2021-22 MChem Projects: Students' experiences of mental health and studying chemistry at Oxford
My MChem project students have submitted their theses to the online repository this year, and I’m writing a short blog about each one to help share the excellent work they did.
Lynne Ye Evans wrote a thesis titled Students' experiences of mental health and studying chemistry at Oxford, which can be found in the ORA database. The project involved an anonymous survey with both quantitative and qualitative dimensions.
Mental health has become a central concern in modern HE, and the social fragmentation resulting from pandemic social distancing measures has perhaps increased the salience of the fundamental issues. Surveys at a national level often return strikingly poor results: it seems that students are really struggling with their mental health sector-wide. We have a very poor understanding of how the disciplinary dimensions of study relate to student mental health, and this study explores the subject-specific experiences of Chemistry students as well as the subject-generic ones.
My hope is that this thesis can serve not only as a study of Oxford Chemistry in particular, but also serve more generally as a ready-to-go template for related projects in other contexts. The survey and the literature review here might serve as a great starting point for future MChem projects on student mental health, for example.
Content Warning
This blog contains discussions of mental health and mental illness, most particularly stress, anxiety, and depression. There is one section in the Chapter 4 discussion (with another content warning just before it) which relays student expressions of vomiting, panic attacks, and self-harm.
Chapter 1
Ye Evans clarifies the key terms, distinguishing ideas like Mental Health, Mental Illness, and Wellbeing. Ryff’s dimensions of personal wellbeing, the central model for chapter 4, is set out.
The survey of existing prevalence literature is analysed, including a brief discussion of Ibrahim’s observation that a study’s response rate seems to correlate negatively with the prevalence of mental illness reported.
The medical and social models of disability are discussed in the context of mental health, and the central education-relevant theories (cognitive load theory, the window of tolerance) are outlined.
Chapter 2
Ye Evans states her research questions:
1. How common are stress, anxiety and depression among undergraduate Oxford MChem students?
2. How does studying chemistry interact with students’ mental health?
Chapter 3
Chapter 3 is quantitative. A clinically-validated survey - the DAS-21 instrument - was used to quantify levels of stress, anxiety, and depression in respondents. To reduce ethical risk, the survey was designed to be anonymous, and this let us ask some very broad demographic questions to analyse sub-populations. [MON note: a point of technical discussion in the ethics process was whether the gender category “non-binary/other” was a satisfactory compromise between anonymity and respect for participants’ identities.]
The survey attracted 102 responses (102 students is appx. 14% of the undergraduate cohort), and the responses were compared with literature reports of DAS-21 studies. This blog’s discussion from this point on focuses on respondents (e.g. when talking about ‘students’), and it is important to be cautious when extending these analyses beyond the sample group.
The global distributions showed that substantial proportions of students had severe or extremely severe levels of stress, anxiety, and depression.
Comparing response distributions by gender at the p<0.05 level showed that female students and the (numerically few) non-binary/other students reported higher levels of anxiety and stress than male students. The difference in depression score for male and female students was not statistically significant, but non-binary/other students had significantly higher depression scores than male students.
Anxiety score distributions, stratified by gender.
Comparing results by year of study showed that the median level of stress and anxiety became lower from first year to fourth year. The depression trend was similar, except that the fourth year had a higher median score than third year.
Stress score distributions, stratified by year group.
Comparing students by international student status showed the distributions to be statistically indistinguishable at the p<0.05 level.
Depression score distributions, stratified by domestic/international status.
Ye Evans acknowledges the limitations of sample size, but goes on to say that
“Even so, the DASS-21 results in this study seem troubling. 44% of participants exhibited “Severe” or “Extremely Severe” levels of depression, and a third of participants had anxiety scores in the “Extremely Severe” range. The global medians for depression, anxiety and stress all sit in the “Moderate” bracket. These absolute levels of depression, anxiety and stress among all participants are high, and should be cause for concern.”
The statistics are an important basis for recognising and understanding the incidence of issues such as depression. Chapter 4 explores the qualitative responses to develop a fuller picture of how these numbers relate to these students’ qualitative experiences of the degree.
Chapter 4
Ye Evans analysed the free text responses using Ryff’s dimensions of wellbeing, and constructed themes which centred the relationship between expectations and capacity: negative wellbeing is typically associated with expectations somehow exceeding personal capacity.
I have presented less of the theory than the data below, trying to sketch in only the skeleton structure of the chapter’s argument. It is again important to emphasise that these qualitative responses relate to the same sample as the quantitative work: this chapter might be seen as deeper exploration of a population already shown to have poor stress, anxiety, and depression distributions.
[MON note: there is a lot of pain here. I feel it is important to witness this, so I have excerpted the chapter’s quotes quite extensively. I encourage you to skip the Chapter 4 discussion if you aren’t in a good place to read it right now.]
Academic work was described as relating closely to students’ mental states.
“[Studying chemistry] constantly interacts with my mental health. I feel smarter, more valuable and more positive when I understand things in tutorials/do well in exams. However there is a constant feeling of stress and a need to constantly work because the workload is massive, and not understanding things gives a feeling of dread for exams, as if it will never be possible to learn it all in time/know it all.” ~ Female, 2nd year
The experience of being in the lab was often described positively
“Restarting labs and having success at practical chemistry benefitted my mental health as I felt like I was actually capable of doing something good.” ~ Female, 2nd year
But the overall workload - including the lab hours - was often described as overwhelming both in a wellbeing and an academic sense:
“The lab hours are what really make the degree very difficult and stressful. In my third year I have had the most relaxed time because of the fewer labs, since I have done a supplementary course and a literature review to take lab hours away. Going to two lectures without a break, then into a 6 hour lab, which would once a week be followed by a two hour physics class is simply not doable. 30 minutes break for lunch in labs is also not sufficient. It just felt like we'd be worked to the bone and then expected to wake up and do it all again, regardless of whether or not we understood the chemistry behind what we did.” ~ Male, 3rd year
“The content is hard and there is so much of it. We have so many contact hours and tute sheets to do every week that there isn’t any time to stop and understand a topic, let alone enjoy it. Doing 2 labs, 10 lectures and 3 tutorials a week is such a large work load and is barely [manageable]. I started anti depressants this year (second year) because I was really struggling. I felt overwhelmed by the work load, constantly stressed, like I couldn’t ever catch my breath and that I wasn’t good enough. I felt stupid every time I attempted work and couldn’t understand it, I felt so overwhelmed with the amount of work I had to do that I physically couldn’t get out of bed.” ~ Female, 2nd year
The specific issue of overall workload evoked strong responses, and the number of workload hours described was often concerning.
[On how studying chemistry interacts with MH] “Very very very negatively, this degree is a literal pile of garbage that no one should have to go through. Before uni I thought chemistry it’s cool, now I think chemistry is god awful and a pile of shit that is too much work that is just forced open us with an expectation to just be fine with it. Why would anyone ever be fine with working 12 + hours a day and still feel like they are getting no where???? GARBAGE” ~ Female, 3rd year
These long hours often restricted students’ scope to do other things, sometimes including activities like socialising and sleeping.
“in previous years the long hours (60-70 hour work weeks) for tutorial submissions led to a decline in mental health. Found it very difficult to juggle social/physical life with academic studies, especially for the first two years of the degree” ~ Male, 4th year
“The variety of workload between colleges for the same subject is one of the most demotivating factors. Some colleges having 10 hours of tutorial work per week, whilst mine has 40 hours per week, is very frustrating because it feels impossible to fit in any extracurricular activities or even sleeping at times, whilst others have 30 more hours in their week to fit things into.” ~ Female, 1st year
“In first and second year in particular, I was overwhelmed with the workload of the degree and found myself constantly stressed. I would miss out on social activities and became socially reclusive in order to meet deadlines. I would have little to no downtime, and was often unable to find time for everyday necessities such as exercise, cooking/eating, hygiene, etc. As a result of this, the quality of my work began to suffer, adding further stress and becoming a vicious cycle.” ~ Male, 3rd year
This can influence how students construct their identity. When all you do is study, you have little choice but to build your self-image around it.
“I have regular breakdowns after getting negative tutorial feedback on work which I have spent 20+ hours doing and sacrificed my social life and mental health for. I would be able to handle criticism except Chemistry requires so much work and time that it will never feel worth it and satisfactory. It means I base my whole self worth around how well I do as it is the only thing that I do. Please let me have a life.” ~ Female, 1st year
There was some discussion of how the social restrictions of the pandemic might also have restricted the scope to socialise.
“I think last year during the lockdown it was overall a negative experience. Chemistry work took up a good portion of my life and I found myself with barely enough time left over to maintain a good social life. I ended up sacrificing my hobbies and this meant I kind of lost sight of who I am outside of chemistry. However, this year it has been a much more positive experience. Having everything in person means that my motivation is high and my work life- social life balance is much better. Regaining my personality outside of the subject meant that studying chemistry is a lot more enjoyable again and I am all around happier.” ~ Female, 2nd year
Tutors and colleges were often described as sources of support
“My head tutor - she was really lovely and really helpful and really does her best to support me and assure me that I am good enough. Academic support at college- also really helpful and lovely, referred me to counselling (my tutor helped me get a slot with the counselling service as they are always overbooked) counselling saw me for 2 sessions but nothing else because they are so overbooked but referred me to the GP to get antidepressants which I am currently on and they have really helped” ~ Female, 2nd year
But the actions of tutors could have a negative effect on self-perception.
“my tutors were not helpful- I got told in my first ever organic tutorial that I would never be a good organic chemist as I wasn't gifted at it, which didn't help.” ~ Female, 1st year
And discussions with tutors about disability were sometimes hard to navigate
"I have tried to talk to tutors about concerns with work load with my dyslexia. I believe they don't quite understand the strain it puts me under. The [accommodations] made from them were reasonable though, saying I didn't need to complete sheets etc. But, this sometimes doesn't help as I still feel the pressure to complete things so as not to fall behind […] Lots of these issues stem from the pace of the course: not aided by side comments from tutors about how people should read more, or the speed of speaking in tutorials when my short term memory is pretty bad.” ~ Male, 3rd year
The experience of studying with learning disabilities was brought up a few times, and seems to interact particularly negatively with the overwhelming workload.
“The workload is too high for most students to have a reasonable work-life balance and the system of having short, intense terms followed by a longer break leads to exhaustion and exacerbates this. As deadlines are therefore tight and missing them can lead to a person getting behind quickly, it also disproportionately affects students with learning difficulties (like myself) who take longer than most students to complete tutorial work and absorb information. If the scope of the course was reduced, I think it would have a positive impact on my mental health.” ~ Female, 3rd year
The broader way that illness or disability interact negatively with the experience of workload was expressed in various ways, including delaying help-seeking behaviours.
“Whenever I had to take time off for sickness, missing lectures and/or one tute would put me behind to the extent where i was working 6am-10pm days to try and catch up, as the degree is so intense from a workload/ content perspective. These long days of studying would then make me ill again and so it felt like an endless cycle. This caused me to feel hopeless and overwhelmed on multiple occasions, and over time have caused me to dread studying at all” ~ Female, 1st year
“I would say that even though I have had a very difficult ride with my mental health, it cannot all be blamed on the degree. I do think though that the high pressure and stress of a degree that is so difficult and demands so much from its students definitely stopped me from getting the help I needed initially and made my mental health much worse, though there is no way to know if these issues would have been just as bad on another degree or at another university.” ~ Female, 3rd year
“Wouldn't say that studying chemistry is the 'cause' of any of my mental health problems, but trying to balance the intense demands of the degree alongside my mental health issues has definitely caused them to worsen at times. […] Delaying increasing my dosage of a SSRI because of fear of side effects interfering with my ability to study for exams many weeks in advance (despite the advice of a GP that it would be fine, because the workload was so great I was terrified that literally any extra obstacle would surely result in me failing) - this of course in turn led to my mental health being worse than it had to be in the run up to exams, leading to big spirals etc” ~ Female, 3rd year
There were stark descriptions of how the strain of the course could manifest [Content warning: vomiting, panic attacks, self-harm].
“The workload of the degree is excessive and has made my [pre-existing] anxiety exponentially worse. I have been so overwhelmed so much of the time, I am physically sick at least once a week, primarily during term [time] due to the degree. Since starting university, I have been diagnosed with social anxiety disorder, general anxiety disorder, panic disorder and depression, and have had to start taking anxiety and depression medication, as well as stomach protection due to the excessive vomiting. The way in which tutors interact with me have often made me feel stupid and worthless exacerbating the problem” ~ Female, 2nd year
“I hadn’t ever experienced panic attacks before coming to oxford but in [Michaelmas] of first year I had my first one the night before a thermodynamics deadline. From then on, I continued to experience them more and more as prelims came closer. They were purely based on academic stress alone, whether it be feeling unprepared for a tutorial or the very real fear of failing prelims. In second year the anxiety has got better but I think it may have just been replaced with a sort of numbness towards my degree due the massive increase in workload which leaves very little room for enthusiasm. The tutors and department don’t seem to understand this at all which makes it a lot more difficult to get help.” ~ Male, 2nd year
“My mental health was absolutely fine, and within 2 terms at Oxford I was self harming from the sheer pressure and stress.” ~ Female, 1st year
It is striking that one apparently-positive response to the pressure involved stopping meeting academic deadlines.
“Since receiving therapy and medication, I have realised that meeting every deadline is not necessarily always the best thing for me. By taking that pressure off, I have managed to start bringing the quality of my work back up.” ~ Male, 3rd year
It is important to again acknowledge that the 102 participants were self-selecting, and that these experiences might not reflect an ‘average’ experience of Oxford. At the same time, it seems clear that an overwhelming curriculum can interact very negatively with students’ mental states.
Students’ descriptions of their experiences of the degree invite further questions, both about the specific situations of individual students and the general procedures in place to monitor how students experience the curriculum. In particular, student workload seems to be a cause for substantial concern; many students discuss how their workload grossly exceeds the University’s expectation of 40h/week.
Chapter 5
Ye Evans makes three recommendations on the basis of her study.
Centre Students’ Voices
The department should centre students’ voices in future decisions about the MChem curriculum, assessment structure and teaching strategy.
Groups experiencing particularly high levels of mental illness include first year students, students identifying as female, non-binary or other genders, and disabled students. Chemistry tutors and the department should consider opening a dialogue with students from these groups to determine how they might best be supported.
Reduce the Scope of the Core MChem Material
Many participants expressed that the high workload of the MChem degree negatively impacted their MH.
“The incredibly large workload associated with the MChem degree, which feels much higher than the vast majority of other degrees (except perhaps medicine) has [led] to me becoming depressed which I believe is a direct consequence of the stress of my degree. In particular, as a first year being set questions on 3rd year organic mechanisms has been extremely time consuming and the workload seems to vary wildly between colleges and tutors with very little standardisation across the department. As a department, it seems to be widely accepted that undergraduate chemists should be doing a lot more hours of study than the 40 recommended on the university website, and this is reflected in the high suspension and drop out rates.” ~ Female, 1st year
Students need to have a clear understanding of exactly what is expected of them by tutors and by the department, in order to prevent overload and burnout. The department should therefore review the current expectations expressed by the curriculum, and consider whether such a high volume of course content is compatible with existing university policy.
Reshape the Student-Staff Relationship
The university has committed to providing more training for staff who support students with MH difficulties. Tutors and teaching laboratory supervisors may be the only academic staff with whom students are in regular contact over the whole course. This means that even though supporting students with MH difficulties may not be part of their formal role, tutors and laboratory demonstrators are well-placed to either facilitate or suppress a supportive learning environment.
“At least some of this could be helped if there was more consistency from the department/tutors - currently, there are still some who make comments suggesting that they don't 'believe' in mental health problems, or who clearly have no idea how to react when faced with them (e.g. someone having a panic attack in a tute, someone unable to come because they are too depressed to leave their room).” ~ Female, 3rd year
The way tutors interact with students is key to student’s emotional and psychological well-being. Tutors should receive training on how to cultivate healthy working relationships with their students, including how to communicate the expectations they have of their students. This might include ‘mental health first aid’ training, which teaches people how to offer initial support (e.g. in the case of someone developing a MH problem, experiencing a worsening of an existing condition, or in a MH crisis) until appropriate professional support is received.
In closing, Ye Evans gives the very last words in the thesis to a participant looking back from the end of the degree.
“I hope that future undergrads do not go through the same experience that I, and other people I know who have studied chemistry at oxford, have been through. I hope that there is systematic change such that people can learn and love their subject instead of going through the degree, terrified that you are not going to be able to continue to manage and cope.” ~ Female, 4th year