Mental Health in Higher Education and the Sector Challenges Ahead
By Jane Bozier, Health and Social Sciences Lecturer, LSST Luton Campus
Increasing numbers of students in Higher Education (HE) are feeling depressed and even suicidal. Despite a resilient rise in student mental health awareness, it is time for the entire HE sector to join together and put student mental health first – and keep it there as a planned priority.
Mental health is a global issue that matters to everyone in HE. It determines learning, productivity and the relationships we have with others. Although mental health remains an HE imperative, the way we collectively understand it remains a colossal challenge.
Mental health issues and stress
Understanding mental health begins with accepting that its causes vary greatly from person to person owing to a multifaceted range of circumstantial issues (Murray, 2019). Although there are established causes for mental health problems – such as biological factors, life experiences and trauma – these are often complexly interlaced with stress and require further collective and intense investigation.
The National Union of Students (NUS) highlights that the top causes of student stress are: meeting assignment deadlines 65%, exam pressure 54%, financial worries 47%, making new friends 27% and living away from home 22% (see Lawton, 2019 and Murray, 2019). When students are enrolled onto HE courses, there are unique contributing factors which raise student stress levels. These, in turn, increase the risk of developing a mental health problem (Vieber, 2017). Out of 1,000 students surveyed by Unihealth, a free wellbeing messaging service for students, 82% reported suffering with stress and 45% with depression (Szteliga, 2018).
The HE sector places students under an additional set of distinctive circumstances – including balancing studies with work and life. When these circumstances combine they can be particularly damaging to mental health if not managed (Aronin and Smith, 2016).
The student stereotype
The student stereotype is often insincerely portrayed in popular culture as that of dancers, drinkers and daters – who are apparently enjoying the best years of their life. Yet, by contrast, a startling 1 in 4 students in HE experiences mental health problems each year (The Insight Network, 2018).
NUS Connect (2018) reports a 76% increase in demands for counselling services and the University of Oxford (2018) shows a continued increase from 7.4% to 11.7% of students accessing counselling services. With such figures, it is clear the sector collectively – and urgently – needs to improve student mental health and wellbeing.
For students who have to deal with mental illness at any HE establishment, there is a likelihood of feeling a continual disappointment for not fitting the aforesaid popular culture student stereotype.
Despite the social interactions of a classroom and the busy learning environment, HE can, in itself, be isolating especially when students move away from home comforts, close friends and family that they have grown familiar with.
What is ‘good’ mental health?
Good mental health is when we can express and manage a range of positive and – more surprisingly – negative emotions. Speaking up about negative thoughts, feelings and emotions are all perfectly fine and part of good mental health (Veiber, 2017).
The array of clear definitions of good mental health are teeming and crowded. For example, Mind, a mental health charity, defines good mental health as, ‘being generally able to think, feel and react in the ways that you need and want to live your life’ (see Mind, 2013). However, when it comes to clearly defining poor mental health, the opposite is true. There is very little clarity, in comparison. However, notionally, perhaps bad mental health is the opposite of good mental health – or the absence of it?
More recently, mental health is often used as a synonym for a range of different mental health conditions. These may include schizophrenia, depression and anxiety – all of which are very distinct from one another. Other common mental health problems include self-harm and eating disorders (Hawkins, 2019 and Aronin and Smith, 2016). Adding to a complex mental health lexicon, terms such as ‘positive mental health’ and ‘mental wellbeing’ have been used to underline that mental health is more about wellness than illness.
Signs of possible mental health problems
There are many warning signs that could indicate that students may be struggling with mental health issues (Murray, 2019 and Wynaden, 2014). The student may notice that they have:
Students need to be confidently reminded that if they have any signs or symptoms of a mental illness, they should see their GP or a mental health professional. No mental illnesses will improve by itself, and if untreated, may actually get worse over time. Ideally, the most important time to focus on student mental health would be at the start of term (Veiber, 2017). This is when students start to adjust to new environments and may feel lonely and isolated.
Regulatory recognition of mental health
The Office for Students (OfS), the independent HE regulator, encouragingly recognises the growing mental health needs within the HE community, alongside the need for an approach based on prevention and early intervention. Yvonne Hawkins, the OfS Director of Teaching Excellence and Student Experience, states:
‘For students to thrive, wellbeing is vital – and good mental health is an essential ingredient.’
As a result, the OfS is funding innovative projects which aims to improve student health, wellbeing and educational outcomes whilst studying. Some of these initiatives include: emotional resilience sessions, access to sport and exercise wellbeing activities, mental health training for staff and peer support groups to empower students throughout their learner journey (Hawkins, 2019).
Students are failing to seek enough help
When students are experiencing a mental health problem they can feel overwhelmed, sometimes confused and frightened. Unfortunately, it is common for students to feel alone, to try and ignore what is happening, keep quiet and try to ‘keep coping’ and pretend that everything is okay (Abrams, 2017 and Aronin and Smith, 2016).
Students should be encouraged to talk with professionals, support staff, family, friends and peers about how they are really feeling. Maybe they feel uncomfortable or embarrassed talking about their feelings or possibly feel that others will not understand. Students might even incorrectly feel that getting help will not work and that they are ‘not worth it’ and, in some cases, may not even recognise or accept that they are experiencing difficulties (Weale, 2019 and Wynaden, 2014).
How do we help and what should we do?
We can all do small things that can make a big difference. If you notice that someone is showing signs of a mental health problem – listen without judging! Messaging, ringing or popping in to see someone just to say “Hi” lets them know that you are there for them and reminds them that you care.
Remind students that talking about how you feel can sometimes be all that is needed, so it is important not to stay silent. Ask students to involve themselves with The Student Room, a student discussion forum and Papyrus, a youth suicide prevention charity. They are both working jointly to raise awareness of mental health problems within the student population, reducing stigma and encouraging students to speak up (Abrams, 2017, NHS, 2016 and University Business, 2019).
Top tips for good student mental health
1. DO NOT be silent about mental health! Speak up NOW! Speak up and ask for help, talk to friends and family and if you feel you cannot talk to them, talk to someone in student support or your GP. There are also many specialist services you can ring, email or text, if you find that easier. Some are listed below?
2. Exercise. Any activity that you enjoy releases happy chemicals into your body which lift your mood. It does not have to be an hour in the gym, it could be a walk or dancing. What is important is that it is something you enjoy.
3. Eat healthily. Cut down on caffeine and alcohol.
4. Get a good night’s sleep. Think sleep hygiene which includes setting a regular time for going to bed, shutting of technology an hour beforehand, gentle yoga or meditation, a warm bath, listening to some relaxing music or a little light reading. Pause from your busy day and prepare your mind for sleep.
5. Set small positive goals. This could include making your bed, making a cup of tea, washing up, whatever you do is an achievement helping you to feel better about yourself.
6. Keep in touch. Stay in touch with friends and family and do positive things. Ask how they are and what have they been doing?
Here is a powerful message from Emma, a mental health survivor, who has shared her story online, on Time To Change (2018):
“To anyone reading this, remember it is ok to not be ok. It is ok to seek help. It is ok to speak out. Please do not suffer in silence. Silence is painful, soul destroying and will never help you. You are not letting your parents down if you tell them you’re struggling. You do not become anything less to your true friends when you tell them you’re not doing so well. You will always have someone thinking of you because those with mental illness are never alone. If there are 7 people in a room with you, chances are one of them is struggling too. Break the silence. Break the stigma”.
Mental health – what is next?
Cultivating mental health centric environments and communities and providing access to support services is the most effective approach to reducing mental health issues in the HE sector. Everyone openly needs to share best practice and continue to keep the OfS in the loop.
Mental health is a strategic priority, embedded across all HE activities. The collective effort to date is commendable but sadly mental health services are seen as an ‘add on’ – rather than a ‘built in’. There are excellent examples of best practice – but collaboration with wider stakeholders remains in its infancy. Everyone needs to be involved in the mental health mix and adopt a ‘whole HE sector’ approach that uses a sector-led approached strengthened by the NHS.
No student – anywhere – should be held behind by their mental health – especially not by the sector that supports and empowers them.
Useful websites and contacts
• Mind a mental health charity. Information line: 0845 766 0163 https://www.mind.org.uk/media/3244655/understanding-mental-health-problems-2016.pdf
• Samaritans is a 24/7 charity dedicated to reducing feelings of isolation and disconnection making sure there’s always someone there for anyone who needs someone. 08457 90 90 90 (24 hour) www.samaritans.org
• Students against Depression aimed at students offering advice and information about depression, low moods and suicidal thoughts. www.studentdepression.org
•Unihealth, a health and wellbeing messaging platform for students to deliver proven health and wellbeing support to students via a unique social messaging programme. https://unihealth.uk.com
• If you, or someone you know, would like confidential suicide prevention advice, contact Papyrus on 0800 068 4141 or firstname.lastname@example.org
• www.thestudentroom.co.uk a student discussion forum.
How to reference this article:
Bozier, J (2019) Mental Health in Higher Education and the Sector Challenges Ahead. LSST Staff Blog. 30 October. Available at https://www.lsst.ac/blogs/mental_health_in_HE [Add the date you accessed the article here].
1. Abrams, A (2017) ‘The Catastrophic Effects of Mental Health Stigma, Transforming a broken system’. Psychology Today, 25 May [online]. Available at:https://www.psychologytoday.com/gb/blog/nurturing-self-compassion/201705/the-catastrophic-effects-mental-health-stigma (Accessed: 23 September 2019).
2. Aronin, S and Smith, M (2016) ‘One in four students suffer from mental health problems’. YouGov, 9 August [online]. Available at: https://yougov.co.uk/topics/lifestyle/articles-reports/2016/08/09/quarter-britains-students-are-afflicted-mental-hea (Accessed 20: September 2019).
3. Blurt Team (2018) ‘The mental benefits of having a daily routine’. Blurt, 8 November [online]. Available at: https://www.blurtitout.org/2018/11/08/mental-health-benefits-routine/ (Accessed 25 September 2019).
4. Hawkins, Y (2019) ‘Mental wellbeing: let’s find new ways to support students.’ Office for Students, 7 March [online]. Available at: https://www.officeforstudents.org.uk/advice-and-guidance/student-wellbeing-and-protection/mental-health/what-we-re-doing/ (Accessed: 03 October 2019).
5. Lawton, G (2019) ‘Why are students so stressed at University?’ The Guardian, 31 May [online]. Available at: https://www.theguardian.com/education/2019/may/31/why-are-students-at-university-so-stressed (Accessed: 20 September).
6. Mental Health Foundation (2019) ‘How to look after your mental health’. [Online]. Available at:https://www.mentalhealth.org.uk/publications/how-to-mental-health (Accessed 20 September 2019).
7. MIND (2013) ‘How can family and friends help’? [online]. Available at:https://www.mind.org.uk/information-support/types-of-mental-health-problems/depression/for-friends-and-family/#.XYixvy5Kjcs (Accessed: 20 September 2019).
8. MIND (2013) ‘How to improve your mental well-being’. [online]. Available at: https://www.mind.org.uk/information-support/tips-for-everyday-living/ (Accessed: 20 September 2019).
9. Murray, J (2019) ‘How to look after your health at University’. Save the Student, 6 March [online]. Available at: https://www.savethestudent.org/save-money/health/mental-health-at-university.html (Accessed: 20 September 2019).
10. NHS (2016) ‘Student Mental Health’. [online]. Available at:https://www.nhs.uk/conditions/stress-anxiety-depression/student-mental-health/ (Accessed: 20 September 2019).
11. NUS Connect (2018) ‘Demand for student mental health services skyrockets’, NUS Connect News, 2 May [online]. Available at: https://www.nusconnect.org.uk/articles/demand-for-student-mental-health-services-skyrockets (Accessed: 23 September 2019).
12. Rosegil, N (2016) ‘Six things students can do to boost their mental health’. The Guardian, 3 March [online]. Available at:https://www.theguardian.com/education/2016/mar/03/students-how-to-boost-mental-health-at-university (Accessed 20 September 2019)
13. Szteliga, N (2018) ‘Is stress awareness at university always bad?’ Unihealth, 6 April. Available at: https://unihealth.uk.com/is-stress-at-university-always-bad/ (Accessed: 23 September 2019).
14. The Insight Network (2018) ‘University Mental Health Service Survey’. [online]. Available at: https://uploads-ssl.webflow.com/561110743bc7e45e78292140/5c7d4b5d314d163fecdc3706_Mental%20Health%20Report%202018.pdf (Accessed: 23 September 2019).
15. Time To Change (2018) ‘Time to change. Breaking the silence around mental health’. [online]. Available at: https://www.time-to-change.org.uk/blog/breaking-silence-around-mental-health (Accessed 20 September 2019).
16. University Business (2019) ‘Seats of silence: in memory of the students lost to suicide’. University Business, 7 March [online]. Available at:https://universitybusiness.co.uk/Article/seats-of-silence-in-memory-of-the-students-lost-to-suicide/ (Accessed: 20 September 2019).
17. University Business (2019) ‘50% rise in student mental health counselling demand’. University Business, 7 March [online]. Available at: https://universitybusiness.co.uk/Article/50-rise-in-student-demand-for-mental-health-counselling-services/ (Accessed: 17 October 2019).
18. University Business (2018) ‘Students continue to suffer in silence’. University Business, 15 May [online]. Available at: https://universitybusiness.co.uk/Article/students-continue-to-suffer-in-silence/ (Accessed: 20 September 2019).
19. University of Oxford (2018) ‘Student Welfare and Support Services Annual Report 2017-18’. [online]. Available at: https://www.ox.ac.uk/sites/files/oxford/field/field_document/CS%20Annual%20Report%2017-18.pdf (Accessed: 23 September 2019).
20. Veiber, L (2017) ‘82% of students suffer from stress and anxiety’, The National Student, 31 October [online]. Available at: https://www.thenationalstudent.com/Student/2017-08-31/82_of_students_suffer_from_stress_and_anxiety.html (Accessed: 20 September 2019).
21. Weale, S (2019) ‘Levels of distress and illness among students in the UK ‘alarmingly high’.’ The Guardian, 5 March [online]. Available at: https://www.theguardian.com/education/2019/mar/05/levels-of-distress-and-illness-among-students-in-uk-alarmingly-high (Accessed: 20 September 2019).
22. Wynaden, E (2014). The silence of mental health issues within university environments: A quantitative study. Archives of Psychiatric Nursing, 28, 339-344.