Health and well-being in higher education

The COVID-19 pandemic has brought more attention to issues of health and well-being to all in higher education. The focus of CDC and the American College Health Association on comparing and coordinating mitigation strategies in the face of the largest public health crisis in a generation will help. However, concerns about healthy and positive campus climates have been present for many years; recent increases in reported crises and student suicides simply spotlight the problem, one that includes high levels of anxiety and burnout that is likely to last for some time. The pandemic has also spurred increased numbers of students who claim psychological disabilities, therefore requiring evaluation and accompanying accommodations to help them succeed.

As the fall 2021 semester entered full-swing, some surveys reflected a decline in student stress and anxiety but other studies suggested a continuing rise in stress as a result of COVID variants. Health centers reported high demand that was overwhelming some health providers and the Departments of Education and Justice issued guidelines to help with severe mental health challenges that have led to increases in suicide ideation.

As of Winter 2022, assessments indicated that 34% of current students struggled with anxiety disorder, which justified a breadth of responses to individual needs. Those who express concern about anxiety differ in level of severity and symptomatic expression. Providing triage that effectively guides students to pursue appropriate levels of help is key. Some may respond to student support groups and willingness to be open about their struggles while others require referral for intensive counseling or medication. Student Voice surveys timed throughout the COVID period of 2019-2022 documented shifts in students general mental health, with Winter of 2022 being the best during this period. And further evidence of improvement was that seniors who were preparing to graduate in 2022 were upbeat and positive about the futures, suggesting that resilience had been one of the most important lessons during their studies.

Instead of focusing on what's causing an apparent decline in student wellness, some advocate that institutions should focus on the factors that create student distress. The inter-association initiative Health and Well-being in Higher Education: A Commitment to Student Success offers a chance for institutions to adopt "upstream approaches that will allow increasing numbers of students to flourish and thrive" and the student housing companies have established a coalition to destigmatize mental health concerns. The Student Voice survey identified seven key things faculty can do to contribute to an institutional approach to student health. Access to and analysis of data is key to getting out in front of mental health concerns. Centering student success in conversations about, and plans to address, well-being requires looking at the identities and traumas that students face. Childhood trauma, learning disabilities, or coming from a lower socio-economic background are key factors that result in increased challenges in everything from time management to fitting in.

The bottom line is that students will be most successful when faculty, staff, students, and the campus environment is all more healthy. Makerspaces are a relatively easy way to provide oases on campus that foster both individual and community well-being. A pan-campus approach may also need to view mental health as a "trauma-induced" phenomenon that requires faculty teaching and advising informed by safety, transparency, peer support, mutuality and an overall commitment to empowerment, voice, and choice. A fundamental question has been raised about one of the greatest and most persistent stresses for students - grades.

Responding to student mental health decline, the whole community idea is particularly important, and "community" should also include entities outside the confines of a given college or university. Examples of how to respond include calling for higher and secondary education cooperation in providing "well-being" courses to students while they are still in high school and another is focused on cultivating students' mental immunity to the disruptions they experience. Partnering with students is essential, especially when seeking to reach underserved groups. Most institutions are investing in mental health resources, some funded by donors concerned about student mental health, including peer helper networks like Lean on Me and offering virtual health resources and online peer counseling. Students' satisfaction is mixed and diverse methods, including referral to off-campus resources, will likely be the only way to meet their mental health needs.

The interim director of counseling and psychological services at the University of New Hampshire says that actually students weathered the pandemic storm better than some believe and that encouraging students to adopt self-care and ongoing access to informal and primary care mental health resources is key. Research on the changes in student habits resulting from the pandemic highlight the need to assess and then intervene when they undermine health.

Boston University has demonstrated responsiveness to student mental health needs by actively providing guidance to students who might be considering, or are taking, a break. A student cited in the BU article recounted the isolation he felt as he struggled with anxiety and depression, absorbing the stigma he felt he would endure if he dropped out of his studies. Openly communicating to students that stopping out is alright and can be managed well is critical to students who are challenged. Student success coaches at 25 institutions in partnership with Inside Track reached out to 27,000 students who stopped out, an intervention resulting in the return of 3,000.

Counseling centers on many campuses are under-utilized, which is ironic in the face of reported higher need. Reaching more vulnerable students, such as first-generation and minority students, can be done through such simple gestures as providing "mental health kits" to signal support. Some are calling for senior academic officials to become healing leaders, including things such as conducting wellness checks, building inclusive teams, and monitoring their own health. Actively promoting mental health services, with a resiliency focus among marginalized groups, is part of the solution. LGBTQ+ students are at higher risk as well as Tribal college students, especially in mental health concerns. A pilot program called the Equity in Mental Health on Campus and Colorado State University's inclusive practice demonstrate the focus on serving students of various identities. With recent highly visible suicides among college athletes, the unique stresses of competitive athletes are receiving greater attention. Recognizing counseling as education and involving faith community leaders offer other opportunities. A report on how community college leaders look at the overall experience of students reveals the importance of collecting and utilizing data. The point is that awareness of our strengths and vulnerabilities, and the importance of learning to manage our mental health, could achieve a great deal in regard to prevention and effective coping.

The pressure on faculty and staff, coupled with more virtual work, has caused many to abandon any attempt to maintain boundaries on when they work. Joshua Kim offers 11 questions that quickly surface the problem. If the pervasive answer to these questions reflects a 24/7 view and little control of how that time is used, then it's pretty easy to conclude that the work environment is not healthy.

The Biden administration eventually urged colleges to use their Higher Education Emergency Relief Funds (HEERF) to enhance mental health services on campuses. With such a complex issue, each institution will have the latitude to devise approaches that fit its unique environment.

Inside Higher Education compiled a "Wholistic Approach to Student Wellness" summary as a resource for educators. The idea of viewing campuses as "wholistic" systems is central to a student affairs perspective. This doesn't mean that student affairs educators are the only, or even primary, ones who advocate this view but it does mean that one of the most powerful ways to improve campus climate is being a catalyst with and through others. Especially as institutions recalibrate to the financial restraints of COVID-19's impact, partnerships across campus such as the "Health and Well-being..." initiative are likely the only way, and perhaps a better way, of fulfilling a commitment to wholistic learning and development.