Student Mental Health and Pressure to Do Well

Exams are the top academic stressor for students over all, according to the most recent Student Voice survey on health and wellness, with about six in 10 students citing this as a major concern. Students’ next-biggest stressor is pressure to do well, with more than four in 10 students citing it. Next up: balancing school and other obligations, essays or papers, and getting a bad grade, each stressing out between three and four in 10 students.

Rounding out the top 10 stressors from a dozen possible choices are homework and readings, pressure to decide on a career, group projects, “other” or not listed, and individual projects.

This hierarchy of stressors is relatively consistent across a variety of student characteristics in the survey of 3,000 two- and four-year undergraduates across 158 institutions, conducted in April and May by Inside Higher Ed and College Pulse. One big exception? How students experience academic stressors appears linked to how they describe their mental health.

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Pressure do well, in particular, affects relatively more students who say their mental health is ailing. Respondents who rate their mental health as poor, for instance, are significant more likely to choose pressure to do well as a top academic stressor than are students who say their mental health is excellent.

What’s driving the relationship between mental health and pressure to do well? What does pressure to do well—which is clearly connected to academics but distinct from other lower-ranking stressors such as getting a bad grade—really mean to students? And, perhaps most importantly, what can colleges and universities do to help students relieve some of this pressure?

Read on for five expert analyses and recommendations.

1. Re-evaluate a hyperfocus on grades.

Wendy Fischman, director of Project Zero at Harvard Graduate School of Education, says the Student Voice data on pressure to do well reflect the open-ended conversations with students she and co-author Howard Gardner conducted for their 2022 book, The Real World of College: What Higher Education Is and What It Can Be (MIT Press). That is, while many of their student interviewees were navigating significant mental health issues, most students traced their mental health concerns back to academic pressure.

The phrase “mental health” was synonymous with “stress,” “anxiety” and “pressure,” Fischman recalls. And when she and Gardner further analyzed their data to understand what academic pressure meant to students, they found that it was about “doing well.” Specifically, it was about securing high grades, near-perfect grade point averages and a good résumé for their first job or graduate school. Indeed, more than half of the 1,000 first-year and graduating interviewees described getting A grades as more stressful than keeping up with the workload in college, balancing workload with other responsibilities or even feeling prepared for academic material.

Few interviewees, if any, talked about mastery of academic content.

Fischman argues that such problems start before college, when students are prepped for getting into college but not navigating the college experience. Precollege students and, frequently, parents “are programmed to focus—and often obsess—about grades and GPAs as the most important outcome of the academic experience,” she adds. In this light, students need “more preparation before college to understand what college is for, why they are there, the promises and opportunities for lifelong learning that higher education can—and should—offer.” (For what it’s worth, Student Voice survey respondents who’d sought treatment for a mental health issue prior to college were about as likely as those who hadn’t to feel pressured to do well.)

What can college and university leaders do to help current students under pressure? Fischman says they could encourage an ungraded first semester or first year to help students settle in and to “convey the important message that students should take classes that interest them and expand their minds,” rather than look for “easy A’s.”

Faculty and administrators can also address the issue directly with students, Fischman adds.

Moreover, institutions should be encouraging students to “think beyond the self,” about problems that exist on campus and off. Says Fischman, “We find that students are preoccupied with their own selves—their own goals and their own problems.” Yet “becoming aware of and thinking through problems our society faces may help students to gain perspective” and to realize they are in school for “larger purposes.”

2. Normalize failure and negative feelings as part of the growth process.

David Walden, director of counseling at Hamilton College and a board member of the Association for University and College Counseling Center Directors, says that students, like everyone else, “are just trying figure out how to live. And the pressure to do well in life, to be successful in whatever way the people and spaces around us measure it, is a very natural result of that desire.”

Traditional college-age students might be especially vulnerable to this pressure, he adds, because they’re “young and new to navigating life, but also because college is a time and space to be at least partially concerned about measures of success,” such as grades, social activities or athletics.

So what’s the relationship between pressure to do well and mental health? Walden says they probably “impact each other in a kind of feedback loop. The natural pressure to do well can impact some of us more deeply and worsen our mental health, which in turn impacts our ability to perform and deepens the pressure.” Similarly, he says, “when we’re not feeling grounded and OK in ourselves, we may feel more pressure to succeed as a way of compensating.”

As for what colleges and universities can do, Walden says educators must guide students, “partially from our vantage point of having more life experience and more time spent navigating our own pressures, successes and failures.” This means, in part, encouraging students to see “so-called negative experiences as part of growth.”

Discomfort and negative emotions are often seen as “something pathogenic or bad,” Walden continues, but “failure and negative emotions are salutogenic,” or “inevitable and necessary parts of growth and health.” Professional help is available when such feelings are too difficult to manage, he adds but “our systems can help students relieve some of the pressure by acknowledging that when we don’t do well it’s sometimes just as much of a success on the journey of life.”

3. Promote positive coping strategies and social connection.

Lucia Ciciolla, associate professor of psychology at Oklahoma State University, says that pressure to do well often has to do with “meeting expectations, both from oneself and from others, like parents or broader society, where there is often a narrow view of success.” While some amount of pressure can be motivating, she says, students may also feel that they lack the “skills, tools or support they need to succeed,” or that they should prioritize academic success in ways that are harmful (e.g., not getting enough sleep, healthy food or physical activity, or neglecting key relationships and not having time to recover and recharge with things they enjoy).

All this can take a toll on both students’ performance and their mental health, Ciciolla notes, and may trigger symptoms of anxiety and depression. Anxiety and depression then make it harder to cope with life in general, increasing chances that students “feel they don’t have the skills or what it takes to succeed,” and that they engage in coping strategies that hurt more than help, such as substance use, doomscrolling, procrastinating and self-isolation.

“Many students find themselves in this negative cycle that makes their performance and mental health worse, and likely makes the pressures they face seem so much bigger, more demanding and impossible to achieve.” (Another finding from the recent Student Voice survey: three in four students say academic stress is negatively impacting their ability to focus, learn and do well in school).

Colleges and universities must therefore make mental health support available and accessible to students—not just via counseling and support groups but also through programs that promote helpful coping strategies, work-life balance and self-care, Ciciolla says.

Connection and relationships are “extremely important for mental health,” she adds, “so creating opportunities for more isolated students to have meals with others or social events that are low-stress and focused on enjoyment can help students form positive relationships and feel supported and included.” This includes making connections with faculty and staff members.

4. Offer therapy groups.

Psychologist Mary Alvord, adjunct associate professor of psychiatry and behavior sciences at George Washington University’s School of Medicine and an advocate of resilience-based group therapy, says that the first year in college is a critical time for mental health, and therefore ripe for possible interventions.

One idea? Offering cognitive behavior therapy groups for students struggling with academic anxiety. “First of all, groups give you the immediate message that you’re not alone. You’re not only the only one suffering with this,” Alvord says. “And behavior group therapy really helps students understand the relationship between their emotions and even their bodily sensations and their thoughts—as well as their action or their avoidance.”

5. Encourage professors to be flexible.

Colleen Conley, associate professor of clinical psychology and director of the Improving Mental-health and Promoting Adjustment through Critical Transitions (IMPACT) lab at Loyola University Chicago, says there’s “mutual determination between academic performance and stress and mental health.” In other words, it “might be that the students who aren’t doing very well in terms of their mental health are also not doing well academically, and so they feel more of the pressure.”

What can campuses do? Conley says faculty and staff members must acknowledge that students are complex, emotional beings who require flexibility from time to time. Conley gives her own students a few “freebie” or automatic extension days for assignments, no questions asked.

“We can hold students to high academic standards and also allow them some flexibility that will relieve some of that pressure and allow them to perform at their best,” adds Conley, who also has championed embedding wellness interventions within academic services across the university.

We’d love to know what you’re doing to help students cope with academic anxiety and pressure to do well. Tell us here.