COLLABORATION

Student mental health: Key considerations for universities & colleges

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Tackling mental health is tough for even the professionally-trained. What should higher education institutions do to help their student sufferers?

Get into a good university, study hard, graduate, find a job. Easy, right?

So why are today’s student generations constantly battling mental health problems? Critics would say it’s because they are particularly sensitive, entitled and flaky, ie. “snowflakes” that lack the resilience of generations past who had to do a lot more with less. 

Given how the pre-determined college-graduation-work life path has existed since time immemorial, whatever the challenges it brings should no longer come as a surprise to anyone. 

But while this holds some truth, it fails to consider the pressures of life in the 21st century. And a growing body of research has proven that slapping the “snowflake” label on millennials and Gen Zers isn’t just ill-informed, it also reverses the progress of destigmatising mental health.

This is a dangerous thing.

Living in the age of hypercompetition

Millennials and Gen Zers actually do experience higher levels of anxiety, depression and suicide than their predecessors. 

A major contributing factor is that they live in an age of hypercompetition, where elevated expectations create impossible standards by which they must all live by, no matter what their socioeconomic backgrounds.

Today’s graduates also have to jump through more hoops to survive the current world of work, with fortune favouring only those with the deepest pockets or brightest minds. Even the naturally entrepreneurial types don’t have it easy, finding themselves pitching business ideas to sectors already dominated by industry titans.

Job interview
It’s much harder for graduates today to make a splash in a sea of cookie-cutter graduates. Source: Tim Gouw/Unsplash

Not too long ago, the Bachelor’s degree was the gold standard of education. Today, many degrees are not even worth the paper they are printed on; employers are looking for the crème de la crème of candidates, ie. those with the kind of standout technical and soft skills most would only develop after years on the job. 

But how many of our young job seekers fit the bill? And what happens to those that don’t? Is there a place in society for the academically mediocre that doesn’t involve perennial debt or dead-end jobs they will likely lose to automation? 

Today’s graduates are often forced to work in roles outside their fields of study or interest, which they discovered too late were no longer in demand.

In such an environment, it’s no wonder why the student mental health problem has become such a global crisis. 

Global and growing

In the UK, a recent poll of some 38,000 students reported “alarmingly high” levels of anxiety, loneliness, substance abuse and thoughts of self-harm, suggesting rates of psychological distress and mental illnesses are on the rise in universities there.

Half of those polled (50.3 percent) admitted to thoughts of self-harm, nearly double the numbers reported in 2017, while close to one in 10 (9.4 percent) said they thought of it often or always.

These numbers line up with other reports of rising prevalence of student mental health problems around the world, especially among first-year students.

Many enter college or university with some form of disorder; a 2018 World Health Organisation survey of 14,000 students around the world said one in three freshmen were struggling even in the years leading up to college.

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Another more recent survey by Barnes & Noble Education Insights labelled Gen Z students as those most at risk of a mental health disorder, with 76 percent of student respondents saying they have experienced significant stress, anxiety and depression. The survey showed that these issues were more prevalent among women, and first-generation students, meaning those who are the first in their families to attend college or university.

And without recognition, proper support or treatment, their conditions are left to fester and only worsen with time.

The same UK study said students moving into their second and third years report the highest rates of anxiety, loneliness and substance misuse. From the sample, 12.1 percent had considered self-harm often or all the time, more than 9.2 percent of first-years or 11.1 percent of third-years.

The time to act was yesterday

Given these alarming statistics, it cannot be denied that mental health is an issue that requires urgent and immediate attention.

And given that large numbers of those most vulnerable are attending either college or university, learning institutions are best placed to help sufferers. Many are already trying but are struggling to keep up with the sudden explosion in demand for help. 

In the US, Penn State allocated some US$700,000 in additional funding for counselling and psychological services in 2017. In the 2016-17 school year, Ohio state beefed up campus health services with a dozen mental health clinicians, also launching an app to help students schedule appointments, access breathing exercises and connect with the clinic in case of an emergency.

Still, as of 2016, the average university in the US only had one professional counsellor for every 1,737 students, lower than the minimum of one for every 1,00o to 1,500 students recommended by the International Association of Counseling Services.

In the UK, up to 94 percent of universities have reported a steep rise in the number of students seeking help from support services at their institution. Responding to the demand, the National Health Service has been working with institutions on a more collaborative and holistic approach to improving the mental health and wellbeing of students.

Student Mental health issues
Universities are struggling to cope with rising demand for mental health support. Source: Dan Meyers/Unsplash

The hard truth is, tackling mental health is about more than simply throwing money at the problem. Investing in support services to treat those who already have a diagnosis or who are aware they have a problem is akin to shutting the stable door after the horse has bolted. 

When it comes to student mental health, the time to act was yesterday.

A more effective method of tackling the crisis is by implementing a “whole university” approach that focuses on preventative measures in addition to treatment and counselling, but this requires major stakeholder buy-in, from governmental agencies to parents and the students themselves.

Here we compile a few key considerations to help learning institutions around the world keep their students safe and healthy, both physically and mentally.

#1: Understand the causes & issues

Before going out and hiring teams of therapists or throwing new processes at the administrative body, its critical that the institution first identifies and understands the many issues and causes that may lead to a student suffering from a mental health disorder.

No two problems are identical and institutions may also find their students are triggered by different issues to those at other schools. These triggers vary because their learning environments vary in terms of climate, location, academic focus, teaching faculty… the list continues. Even the design of the built environment affects student mental health.

As such, no broad-brush approach will work when handling such delicate matters; every sufferer is going through a different journey and depending on the severity of their condition, will require some level of personalised attention.

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Some of the most common causes of anxiety, stress and depression among students are financial problems, exam horrors, homesickness (most prevalent among international students), culture shock (also prevalent among international students) and the political & social environment.

It must also be reminded that while mental health has become somewhat destigmatised in most advanced economies, the same isn’t true in all parts of the world. 

Universities with a large international student body must therefore consider that those coming in from countries where mental health is hardly discussed may not dare to come forward to report a problem.

The onus falls on the institution to ensure the student is first aware of the avenues available to them and most importantly, that they can safely discuss their problems with a counselling service or trained professional with complete trust and anonymity. 

Awareness campaigns not only help raise mental health literacy among students, it also normalises help-seeking and teaches students the value of reaching out when they’re feeling down. 

Student Minds in the UK is a student mental health charity tasked with doing exactly this–through regular national campaigns and training workshops, it empowers students and everyone across the university ecosystem to develop the knowledge, confidence and skills necessary to both look after their mental health and provide support to those who need it.

#2: Gender minorities have it worse

Lesbian, gay, bisexual, transgender and queer (LGBTQ) students are becoming more visible than ever in campuses around the world.

Yet, by their numerical proportion of the total student body, they remain minorities and a target of discrimination and oppression, whether among their peers or in national policy.

They are also the most misunderstood; campuses are often guilty of conflating sexual orientation with gender identity, lumping everyone who don’t identify with their birth sex into the single LGBTQ category. In reality, however, they are very different concepts. 

This dismissive and discriminatory attitudes towards these groups make them the most at-risk of mental health disorders. A recent study in the US confirmed this. 

According to the research published by the American Journal of Preventive Medicine, gender-nonconforming and transgender students are four times more likely to report mental health issues compared to their peers. 

Almost 80 percent of the gender-minority students studied reported having at least one mental health issue compared to 45 percent of their cisgender peers (students whose genders align with their assigned birth sex). Some 58 percent, meanwhile, screened positive for depression while 53 percent admitted to having intentionally injured themselves in a non-suicidal way. 

Of the cisgender students, on the other hand, 30 percent were suffering depression, while 20 percent reported non-suicidal self-injury. For their work, the researchers sifted through the responses of more than 65,200 students from 71 US institutions enrolled between 2015 and 2017, extrapolated from the Health Minds Study, an annual online student mental health report from colleges across the country.

These alarming numbers make it incumbent on institutions to offer these groups the right protections by creating policy environments that promise full inclusion and prohibit discrimination. 

Faced with discrimination, nonconforming and transgender students are four times more likely to report mental health issues compared to their peers. Source: Scott Olson/Getty Images/AFP

The first step, as always, is understanding and accepting who they are. What follows is affording them the same freedoms and privileges their cisgender peers enjoy.

Campuses should also consider employing trans-experienced therapists or counsellors to tackle issues faced by these groups, as well as create support groups for trans students. 

The American Council on Education suggests that universities also include sexual orientation and gender identity in institutional policy, regardless whether or not federal or state law mandates against discrimination. Some examples campuses can take note of are the policies of Georgetown University, Purdue University and Santa Ana College.

Non-discrimination policies should also be covered in areas such as admissions, graduate employment, educational programmes, athletics, student health insurance, and facilities (gender-inclusive locker rooms, restrooms, residence hall rooms, etc). 

A campus-wide steering committee tasked with overseeing all gender identity and sexual orientation student issues could provide clear oversight and guidance to ensure adherence to these policy guidelines, as well as improve engagement and understanding between the school, parents and wider society.

#3: The impact of unmet student mental health needs

Left untreated, mental health illnesses can lead to terrible things, the worst of which is death and suicide.

Last year, Birmingham University was accused of failing students suffering mental health problems, following the suicides of two young men. Reports claimed those seeking counselling would be told to seek outside help or access NHS services because the school was ill-equipped to take their cases. 

There have been several other similar incidents, including in Liverpool and Bristol, where students reportedly struggled to get mental health support before they died.

The most recent case involves the Royal Melbourne Institute of Technology (RMIT) in Australia, which entered the spotlight following complaints from students against its response to two recent tragedies at the campus: the death of a student on August 5 and injuries to another just three days later, at the same building, no less.

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After the incidents, several former and current students complained publicly against the university, claiming it failed to properly inform the campus community about what had happened until much later. The university reportedly posted several tweets, a Facebook update and sent a mass email, of which some students said they only came to know of later.

Even worse, some alleged that student support responders were not always available to provide vital care to mental health sufferers, despite them coming forward. 

Former student Seb Starcevic is one of them. He told 10 Daily he left the school last year because of this lack of support.

He said when he first came to the university, he struggled with feelings of isolation and depression and tried to contact student services for help but was told he’d have to wait weeks to see a professional. Even then, he explained, no one took his name or student ID or offered to call back.

“At that point, I was feeling suicidal for one of the first times in my life, and being wait-listed didn’t help,” he said in the report.

Out of respect for the families of the deceased, RMIT has declined to comment on these comments and has also defended its decision to hold counselling sessions at the same building the two incidents took place. 

RMIT
RMIT entered the spotlight recently following complaints from students against its response to two recent incidents at the campus. Source: Shutterstock

These incidents underscore the value of an integrated, “whole-university” approach to tackling student mental health.

Having the right number of professional mental health advisors and counsellors is important. But when counselling centres are overwhelmed with cases, as they inadvertently will be given the rise of student mental health problems everywhere, turning the sufferer away to seek help on their own should not be the accepted response.

Their efforts should be supplemented by a team of student-facing welfare support staff, which could comprise faculty members, student services, Resident Assistants or student leaders, each one with enough training to offer preliminary support until the sufferer is able to seek professional help.

#4: Mental health training

Every higher learning institution should offer training to both staff and students on the different aspects of mental health issues.

For students, this not only helps further destigmatise the topic, it also promotes self-awareness among potential sufferers, teaching them to identify possible stressors and how to cope with them. It also teaches them how to support others who may be in distress.

According to Harvey Mudd’s Vice President for Student Affairs and Dean of Students, Anna Gonzalez, her school offers a six-week course on emotional intelligence every semester. It uses a programme called Kognito, an avatar-based app that helps students identify what makes them tick and how to deal with it, also showing them the resources available.

“It not only teaches students how to be more self-aware but also how to be more aware of their environment in terms of friends, peers and classmates,” she says in an interview with Forbes.

“They learn to recognise the symptoms of distress in themselves or someone else, and they learn what interventions they could pursue before they reach a high level of distress.

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Staff and faculty training is equally as important, if not more. 

ACE in its recent survey of 400 college and university presidents highlighted the importance of institutional leadership in dealing with student mental health and wellbeing. 

The presidents surveyed said student mental health has become a key priority for their institutions, many of them expressing their desire to hire more staff to beef up counselling teams. But some also said providing professional development for faculty and staff was the better alternative to staffing up.

“I would broaden the range of people who could help students by [providing] proper training rather than staffing up the counseling center,” one president reportedly said.

“We need training to be able to identify someone who may be experiencing a mental health episode or breakdown and strategies to assist that individual,” another wrote.

Most notably, an overwhelming number agreed it was very important that they, personally, understood all the issues related to student mental health. In fact, a good 92 percent said they already felt very or moderately knowledgeable about the issues.

Given the global prevalence of the student mental health crisis, these numbers are promising to say the least.

The harsh reality is that the age of hypercompetition we described above is only just beginning. Countries, whole industries and businesses large and small are all too aware of this, swept up in the whirlwind that is the Fourth Industrial Revolution.

And while progress and innovation are necessary to improve life for the generations of tomorrow, room must be made for those who have fallen, or may fall, by the wayside, unable to keep up.