Hannah Farquhar

INTRODUCTION

Numerous studies suggest that poor mental health among students is increasing (Knapstad et al, 2019, Siverston et al, 2019, Tung et al, 2018, Rotenstein et al, 2016). Despite, higher education being associated with better-informed health choices and improved social support (Freudenberg and Ruglis, 2007), ongoing stress as a result of academic pressures has been linked with reduced quality of life (Ribeiro et al, 2017) and susceptibility to other mental health conditions such as anxiety and depression (Moylan et al, 2013). 

AIMS OF STUDY

This study aims to critically review current strategies and initiatives employed by UK HEIs around the provision and promotion of positive mental health in students. In addition, the study will scrutinise the ‘Office For Students’ among other structure frameworks and policies and analyse existing research that examines the problems students face in HEIs’ that may also account for the drop-out rates.

University drop-out rates in association with poor mental health are a global issue with findings in Danish (Hjorth et al, 2016) and French students (Saïas et al, 2014) as well as british students all linking declining mental health with a greater risk of dropping out of higher education (Baik et al, 2015). In Finland, a study of 13-17 year old students concluded that poor mental health was linked with adverse academic performance, insufficient reading and writing and poorer social relationships (Fröjd et al, 2008). Depression and anxiety are the most likely developed MHC in students (Thorley, 2017). 

STUDENT WELLBEING is declining (Neves and Hilman, 2017) and pre-existing mental health conditions may be exacerbated during the COVID-19 lock-down (Yao et al, 2020) as well as emerging anxiety due to worrying about family (Cao et al, 2020).

POOR MENTAL HEALTH is negatively associated with student’s academic outcome (Sæle et al, 2016, Gnambs and Hanfstingl, 2015), performance and attainment (Patalay et al, 2015, Veldman et al, 2014).

HEIs in England are at risk of encouraging unhealthy behaviours such as drinking, poor diet and sedentary behaviour through the range of social activities, prominent focus on nightlife and community student outlets. More so a significant lack of emphasis placed on healthy eating, food preparation, exercise, money management and academic focus can inadequately prepare students for the transition to adult life and independency. Preventative measures rather than ‘treatments’ for self-reported mental health and support needs are necessary to achieve long-term behaviour change.

ACADEMIC RELATED STRESS (ARS) was said to be the number one cause for student anxiety followed by financial stress (Jones et al, 2018). A German study involving 456 undergraduate medical students displayed lower academic performance as a result of ARS (Kötter et al, 2017). In addition, motivation becomes debilitated (Liu, 2015) and students become disengaged (Benner and Curl, 2018) due to ARS. Walburg (2014) noted that preventing stress and burnout reduced the rate of drop-out as well and improving academic achievement.

FINANCIAL STRESS affects students every year alongside their studies and has been attached to the deteriation in student mental health (Richardson et al, 2015). Financial stress is also linked with an increased likelihood of discontinuation of studies (Britt et al, 2017) and seen as causing students to seek paid work in place of education (Tran et al, 2018, Joo et al, 2008). A 2019 survey of over 3000 students in the UK (Bushi, 2019) found that 79% were worried about having sufficient money to live off and 52% of students were tormented by the thought of loan repayments.

PHYSICAL INACTIVITY (PA) is seen as a cause of declining mental health (Teychenne et al, 2015).

Studies have associated overuse of social media with risk of MHC such as depression and impaired cognitive function (Syväoja et al, 2014) and it was noted that students were spending an average of 2 hours a day on social media at the expense of PA (Calestine et al, 2017).

Students who don’t study a physical education are less likely to engage in PA (Park and Kim, 2013). Raised awareness of PA and varied activities is said to entice students (Deliens et al, 2015).

OBESITY causes students to be ‘at risk of drop-out’ (Lanza and Huang, 2015) and poorer academic achievement (Arora et al, 2013, McCann and Roberts, 2013) as a result of disengagement (Finn et al, 2018). The reduction in parental influence is a paramount cause for the change in food preferences and eating habits in students (Fedewa et al, 2014, Hilger et al, 2017, Barnes et al, 2012) and subsequently university students are more than likely to gain weight during their two years (Brown et al, 2014).

DRINKING and subsequent MHC are a leading public health issue (Bell and Britton, 2014, WHO, 2012) and is a cause of poorer academic performance (Patte et al, 2017) along with SMOKING and DRUG USE (Lee et al, 2013a). Student drinking also causes a greater likelihood of drop-out (Kelly et al, 2015, Latvala et al, 2014).

A poorer Mental Composite Score and increased depressive symptoms were seen in smoking students (Milic et al, 2020) and it is suggested that continuous substance use among students reduced retention (Sillins et al, 2015) and so increases rates of drop-out (Wang and Fredericks, 2014, Arria et al, 2013).

OFFICE FOR STUDENTS Rates of poor mental health among university students has tripled since 2012-2013 to 2017-2018 s (OFS, 2019). Students with a reported mental health condition presented lower rates of progression.

Subjects allied to medicine that may include nutrition, complimentary medicine, therapies and wellbeing, (UCAS, 2014) report the lowest level of poor mental health (OFS, 2021). In the same way that there is a positive response to teaching mental health, perhaps we could consider those studying an allied health subject obtaining a broader understanding of health and wellbeing and so enabling them to become more resilient to poor mental health (McAllister et al, 2017). Higher-achieving HEIs reported higher levels of anxiety compared to specialist, medium and low tariff HEIs (OFS, 2021, Luther et al, 2020).

METHODOLOGY

Out of over 166 “recognised bodies” (Study in the UK, 2021) or universities within the UK, a random selection (Elfil and Negida, 2017) of 20 of those residing in England (140) will be used for a scoping review of HEI websites (as the current ‘prospectus’) (Firth et al, 2019, Young, 2008). The presentation of results will be delivered in the form of SWOT diagram, as it was decided that this template allowed summation of key themes and enabled the study to conclude and  present key recommendations for HEI development.

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Out of the 20 HEI reviewed, none provided on-campus guidance and support for all of the contributing factors to student wellbeing and happiness as outlined in the literature review. Among all the HEI’s in the study, the area of greatest service variation was mental health support and determinant of student wellbeing most underrepresented was Nutrition. The most common threat identified was the risk of student addiction to alcohol, smoking and substance use due to lack of preventative measures and services for support. The frequently identified opportunity for all universities was the introduction of more preventative measures rather than ‘treatments’ for self-reported mental health and support needs.