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In the wake of the COVID-19 pandemic, much has been written about student mental health and student well-being more broadly. Administrators have noted quantitative and qualitative differences in the mental health needs of their student populations, and campus officials have presented a host of solutions, ranging from hiring more counseling center staff to offering resilience training programs, from increasing after-hours access to counseling to referring to health and wellness educators.
Many of these efforts, while laudable, feel insufficient. Throwing programming dollars or an additional full-time employee at the complex problem of student well-being may seem like an appropriate strategy, but these tactics are ultimately insufficient in addressing the systems and policies that foster unhealthy, unengaged and uninspired students. Although the campus may applaud a new program, a comprehensive approach to student well-being that centers equity, access and choice and decenters an exclusive focus on pathology presents more hope for our nation’s overwhelmed students.
As a clinical psychologist, trained in addressing psychopathology specifically, anything that I write or say that de-emphasizes psychopathology is challenging for my brain to process. My professional training was in the assessment and treatment of mental illness, and, as they say, when your tool in life is a hammer, you see nails everywhere. I see nails in the way that many students of color around the country are presumed incompetent and inferior, and I know how this breeds distress. I know that our students need culturally sensitive treatment approaches from providers who are trained to address issues specific to the marginalized student experience. I see nails when I see the number of students who have had terrible adversity and trauma in their childhoods, and I know that we need counselors trained in the latest trauma-informed treatment modalities. I know that the specter of a campus suicide looms large.
Of course, we need to focus on equitable access to mental health care services. However, when we think about the way marginalized students are treated on some campuses and in the larger society, the notion that we can just send these students to the counseling center for repair while they are being actively harmed elsewhere on campus is unreasonable. So many campuses compete with one another, rushing to hammer nails and centering strategies to address only pathology and disease. And even when resiliency programs are created, these too have the potential of falling short, as one-off programs are often tied to individual staff members, who, as you may have noticed, are slowly trickling off our campuses due to their own burnout or the desire to seek more lucrative positions elsewhere.
What if we thought about well-being in a different way? What if, in addition to thinking about the next mental health program you feel inspired (or perhaps pressured) to create, you think about structural issues, procedures, policies and the invisible, less flashy ways that you can make a difference in student well-being? This is not to say that you should abandon a new program or the hiring of additional counseling staff. However, I believe real, sustained change is more likely to occur when you also think about the campus structures that support whole-person well-being. These less visible actions are harder to tout, perhaps, and you may not easily get credit for innovating in this space, but there is a group of universities with individuals who believe that adopting a new way of thinking about well-being is a more sustainable strategy. There is a network of campuses and individuals who are eager to share stories and strategies as we try to truly move the needle on student, faculty and staff well-being and health.
My campus, the University of California, Irvine, was one of the initial universities to join the U.S. Health Promoting Campuses Network (USHPCN), which was formed in fall 2020. Inspired by a document drafted at the University of British Columbia’s Okanagan campus in 2015, the USHPCN is a network of campuses that aspire to be health-promoting universities. Note that this isn’t a network of campuses that have agreed solely to have a certain number of counselors in the counseling center or a mindfulness day each semester; we have taken a pledge to transform our institutions into institutions that embed wellness principles into the fabric of what we do. It is an aspiration and a mission, not a commitment simply to a singular event. We are a network of campuses exploring what it means in each local context to center well-being throughout the institution, including the curriculum, the built environment and administrative services.
What if we thought about our relationship to the environment as a tool for well-being, healing and meaning-making and created public spaces for students to be in nature with one another? These spaces would long outlive any of our individual careers. What if we thought about biophilic design in new construction and let natural light into spaces starving for light during the winter months? What if we rethought policies and procedures that made it difficult to switch majors and schools, alleviating real suffering for students who thought they knew what they wanted to be when they applied to college at 17 but later changed their minds? What if we thought about well-being as a function of housing policies or parking policies? I suspect the parking office on your campus gets its fair share of parking ticket appeals that refer to fragile mental health. Thinking of parking as a potential campus partner in your well-being efforts might start to transform your sense of what’s possible and who can be helpful.
Further, what if we thought about suicide prevention efforts differently? In addition to mental health first aid trainings or QPR trainings (programs that many universities, including ours, hold), what if we also thought about means restriction? Restricting access to rooftops, installing physical barriers or netting for bridges, or attending to landscape design features, such as awnings or plantings, in ways that make jumping from tall structures less accessible are all systemic steps institutions can take that can reduce the lethality of a momentary desire to end one’s life.
Last, what if your professors discouraged 8:00 a.m. paper deadlines, as those tend to inspire all-nighters, and we encouraged faculty to run PowerPoints ahead of class with wellness office resources? These thought experiments, many of which contain free or low-cost options, are not substitutes for licensed therapists (obviously), but these additional ways of thinking about health inspire us to embed well-being principles into our policies and procedures and add an extra layer of support to students. The time has come for us to consider whole-person wellness.
For example, on our campus, our health promotion office, called the Center for Student Wellness and Health Promotion, discovered a plan for a campus partner to distribute caffeinated gummies in opening week welcome bags. Concerned about the message this might send to students (one gummy contains more caffeine than a soda), we worked with that partner to help them understand that while students are free to decide on the level of caffeine consumption that suits them, including free gummies in a welcome week bag sent the message that we somehow believed that this item was so essential to the first week of their campus experience that we needed to get it in their hands as soon as possible. It wasn’t the welcome message that we wanted to send. And if you’ve ever sat beside someone who is hallucinating that bugs are crawling on them due to overconsumption of caffeine and stimulant medication (as I have), you’ll probably understand why making this careful choice about what not to give away to first-year students was made. Students (at least the ones who don’t read this article) will never know that this item was taken away. They still have access to the product and to many other energy drinks, but we feel that this was an important and meaningful step for our community, and we were delighted that our campus partner ultimately agreed. Sometimes, it’s the small things that don’t happen that will be your most important marker of success.
In another example, Western Washington University recently approved a campus alcohol policy that is intended to better align its campus environment with both federal and state law. In this revised policy, Western Washington University prohibits the use of alcohol on any university property during university work hours and academic and student activities. My colleague Sislena Ledbetter, associate vice president for counseling, health and well-being at Western Washington, noted that all campus entities are covered under the new policy.
Regardless of what you think about this policy or whether you’d ever vote for it, you have to admit that it is an “upstream” approach to the problem of underage drinking and alcohol-related violations. One approach to an identified problem would be to offer substance abuse referrals and programming, which are necessary and useful tools. Along with that, however, we must also think about policies and procedures that have the potential for enhancing well-being. This may not be the answer on your campus, but perhaps there is a similar policy that you can implement that speaks to your unique local culture.
Before you think that every example of a health-promoting university involves taking away alcohol or caffeine from students (it doesn’t, as clearly a healthy lifestyle for adults can include the consumption of both caffeine and alcohol), consider an additional example. We had a food voucher program for many years as our students reported food insecurity. A social worker provided meal swipes for students who had run out of funds for meals. In many ways, the voucher program was successful, meeting a need. But after collecting data and documenting the prevalence of food insecurity in the region and among our students, we knew that something larger needed to happen, and the campus food pantry was born in the 2015–16 academic year.
Embedded in the food pantry is a social worker who can get students plugged into county resources or who can address other stressors that frequently co-occur with food insecurity. The space is intentionally designed to give students a shopping experience, and recyclable totes are used to reinforce important notions of sustainability. A dietitian or chef shows students how to prepare healthy meals during special programs, and our campus recreation unit is working on a teaching garden to illustrate the concept of food as medicine. Food insecurity isn’t relegated to a single program on campus or a building that embarrassed students struggle to find; food insecurity is normalized, with policies and staffing that give dignity to a stressful situation. Not only do we hope students get the basic nourishment that is so essential for learning, but we also hope they experience the campus as a place that cares about the creation of a lifelong positive relationship to food. Food is so much more than what you can find to stave off hunger; it is wrapped in social and cultural meanings that must be humbly respected and honored. Medical students even receive modules on culinary medicine in groundbreaking curricular offerings. This is what we mean when we say we aspire to be a health-promoting university.
Addressing rising mental health issues among our students around the country involves recognizing that there is no single variable that causes mental illness and therefore there is no single solution that will fix the “crisis.” Rather than tout one new program that is suddenly going to fix everything but never does, consider taking a larger holistic approach to student well-being, one that focuses on your policies, structures and curriculum. Let’s focus on community care and the university as a living, breathing agent for well-being and change.