Student mental health - a public health challenge?

By Michael Baber

There’s a student mental health crisis. With half of all young people now going to university this is now a public health crisis. And universities are to blame for not providing enough support to students, leading to unusually high levels of student suicide. That’s what media stories were suggesting, even before the pandemic hit. However, is this really true?

Our research suggests a different picture. For example, we found no evidence of a significant increase in rates of serious diagnosed mental illness among university students and no evidence that they were more at risk of suicide than their non-university counterparts. What we found is:

Normal feelings and emotions have been medicalised.

In particular there has been:

A significant, controversial lowering of the threshold for diagnosing common mental health disorders like generalised anxiety disorder, dating back to 2013. Many people who would have been diagnosed as having normal mental health pre-2013 suddenly became diagnosable as having a mental health condition, artificially increasing reported levels of mental ill-health.
A significant increase in self-reported ‘mental distress’ i.e. negative feelings and emotions, due to feeling stressed, anxious, panicky, worried, lonely etc. These would previously have been viewed as normal responses to the challenges young people can face as they navigate adolescence and early adulthood (exemplified, for instance, by Elvis Presley’s first million selling record, Heartbreak Hotel). These normal feelings and emotions have been now been given a mental health label.

Mental distress usually starts at school not university

This ‘mental distress’ starts at school for 81.6% of students who will experience it, according to the largest ever UK student mental health survey and at school for ‘the vast majority’ of students according to another large-scale survey. So, if there is a problem, waiting till university to tackle it is too little, too late.

Three factors have combined to make young people more vulnerable

Our research suggests three factors are reducing the resilience, study and coping skills of young people and predisposing them to mental distress at university:

Over-protection: As the children’s charity Barnardo’s reported as early as 2002, the more western countries have sought to protect children from risk, the less resilient and prone to psycho social disorders they have become. More recently, schools in middle class areas are reporting an increase in ‘helicopter parenting’ (parents hovering over their children, ready to swoop down to protect them at the first hint of a problem) – with most studies suggesting this increases the risk of anxiety, stress, depression and emotional problems.

Spoonfeeding: By 2013 the Paired Peers Project in Bristol was reporting, ‘The school/college experience was persistently described as ‘spoonfeeding.’ Students are arriving at university having been deprived of the wellbeing benefits of ‘deep learning’ and less prepared for independent learning than their 20th century predecessors - and therefore more likely to struggle to adjust and more prone to mental distress.

The medicalisation of young people’s normal emotional upheavals: As Professor Frank Furedi commented in the Times Educational Supplement (TES) in 2016, 'Children have become socialised into interpreting their experience through the language of mental health deficits…..Through medicalising children’s normal emotional upheavals, young people are trained to regard the challenges integral to growing up as a source of psychological distress.’

Conclusions

There isn’t a student mental health crisis but students are increasingly being led to interpret negative feelings and emotions as mental distress. To reduce the incidence of student mental distress, we need to:

Focus on what is happening to young people BEFORE they come to university – working with schools, parents and OFSTED.
Encourage more pre-university opportunities to develop resilience through life experiences away from parental oversight and excessive safeguarding, for example as a Guide or Scout or through outdoor adventure programmes.
Work with OFSTED (which changed its inspection framework in 2019 to encourage schools to do more than teach to the test) to help schools (and parents) recognise the value of deep learning rather than spoon-feeding, to enhance wellbeing and enable an easier transition to independent learning at university.
Challenge the medicalisation of feelings and emotions and concentrate support on students with diagnosed mental illness.