Now is the time to revamp university student mental health reporting systems
University student mental ill-health — the “hidden pandemic”
Dr Catherine Drane, Research Fellow, NCSEHE
There continues to be a sustained and enduring challenge in addressing university student mental ill-health: namely the under-reporting of mental health issues. In part, this can be attributed to inadequacies in the current university systems for collecting mental health information. Why is this the case?
Prior to 2021, students were expected to disclose mental health issues in terms of an “Other disability” category on enrolment forms. As many students do not perceive their mental health difficulties in such terms—as a disability—research has indicated these health issues have been under-reported. To provide a hypothetical example: a second-year student is overwhelmed by a family situation and has become acutely anxious and depressed, resulting in an inability to submit course assignments. Would they perceive their recent mental health challenges as a “disability”? Do they still require support?
Globally, there are growing concerns about the increase and severity of mental health difficulties experienced by young people. In 2020, 34 per cent of young Australians reported experiencing high or very high levels of psychological distress. The 18–24 age group has the highest prevalence of mental ill-health when compared to any other age group, which places many university students in the high risk category for mental ill-health.
As well as being in a high risk group, university students have additional stresses and demands placed on them, including a range of environmental and social factors that increase their vulnerability to depression, anxiety, and suicidality (suicide thoughts, plans, and attempts), when compared to their same aged peers in the population. These risk factors include irregular sleep patterns; poor diet; drug and alcohol use; financial stress; work/study balance; isolation from family and support networks; and performance expectations and pressures.
The circumstances in which students live and study can also shape their mental health; for example, students from disadvantaged backgrounds are at a greater risk of developing mental health problems.
Notwithstanding the risk factors outlined above, the COVID-19 pandemic has created another level of unforeseen stressors impacting the mental health of students: social isolation, emotional challenges associated with change, issues related to independence, uncertainty, disappointment, and grief.
A US study examining the effects of COVID-19 on 2,086 American college students indicated that 80 per cent of students found COVID-19 had negatively impacted their mental health. These impacts included stress or anxiety (91 per cent), disappointment or sadness (81 per cent), loneliness or isolation (80 per cent), financial setbacks (48 per cent), and relocation (56 per cent).
While some students commence university with pre-existing mental health issues, the additional academic demands placed on university students, coupled with the developmental changes akin to transitioning into adulthood, can lead to the development of symptoms in this high-risk group.
The complex interplay of factors that produce negative outcomes for students with mental health challenges needs to be more clearly understood — this is particularly pressing with the current pandemic.
The gaps in the current reporting system have become more pronounced in recent years.
Undoubtedly, the recently launched (2021) student collection system in higher education, the Tertiary Collection of Student Information (TCSI), has addressed some of the gaps previously outlined. For example, a key change has been the expansion of disability definitions to include a new category for “Mental health condition”. Although this is a positive step forward for collecting higher education mental health data, the new category remains situated within disability, and is not broad or nuanced to capture the full extent of the mental health difficulties experienced by higher education students.
It is important to note that mental health issues are dynamic in nature and not always present at the time of enrolment, but rather emerge during a student’s educational journey. Therefore, collecting student mental health information only once at enrolment will not, and is not, capturing the fluctuating and developing mental health issues experienced by students. The absence of an adequate reporting mechanism that tracks student mental health across the student life cycle means not all students’ psychological needs are being met by current support systems and equity services.
In addition, reporting complexity involves the negative impact of stigma — a powerful barrier to help-seeking behaviour, disclosing, and communicating mental health difficulties. Not all students are comfortable divulging their mental ill-health, in fact some students go to great lengths to conceal such issues. For this reason alone, universities may be reluctant to collect mental health information. However, universities must develop and implement comprehensive care systems for their students and make evidence-informed decisions. Therefore, a nuanced understanding of the mental health challenges faced by students—beyond the mere presence or absence of disability, and incorporating the needs, perspectives, and reality of the student experience—is urgently required.
Universities are well placed to revamp their student mental health reporting systems, and in doing so, continue to play an important role in supporting the mental health of their students.