Six factors that impact student mental health

Young people attending university experience higher rates of stress, depression and anxiety than their peers who are primarily engaged in full or part-time work. What is going on here? And how can universities better support their students’ mental health?

I’ve been investigating the mental wellbeing of undergraduate and postgraduate students at The University of Melbourne since 2011.  Results from our most recent (pre-Covid-19) survey of the mental wellbeing of coursework students in eleven Bachelor and coursework Masters programs have just been published. Our study confirms many university students are struggling with mental health difficulties: more than 4,500 students responded to our anonymous, online survey and, of these, almost one-third reported ‘severe’ or ‘extremely severe’ levels of depressive symptoms, anxiety or (chronic) stress (as measured by the DASS-21). These symptom levels would impede students’ daily functioning (sleep, memory, cognitive processing), social interactions and learning. So there is definitely a problem.

What is going on here?

It seems that university study and university experiences are highly variable. For many, and even most, young people, university study affords positive experiences of personal and intellectual growth, exploration and achievement; university is a time and place for thriving. For some, however – around one in three in our study – their experiences are negative, and this appears to contribute to a spiral of stress, dis-engagement and mental health difficulties.

What can universities do about it?

Most universities are taking active steps to improve mental health services and information for their students and many now offer stress-management tools and strategies such as mindfulness. But such services are responsive, rather than preventive. My colleagues and I at the Melbourne Centre for the Study of Higher Education want to understand what university administrators and educators can do to ensure that more students thrive, not just survive, during their time at university. 

Our latest study identified six common course experiences that predict substantial variations in students’ levels of mental wellbeing. This is really important because it means that universities, and university teachers (academics) in particular, can do more to make a difference to student mental wellbeing than they, and others, might imagine.

But before explaining those course experiences, I need to first explain that we didn’t only consider course experiences. We all have lots of ideas about why university students might be experiencing high levels of stress and mental strain these days. For example, it’s widely discussed that the increasing costs involved in attending uni are putting many students under financial pressure. Most Australian uni students graduate with considerable Fee Help debts that may take decades to pay off and, in many disciplines, there is no guarantee – or even a reasonable prospect – that all graduates will find a job in their chosen field at the end of a degree. 

As a result, there’s pressure on uni students to do more than pass; they may need to graduate in the top X%, or to build a grade-point-average that is, ironically, ‘above average’ to secure a job. Such expectations might be particularly onerous for local students whose educational backgrounds haven’t prepared them for the styles of teaching and learning at university, those who speak English as an additional language, international/overseas students, those who are the first in their immediate family to attend a university, and so on.

We took stressors like these into account in our study. What we wanted to find out is: Do students’ course experiences – that universities can influence through curriculum design and teaching practices – predict mental wellbeing after students’ individual circumstances and backgrounds are taken into account? The short answer is, yes, they do. In fact, our study found that the six coursework experiences are stronger predictors of students’ mental health than demographic factors (such as age, gender, living situation, hours of paid work and family care per week etc) and individual stressors including financial stress, worry about job prospects or English language difficulties.

For example, in our statistical model of DASS-Depression, demographic factors accounted for 6% of variance in scores, individual stressors accounted for an additional 7%, while course experiences accounted for 16% (after taking all other factors into account). 

What this means is that ensuring that all students have positive course experiences can make a substantial difference to their mental wellbeing, notwithstanding common pressures on uni students, such as juggling family care and paid work commitments; financial strain; career uncertainty; or English language difficulties. 

Which course experiences predict students’ mental wellbeing? 

Course experiencesExample items
Sense of belonging (in the course, or to the university)‘I sometimes feel that I don’t belong here’
Assessment pressures‘When I work on assessment tasks I think about how poorly I am doing compared with other students’
Positive engagement with other students in the year/program/school‘I have made at least one or two close friendships with other students in my course’
Finding course content interesting or useful‘I’m really interested in what I’m studying’
Teachers perceived as supportive of students‘My teachers convey confidence in my ability to do well in the course’
Academic workload ‘The course workload is too heavy’

Feelings of not belonging and worry about assessments were most strongly predictive of both DASS-depressive and DASS-anxiety symptoms; while perceiving the course workload as unreasonable is independently associated with DASS-Stress. ‘Autonomous’ motivation for study – being interested or perceiving value in what you are studying – is strongly predictive of positive Psychological Wellbeing and Satisfaction with Life. Engagement with other students in the course is independently associated with all – positive and negative – mental health outcomes; while perceptions of Teacher Support are most strongly associated with DASS-Depression and Satisfaction With Life.

So. What can universities do to better support students’ mental wellbeing? Our findings suggest a twin focus – on (course)work and relationships. Rationalising and organising students’ academic workload will be helpful, as will ensuring that assessment tasks are well-spaced and designed to assess and promote learning, not only to normatively rank student performance (see, eg, Slavin, Schindler & Chibnall, 2014; Tang & Ferguson, 2014). Promoting respectful and accepting relationships among students and between staff and students is also vital if students are to form positive, rather than competitive, peer relationships (see Larcombe et al., 2013) and feel that they ‘belong’ within the program or university (van Gijn-Grosvenor & Huisman, 2020). The value of academic teachers showing interest in their students is difficult to over-state (Baik, Larcombe & Brooker, 2019). Our findings confirm previous studies that have found students thrive psychologically when teachers acknowledge their perspectives, offer meaningful choices and justify course requirements (see Su & Reeve, 2011). Student motivation for study is also known to be maintained when teachers support students to pursue their intrinsic interests and goals (Ryan & Deci, 2000), and when feedback on assessment is consistent and informative (Hoskins & Newstead, 2009). Recent research also suggests that students’ sense of belonging is strengthened when teachers value and respect all students’ contributions in class, and create welcoming and empathic learning environments (Wilson, Murray & Clarke, 2018; see also http://unistudentwellbeing.edu.au/).

Of course, there are already many pressures on curriculum designers and academic teachers. If supporting student mental wellbeing is to be added to, or elevated among, the list of priorities for academic teachers, they will need to be supported and resourced to explore evidence-based strategies and approaches. And those strategies and approaches in turn need appropriate resourcing. 

We hope that our research prompts university administrators and funders, not only university teachers, to think about how students’ course experiences might impact their mental health – both positively and negatively – and about the steps that can be taken to address students’ high levels of psychological distress. We have long known how much teachers matter for student learning; our study provides new insight into how much teachers and teaching practices matter to student wellbeing.

Dr Wendy Larcombe is a Principal Fellow at the Melbourne Centre for the Study of Higher Education and Melbourne Law School.