Nationwide assessment of the mental health of UK Doctoral Researchers

The study investigates whether UK Doctoral Researchers (DRs) are at higher risk of poor mental health compared to similarly educated working professionals (WPs). It is motivated by concerns that poor mental health contributes to DRs leaving academia, with potential consequences for research output and broader socio-economic impacts. Prior large-scale surveys and reviews report high levels of stress and mental health problems among DRs, but most lack appropriate comparison groups and do not assess serious mental illness (SMI) symptoms or address causality. The purpose is to quantify differences in prevalence and severity of depression, anxiety, mania, and suicidality between DRs and WPs, to gauge DRs’ perceptions of mental health commonality during the PhD, and to test whether differences persist after accounting for pre-existing mental health problems, thereby informing institutional policies and supports.

The paper situates its work within evidence that DR mental health is problematic: Nature surveys report 36% of DRs sought help for anxiety/depression; a mixed-methods systematic review and meta-analysis indicates elevated stress among DRs. A key comparative study (Levecque et al., 2017) found higher psychological distress in DRs than undergraduates and educated employees but used GHQ-12, which has been critiqued for response biases, reliability, and limited clinical validity. Existing studies rarely include SMI measures (e.g., mania, suicidality) or address whether poor mental health among DRs pre-dates doctoral study. The authors highlight these gaps as the rationale for their design choices: validated clinical cut-offs, inclusion of SMI-related measures, and controlling for premorbid mental health history.

Design: Online, cross-sectional, between-group survey administered via Qualtrics, comparing current UK-based DRs with a matched group of educated working professionals (WPs). The broader project was mixed-methods; this paper reports quantitative comparative prevalence and symptomatology.

Participants and eligibility: DRs had to be currently studying for a PhD at a UK university. WPs were required to be aged ≥21, hold at least a UK undergraduate degree at 2.1 or above, and work in the UK at least 0.6 FTE (≥3 days/week), mirroring part-time PhD minimum FTE. Final analytic sample for mental health perceptions and outcomes included 4608 participants (3352 DRs; 1256 WPs), representing ~3.29% of the UK DR population by HESA statistics.

Recruitment: Contacted all UK Doctoral Schools (N=162) to disseminate to DRs; contacted PR departments of top 100 graduate employers and top 500 UK businesses for WPs; none confirmed dissemination. Additional recruitment via project social media, Prolific Academic, paid Facebook advertisements, and snowballing via debrief.

Measures:

• Demographics: Group (DR/WP), age, gender, ethnicity, citizenship, first language, dependents, region, disability (type), study/work area; DR-specific (mode, funding, year, additional work, hours, fieldwork months); WP-specific (occupation, likelihood of future PhD).
• Mental health history: Self-reported lifetime mental health problems (with/without professional diagnosis), current problems and change, history of mental health crisis (hospitalised/not). Premorbid onset assessed using adapted CIDI life-course milestones (before/after primary or secondary school; during undergraduate; after UG; during PGT; during PhD; during employment; other) to improve retrospective accuracy.
• Perceived commonality/impact (DRs only): True/False/Not sure endorsements on statements about mental health being the norm during PhD, peers’ experiences, considering or taking a break, or ending the PhD due to mental health.
• Clinical outcome measures with established cut-offs and reliability: PHQ-9 (depression; 9 items, 0–27; Cronbach’s α=0.89 in-sample); GAD-7 (anxiety; 7 items, 0–21; α=0.90); Altman Self-Rating Mania Scale (ASRMS; 5 items, 0–20; α=0.66); Suicidal Behaviours Questionnaire-Revised (SBQ-R; 4 items; α=0.81; cut-off ≥7 indicates high suicide risk in general population).

Procedure and ethics: Web link access; online information sheet and tick-box consent. Eligibility screen, then optional questionnaires (sensitive items optional). Debrief provided and prize draw offered. Ethical approval: University of Sussex Sciences and Technology C-REC (ER/CH283/9) on 19 December 2017.

Analysis: SPSS v25. Descriptives (means/SDs; frequencies/percentages). Missingness examined via logistic regression predicting complete vs missing data from age, gender (dummy-coded), ethnicity (White British vs others; White vs non-White), disability, and group (DR/WP); no predictors significant (all ps>0.05). Research questions: (1) Frequencies/percentages for DR perception statements. (2) Independent-samples t-test for age of mental health problem onset (DR vs WP), supplemented with chi-square tests for life-phase of onset; significant interactions explored via count distributions. (3) One-way independent-groups MANCOVA (group: DR vs WP) with Bonferroni correction on four dependent variables (PHQ-9 total, GAD-7 total, ASRMS total, SBQ-R total), covarying age, gender (dummy-coded), disability status, ethnicity (two contrasts), and mental health history (any history vs none). Item-level exploratory analyses conducted for SBQ-R facets (lifetime/recent ideation, future intent, attempts).

Sample: 4608 participants (DRs=3352; WPs=1256). Mean age overall 31.36 (SD=9.24); DRs 30.74; WPs 33.02. Females ~65% of DRs and 62% of WPs. Disability reported by ~16% DRs and ~15% WPs.

Perceived commonality/impact among DRs (n≈3056–3060):

• 42.3% believed developing a mental health problem during the PhD is the norm; 40.6% believed most peers had experienced mental health problems.
• 35.8% had considered ending their PhD due to mental health.
• 42.0% had considered taking a break; 14.6% had taken a break (intermitted) due to mental health.

Lifetime prevalence and onset:

• Any lifetime mental health problem (diagnosed or not): higher in DRs than WPs (χ²(1)=18.39, p<0.001; φ=0.06).
• Lifetime prevalence of professionally diagnosed problems: no difference (χ²(1)=0.00, p=0.99; φ<0.01).
• Age of onset: no difference (t(946.51)=0.58, p=0.56).
• Life-phase of onset: small difference (χ²(5)=26.09, p<0.001; φ<0.10), with DRs reporting later onset (during/after undergraduate studies) than WPs; pattern remained when stratified by diagnosis status.

Clinical cut-offs (Table 3):

• Depression (PHQ-9 categories): higher prevalence of moderate-to-severe in DRs vs WPs (χ²(4)=41.74, p<0.001; φ≈0.10). Overall, 70.9% of DRs exhibited at least mild depression vs 62.5% of WPs (from category counts).
• Anxiety (GAD-7 categories): higher prevalence of moderate-to-severe in DRs vs WPs (χ²(3)=98.47, p<0.001; φ≈0.15). Overall, 74.2% of DRs had at least mild anxiety vs 62.4% of WPs.
• Mania (ASRMS): higher high-probability of mania among WPs (23.0%) than DRs (15.4%) (χ²(1)=33.61, p<0.001; c=0.09).
• Suicidality (SBQ-R): no group difference in overall risk categories (χ²(1)=1.28, p=0.26); 35.1% of DRs and 33.2% of WPs met the “at risk” threshold (≥7).

Symptom severity (MANCOVA with covariates): overall group effect significant (Λ≈0.98), F(4,3737)=22.60, p<0.001.

• Depression: DRs higher (EMM=8.77, SE=0.11) vs WPs (EMM=7.96, SE=0.18); F(1,3740)=14.97, p<0.001.
• Anxiety: DRs higher (EMM=8.47, SE=0.10) vs WPs (EMM=7.08, SE=0.16); F(1,3740)=57.58, p<0.001.
• Mania: WPs higher (EMM=3.53, SE=0.08) vs DRs (EMM=3.06, SE=0.05); F(1,3740)=27.97, p<0.001.
• Suicidality: no difference (DRs EMM=5.92 vs WPs EMM=5.98); F(1,3740)=0.39, p=0.53.

SBQ-R item-level exploratory analysis:

• Suicide attempts: WPs slightly higher (EMM=1.30, SE=0.02) than DRs (EMM=1.26, SE=0.01); F(2,3748)=5.72, p=0.02.
• No differences for lifetime ideation, recent ideation, or future intent.

Overall, DRs show elevated depression and anxiety compared with educated working controls, not explained by higher rates of pre-existing diagnosed mental health conditions; suicidality is high in both groups relative to general-population benchmarks.

Findings address the central question by demonstrating that DRs have significantly higher levels of depression and anxiety than matched educated working professionals, even after controlling for demographics, disability, ethnicity, and mental health history, suggesting that doctoral study conditions may contribute to poorer mental health. The absence of differences in diagnosed lifetime prevalence and age of onset, coupled with a later life-phase onset among DRs, argues against pre-existing conditions being the primary driver of the observed differences. Mania indicators were higher in WPs, and overall suicidality did not differ between groups, though both groups exhibited concerningly high suicide risk relative to general population estimates. DR perceptions that mental health difficulties are common, and reported consideration or enactment of study intermissions due to mental health, underscore the occupational impact. The results extend prior international work (e.g., Levecque et al.) by using clinically validated measures with cut-offs and including SMI-related constructs (mania, suicidality), and by incorporating premorbid mental health controls. They highlight the potential for depression and anxiety to impair cognitive functions critical for PhD completion (executive function, attention, working memory), emphasizing the need for proactive institutional support. Policy implications include a mandate for universities and funders to review doctoral training practices and invest in preventive and responsive mental health interventions; national surveillance of student suicide should disaggregate by study phase to monitor DR-specific risk.

This nationwide UK study provides robust comparative evidence that Doctoral Researchers experience higher depression and anxiety than similarly educated working professionals, not attributable to higher premorbid mental health diagnoses, and perceive mental health difficulties as common during PhD study. While mania risk appears higher among working professionals and overall suicidality does not differ between groups, the prevalence of suicide risk is high in both samples. These findings call for universities and funders to reassess doctoral training environments, implement preventive measures, and expand access to targeted mental health support. Future research should investigate mechanisms underlying elevated DR anxiety and depression, examine heterogeneity across funding, discipline, and student status (home/international), include broader SMI and unusual experiences, and improve national monitoring of suicidality with DR-specific disaggregation. Longitudinal and mechanistic studies are needed to clarify causal pathways and inform effective interventions.

Potential selection bias may inflate prevalence estimates: the survey may have disproportionately attracted participants with mental health difficulties in both groups. The sample overrepresented White British and female participants, limiting generalizability and applicability beyond the UK. Mental health outcomes relied on brief self-report screening tools rather than diagnostic interviews, which may affect validity, although online formats may reduce social desirability bias. The exploratory item-level analysis of the SBQ-R was post hoc and should be interpreted cautiously.