The EMBRACE HE team reviewed international empirical studies focusing on Higher Education Student (HES) mental health and wellbeing. The mental health and adjustment challenges facing HES have been referred to as “a significant mental health concern” (Chen et al., 2019, p. 242), “the crisis in higher education” (Hubble & Bolton, 2020, p.3), and “trouble in paradise” (Blum, 2016, p. 34). In turn, Higher Education Institutions (HEIs) are facing an unprecedented demand for counselling services and changes to the teaching-learning realm of academic life.
International empirical researchers have stated that approximately one-third of college first-year students from eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, and the United States) experience diagnosable levels of anxiety, mood, and substance abuse problems (Auerbach et al., 2018). In a narrative review article focusing on the impact of academic stress on HES’s mental health, academic performance, and wellbeing, Pascoe, Hetrick, and Parker (2020) reported the learning capacity, mental distress, sleep, and substance abuse of students from 72 countries were affected. HES are burdened with increased levels of stress, anxiety, and depression (Ballester, et al., 2020; Karyotaki et al., 2020). They often face difficulties in their attempts to cope, navigate, and embrace tertiary education responsibilities (Goodman, 2017; Xiao et al., 2017). The most frequent concerns that bring students to counselling centres include anxiety, depression, stress, trauma, interpersonal functioning/relationship problems, family issues, suicidal ideation and attempts, academic difficulties and pressure, sleep problems, social isolation, and adjustment to the new environment (LeViness et al., 2018; Pérez-Rojas et al., 2017). Other challenges include mood instability, eating/body image concerns, sexual concerns, self-esteem, attention/concentration difficulties, identity development, financial difficulties, career decisions, worries about future job security, test-taking anxiety, and family issues (Center for Collegiate Mental Health, 2020).
It is also important to note that mental health issues in higher education are exacerbated by social challenges, including how student performance is evaluated, the pressure of evaluation, the ‘student as a consumer’ approach to HE, the high tuition fees in some countries or universities that lead to financial difficulties or to students being unable to begin or finish their university studies (Zimas, 2015). These issues mean university students are at a higher risk of mental health problems (McCloud & Bann, 2018), highlighting the contradiction between the social purpose and scope of higher education. Across 13 European countries, there are differences in how HE is conceptualised vis-à-vis the public good (Boyadjieva & Illieva-Trichkova, 2019). Since the discourse on the quality of education has been established, contemporary universities have had neoliberal systems that reinforce the social exclusion of students and create pressure to prioritise the acquisition of labels of excellence at the expense of social purposes (Mampaey, 2017). This is evidenced by the high costs of university tuition, which lead the British government to define students as consumers (Bunce et al., 2016). Additionally, admission criteria exclude people who do not have excellent academic performance or economic solvency. Students are assessed through excellence and quality, creating pressure that contributes to their stress and mental health problems. It is, therefore, important to question the design of the higher education system as well as whether it can be a source of discomfort and social exclusion for students.
All the issues outlined in the research cited above have impacted HEIs, who are facing an unprecedented demand for counselling services (Hubble & Bolton, 2020). Nevertheless, although students report high levels of anxiety, depression, and other mental health challenges, according to Shea and colleagues (2019), there are barriers to seeking help in HE settings. These include the negative perceived value of counselling or psychotherapy, uneasiness in dealing with emotions, stigma, lack of awareness or knowledge on mental health issues, access delays, and cultural barriers. Similar barriers were found by Nash et al. (2017), who also reported that disengagement and multiple stressors constitute obstacles to help-seeking. Moreover, stigma continues to be a barrier for students with disabilities, impeding their chances of fitting in (Bogart et al., 2019).
The challenges cited above have been exacerbated during the ongoing COVID-19 pandemic, which has gravely impacted HES’s mental and financial wellbeing as well as HEI funding (Hubble & Bolton, 2020).