment and Planning C: Politics and Space 36 (8): 1355–70.
- Salinas-Perez, J. A., M. L. Rodero-Cosano, A. Rigabert, and E. Motrico. 2019. “Actions and Techniques in Supervision, Mentorships and Tutorial Activities to Foster Doctoral Study Success: A Scoping Literature Review.” International Journal of Educational Research 96: 21–31. DOI: 10.1016/j.ijer.2019.05.004.
- Schmidt, M., and E. Hansson. 2018. “Doctoral Students’ Well-Being: A Literature Review.” International Journal of Qualitative Studies on Health and Well-Being 13 (1): 1–14. DOI: 10.1080/17482631.2018.1508171.
- Skopek, J., M. Triventi, and H. P. Blossfeld. 2020. “How do Institutional Factors Shape PhD Completion Rates? An Analysis of Long-Term Changes in a European Doctoral Program.” Studies in Higher Education, 59 (5): 529–552. DOI: 10.1080/03075079.2020.1744125.
- Stubb, J., K. Pyhältö, and K. Lonka. 2011. “Balancing Between Inspiration and Exhaustion: Phd Students’ Experienced Socio-Psychological Well-Being.” Studies in Continuing Education 33 (1): 33–50. DOI: 10.1080/0158037X.2010.515572.
- Sverdlik, A., Hall, N. C., McAlpine, L., & Hubbard, K. (2018). “The PhD Experience: A Review of the Factors Influencing Doctoral Students' Completion, Achievement, and Well–being.” International Journal of Doctoral Studies 13(1): 361–388.
- Sverdlik, A., and N. C. Hall. 2020. “Not Just a Phase: Exploring the Role of Program Stage on Well-Being and Motivation in Doctoral Students.” Journal of Adult and Continuing Education 26 (1): 97–124. DOI: 10.1177/1477971419842887.
- Tricco, A. C., J. Antony, W. Zarin, L. Strifler, M. Ghassemi, J. Ivory, Laure Perrier, Brian Hutton, David Moher, and S. E. Straus. 2015. “A Scoping Review of Rapid Review Methods.” BMC Medicine 13 (1): 1–15. DOI: 10.1186/s12916-015-0465-6.
- UBGA – University of Berkeley Graduate Assembly. 2014. Graduate Student Happiness and Well-Being Report. Berkeley, CA.
- UUK - Universities, UK. 2015. Student Mental Wellbeing in Higher Education. London: Good practice guide. Universities UK. ISBN: 978-1-84036-331-9.
- Vekkaila, J., V. Virtanen, J. Taina, and K. Pyhältö. 2018. “The Function of Social Support in Engaging and Disengaging Experiences among Post PhD Researchers in STEM Disciplines.” Studies in Higher Education 43 (8): 1439–53. DOI: 10.1080/03075079.2016.1259307.
- Waight, E., and A. Giordano. 2018. “Doctoral Students’ Access to Non-Academic Support for Mental Health.” Journal of Higher Education Policy and Management 40 (4): 390–412. DOI: 10.1080/1360080X.2018.1478613.
- Walker, J. 2015, November 12. There’s an Awful Cost to Getting a PhD that No One Talks About. Quartz. Retrieved from http://qz.com/547641/theres-an-awful-cost-to-getting-aphd-that-no-one-talks-about/.
- Whitman, D. S., D. L. Van Rooy, and C. Viswesvaran. 2010. “Satisfaction, Citizenship Behaviors, and Performance in Work Units: A Meta-Analysis of Collective Construct Relations.” Personnel Psychology 63 (1): 41–81. DOI: 10.1111/j.1744-6570.2009.01162.x.
- Williams, S. N., B. K. Thakore, and R. McGee. 2017. “Providing Social Support for Underrepresented Racial and Ethnic Minority PhD Students in the Biomedical Sciences: A Career Coaching Model.” CBE—Life Sciences Education 16: (4): 1–12. DOI: 10.1187/cbe.17-01-0021.
- World Health Organization. 2005. Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva: World Health Organization.
- Wright, T., and R. Cochrane. 2000. “Factors Influencing Successful Submission of PhD Theses.” Studies in Higher Education 25 (2): 181–95. DOI: 10.1080/713696139.
- Wright, T. 2006. “Issues in Brief Counselling with Postgraduate Research Students.” Counselling Psychology Quarterly 19 (4): 357–72. DOI: 10.1080/09515070601043203.