Background: Graduate student mental health is a global public health concern that has worsened during the COVID-19 pandemic. Experts call for collaboration to create infrastructure to engage and treat graduate student mental health.

Proposed Solution to the Problem: This project will engage students as the patient population and researchers, healthcare providers, and university administrators in capacity building and engagement activities to prepare for future patient-centered outcomes research (PCOR) and/or comparative clinical effectiveness research (CER). The leadership team will employ PCORI patient-centered values throughout the project. Using community-based participatory research, the project team will engage patients and stakeholders in activities promoting two-way capacity building and follow PCORI-investigator recommendations for successful engagement by building relationships, defining expectations, establishing communication, developing guidelines, co-learning, facilitating dialogue, and valuing contributions.

Objectives: The long-term objective of this award is to increase the capacity of graduate students, faculty, staff, on- and off-campus healthcare providers, and university administrators to collaborate in PCOR/CER that effectively addresses the mental health needs of underrepresented graduate students and improves health outcomes among this patient population. The project team propose three aims to meet this objective:

1. Engage key stakeholders (e.g., graduate student patients, healthcare providers, academic researchers, and university administrators) in a collaborative governance structure and form a mental health taskforce.
2. Build graduate student/patient, healthcare provider, administrator, and researcher capacity to engage in PCOR/CER through co-learning activities focused on underrepresented graduate student mental health and patient-centered and partnered research.
3. Conduct deliberative democracy forums to prioritize research on the mental health needs of underrepresented graduate students and convene research workgroups to prepare for future PCOR/CER.

Activities: First, the project team will establish a shared governance structure, including a Steering Council that will guide the project’s engagement activities. This council will include representation from underrepresented graduate students, healthcare providers, advocates, and experts in student mental health in the University of California (UC) education system and across the United States. Members will identify patients and stakeholders for a workgroup focused on mental health education. The taskforce will meet regularly to develop PCOR trainings, educational material, and a podcast series on graduate student mental health. The trainings will include Research 101, Ethics in Research, and PCOR/CER. This will be followed by a virtual photovoice gallery featuring photographs taken by graduate students as part of the project team’s previous work. The educational workshops move from basic information such as “Mental Health 101,” to more nuanced understandings of the academic environment on graduate student mental health and potential interventions. These workshops will then inform a podcast series involving three to four episodes focused on underrepresented graduate student mental health and will include testimonials and experiences in settings of higher education.

Finally, the project team will use recommendations for future research collected after each co-learning activity to carry out a series of community forums. The team will use deliberative methods, an approach that encourages patients and stakeholders to share their experiences and hear diverse perspectives, to collectively decide upon next steps for PCOR/CER. The project team has used this method in previous PCORI engagement awards and found it produces informed and well-reasoned input that can inform collective action. The team will hold five virtual forums with members and affiliates of five UC campuses recognized as Hispanic-serving Institutions. The information gathered will be compiled in a report and shared with a workgroup of patients and stakeholders who will develop comparative effectiveness questions for future research.

Projected Outcomes and Outputs: During the award period, the project team will develop: 1) a three-part training series on PCOR/CER focused on graduate student mental health, 2) an education webinar series on underrepresented graduate student mental health, 3) a podcast series with graduate students living with mental health conditions, and 4) a report summarizing information gathered and next steps for PCOR/CER. By the end of the award period, the team will have built the capacity of student patients and stakeholders who can continue to partner in PCOR/CER. This award will result in strategies to address the mental health needs of underrepresented graduate student and will lead to subsequent intervention research.

Patient and Stakeholder Engagement Plan: This project has four primary stakeholder groups: 1) student patients; 2) UC faculty and academic researchers; 3) behavioral health providers; and 4) UC administrators including department chairs, deans, provosts, vice chancellors, and chancellors. A key goal of this project is to bring these key stakeholder groups together in neutral spaces where ideas and perspectives can be shared and plans for future research to reduce mental health disparities among underrepresented graduate students can be developed.
 
Project Collaborators: This project will be carried out in California by academic investigators at the University of California Riverside (UCR) School of Medicine and UCR Health, in collaboration with Solid Ground Wellness in Recovery. The leadership team will build on UC-wide networks, including the UC Graduate and Professional Council and Healthy Campus Network.