80% of Sheffield students self report disturbances in mental health. This was the shocking statistic presented by Anna Mullaney, welfare officer for the students union, speaking at a debate, organised by Sheffield’s University Counselling Service. More objective studies have shown that 1 in 4 students have a mental health problem. Around 50% of people attending doctors surgeries or specialist clinics have illness that defies medical explanation, such as eating disorders, Irritable Bowel Syndrome or Chronic Fatigue Syndrome, all of which often start during a period of adolescent dependency extending into the mid twenties or beyond.
Why might this be so? Is it because children are so overprotected they are ill equipped to cope with the stresses and pressures of independent life at university? Or is it that modern Universities are particularly toxic for students? Or are we just over-medicalising everyday experience?
Are Universities dangerous?
When I went to University in the nineteen sixties, I was among a privileged 30%. I knew I had a job waiting for me as soon as I left. The government funded my tuition fees and I had local authority support for my accommodation and sustenance. As the Prime Minister of the day proclaimed, ‘we had never had it so good!’ It was true. We were very fortunate. We were also eager to make our way in a world that seemed more secure than it does now.
Nowadays, most young people expect to go to University. It is a rite of passage into adulthood but there is not a guarantee of a job at the end of it. Many university leavers start life on benefits. The bar has been raised. Employers are often looking for students with Masters degrees or Doctorates and these are only awarded to the most competitive students.
The pressure to succeed, claimed Ms Mullaney, often means extra courses, assignments and ‘character-developing’ involvement in student politics, administration and sport. Universities were always a preparation for life, but that life has become much harder. Most students have to take casual employment in bars or restaurants just to earn enough for the necessities of food, shelter and entertainment. Many find it more economic to live in a house together with other students, but this gives them no privacy and little time for thought and study. They may fall out with their housemates or feel coerced into drinking too much, taking drugs or casual sex. The stereotype is that students work all day, finish their shift in the restaurant late a night, then hang out with their friends until the early hours and then get up for lectures again the following morning, but that may not be the norm. Nevertheless, loneliness, poverty, the stress of assignments and exams, alcohol, drugs and sex make for such a toxic mix, it is amazing that so many students get through it. But many don’t and what happens during what should be ‘the time of their lives’ may leave them increasingly susceptible to illness and stress. So is university that dangerous or does it just seem so? Is this why more students are living at home these days?
The Pathologising of Everyday Life
The other speakers in the debate went to University in ‘the golden age’. Sir Simon Wessley, now President of the Royal College of Psychiatrists, acknowledged the results of mental health surveys of young people and the stresses of university life, but questioned whether such stress should be considered abnormal or just part of growing up. Change is always stressful and leaving home and going to university has always been a challenging transition. It is way we deal with stress and the experience and resolution of anxiety that helps people learn and grow in confidence and enjoy life. Enjoyment and self confidence always comes with overcoming risk.
Wessley questioned whether we were not in danger of pathologising everyday experience?’ Might, for example, everyday sadness and disappointment now be regarded as depression; life stress, anxiety disorder; a robust exchange of views, bullying; focus and hard work, autism or obsessive/compulsive disorder; or the boredom of an intelligent child, attention/deficit hyperactivity disorder? There is obviously something in that but such assumptions may condemn many to accusations of malingering, rejection and stigmatisation.
Quoting from a study of those soldiers deemed at risk from battle trauma, Wessley noted that the greater proportion of those at risk showed resilience under fire and grew from the experience. The same applies to assessments of vulnerable students. Fitness to study assessments could rule people, who otherwise might do brilliantly, out of university.
Does Awareness make people ill?
Ken McLaughlin, Professor of Social Care & Social Work at Manchester Metropolitan University questioned the benefits of awareness campaigns for mental illness. He wondered whether this might focus too much attention on vulnerability instead of celebrating the risk and the excitement of life. Awareness creates labels, which makes people more conscious of being sick and justifies illness behaviour? Have we become so Health and Safety conscious that we worry ourselves sick about the risks of everyday life than just accepting them and enjoying the challenge? Moreover, he added, by labelling people as mentally ill, are we producing a stigma, that isolates the individual, causing rejection and more tension and illness.
Blaming the individual for society’s ills.
McLaughlin was was concerned that societal and political problems were so often reconfigured as psychological issues for the individual. People who are unemployed may not so much need counselling or CBT; they just need help to find a job. Trades Unions seem more concerned with helping people cope with inequalities than fighting them. The same might apply to student union initiatives. It’s often when people feel entrapped in a situation where they feel ignored or unfairly treated that they get ill. Expressions of frustration and anger can be quite rational responses to the injustices of life. CBT may help the individual deal stay with their troublesome feelings, but positive action may be more effective.
Situations that induce feelings of entrapment, impingement, rejection, isolation, loneliness, inequality, poverty and hopelessness often underpin distress and illness and should not just be seen as a failure on the part of the individual. We need to address what it is about society that makes people feel bad.
Are interventions exacerbating the problem?
Professor Kathryn Ecclestone, from The University of Sheffield’s School of Education said that the university has trebled its expenditure on psychological support of students, but questioned the evidence base of such interventions. Mindfulness courses, resilience training, trigger warnings on upsetting lecture material and provision of ‘safe spaces’ for vulnerable students have become commonplace. She questioned how helpful these were. ‘Are we offering much needed support and recovery facilities or are we in danger of fostering dependency? Do self help groups keep people in illness?
Simon Wessley quoted from research showing that psychological debriefing after trauma doubled the rate of breakdown. It was better to talk about normal things with family and friends, he claimed.
At the age of 19 to 21, young people are still trying to find who they are. Students are very suggestible; they take on many worries about the way they feel they should be. Experience gains at University lasts throughout life. Instead of creating a space to talk about a perceived problem or seeking escape through sex and drugs and loud music, universities might help students to work together, face life and experience that frisson of risk and resolution that will them grow into responsible and confident adults.