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In September 2019,\u00a0The Guardian<\/em>\u00a0headlined\u00a0an article<\/a>\u00a0\u201c\u2018The way universities are run is making us ill\u2019: inside the student mental health crisis\u201d.<\/p>\n We hear similar talk on all sides. Couched in the alarming vocabulary of \u201ccrisis\u201d and \u201cepidemic\u201d, data presented at conferences, at staff training sessions and in the media create a sense of panic. Politicians have also embraced such claims. In September 2018, Sam Gyimah, then secretary of state for universities, science, research and innovation,\u00a0wrote a letter<\/a>\u00a0to vice-chancellors stressing the importance of the issue and saying that \u201ccollectively, we must prioritise the wellbeing and mental health of our students \u2013 there is no negotiation on this\u201d.<\/p>\n The government\u2019s non-negotiable steer presaged high-profile research and development programmes. Working with the mental health charity Student Minds and led by\u00a0King\u2019s College London,\u00a0SMaRteN<\/a>\u00a0is a national research network funded by UK Research and Innovation for the period 2018-22 to improve understanding of student mental health. In July 2019, the Office for Students (OfS) launched its own \u00a314.5 million research\u00a0programme<\/a>. In December 2019, Student Minds issued the\u00a0University Mental Health Charter<\/a>. Backed by the government, the OfS and Universities UK, this calls for support services, accommodation, teaching and university bureaucracy to be geared towards students\u2019 mental well-being and to \u201cenable them to thrive\u201d.<\/p>\n Such a goal may seem admirable and uncontentious. Yet behind the scenes many academics, administrators and support service managers are uneasy. Sparked by a workshop on curriculum, pedagogy and mental health that I ran with colleagues for SMaRteN in July 2019, as well as numerous comments I have heard over the past few years, I want to explore how talk about a student mental health crisis translates from policy injunctions into everyday institutional practices and why this has raised many concerns.<\/p>\n Many institutions are undertaking comprehensive development projects to promote well-being. The\u00a0University of Cambridge, for example, is adopting a \u201cpublic health approach\u201d to all aspects of university life. As well as the perceived negative impact of course content, teaching and assessment, this includes tackling loneliness in halls of residence, and encouraging extracurricular activities and healthy relationships. According to Sara Weller, a member of the university\u2019s council, this approach aims to \u201cslow, and eventually reverse\u201d the prevalence of mental health problems while building \u201ca healthier culture and community where students have the personal psychological well-being to realise their fullest potential\u201d.<\/p>\n Yet such initiatives are a response to intense political and institutional anxiety. This is generating what Alan Percy, head of counselling services at the\u00a0University of Oxford\u00a0and past chair of the Heads of University Counselling Services, sees as more \u201cheat\u201d than \u201clight\u201d in understanding what is happening and responding appropriately to a clearly defined problem. Alarming depictions of a \u201csuicide epidemic\u201d in universities, for example, are not supported by\u00a0a report from the Office for National Statistics in 2018<\/a>, which shows that the suicide rate among students is lower than for the same age group in the general population, and that it has more than halved since the early 1990s.\u00a0Percy argues that the emotive, disproportionate picture painted by the media and campaigning groups fuels panic-driven reactions rather than considered responses.<\/p>\n It\u2019s clearly vital that universities address a national spike in mental illness, reflected, as Hughes points out, in increased demand for support and the severity and complexity of problems. We\u00a0are<\/em>\u00a0seeing more students admitted to hospital, engaging with crisis teams and being sectioned than in the past.<\/p>\n Yet a slippery terminology that elides \u201cmental illness\u201d with \u201cissues\u201d, \u201cproblems\u201d and \u201cdifficulties\u201d is rife, and this blurs the distinction between serious and everyday problems. Sir Simon Wessely, professor of psychological medicine at\u00a0King\u2019s College London\u2019s Institute of Psychiatry, Psychology and Neuroscience, sees a danger that over-professionalising and\/or medicalising routine difficulties means that \u201csome of those now who tell me they have mental health disorders seem to be describing loneliness, exam stress or homesickness, which I as a psychiatrist would not classify as mental health disorders\u201d.<\/p>\n One university registrar, who wished to remain anonymous, observed a strong \u201ctendency to lump together all mental health issues as if they all have the same effect on students\u2019 studies in a way that doesn\u2019t happen with physical health\u201d. In reality, he says, there\u2019s a spectrum going all the way \u201cfrom an enhanced sense of normal anxiety about assessment to very serious conditions at the other end of the scale\u201d. Although it shows \u201ca lack of proportion\u201d not to take this into account, he thinks universities don\u2019t have the expertise to do otherwise.<\/p>\n Academics and support service staff also report that vague, often casual, references to mental health compound this lack of proportion. It is commonplace to hear students describe assignments, lectures, material or content not seen as relevant to assessment and even lecturers as \u201creally bad for my mental health\u201d. This is combined with talk of being \u201ctotally stressed out\u201d, traumatised, \u201cneeding a safe space\u201d, and experiencing something as triggering or psychologically harmful. Beth Guilding, an academic at\u00a0Goldsmiths, University of London, thinks mental health and well-being are increasingly coming to \u201cmean everything and nothing\u201d.<\/p>\n Given that the notion of mental (ill)health has been diluted in this way, it is not surprising that lecturers find it difficult to decide whether problems require specialist support, calm reassurance or, as one GP in a university medical centre put it, \u201cbenign neglect\u201d, in the expectation that the problem in question will resolve itself.<\/p>\n Uncertainty and what Brendan Bartram, reader in education at the\u00a0University of Wolverhampton, sees as \u201ca culture that encourages invocations of vulnerability\u201d can lead some students to engage in \u201cemotional bargaining\u201d to press lecturers for concessions. He argues that institutional climates highly sensitive to maintaining and monitoring students\u2019 well-being turn declarations of a lack of support into a source of power and currency.<\/p>\n Using mental health as a lever isn\u2019t confined to students: one social science lecturer, who wished to remain anonymous, reports that \u201cwe sometimes actively encourage good students who we think deserve another chance (because, for example, failing an assignment will mean them failing a whole year) to make up mental health problems\u201d. She cites examples both where this happens in advance, in case someone fails a module, and afterwards, so that they\u2019re allowed to go through anyway. \u201cThey have to provide evidence, of course,\u201d she admits, \u201cbut this never seems to be a problem.\u201d<\/p>\n Some academics and support service staff criticise the pursuit of satisfaction ratings and fear of media scrutiny\u00a0that make managers too often inclined to accommodate requests or complaints, regardless of whether they\u2019re valid or not. Linda Murdoch, director of the careers service at the\u00a0University of Glasgow, reports that all decisions about academic matters \u201cmust account for impact on student well-being\u201d.<\/p>\n There is also widespread concern that students in real need are not getting access to proper services. Despite recent student demonstrations demanding more counselling and emotional support, criticism of inadequate provision is perhaps too simplistic. Counsellors report growing difficulty in offering support to those most in need because of the strain on services imposed by students’ tendency nowadays to seek an adult expert, rather than friends or family, for \u201ca chat\u201d about everyday stresses.<\/p>\n Murdoch notices a parallel marked change in how students use careers advice. \u201cStudents are returning time and again for \u2018checking\u2019 or \u2018reaffirming\u2019 appointments. It seems they lack confidence to act on advice offered at the first appointment. Nowadays a significant minority book two to five appointments. Some request significantly more. One colleague said she felt she was just being used as a crutch.\u201d<\/p>\n Although there is widespread agreement that many students face a raft of life and educational adversities, and are often isolated and overwhelmed by challenges and existential doubts, Nicola Byrom, senior lecturer in psychology at King\u2019s (and lead investigator for SMaRteN), observes that most aren\u2019t looking for therapy or an expert but \u201ca compassionate human who can help them make sense of things\u201d. Yet opportunities for academics to relate to students authentically and compassionately, in ways that aren\u2019t framed by mental health narratives, are under intense pressure from workloads, research targets, satisfaction ratings and the casualisation of academic work. Some universities require lecturers to take on 50 personal tutees. Others are making \u201cmental health first aid\u201d roles mandatory, often without releasing the people given such roles from other duties.<\/p>\n As China Mills, senior lecturer in public health at\u00a0City, University of London, notes, senior managers rarely, if ever, address how structural factors undermine staff and student well-being but, \u201cinstead, they prioritise\u00a0one-off \u2018well-being events\u2019\u201d which are widely viewed as patronising and pointless.<\/p>\n Framing the need for support through the lens of mental health can have political repercussions. According to Lydia Lewis, a postdoctoral research fellow in the Faculty of Education, Health and Wellbeing at Wolverhampton, individualistic psychological understandings of problems that are actually rooted in socio-political relations \u201ctempt students to shape their sense of self and self-label in ways that are unhelpful to them in the long run\u201d. Crucially, this framing masks class, gender and race inequalities.<\/p>\n Psychological interpretations can also be used politically against particular groups. Mills reports cases where Muslim students\u00a0fear (she thinks rightly) that staff in well-being services made to undertake mandatory Prevent training might interpret signs of distress or the accessing of support as indicators of potential radicalisation.<\/p>\n Perhaps the crucial issue, however, concerns the impact of the mental health narrative on education itself.<\/p>\n