- This HEPI blog was kindly authored by Dr Michelle Morgan, Dean of Students at the University of East London.
- This piece is the first part of two discussing the rise in student mental health issues. The second part will be published tomorrow.
Over the past few years there has been veritable blizzard of articles and reports about the rise in wellbeing and mental health issues, especially among young people in higher education. Mental health and wellbeing challenges are not new phenomena, yet Generation Z is being labelled as less resilient than previous generations. Better information, social change in attitudes to mental health and wellbeing and an increase in students entering higher education must all be taken into account when explaining this rise.
First we have better data but we need more of the ‘right’ data
Statistical reporting on this issue has become more detailed in recent years as applicants applying to university have rightly been encouraged to disclose disabilities without fear of being refused a place at their chosen institution. These data provide valuable insights into student characteristics. For example, UCAS’s report in Starting the conversation highlights that women are over two times more likely to declare a mental health condition than males, and care-experienced applicants are three times more likely. Other differences also include 21-24 year olds being three times more likely to declare, and some LGBT+ groups six times more likely. If you are a male heterosexual and young, you are the least likely to declare.
It is important to note that three-quarters of suicides nationally and within HE are males. Student Minds research highlights that 40% of males have never spoken to anyone regarding mental health, with 29% feeling too embarrassed. These findings are a likely causal factor for the high withdrawal rates of males, especially those from minority ethnic groups as highlighted in HESA data.
However, the sector and each higher education provider need more nuanced data to fully be able to support our students on entry to university and throughout if they are to succeed. A recent report was published by the Office for Institutional Equity at the University of East London exploring the Prior learning experience, study expectations of A-Level and BTEC students on entry to university and the impact of Covid-19 across three universities (Bournemouth, Leeds Beckett and East London) via the pre-arrival academic questionnaire (PAQ) undertaken at course level. It found that males expressed lower levels of concern across all areas (e.g. finance, housing, L&T, social engagement) than their female counterparts, had a stronger perception of their skill ability than females and were least likely to say they would use key university support services such as health and wellbeing, academic, finance and careers and employment advice, all of which help students succeed. These findings were mirrored across all students who undertook the PAQ. If you think you don’t need support then you are not going to be aware of it when you need it. Again, these findings are likely to contribute to higher withdrawal rates among males.
Insights from surveys such as the PAQ will help avoid making assumptions about one’s student body, support the management of engagement and expectations, and create initiatives to mitigate the impact. For example, one of the findings from the survey was males were three times more likely to use sports facilities compared to mental health services. The question then is: how can mental health and wellbeing be promoted through sports?
Secondly, we have a better understanding of mental health
Mental health issues such as anxiety and depression, which have long been known to commonly occur in the early teens, can often be associated with a reaction to (and symptom of) someone’s environment. Unless such issues are dealt with effectively at the time, they can reappear later if triggered by a stressful event. The transition to higher education can be one of these triggers. And often it is a combination of factors as this list from MINDS What causes mental health problems? highlights. They can include:
- Childhood abuse, trauma, or neglect
- Social isolation or loneliness
- Experiencing discrimination and stigma, including racism
- Social disadvantage, poverty or debt
(A recent HEPI blog by Tom Allingham of Save the Student highlighted the ongoing issues of the cost of living crisis especially amongst English students due to maintenance support not catching up with inflation.)
- Bereavement (losing someone close to you)
- Severe or long-term stress
- Having a long-term physical health condition
- Unemployment or losing your job
- Homelessness or poor housing
- Being a long-term carer for someone
- Drug and alcohol misuse
- Domestic violence, bullying or other abuse as an adult
- Significant trauma as an adult, such as military combat, being involved in a serious incident in which you feared for your life, or being the victim of a violent crime
- Physical causes (e.g. Head injury or a neurological condition such as epilepsy can have an impact on your behaviour and mood.
We also know from NHS research from 2022 on Sleep, loneliness and health behaviours that the level of insomnia being experienced by young people is increasing. Of children between 17-16 years of age, 34% had a problem with sleep 3 or more times over the previous 7 days. For 17-23 year olds this was 64%. This affects mental health and wellbeing.
Another issue which can create challenges but is so often ignored is the pain, discomfort and cost women experience due to periods and Period Poverty as Laura Coryton spoke about in her recent HELPI blog.
How many of the mental health experiences listed above are submitted as mitigating circumstances to examination boards, especially as a direct result of recent events such as Covid-19 and the cost of living crisis, within an institution and across the sector? We do not know because we do not collect this data.
We also need to be mindful of the possible impact of a student seeking support from a staff member who may be emotionally affected or triggered by the issue reported by the student.
Thirdly, we have an increasing openness with taboo subjects
As a society, we have become more open to discussing taboo subjects such as mental health. We have better access to information, and advice from organisations such as Student Minds, Mind , Papyrus UK Suicide Prevention and the Samaritans is available via avenues such as social media. Celebrities across age groups from the young like Roman Kemp and Billie Eilish to those who are older such as Stephen Fry and Alastair Campbell are leading the discussion by talking about their own challenges.
Openly discussing challenging topics such as mental health is a healthy, mature, approach and something we should encourage within higher education. This is becoming even more important as the pressure on all university staff to deliver the all-important metrics by which an institution is weighed measured and judged increases.
About 6 years ago, I was a panel member for my old university’s Students’ Union Debate Society discussing whether students today are more sensitive and what the impact of social media has been on young people’s health and wellbeing. Alongside me on the panel was a 17-year-old well-known female “vlogger” who spoke on wellbeing and mental health issues. She told her story – how she had felt worthless as a young teenager, had become anorexic, depressed, and how just over a year before, she had attempted suicide. She spoke openly and honestly about her experience, explained how she was dealing with her depression, the support she was getting, and how she was helping others as a result.
Thirty-three years separated us but our stories were almost identical. However, her response and experience were in total contrast to mine. In the early 1980s, when I was 14 years of age, I became anorexic due to life challenges and feeling worthless. At 17, I also attempted suicide. The difference though was that in the 1980s, I was a forgotten statistic like so many others. Wellbeing and mental health issues amongst teenagers were not discussed and there was limited help. I remember waking up in a hospital bed after my attempt and being told by an aggressive doctor to not be “so stupid again”. The attitude was to “pull your socks up, stop being weak and just get on with it”. You were made to feel ashamed – my parents never discussed the incident with me because of their upbringing and experience. As a mature student at the start of the 90s, I studied alongside students with wellbeing and mental health issues that were still not spoken about or supported. I was lucky enough to obtain extensive counselling in my early 30s and was able to deal with the issues that haunted me in my teens and 20s.
Lastly, we are stopping seeing mental health disclosure as negative
Admitting to having a mental health condition can still hold stigma and is viewed by some as negative although this attitude isn’t held for other health conditions.
Over the years, I have heard colleagues say that some students are using poor wellbeing and mental health issues to “play the system” by using mitigating circumstances for deadline extensions and the justification for producing poor-quality work. Of course some may but the majority of students I have dealt with over the course of my career most certainly have not.
We still have a lot to do as a sector to inform and train students to help themselves, and in supporting staff to support students as well themselves in terms of mental health and wellbeing. Our students will experience a lot of challenges including imposter syndrome but many will be hidden, whether it is a conscious decision or not. All impact on retention, success and one’s sense of belonging. All too often I hear the argument at national, sector and institutional level that ‘students are adults and should be able to deal with the pressures’. It is important to recognise that overnight, the majority of our students entering higher education who are 18 or 19 years old have come from a legally protected child space. School and college are compulsory activities, but students have moved to an adult one which is voluntary. It also has new legal ramifications such as signing accommodation and learning contracts and taking on loans. This is especially the case for care-experienced and estranged students.
We have come a long way but we still have a way to go. With generational and cultural differences between students, and students and staff, we need to bridge the divides of perceptions and lack of knowledge, with facts, openness and support.