University Counselling Services in Australia and New Zealand: Activities,Changes, and Challenges

The high prevalence of stress and psychological distress in university students highlights the need for adequate support services to enable students to achieve their goals. This study aimed to describe counselling services available to university students in Australia and New Zealand and to benchmark them against international services. Participants were five Australian and three New Zealand Counselling Services. Results showed that counselling services are using a variety of formats and e‐technologies to deliver services to students, but are hampered by limited resources compared with their international counterparts. These include very high counsellor student ratios, lower average number of consultations per student, and lower mental health qualifications of counsellors. This has even greater implications in the context of higher education reform in Australia that may further widen the gap between needs of students and available counselling services. Inadequate counselling support can negatively impact on students, universities, and the community through lost potential.     

The relation of depression and anxiety to life‐stress and achievement in students

Objectives: An apparent increase in seriously disturbed students consulting student health services in the UK has led to concern that increasing financial difficulties and other outside pressures may affect student mental health and academic performance. The current research investigated whether student anxiety and depression increases after college entry, the extent to which adverse life experiences contribute to any increases, and the impact of adversity, anxiety and depression on exam performance. Method: 351 UK‐domiciled undergraduates completed questionnaires one month before university entry and mid‐course. The Hospital Anxiety and Depression Scale (HADS: Zigmond & Snaith, 1983) was administered at both time points and a modified List of Threatening Experiences (Brugha, Bebbington, Tennant, & Hurry, 1985) was administered mid‐course. Results: By mid‐course 9% of previously symptom‐free students became depressed and 20% became anxious at a clinically significant level. Of those previously anxious or depressed 36% had recovered. After adjusting for pre‐entry symptoms, financial difficulties made a significant independent contribution to depression and relationship difficulties independently predicted anxiety. Depression and financial difficulties mid‐course predicted a decrease in exam performance from first to second year. Conclusions: This is the first study to confirm empirically that financial and other difficulties can increase British students' levels of anxiety and depression and that financial difficulties and depression can affect academic performance. However, university life may also have a beneficial effect for some students with pre‐existing conditions. With widening participation in higher education, the results have important implications for educational and health policies.     

Mentoring for Mental Health within a University: A psychodynamic approach

This paper explores the role of mentoring in a British University for students with mental health issues and is written from the perspective of the Mentor who is also a Psychodynamic Psychotherapist. Psychodynamic theory is applied to two case studies in order to understand the conscious and unconscious factors when considering these students’ particular learning difficulties and motivation for entering a learning environment. In the first case study, it is suggested that the student hopes to find his lost father within the containing bricks of the institution. When confronted with frustration and disappointment, he mobilises schizoid defences, precipitating a psychotic episode. The second case study formulates the student’s chronic procrastination, which verges on academic sabotage, as a defence against the unbearable guilt concerning his abilities and achievements in contrast with his unsuccessful and disabled siblings. The challenge of helping these students is explored, including the approaches taken by the Mentor, given her remit and the particular issues presented by the students.     

Psychosocial Characteristics of Student Veterans with Service-Related Disabilities: Implications for Further Research and Occupational Therapy Involvement

The purpose of this study was to assess how post-9/11 university student veterans differ from nonveteran university students on four mental health indicators. In comparison to a demographically matched sample of nonveteran students, it was found that veterans in this study had significantly higher levels of depression and post-traumatic stress symptomatology and non-significantly lower levels of engagement in meaningful activities and meaning in life. This non-experimental study indicates that mental health differences between student veterans and their nonveteran peers do exist, and argues for the inclusion of occupational therapy services for student veterans.     

Improving Mental Health on College Campuses: Perspectives of Indian College Students

The mental health of college students is increasingly viewed as an important public health priority. However, there has been little attention paid specifically to college students’ perspectives on factors that contribute to mental health challenges or on potential initiatives that could address them. Even less research has focused on students in low- and middle-income countries. In an effort to better understand how to improve mental health and wellness on college campuses, we administered an open-ended survey to 141 Indian college students (M_age = 19.47, 65% female). We asked the students to identify: (a) issues that contribute to mental health problems among college students, (b) potential initiatives or strategies that could be used to improve mental health and wellness, and (c) topics that students would like to learn about in a course about mental health and wellness. Applying thematic analysis, we identified academic stressors (e.g., pressure to succeed, competitiveness) and social stressors (e.g., lack of community, party culture and substance abuse) that students reported as contributors to mental health problems. Students also described mental health promotion strategies that could be implemented by faculty members (e.g., providing academic accommodations for students with mental health concerns), the student body (e.g., establishing peer counseling groups), and individual students (e.g., checking in with others). Finally, they identified topics that they would like to learn about in mental health and wellness courses (e.g., how to identify mental health concerns, how to support friends). By raising several potential targets for mental health and wellness interventions for Indian college students, our study illustrates how open-ended surveys can be a useful and feasible way to solicit input from stakeholders in low- and middle-income countries. Future research will be needed to assess the effectiveness and feasibility of mental health promotion strategies, including those proposed by students.     

高中生心理健康水平及其影响因素的研究

采用ＳＣＬ－９０量表评定了５００名高中生的心理健康状况,运用因素分析的方法探讨了影响高中生心理健康的主要因素。结果表明：有１０．８％的高中生存在着各种明显的心理健康问题;高中生的心理健康问题主要表现为强迫、敌对、偏执、人际关系敏感和忧郁等症状;影响高中生心理健康的主要因素为学校教育、家庭环境、社会文化及学生自身等方面的生活事件;高中生不同的心理健康问题有其不同的影响因素。     

心理弹性对大学生心理应激与心理健康关系的中介作用*

采用梁宝勇、程诚编制的“中国成年人心理弹性量表”、梁宝勇和郝志红编制的“中国大学生心理应激量表”和郑日昌、邓丽芳和张忠华等编制的“中国大学生心理健康量表”,对4所大学620名在校大学生进行测试,探讨心理弹性在大学生心理应激与心理健康关系中的作用。研究结果表明,心理弹性可以缓冲心理应激对大学生心理健康的消极影响,心理弹性部分中介心理应激与心理健康之间关系。     

Towards an evidence‐base for student wellbeing and mental health: Definitions,developmental transitions and data sets

Against a background of huge changes in the world of university and college students since the turn of the millennium, together with a multitude of reports on student mental health/wellbeing, this article argues that the field of student mental health is hampered by the imprecise use of terms, a rush to action by universities in the absence of a robust evidence‐base, and a lack of overall coordination and collaboration in the collection and use of data. In response, we argue for clearer and more consistent use of definitions of, as well as differentiations between, student wellbeing and mental health, for a longitudinal approach to the student body that captures their developmental transitions to and through university, and a strategic and systematic approach to the use of bona fide measures in the collection of data on wellbeing and on the process of outcomes in embedded university counselling services. Such a coordinated approach will provide the necessary evidence‐base upon which to develop and deliver appropriate support and interventions to underpin and enhance the quality of students’ lives and learning while at university or college.     

The Stride program: Feasibility and pre-to-post program change of an exercise service for university students experiencing mental distress

Rates of mental illness are disproportionately high for young adult and higher education (e.g., university student) populations. As such, universities and tertiary institutions often devote significant efforts to services and programs that support and treat mental illness and/or mental distress. However, within that portfolio of treatment approaches, structured exercise has been relatively underutilised and greater research attention is needed to develop this evidence base. The Stride program is a structured 12-week exercise service for students experiencing mental distress. We aimed to explore the feasibility of the program and assess pre- and post-program change, through assessments of student health, lifestyle, and wellbeing outcomes. Drawing from feasibility and effectiveness-implementation hybrid design literatures, we conducted a non-randomised feasibility trial of the Stride program. Participants were recruited from the Stride program (N = 114, M_age = 24.21 years). Feasibility results indicated the program was perceived as acceptable and that participants reported positive perceptions of program components, personnel, and sessions. Participants’ pre-to-post program change in depressive symptomatology, physical activity levels, mental health-related quality of life, and various behavioural outcomes were found to be desirable. Our results provide support for the feasibility of the Stride program, and more broadly for the delivery and potential effectiveness of structured exercise programs to support university students experiencing mental distress.     

Student mental health: A pilot study

In this country, little research has been undertaken into the difficulties faced by students and the contributory stressors. It is apparent that they have a lot with which to content. Identification of stressors, assessement of stress levels and consequences on mental health appear vital.A pilot study was undertaken of 40 studets: 10 males aged under 21 years, ten males 21–40 years, 10 females under the age of 21 and 10 females 21–40 years, The purpose was to identify the potential factors leading to student discontent, problems and stress. Students were in the professions allied to medicine. Oral semi-structured interviews and a written questionnaire were used. Results indicated that for students the major difficulties were coursework and emotional state. Finance was a recurring problem but not as troublesome to the students as the other two problems. What must be considered are ways to alleviate student unhappiness. Emphasis should be placed on prevention where possible. Ongoing counseling throughuot the educational years is desirable as are various programmes which address student concerns. Of particular value would be a Student Mental Health Service. ‘Unnecessary’ coursework could be an added burden.     

An Ex-Patient/Practitioner's Comments on Professional- and Consumerisms,with Poetry

SUMMARY

This article, more like a stream of consciousness or conversation, touches on a personal story and leads to a clinical/political stance. It seeks to convey some of the difficulties in the field's quest to practice “consumerism,” the inclusion of mental health service recipients and ex-patients in all aspects of the mental health system. It tells part of the author's story as an ex-patient who has professionalized in the field, and offers readers the chance to ponder their roles relative to the recent phenomenon of asking consumers to participate. It concludes with poetry meant to be read as a letter to mental health workers from a composite client who seeks their support.     

亲子关系对中学生心理健康的影响:社会支持和心理素质的链式中介作用

为探究亲子关系、社会支持和心理素质对中学生心理健康的影响,本研究采用问卷调查的方式,对全国23个省（市）共10190名初一至高三年级的中学生展开调查。结果表明：（1）父子关系、母子关系、社会支持和心理素质两两之间呈显著正相关,且均与心理健康问题呈显著负相关;（2）相比于母子关系,父子关系对中学生心理健康的影响更大;（3）亲子关系通过三条中介路径对中学生心理健康产生影响：①是社会支持和心理素质的单独中介作用;②社会支持和心理素质的链式中介作用。本研究进一步明确了亲子关系和中学生心理健康之间的内在心理机制,同时能帮助教育工作者预防和干预中学生的心理健康问题。     

Medical Student Burnout: Interdisciplinary Exploration and Analysis

Burnout—a stress-related syndrome characterized by exhaustion, depersonalization, and a diminished sense of accomplishment—is a common phenomenon among medical students with significant potential consequences for student health, professionalism, and patient care. This essay proposes that the epidemic of medical student burnout can be attributed to a technocratic paradigm that fails to value medical students as persons with human needs and limitations. After briefly reviewing the literature on medical student burnout, the author uses two theories to elucidate potential causes: unsatisfactory aspects of the learning environment and a feeling one’s efforts are meaningless or irrelevant. Cultural factors also facilitate burnout in medical students immersed in a clinical environment that cultivates excessive detachment from patient and self, impairing self-care, damaging a sense of self, and impeding the development of a mature, well-integrated professional identity. The ethical implications of medical student burnout are also addressed. Finally, this paper suggests possible preventive and remediative strategies such as optimizing the learning environment as well as narrative approaches that promise enhancement of both individual and institutional well-being.     

The study-skills workshop

A concern for improving the study skills of individual students led the Student Counselling Service at the University of East Anglia to consider aspects of the learning environment as a whole, and particularly the relationship between faculty and students. From cautious beginnings the development of the study-skills workshop has enabled counsellors, faculty and students to share problems, experience and expertise in a non-threatening context. The work-shop with its emphasis on an experiential approach provides ample opportunity for developing empathic qualities in both students and faculty, and is often a springboard for change, faculty members being persuaded to reassess their teaching and tutorial performance in the light of student concerns and difficulties expressed during workshop sessions.     

“My Entire World Stopped”: College Students’ Psychosocial and Academic Frustrations during the COVID-19 Pandemic

The COVID-19 pandemic disrupted normalcy for college attending young adults which resulted in a loss of the campus environment and classroom setting. This change in setting may interfere with a student’s personal and academic wellbeing. This study used an online survey to evaluate college students’ academic and psychosocial frustrations during the COVID-19 pandemic. Data were collected from March–April 2020 at a land-grant university in the Appalachian region. Data were available from 2643 undergraduate and graduate students. There was a 65.8% and 15.7% increase in the number of students who reported their learning and health as fair, poor, or very poor after the COVID-19 pandemic, respectively. Qualitative responses were coded and 8 themes and 24 subthemes emerged. College students expressed frustrations regarding technology, classwork, research, family, social, emotional, behavioral, and financial aspects of life. These results can be used by higher education administration, faculty, and staff when planning for online courses. Ensuring that student frustrations and barriers to success are recognized and considered may help prevent students departing from higher education during this time.

     

Developing a family-based depression prevention program in urban community mental health clinics: a qualitative investigation

Extensive research documents that children of depressed mothers are at a significantly higher risk for developing a variety of socioemotional difficulties than children of nondepressed mothers. Yet, little prevention research has been conducted for this population, and low-income, minority, and urban families are rarely included. To address this deficit, we are developing the Protecting Families Program (PFP), a family-based multicomponent depression prevention program for mothers in treatment at urban community mental health agencies and their school-aged children. To inform intervention development and begin relationship building with the agencies, patient and staff focus groups were conducted in the participating agencies. Eighteen mothers with depression participated, and eight major themes were identified: (1) depression symptoms, (2) generational legacy, (3) parenting difficulties, (4) child problems, (5) social support, (6) stressful life events, (7) therapy and other helpful activities, and (8) desired treatment. In the focus groups with 10 mental health providers, the five major themes identified were parenting difficulties, lack of social support, life stress, current mental health practices, and intervention development. The findings support the multicomponent design of PFP, which focuses on increasing knowledge of depression, enhancing social support, and improving parenting skills. The study helped clarify many of the challenges of conducting research in a community mental health system.     

A follow-up study of new users of a university counselling service

For many students the demands of a university course, often coupled with financial and relationship difficulties, create circumstances where counselling or specialist psychiatric support are needed. Few published studies exist of these services. A follow-up study of new users of the University of Cambridge Counselling Service during the course of the 1993/94 academic year is reported. The study aimed to describe morbidity levels and to identify the determinants of change in students' mental health status. Data were obtained from two initial questionnaires: one completed by each student at the time of their initial consultation; the second by the counsellor completing an assessment consultation. About one year following their first assessment, students were asked to complete a further questionnaire. The clear demonstration in this study of depression and anxiety symptoms, as dominant features for many students at their assessment consultation, suggests that training to improve counsellor recognition of such symptoms and of their knowledge of the effectiveness of available therapeutic approaches would be valuable. Such training should also provide guidance on when to refer students to other professionals.     

The relationship between mental vitality and cardiovascular health

Past measurement of vitality has included both emotional and physical components. Since aspects of physical vitality such as fatigue can be indicative of physical illness, the usefulness of existing measures of vitality to predict health is limited. This research was designed to examine the psychometric properties of a new Mental Vitality Scale and to test its associations with measures of cardiovascular health over the course of 2 years. The measure of mental vitality was administered in a two-part study using three different samples. In part 1, the reliability and validity of the scale was assessed with a student and a clinic sample. In part 2, medical data on mental and physical health were abstracted over a two-year period from 1041 patient records from a multi-specialty medical practice, and mental vitality assessed through a mailed questionnaire. The findings indicate that the Mental Vitality Scale is a valid and reliable questionnaire for measuring this construct. Mental vitality was also associated with reduced odds of several cardiovascular outcomes and prospective analyses suggest that mental vitality may serve a protective function in the development of cardiovascular disease. The results lend support for the importance of mental vitality as a construct that may be relevant for considering resilience in relation to cardiovascular disease.     

开放教育学生金钱态度与主观幸福感的关系:社会支持的中介作用

开放教育是高等教育的重要组成部分,加强开放教育学生学习的同时,提升其幸福指数,注重心理健康发展是开放教育的重要内容。文章采用《金钱态度量表》、《主观幸福感量表》、《社会支持量表》对开放大学系统 345名在校生进了调查并采用中介效应分析。结果表明,(1)社会支持、金钱态度和主观幸福感相关显著;(2)金钱态度因子金钱行为倾向对社会支持、总体幸福感及其因子回归效应显著; 社会支持在金钱行为倾向的基础上,对主观幸福感及其因子精力、对生活的满足和兴趣、对情感和行为的控制回归明显,同时在两者之间起了中介作用。说明金钱态度因子金钱行为倾向直接影响开放教育学生主观幸福感,另一方面通过社会支持影响开放远程教育学生主观幸福感。因此,建议开放教育从建立社会支持系统、师资队伍建设、心理健康教育、金钱观培养四方面着手,提升开放教育学生的幸福指数,促进其全面发展。     

The effects of different learning environments on students’ motivation for learning and their achievement

Background. Research in higher education on the effects of student‐centred versus lecture‐based learning environments generally does not take into account the psychological need support provided in these learning environments. From a self‐determination theory perspective, need support is important to study because it has been associated with benefits such as autonomous motivation and achievement. Aim. The purpose of the study is to investigate the effects of different learning environments on students’ motivation for learning and achievement, while taking into account the perceived need support. Sample. First‐year student teachers (N= 1,098) studying a child development course completed questionnaires assessing motivation and perceived need support. In addition, a prior knowledge test and case‐based assessment were administered. Method. A quasi‐experimental pre‐test/post‐test design was set up consisting of four learning environments: (1) lectures, (2) case‐based learning (CBL), (3) alternation of lectures and CBL, and (4) gradual implementation with lectures making way for CBL. Results. Autonomous motivation and achievement were higher in the gradually implemented CBL environment, compared to the CBL environment. Concerning achievement, two additional effects were found; students in the lecture‐based learning environment scored higher than students in the CBL environment, and students in the gradually implemented CBL environment scored higher than students in the alternated learning environment. Additionally, perceived need support was positively related to autonomous motivation, and negatively to controlled motivation. Conclusions. The study shows the importance of gradually introducing students to CBL, in terms of their autonomous motivation and achievement. Moreover, the study emphasizes the importance of perceived need support for students’ motivation.