Irish Journal of Psychological Medicine, page 1 of 8. © The Author(s), 2020.

Published by Cambridge University Press on behalf of The College of

Psychiatrists of Ireland PERSPECTIVE PIECE
doi:10.1017/ipm.2020.110

Student mental health and well-being: Overview and

Future Directions

M. Hill1,*, N. Farrelly2, C. Clarke3 and M. Cannon4

1
Consultant Psychiatrist and University Lead for Student Mental Health and Wellbeing, University College Cork, Cork, Ireland
2
Consultant General Adult Psychiatrist, College Health Service, Trinity University College Dublin, Dublin 2, Ireland
3
Senior Registrar in Psychiatry, Dublin North Mental Health Services, Dublin 9, Ireland
4
Consultant General Adult Psychiatrist Beaumont Hospital, and Professor of Youth Mental Health, Royal College of Surgeons, Dublin 2, Ireland

The mental health of third-level students is of major societal concern with the gap between the demand for services and supports
offered at crisis level. In Ireland, similar to elsewhere, colleges have responded to this need in vastly differing ways, with student
counselling services available to all institutions, and student health departments and sessional psychiatry in some of the larger
institutions, with none operating as a single multidisciplinary service. There is an increasing recognition for a more systematised
approach, with the establishment of International Networks, Charters and Frameworks. These advocate for a whole institutional
approach to student mental health, in addition to the development of an integrated system of supports with effective pathways to
appropriate care. This paper, by members of the Youth and Student Special Interest Group of the College of Psychiatrists of Ireland,
contextualises student mental health currently and describes future directions for this emerging field. It is a call to action to develop
a structure that supports the needs of students with mental health problems across the full range of the spectrum from mild
to severe.

Received 01 July 2020; Revised 04 September 2020; Accepted 08 September 2020

Key words: Student, whole institution approach, youth mental health.

Introduction health and well-being as core institutional objectives.

Students themselves are central to this movement. In
The mental health and well-being of third-level stu-
August 2019, the Union of Students of Ireland launched
dents is a topic of increasing interest worldwide over
the results of their national student mental health sur-
the past few years. Many reports, surveys and initia-
vey (Union of Students in Ireland, 2019), which demon-
tives have emerged from countries such as the UK
strated the presence of a collective will to focus on this
[(The Insight Network and Dig-in, 2019), the Student
issue in the context of growing demand and increased
Mental Health Research Network (SMarTeN, n.d.)
complexity of mental health challenges experienced by
https://www.smarten.org.uk//] and Australia
students.
[Under the Radar] (Orygen, 2017). There is a recogni-
This article focusses on the following aspects:
tion that the differentiation between student well-being
(1) Challenges faced by third-level students, (2) Irish
and mental ill health is unclear (Barkham et al. 2019),
context and culture, (3) models of care and the role of
that institutions differ vastly in terms of their service
the College Psychiatrist, (4) relationships to external
models (Royal College of Psychiatrists, 2011) and that
agencies and (5) relevant national and international
coordinated, collaborative data collation on the effec-
developments and (6) a ‘whole institution’ approach
tiveness of current care models is essential in informing
the future development of services (Duffy et al. 2019).
In Ireland, mental health in young people has been Challenges faced by third-level students
addressed to varying degrees with the establishment of Starting third-level education marks a significant mile-
Jigsaw (A National Centre for Youth Mental Health) stone in the lives of young people, as they move from
and a Youth Mental Health Taskforce; however, signifi- their former ‘child’ (family) life to their new ‘adult’
cant gaps remain in the delivery of care to this popula- (independent) life and transition from a world, that
tion. Such organisations have emphasised the for many, is an organised, structured and supported
importance of student mental health with higher educa- home and school environment, into an unstructured
tion institutions (HEIs), identifying student mental university environment. This transition offers not only
freedom, which can be liberating, but also challenges,
*Address for correspondence: Michele Hill, Student Health
Department, Consultant Psychiatrist and University Lead for
which can be overwhelming (McLafferty et al. 2017).
Student Mental Health and Wellbeing, University College Cork, This period of emerging adulthood is defined by
College Rd, Cork, Ireland. (Email: Michele.hill@ucc.ie). increased autonomy from parents and shifts in social
2 M. Hill et al.

and relational stability and requires multiple skillsets in Irish context and culture
order to establish a healthy routine, a supportive peer
Universities are academic institutions, and their pri-
network and a habit of self-directed learning
mary remit is educational rather than therapeutic.
(Auerbach et al. 2018). A range of new experiences faced
Investment in professional support services is primarily
by students, including social media; sleep disruption;
to support students in reaching their academic potential
exposure to recreational drugs and binge drinking
and, therefore, has changed and evolved hugely over
and financial stresses and career uncertainty, in the con-
the years with changes in the composition of students.
text of an increasingly competitive job market (Bewick
Some staff have always had pastoral responsibilities,
et al. 2010). It is perhaps for these reasons that students
e.g., personal tutors or accommodation officers, but
demonstrate a poorer sense of mental well-being than
counselling and health services were developed to
their age-matched peers (Karwig et al. 2014). Prompt
address the aspects of student life that made learning
effective adjustment is required to avoid any negative
difficult, and as a result of the increased student to staff
impact on health and academic well-being.
The age of third-level students (mostly ranging from ratio. It is useful to keep in mind the educational aim of
18 to 25 years) corresponds with a period of accelerated higher institutions when trying to understand the
brain development and the peak age of onset of mental nature of support services offered within this context,
illness (Kessler et al. 2007). The pressures identified compared to what is offered in the general population.
above can bring heightened stress to a young person Ireland has one of the highest rates of educated
with pre-existing psychiatric vulnerabilities or unmask employees internationally, with 41% of the workforce
previously unidentified difficulties that were scaffolded with a higher education qualification, increasing to
by the family, such as autistic spectrum disorder or 53.5% in adults <35 years compared to an EU average
attention deficit hyperactivity disorder. University cam- of 40% (IDA, 2019). The number of students enrolled in
pus communities are different from communities in the third-level institutions has grown significantly from
general population in ways that may be important for 10% of the relevant age cohort in the 1960s to 65% in
mental health service utilisation (Eisenberg et al. 2007). 2010 (Hyland, 2011). The student profile has diversified
There are large numbers of students with gender iden- dramatically in recent years, largely driven by national
tity issues (McKinney, 2005), international students, stu- policy that promotes equity of access to higher education
dents from deprived socio-economic backgrounds, across society and protection against discrimination such
students with disabilities (AHEAD, 2017): groups who as The Free Fees Initiative (1996), the Equal Status Act
are at higher risk of mental health difficulties. (2000), the Equality Act (2004) and the Disability Act
Mental ill health impacts negatively on academic per- (2005) (Higher Education Authority, 2019). The State
formance and course completion rates (Orygen, 2017). has developed two higher education reduced points
Mental illness can impede university-to-work transitions, admission schemes to facilitate this: Higher Education
damage early stages of career path formation and the Access Route: for school-leavers from socio-economically
acquisition of work values, work ethics and core work disadvantaged backgrounds and Disability Access Route
skills (McAuliffe et al. 2012). Well-being is an important to Education: for school-leavers, whose disabilities have
determinant of successful transition across stages of life impacted on their second-level education (Higher
and career acquisition and retention (Haase et al. 2011). Education Authority, 2019), two groups at higher risk
On a positive note, there are several opportunities at of mental health difficulties. There has been a steady rise
college to pursue recreational, sporting and social inter- in demand for support services on campus that exceeds
ests, as well as to form new friendships. Students are these enrolment increases (Thorley, 2017), without matched
often bright, articulate and likely to be curious about resourcing to match these trends (Xiao et al. 2017).
themselves. They are more likely to seek counselling There is limited research overall investigating the
and psychotherapy and to benefit from it. Phases of nature and prevalence of mental health issues among stu-
transition can afford opportunities for growth and dents in Ireland. A study conducted by Reachout and the
maturation. College is a unique environment in ways Irish Association of University and College Counsellors
that are relevant to the emergence, detection and treat- (IAUCC) reported that students had significantly lower
ment of mental disorders in students as it is perhaps the mental health status than their aged matched peers
only time when work, leisure, social life, accommoda- (Houghton, 2010), and the My World Survey 2 reported
tion, medical care, counselling and social support are significant increases in anxiety and depression since My
provided in one environment. World Survey 1, with 38% reporting a history of self-harm
The college years therefore represent a distinct (Dooley et al. 2019). There is international recognition that
period whereby it is critical to improve early identifica- the field has been under-researched and lacking in a uni-
tion and treatment of debilitating mental health issues. fying strategy for data collection and reporting. Instead,
 Student mental health and well-being 3

there have been a plethora of unrelated survey-based needs of this age group, Mental Health generally accounts
reports with different measures for well-being and illness for approximately 20–40% of all consultations.
(Barkham et al. 2019). Nonetheless, the WHO World Counselling services are embedded across all third-
Mental Health International College Student Initiative level institutions and are therefore the figurehead of
reported that 35% of first year students screened positive mental health supports offered to students.
for at least one common lifetime mental disorder In Ireland, they see about 6.4% of the student body,
(Auerbach et al. 2016). The figures reported across studies an average of one counsellor per 2446 students, which
highlighted high rates of mental distress and resulted in is far below the recommended ratio of 1:1000 (IACS,
rapid responses by universities that are not necessarily 2011), and are the largest provider of psychologically
evidence based (Nunez-Mulder, 2018). There is a need based mental health supports for the age range of 18–
first for accurate data collection and education on the 25 years in Ireland (PCHEI, 2019).
differences between well-being and mental ill-health, The role and tasks of the College Psychiatrist have
and second, a need to address the increased strain on developed to incorporate a range of skills specific to
existing resources that successful anti-stigma campaigns their core population. The College Psychiatrist needs
can cause (Arie, 2017). In Ireland, The HEA Innovation to adopt a multi-faceted approach, which encourages
and Transformation Fund has funded a three-year project collaboration with medical providers, family members
across higher education institutions to create a National to support patients and university support services.
Research group and standardised dataset across student Student psychiatry incorporates a biopsychosocial
counselling centres. While this is a hugely welcome devel- treatment approach with medication, short-term
opment, however, the information collected will be lim- psychotherapy and work to improve nutrition, exercise,
ited to students who present to student counselling sleep and relationships with other people to help sup-
centres, and will not include those who present to student port recovery from mental illness and to assist in
health centres, external organisations, or the HSE, with long-term maintenance of progress made in treatment.
mental health issues. In terms of pharmacotherapy, important variables must
be considered during the selection process of
medication, including potential side effects such as
Models of care and the role of the College
sedation, cognitive clouding, weight gain and sexual
Psychiatrist
dysfunction.
Services that support student mental health differ in their An additional role of the College Psychiatrist is the
design, staffing and models of care across institutions and provision of care alongside concerns for professional
none have been effectively evaluated (Royal College of practice standards of a student. Institutional obligations
Psychiatrists, 2011). The range of support services avail- and individual responsibility to students with mental
able has arisen in the context of supporting the individual health difficulties can be complicated by programmes
and the institution, in its educational aims, and therefore of study that contain or lead to professional qualifica-
what was deemed appropriate for one institution may not tions (Stanely & Manthorpe, 2002). The College
readily transfer to another. Local factors such as the insti- Psychiatrist is therefore at times involved with deci-
tution’s size, culture, strategic priorities, the students’ pre- sions about the fitness of students to continue to study
senting needs and the internal and external resources or fitness to practice statements. The College
available all have a role to play. There is, however, increas- Psychiatrist’s duty to maintain confidentiality regard-
ing recognition that this level of variability is problematic, ing the student’s mental health illness may come into
with calls for university leaders to adopt a strategic conflict with duties to third parties, such as patients
approach to mental health and for the development of with whom the student will come into contact. This
government-level initiatives and formalised relationships usually occurs in the case of students who are seriously
with local health services (Thorley, 2017). unwell and clearly not coping with the demands of
At present, students in higher education have access studying.
to a variety of on-campus services including student The role and tasks of the College Psychiatrist are
counselling services, health centres and disability ser- similar across organisations in terms of the range of
vices (Hunt & Eisenberg, 2010). clinical skills required and dilemmas faced. Their posi-
The Irish Student Health Association (ISHA, 2019) tion within the support services and clinical governance
serves as a forum for healthcare providers of students structure differs between institutions, however, with
at third level. Many HEIs provide a Student Health vastly differing models of care from one institution to
Centre on or near campus, which are nurse or doctor the next (Royal College of Psychiatrists, 2011).
led, and differ in their design, staffing and models of care. There is no agreed role or definition of the College
They generally aim to complement versus replace regular Psychiatrist and their funding source can influence
GP or Health Service Executive (HSE) care but due to the the referral pathway and reporting structure.
4 M. Hill et al.

For instance, if solely funded by one service within the Relationships to external agencies
student support services, it is likely their time will be
Students with emerging mental illnesses, similarly to all
spent largely meeting the needs of students and staff
young people, typically lack sufficient symptom speci-
within that service. Currently, psychiatrists employed
ficity and severity to meet adult-type diagnostic criteria
in Irish universities are generally employed from a sin-
(McGorry et al. 2007). This, together with stigma and
gle fund such as Student Health, and while there is flex-
reduced mental health literacy, limits their access to
ibility around their response to other services, they do
Adult Mental Health Services (AMHS) (Rickwood
not have authority over a mental health team such as
et al. 2019). Youth-friendly enhanced primary care set-
college counselling psychologists. This in itself is not
tings such as Headspace, and quite possibly University
problematic, as a significant proportion of issues within
Counselling and Health services with sufficient
the student population would ideally be managed
resourcing and service reconfiguration, could be
exclusively by psychological supports and/or primary
expected to support the needs of a large proportion
care physicians, without referral to the College
of this population. However, there is a recognition that
Psychiatrist. However, when the level of need in the
without vertical integration (seamless open referral sys-
individual is such that it warrants such referral, and
tems to more specialised care) that there is a significant
the mental health records of students are held in several
proportion (up to 30%) whose mental needs will not be
different systems with an unclear clinical governance
met, because they are too great to be effectively treated
structure, care for the student may become disjointed,
in primary care, and not severe enough to be accepted
increasing clinical risk and also potentially duplicating
into AMHS, the so-called ‘missing middle’, wherein lies
work and wasting resources. Having access to a
a missed opportunity for effective treatment, and an
Psychiatrist, whether on site in larger institutions, or
increased likelihood for adverse outcomes and the
via established pathways to secondary care in smaller
entrenchment of symptoms (McGorry & Mei, 2018).
settings, is integral to the delivery of a comprehensive
Students are often a transient population, who lack
mental health service for students, to ensure the full
awareness of the service implications of changing
range of mental health needs from mild-severe can
address across catchment areas boundaries. Community
be met.
services are not designed to meet the significant needs of
In the past decade in the UK, there has been prolif-
this group in respect of responding prior to symptom
eration of multidisciplinary teams within Colleges,
entrenchment and within term time, and the rigidity of
with many introducing a single point of access to a men-
catchment area boundaries can essentially act as a barrier
tal health and well-being team (Streatfield & Prance,
to care (Duffy et al. 2019).
2016). In addition to an obvious need for more invest-
Due to the continued under-investment in AMHS,
ment, reorganisation and strengthening existing ser-
universities are left with little choice but to provide
vices such as developing a stepped care model would
mental health support to their students. The provision
direct the large number of help-seeking students with
of student mental health services could result in state
transient situational problems and uncomplicated
symptoms, to appropriate campus-based resources services rescinding their statutory obligation to provide
and reduce delay to specialist care for more complex evidence-based treatment, particularly where state ser-
cases (Duffy et al. 2019). However, the effectiveness of vices are underfunded and overstretched. An ideologi-
this model is dependent on an easily accessed clinical cal rationalisation may occur that the mental health
triage framework staffed by experienced mental health needs of students are fewer than those of other groups
clinicians, effective interventions and facilitated smooth by virtue of the fact they are in third-level education.
transitions across the identified steps (Duffy et al. 2019). Universities have a duty to support a student’s mental
Finally, it is also important to remember that the vast health and well-being during their academic journey,
majority of students are young people and we cannot safely within the resources they have in place to do,
afford to treat educational systems as separate from without and expectation of reorienting themselves as
the real world. While there is an international recogni- a stand-alone mental health service to buffer the over-
tion that the healthcare system is weakest where it burdened HSE.
needs to be strongest (McGorry & Mei, 2018), service In Ireland, there is no formal relationship between
models have been developed internationally to meet HEIs and HSE mental health services or clear definition
the mental health needs of young people, for example, of what presentations are the remit of the university and
Headspace in Australia (Rickwood et al. 2019). The uni- what is the remit of the HSE. As a result, students can
versity sector would benefit from incorporating the struggle to access the care they require in a timely fash-
knowledge base from this field and partnering with rel- ion, and university support services often end up man-
evant organisations such as the International aging complex cases far beyond their skill set or their
Association for Youth Mental Health (IAYMH, 2019). primary care remit. Defining this remit at a national
 Student mental health and well-being 5

and local level would be helpful, but unlikely to protect HSE Department of Health Promotion have developed
the needs of the student. The development of close ties a Healthy Campus Charter and Framework that will be
and partnerships with local external services is vital in launched in 2020. This outlines guidelines for institu-
order to have accessible pathways to specialist care tions to follow in the development of their own whole
when required. There are examples of sector-led part- system approach to ensure that health is infused into all
nerships creating innovative co-produced student aspects of campus life: operations, business practices
friendly services that are organised around the struc- and everyday teaching.
ture of the academic year example. The Belfast Trust, Connecting for Life: Ireland’s National Strategy to
Queens and Ulster University partnership and The Reduce Suicide 2015–2020 (National Office for
Greater Manchester NHS partnership with the region’s Suicide Prevention, 2016) urged the HEA as lead
four universities (University of Manchester, 2019). At agency and in partnership with the National Office
an individual level, the development of a digital stu- for Suicide Prevention to create ‘The National Student
dent health passport to ensure their health records Mental Health and Suicide Prevention Framework’ (HEA,
travel with them has been proposed (Thorley, 2017) under review) via a collaborative consultative process
across several stakeholders. It recommends that student
mental health and well-being are prioritised at institu-
National and international developments
tional level and provides guidelines for organisations to
Education policy in Ireland is increasingly referencing a develop their own whole university approach.
more holistic definition of student success. A goal of the
National Plan for Equity of Access to Higher Education,
A ‘whole institution’ approach
2015–2021 includes ‘enhanced supports/completion
rates for students with mental health issues’ (Higher A whole institutional approach recognises that there
Education Authority, 2019). are multiple causes and consequences of mental health
Recently, student mental health and well-being and well-being in higher education requiring a collec-
are gaining traction at the organisational level. The tive, creative response. Most importantly, it aims to
Okanagan Charter is an International Charter for transform culture at third level into a health promoting
Health Promoting Universities and Colleges, which setting that no longer delegates mental health to the
calls upon post-secondary schools to embed health into support services (Universities UK, 2017). A whole insti-
all aspects of campus culture, and to lead health promo- tutional approach is enabled by leadership through sus-
tion and collaboration locally and globally (Okanagan tained strategic prioritisation at every institution, with
Charter, 2015). Institutional Leaders and Academic Heads as cham-
Australia has recently started to tackle this area, with pions, full engagement from all members of staff and
a report from Orygen showing that university leaders, an identified campus Mental Health Committee/
staff and students are attempting to respond to these University Taskforce that guides strategic planning,
issues, but are doing so without national leadership, policy development and allocation of resources based
data collection or comprehensive guidance and a on need, identified gaps in services and future projec-
National University Framework is now in development tions. Universities UK recommend that strategy devel-
(Orygen, 2017). opment is a consultative activity with strong student
The UK Institute of Public Policy Research is calling representation. This guides the policies and procedures
for prioritisation of student mental health via a sector- linked to the support of student mental health and well-
led approach, accompanied by strengthened health being, taking into consideration the need to balance the
service provision and government-level initiatives support of students with mental health difficulties
(Thorley, 2017). The University Mental Health against the duty of care to the wider student and staff
Charter was launched in December 2019 (Hughes & community. Currently in higher education, there are
Spanner, 2019), following an 18-month consultation independently developed policies with marked vari-
process, building on the work of Student Minds and ability across institutions and lack of clarity around
the Stepchange Framework (Universities UK, 2017). how they are implemented in practice or embedded
The Charter has two aims. First, to provide a reference in campus life.
point for HEIs to adopt a whole-system approach to Enhancing the supports that are in place in campus
mental health. Second, to launch a Charter Award and referral pathways to adult mental health services
Scheme, which will assess HEIs against the Charter, have been discussed in Sections 3 and 4. Support ser-
providing structure, recognition of good practice and vices are not limited to clinical services, with several
an increasing evidence base. institutions providing a wide array of supports such
In Ireland, there are a number of recent national as peer support workers, identified tutors in specific
developments of relevance. Healthy Ireland and the schools, Disability Support Services that support the
6 M. Hill et al.

educational needs of registered students, Careers at risk, e.g., international students and first year stu-
Officers, Budget Advisors, Office of International dents. The ready availability of satisfactory, affordable
Students, Chaplaincy, to name a few. Similar to the ser- student accommodation would also have a significant
vices that provide clinical care, they can be disjointed impact on student well-being.
and suffer from duplication of effort and closed com- Finally, the universities have a role to play in prepar-
munication systems. Some universities offer a single ing students adequately for third level and managing
access point which helps students to navigate the ser- expectations of both students and their families.
vices that are most relevant to their needs. Student-facing literature, open days and international
A key element of a whole system approach is educa- recruitment drives need to make explicit that prospec-
tion and training in mental health literacy and suicide tive student are expected to be critical thinkers, self-
awareness for staff and students, to help identify signs disciplined and self-reliant. In addition to outlining
of distress and direct students to appropriate resources. the support services in place, their limitations also need
Staff need allocated time to train in these areas and on- to be made clear (Jones-Davies, 2019). It is important
line and live opportunities to do so. Mental health liter- that gaps between what support the institution have
acy training might also help address the confusion at a promised and what it actually delivers are addressed,
societal level on the terminology around mental health as these can determine an individual’s decision to apply
and well-being, which can focus attention and channel and accept a place. There are recruitment targets that
resources away from people who need them most institutions need to meet for their sustainability and
(Barkham et al. 2019). survival but with inadequate knowledge of the expect-
Within education and training lies the possibility of ations and offerings of their institution of choice, and
embedding mental health and well-being in the cur- the student may not realistically be able to manage
riculum. Curriculum infusion originally sought to the demands that face them.
raise awareness of wellness and mental health in a
manner that reinforced the academic contents of the
Conclusions
course, e.g., architects designing spaces to minimise
stress and historians examining madness as a concept There are growing numbers of students accessing third-
(Olson & Riley, 2009); however, it has evolved in recent level education and from increasingly diverse cultural
years to include mental health awareness, life skills, backgrounds. They are in the age range most likely to
resilience training and mindfulness, and there are a develop a mental illness. The mental health needs of
number of examples of this with an emerging evidence students are increasing in volume and complexity,
base (Houghton, 2019). Another way to support the and the gap between demand and current student men-
mental health need of students in their educational tal health support has reached a crisis level, with
attainment is via a commitment to inclusive curriculum increasing pressure on universities to respond. While
design principles (Higher Education Funding Council individually institutions have responded in ad hoc reac-
for England, 2015), which recognise that a course is tionary ways to these trends, there is, rather encourag-
likely to be more equitable when learning needs are ingly, an increasing number of international and
anticipated and student mental health needs are valued national networks advocating for leadership, strategic
(Morgan & Houghton, 2011). This approach does not planning and data-driven responses and recommenda-
require everyone to become experts in different mental tions. In addition to the obvious need for additional
health conditions; moreover, it encourages academic financial investment, support services in most institu-
and departmental staff to reflect on what they ask of tions would benefit from reconfiguration to an inte-
their students and to navigate the tension in providing grated and coordinated system with effective triage,
an experience that is challenging from an educational stepped care, smooth referral pathways and embedded
perspective, but not in itself creating undue stress for research. In addition to that challenge, there is a recog-
students (Houghton, 2019). nition that universities need to take the lead role in a
The community and environment have a role to whole university approach to student mental health,
play. While often associated with the elderly popula- which encompasses the culture and ethos of the institu-
tion, there is increasing awareness that young people tion, good teaching and learning practices, mental
in the age range of 16–24 years are also susceptible to health literacy and adequate, clearly defined support
loneliness (Dooley, 2019; Victor et al. 2019). The cure services. We believe it is time to develop an evidence-
for loneliness is connection; therefore, fostering com- informed structure around student mental health ser-
munity engagement by creating an atmosphere in vices within third-level institutions and the Health
which social networks flourish is important, as are Service in Ireland to address the full range of mental
encouraging cultural diversity and providing extra health problems facing students from mild severe.
supports to create social opportunities for those most Student’s mental health is everyone’s business and
 Student mental health and well-being 7

progressive solutions will benefit our young people Eisenberg D, Golberstein E, Gollust SE (2007). Help-
and, ultimately, society as a whole. seeking and access to mental health care in a university
student population. Medical Care 45, 594–601.
Haase C, Heckhausen J, Silbereisen R (2011). The interplay
Conflict of interest
of occupational motivation and well-being during the
Authors have no conflicts of interest to disclose. transition from university to work. Developmental
Psychology 48. doi: 10.1037/a0026641.
HEA (2011). National Strategy for Higher Education to 2030.
Ethical Standards (https://hea.ie/assets/uploads/2017/06/National-Strategy-
for-Higher-Education-2030.pdf). Accessed 11 January 2020.
The authors assert that all procedures contributing to HEFCE (Higher Education Funding Council for England)
this work comply with the ethical standards of the rel- (2015). Understanding provision for students with mental
evant national and institutional committee on human health problems and intensive support needs. (https://
experimentation with the Helsinki Declaration of eprints.lancs.ac.uk/id/eprint/80492/1/HEFCE2015
1977, as revised in 2008. _mh.pdf). Accessed 11 January 2020.
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This research received no specific grant from any fund- Houghton A-M (2019). Academic and departmental
ing agency, commercial or not-for-profit sectors. support. In Student Mental Health and Wellbeing in Higher
Education: A Practical Guide (ed. N. Barden and R.
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