Improving college campus systems for student mental health

Improving college campus systems for student mental health

To be a college student in 2024 is to be surrounded by stressful events, ranging from personal matters—juggling work, family responsibilities and financial obligations—to unprecedented global phenomena, political turmoil and a constant stream of digital information.

“We’re living in an age of anxiety,” says Melissa Saunders, assistant director of clinical services at the University of North Carolina at Chapel Hill’s Counseling and Psychological Services (CAPS). “There are major life stressors going on all across the world—climate change, terrible wars, toxic political discourse—that students have no control over and are completely bombarded with all the time. That is an awful lot to handle at age 18, 19, 20.”

Laura Erickson-Schroth, chief medical officer for The Jed Foundation, works as a clinician with 18- to 25-year-olds, and when clients discuss their stressors, many times they talk about societal issues such as climate change, movements for racial justice, reproductive rights, protests on campus and anti-LGBTQ+ legislation.

“Young people are dealing with a completely different world than we were when we were younger … Young people are thinking about world events in a way that wasn’t true always in previous generations,” Erickson-Schroth explains.

The latest Student Voice survey from Inside Higher Ed, conducted by Generation Lab, found two in five (43 percent) of students say stress is impacting their ability to focus, learn and perform well academically “a great deal.” An additional 42 percent say stress is impacting them at least “some.”

The survey’s findings point to the changing nature of being a young adult, the needs of today’s increasingly diverse college students and how mental health and stress can impact learners in and outside the classroom.

Methodology

Inside Higher Ed’s annual Student Voice survey was fielded in May in partnership with Generation Lab and had 5,025 total student respondents.

The sample includes over 3,500 four-year students and 1,400 two-year students. Over one-third of respondents were post-traditional (attending a two-year institution or 25 or older in age), 16 percent are exclusively online learners, and 40 percent are first-generation students. Over half (52 percent) of respondents are white, 15 percent are Hispanic, 14 percent are Asian American or Pacific Islanders, 11 percent are Black, and 8 percent are another race (international student or two or more races).

The complete data set, with interactive visualizations, is available here. In addition to questions about health and wellness, the survey asked students about their academics, college experience and preparation for life after college.

Getting a Pulse

Across all student respondents, fewer than half (42 percent) rate their mental health as excellent or good. Twenty-eight percent rate their mental health as fair or poor.

Mental health, as a term, has evolved from what was previously known as mental illness to be used more broadly to refer to mental and emotional discomfort due to the ordinary stressors of life, Saunders explains. This makes understanding a growing mental health crisis hard to define.

“We need to start using mental health in the appropriate context,” argues Doug Everhart, the University of California, Irvine’s director of well-being. “Because mental health, like physical health, is something we strive for. It’s something we want to enhance. When I talk about mental health, it’s about health promotion, right? How do we help students increase, enhance [and] improve their mental health through actions that they take?”

Students are more likely to rate their physical health (51 percent) or ability to care for themselves (56 percent) as good or excellent. Only half of respondents say they had good or excellent overall well-being.

Some demographic groups are more likely to rate their mental health as poor. That includes low-income learners (15 percent)—those with a household income of less than $50,000—as well as Black or African American students (12 percent), first-generation students (11 percent), and online learners (11 percent). Among nonbinary students—who made up around 100 of the 5,000 respondents—26 percent rate their mental health as poor, 14 percent say their physical health is poor and 22 percent rate their stress management abilities as poor.

Adult learners, inversely, have higher ratings for their health and wellness across categories compared to their traditional-aged peers, with almost half rating their mental health and physical health as good or excellent. Two-year students of any age are also more likely to rate their ability to care for themselves as excellent (26 percent) or good (38 percent).

Across groups, 41 percent of students say they have good or excellent stress management skills, while 27 percent rate their stress management as poor or fair.

As one first-year student shared in the survey, “One could have two out of the three: good social, academic or physical health but not three from the level of meaningless work assigned. I typically prioritize good academics and social [life] to keep my head above water and [find] motivation through friends.”

Under Pressure

When asked what their top stressors are while in college, Student Voice respondents rank balancing their academics with personal, family or financial responsibilities as the most stressful (47 percent). This was most true for adult learners (60 percent), students at two-year institutions (54 percent) and first-generation students (53 percent).

These results weren’t surprising to Trace Terrell, a current undergraduate student at Johns Hopkins University.

“I have had so many friends and so many of my peers be in situations where they just felt so overwhelmed by everything that they have on their plate,” says Terrell, who also served as a policy intern for Active Minds. “It makes a lot of sense.”

As student demographics have grown more diverse, their needs and characteristics have changed, with more students working part- or full-time jobs, acting as caregivers, or balancing severe health conditions, which in turn impacts their college experiences.

“Students, they bring their academic lives into their dorm rooms or into their clubs, and back home when they visit home. And then, vice versa, they bring their homes with them and their family,” says James Raper, vice president for health, well-being, access and prevention at Emory University.

Experts who reviewed Student Voice findings commented on how college affordability and the rising cost of living can directly relate to student mental health, as well. One-third of survey respondents name paying for college as a top stressor, and an additional 26 percent say paying for personal expenses is a high source of stress.

“We [CAPS] see big gaps between students that don’t have to work to pay for help pay for their college or their spending money, and those that do,” says Saunders of UNC. “I think the stress levels are much higher on those that are juggling outside jobs, or even work-study jobs, that eat up a significant amount of time, than they are on the students who had the good fortune not to have to work. That seems to have gotten worse as the country has had a bigger economic divide.”

Fewer than one-third of students say acute academic stress (32 percent), job or internship searches (30 percent), or chronic academic stress (22 percent) are their greatest stressors.

Institution type and student age reveal differing pressures. Students at private universities, for example, are more likely to point to job and internship searches (50 percent) as a stressor, followed by academic stress (43 percent) before their competing responsibilities.

Emory’s Raper says this could be due to the privileges afforded to many private school students who don’t have to pay for college on their own, but it could also point to students who need jobs to help support their lives during college. “That data may reflect that some students are stressed out because they can’t think about internships, they don’t feel like they have access to them, because they don’t have enough time to do both.”

Students at public institutions (36 percent) or who are taking classes exclusively online (37 percent) are more likely to indicate paying for college is a stressor.

Around one in 10 students say being on their own and caring for themselves is a top stressor, which mirrors the 13 percent of students who rate their ability to care for themselves as poor or fair.

In terms of chronic stress specifically, 41 percent of nonbinary students say this type of personal stress impacts them, compared to 18 percent of all respondents.

Choosing a major or course planning was a top stressor for about 10 percent of all students, but that number grows to 17 percent among learners at two-year institutions.

In the “other” category, which made up 2 percent of responses, three students wrote “all of the above,” and one indicated “everything” is stressing them out.

Finding Their Footing

Just as the pressures that impact students’ mental well-being are complicated, identifying how to alleviate students’ stress is just as complicated.

“It’s not necessarily about the world becoming easier for me to navigate, but ‘What kind of skills do I need?’ and ‘What kind of work do I need to put in to make the world seem easier?’” says Everhart of UCI.

When asked which three of 11 institutional actions would most benefit their overall well-being, students overwhelmingly believe that institutions rethinking high-stakes exams would be most helpful (48 percent). The second-largest number of students identified adding mental health days to the academic calendar (37 percent), followed by encouraging faculty members to build in flexibility with course deadlines (35 percent).

The results highlighted to Raper that students are looking for areas to exercise autonomy over their schedules and assessment, he says. “We experience things that are in our control and out of our control, and to be an 18- or 20-year-old in 2024, there’s a lot that we’re aware of that is just happening to us. And so, rightly so, we’re getting better and better at looking at, ‘Well, where could I leverage some control?’”

College students also value food services as a health priority. Twenty percent of students believe their institutions making campus meal plans or food prices more affordable would positively impact their well-being (this was especially true for students at four-year institutions), and 14 percent say improved quality, variety and access to campus food services would make a difference in their health.

Private school students identified more wellness facilities and services (23 percent) and improved quality of food services (22 percent) as helpful actions for improving campus health, compared to the average student respondent (19 percent naming more health and wellness and 15 percent naming better food services).

One in five students would like institutions to encourage faculty members to build student mental health day policies into their syllabi or for additional investment in wellness facilities or services to promote overall wellness. When asked how students rank the quality of their current campus health and wellness services, the largest share of students (37 percent) rank their campus at average, while 44 percent say it is good or excellent.

A Day for Mental Health

Across the country, institutions have begun to integrate excused absences for mental health and mental health days into the academic calendar, which each serve a different purpose, explains Active Minds’ Terrell.

An excused absence allows a young person to take, for any mental health–related reason, a day off and not be expected to make up activities.

General mental health days emphasize that everyone has mental health, “and so we should all have a break to be able to care for that,” Terrell says. Similar to the excused absence, the intention behind a day off is that students can take a step back from their academic responsibilities.

Historically, mental health days in higher education have been more reactive and, in turn, have become a catch-up day for students to work, Emory’s Raper says. Instead, mental health days should be a time for students to practice wellness in an intentional way.

Some institutions, in their faculty manuals, prohibit or highly discourage instructors from assigning any instruction, exams, essays or projects that could extend into the break period, “to really allow young people to take time for themselves,” Terrell adds.

UNC introduced institutionwide mental health breaks in fall 2020 to give students a pause from classes to focus on their health and wellness and added them as a permanent feature in 2021.

Now, the academic term starts one week earlier, with five mental health days spread throughout the year. The breaks fall at the start or end of the workweek, giving students longer weekends to unplug, Saunders says. “They’re not using it to stay here and study or catch up on their academic work; they’re mostly going home or going out of town or doing something that gets them away from the stress, which I think has been really helpful.”

Eighteen percent of Student Voice respondents say increasing the length of school breaks would support their well-being.

Wellness in the Classroom

Rethinking exam schedules is not a policy solution Active Minds advocates for but is “something that makes a lot of sense,” Terrell says. “When we talk about common-sense solutions to the mental health crisis on college and university campuses, one of the easiest ways is just to reimagine how we are actually giving instruction and formatting tests.”

Alexa Silverman, EAB’s senior director of student experience and well-being research, says institution-level considerations around finals and their impact on student wellness has conversation that’s been slow to build, mostly because it will require an entire college or university to change.

Rather than placing all the burden on faculty members to decrease students’ exam stress, Silverman believes more frequent opportunities for self-assessment or incremental assessment can help students feel confident in their learning and prepared for testing.

Similarly, when students ask for flexibility with deadlines, Silverman wonders, is that the only thing students know how to ask for? “If we don’t show students the whole range of tools and resources we have to support them, then that’s where they’ll go.”

This is another opportunity for faculty members to create earlier and more frequent opportunities for students to evaluate their progress, such as intermediate check-ins before a large research paper is due, to limit the amount of last-minute work students are completing. Similarly, long tests can be divided into more regular quizzes to help students benchmark progress throughout the term rather than one heavily weighed assignment.

“We want to shift the conversation from ‘Can we be flexible about this?’ to ‘How can we create check marks to make sure that students don’t fall behind?’” Silverman says.

Professors can also prioritize student wellness with deadlines in practical ways. “Let’s stop the practice of having due dates at midnight,” Raper says. “It helps with sleep, it reinforces that we’re being very intentional—that’s a very easy change.”

While such actions are individual solutions colleges and universities can evaluate, Raper sees a greater thread for administrators to reprioritize systems and organization to focus on student wellness, rather than responding at each concern.

“If we do not get organized, all we’re going to do is what we’ve been doing for the last 10 years; we just react and fund a lot of downstream things,” Raper says. “Which is not bad, it’s just not the only thing you can do, and [you] can’t expect things are going to change in terms of moving the needle around student well-being if we don’t move upstream.”

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