MHS_STUDY_1 Supporting university students with a mental health condition About this free course This version of the content may include video, images and interactive content that may not be optimised for your device. You can experience this free course as it was originally designed on OpenLearn, the home of free learning from The Open University – www.open.edu/openlearn/health-sports-psychology/supporting-university-students-mental-health-condition/content-section-0 There you’ll also be able to track your progress via your activity record, which you can use to demonstrate your learning.

First published 2025. Unless otherwise stated, copyright © 2025 The Open University, all rights reserved. Intellectual property Unless otherwise stated, this resource is released under the terms of the Creative Commons Licence v4.0 http://creativecommons.org/licenses/by-nc-sa/4.0/deed.en. Within that The Open University interprets this licence in the following way: www.open.edu/openlearn/about-openlearn/frequently-asked-questions-on-openlearn. Copyright and rights falling outside the terms of the Creative Commons Licence are retained or controlled by The Open University. Please read the full text before using any of the content. We believe the primary barrier to accessing high-quality educational experiences is cost, which is why we aim to publish as much free content as possible under an open licence. If it proves difficult to release content under our preferred Creative Commons licence (e.g. because we can’t afford or gain the clearances or find suitable alternatives), we will still release the materials for free under a personal end-user licence. This is because the learning experience will always be the same high quality offering and that should always be seen as positive – even if at times the licensing is different to Creative Commons. When using the content you must attribute us (The Open University) (the OU) and any identified author in accordance with the terms of the Creative Commons Licence. The Acknowledgements section is used to list, amongst other things, third party (Proprietary), licensed content which is not subject to Creative Commons licensing. Proprietary content must be used (retained) intact and in context to the content at all times. The Acknowledgements section is also used to bring to your attention any other Special Restrictions which may apply to the content. For example there may be times when the Creative Commons Non-Commercial Sharealike licence does not apply to any of the content even if owned by us (The Open University). In these instances, unless stated otherwise, the content may be used for personal and non-commercial use. We have also identified as Proprietary other material included in the content which is not subject to Creative Commons Licence. These are OU logos, trading names and may extend to certain photographic and video images and sound recordings and any other material as may be brought to your attention. Unauthorised use of any of the content may constitute a breach of the terms and conditions and/or intellectual property laws. We reserve the right to alter, amend or bring to an end any terms and conditions provided here without notice. All rights falling outside the terms of the Creative Commons licence are retained or controlled by The Open University. Head of Intellectual Property, The Open University There is an increasing prevalence of university students who need mental health support and university staff benefit from training on this topic. This course explores this phenomenon, drawing on an Open University study on how university staff (tutors) can support students with a mental health condition, and considers both what staff and institutions can do to improve student mental health and wellbeing.

The course is divided into the following four sections: Introduction and background Insights from tutors Insights from students on what they need A whole institution approach to supporting students with a mental health condition Please note: If you are an Open University student looking for help with your mental health, you can find further information on the Mental health, wellbeing and keeping safe webpage. By the end of this course, you should be able to: have an insight into the impact having a mental health condition can have on a student’s ability to study understand what skills are needed by a tutor to support a student with a mental health condition understand what support some students who have a mental health condition feel they would benefit from to keep them studying. There has been an increased focus on student mental health in higher education in recent years, with student mental health suggested to be ‘in crisis’. A recent UK parliamentary report stated that student mental health difficulties have increased six-fold since 2010 (Lewis and Bolton, 2023). Recent studies by Lewis and Stiebahl (2025) and Mason et al. (2025) suggest that the growing prevalence is a long-term problem and global issue, pre-dating but amplified by the COVID-19 pandemic and cost-of-living crisis. Not only does poor mental health impact students’ overall wellbeing, but there also is growing evidence that mental health difficulties have significant negative impacts on students’ attainment, progression and study outcomes (Hughes and Spanner, 2019; Office for Students, 2019; Winzer, 2018; Thorley, 2017).

An illustration of a student with the words ‘What? When? How?’.

University students are more likely to experience or develop mental health difficulties than similar aged adults, suggesting studying at university is a negative influencing factor (Brown, 2016; Winzer et al., 2018). According to the National Institute for Health and Care Excellence (2025), factors that contribute to students having poor mental health include moving away from home, academic and financial pressures, and the absence of familiar social and emotional support networks. This link, however, is complex as most undergraduate students are at the age when they experience the developmental process of emerging adulthood, when most mental health difficulties develop. The combination of this major developmental adjustment with the challenges of adapting to and coping with university life and study, combine in a way that can trigger or exacerbate mental health difficulties. Activity 1 What impacts can poor university mental health have on students? (a) reduced wellbeing (b) lower rates of study continuation (c) lower rates of attainment (d) lower rates of progression into skilled workforce or further study (e) less preparedness for working life (f) lower future occupational performance Correct answer: All of the above Various studies have demonstrated numerous negative impacts for students who report poor mental health (Hughes and Spanner, 2019; Office for Students, 2019; Winzer, 2018; Thorley, 2017). Since the consequences of mental health difficulties can be far reaching, it’s important that students are able to understand what support is available and to access the right support early on to enable them to succeed with their studies. The rest of this course focuses on support for students and how universities can support them. The next section focuses on teaching staff, drawing on evidence from an Open University study on staff experiences of providing support to students with a mental health difficulty (Simons and Macaulay, 2025). Academic staff can play a vital role in students’ university experience and support networks. To understand this further, a study was conducted with Open University staff who support students with a mental health condition (MHC) (Simons and Macaulay, 2025). This section of the course is based on the part of the study that focused on staff who had direct course-related contact with students. Interviews were conducted with 39 associate lecturers across first year health, education and language curriculum areas. For the purposes of this section, the staff are referred to as ‘tutors’ but it also recognised that the title of the staff may vary across educational settings.

An illustration of a student with the words ‘Hi Elsie! How can I help you?’.

Two overall themes emerged from the interviews: the needs of students the needs of tutors.

Tutors reported that students needed to be treated as individuals and needed tutors to be flexible, approachable and available. ‘We need to be approachable and I think we need to be available and have understanding and compassion.’ Tutors explained what students needed from them in relation to communication, which is the focus of the next activity. Activity 2 List what you think students told us they need their tutors to be. To start you off here are three examples: encouraging, personable, patient. Can you suggest five more? Other responses from students said that they wanted their tutors to be accommodating, understanding, reassuring, supportive, approachable, flexible, practically helpful, intuitive, receptive, non-judgemental, sensitive, empathetic, realistic, to listen and to believe/value what is being said.

For tutors to be able to provide effective support to students with a MHC, tutors explained they needed to be skilful, to maintain boundaries and to have training in mental health support.

An illustration of a student with two question marks and an exclamation mark.

One tutor summed up what tutors need to be: ‘I think you need to be, yeah, quite skilful in terms of how you develop that rapport and getting the balance right between using your expertise but using it in quite a sensitive way – relationship building.’ Tutors stated that the following skills were needed to support students with a MHC: counselling skills, coaching skills, communication skills, listening skills and interpersonal skills. Tutors emphasised the need to make clear that the role of the tutor is to support students in their learning. Some tutors acknowledged that they had not established clear enough boundaries but pointed out that boundaries can often get blurred. Others said that they had needed to contact the Safeguarding Team following distressing messages from a student who was experiencing a crisis. When asked where they went for emotional support tutors responded that they most frequently go to their line manager, followed by colleagues, family and friends, as well as external professional colleagues, Student Support Team, Tutor Forum, Togetherall (online Mental Health support service) and in-house training sessions. Most tutors said that they would welcome more training to be better prepared to support students with a MHC. Training suggestions were: ‘… anxiety, because that is something that I see students commonly reporting.’ And: ‘I think what I would find useful is actually some training on how I write things down (email or feedback) and how that is perceived with students with poor mental health.’ Having heard from tutors their perspectives on providing support for student with a mental health condition, we then spoke to students who had a mental health condition and were studying at The Open University. Their views are the focus of the next section.

The perspectives of students who had declared a mental health difficulty were sought in relation to tutor support (Simons and Macaulay, 2025). Two focus group discussions were undertaken with a total of nine students who had declared a mental health condition, with questions focusing on communication and support. Three themes emerged from the focus groups: communication being treated as an individual availability of support.

The preferred communication method by the majority of students was email. They felt that this gave them the time and space to consider what to say. However, some students found email to be easy to misconstrue and stressful to deal with. The majority of students found phone calls ineffective and too daunting a prospect. Face-to-face communication was not considered by students as their tuition is online. Also receiving responses to emails in a timely manner and a clear communication of their tutor’s working hours was appreciated and reduced over-thinking and the build-up of anxiety.

An illustration of a student using a computer.

Keeping communication channels open, especially given that there will be periods when students, on account of their mental health conditions, will be unable to engage, was considered to be very important. Students reported that closing the communication channels could lead to them becoming paranoid.

An illustration of three students and their names: Elsie, Jack and Maria.

Students reported that having an individualised as opposed to a generic response from staff was considered to be good practice. They felt it facilitated the building of the tutor/student relationship. Students expected staff to have an understanding of their MHC and then to explore with them how it impacted them personally and in relation to their ability to study. Activity 3 Students explained to us what they wanted from their tutor in relation to being treated as an individual. Can you guess what students said? Below are five examples: I want my tutor to know who I am and understand what triggers me. I want a tutor to know what brings me down. I want my tutor to listen. I want my tutor to see me as more of a person than just as a student. I want my tutor to notice a lack of engagement when I’m going through a mental health crisis and reach out proactively to offer support.

Students reported that regular check-ins, especially around assessment times, were welcomed and would demonstrate that the tutor was ‘there and present’. Tutors who complained to students of having other work/commitments which impacted on their availability contributed to students’ anxiety and often resulted in students struggling alone rather than seeking support.

An illustration of a student with a speech bubble containing the words ‘You got this!’.

So far in this course it is evident that tutors and students are aligned in their perspectives about what is supportive: being treated as an individual and providing flexible, responsive support. The next section will consider how appropriate support can be provided to students with a mental health condition, taking a whole institution perspective.

This section brings the issues from the previous sections together to consider suggestions for a way forward to enable students with a mental health condition to continue studying successfully. Previous research identified academic teachers and teaching practices as well as student services and support as key to student success (Baik et al., 2019) .

An illustration of three people and a university building.

Although the data outlined in the first section demonstrates a high prevalence of students with a mental health condition, Pereira et al. (2019) found that up to 50 per cent of students who identified as having mental health challenges did not declare them to their higher education instutions (HEIs). This was also a prevalent view among tutors interviewed in Simons and Macaulay’s (2025) study. Additionally, the mental health charity MIND (2022) found that 57 per cent of students surveyed reported poor mental health, while only 27 per cent had a diagnosed mental health condition. This suggests that strategies that are designed to support students with a mental health condition, such as being treated as an individual and providing individual support when needed, should be provided for all students, so that those students who have not declared or shared a mental health condition receive the appropriate support to enable them to continue to study. The most likely source of support for such students are academic staff. This places an onus on academic staff, among others, to have the necessary skills to provide such support. Activity 4 Spear et al. (2021) surveyed academics across 135 UK universities. Attempt to answer the following questions based on their findings. Question 1 What percentage of those surveyed reported encountering mental health among their students? 26% 46% 66% 96% Question 2 What percentage of academics surveyed reported that their institution had adequately prepared them for working with and supporting such students? 81% 51% 31% 21% Without minimising the contribution of staff support for students, Lister et al. (2021) argue that individualistic approaches alone are insufficient. Instead, they suggest universities adopt a holistic approach to mental health, providing the support that students with a mental health condition will benefit from to all students. In this way, there is widespread benefit, and the students who won’t declare their condition receive the support they need to continue studying. Activity 5 Additionally, UCAS (2021) suggests a series of next steps to be taken by the sector to achieve the aim of fostering an environment of positive disclosure, where students can see the benefit of sharing their condition, so that everyone who can benefit from support is able to do so. As you come to the end of this course, what next steps do you think should be put in place to help reframe students disclosing their mental health condition? You may have come up with the following: A cross-sector campaign to promote the benefits of declaring one’s mental health condition. Targeted action in areas where disclosure is low. Continued implementation of the Stepchange framework and University Mental Health Charter. Student mental health to be central in admissions reform. The Office for Students (UK) requires universities to make students with a mental health condition a top priority, suggesting they make changes throughout the whole curriculum starting with induction, as well as support services (Office for Students, 2020). Considering how to improve students’ mental health can bolster student wellbeing and success. This course drew on the findings from a study of tutors and students to consider how to provide support. The approaches suggested are practices that all students would find beneficial, not just those with mental health conditions. Therefore, adopting an institution-wide approach to providing support and promoting student mental wellbeing is useful. The Open University has developed Student and Staff Mental Health and Wellbeing Strategy (The Open University, 2020) in line with the Universities UK’s Stepchange framework for mental health in higher education (UUK 2023) and is working to support tutors with regular in-house training. You can also find further resources in OpenLearn’s Wellbeing and mental health collection. If you are an educator you might also find the free OpenLearn course Teaching and learning tricky topics useful. Baik, C., Larcombe, W. and Brooker, A. (2019) ‘How universities can enhance student mental wellbeing: The student perspective’. Higher Education Research & Development, 38(4), pp. 674–87. Brown, P. (2016) ‘The invisible problem? Improving students’ mental health’. Higher Education Policy Institute, 88, p. 66. Available at: https://www.hepi.ac.uk/2016/09/22/3592/ (Accessed: 15 August 2025). Campbell, F., Blank, L., Cantrell, A., Baxter, S., Blackmore, C., Dixon, J. and Goyder, E. (2022) ‘Factors that influence mental health of university and college students in the UK: a systematic review’. BMC Public Health, 22(1), p. 1778. Available at: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13943-x (Accessed: 15 August 2025). Gewalt, S.C., Berger, S., Krisam, R. and Breuer, M. (2022) ‘Effects of the COVID-19 pandemic on university students’ physical health, mental health and learning, a cross-sectional study including 917 students from eight universities in Germany’. PLoS One, 17(8), e0273928. Available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0273928 (Accessed: 15 August 2025). Hubble, S. and Bolton, P. (2021) Support for disabled students in higher education in England. Available at: https://commonslibrary.parliament.uk/research-briefings/cbp-8716/ (Accessed: 15 August 2025). Hughes, G. and Spanner, L. (2019) The University Mental Health Charter, Student Minds. Lewis, J. and Bolton P. (2023) Student mental health in England: Statistics, policy and guidance. Research Briefing, House of Commons Library. Available at: https://commonslibrary.parliament.uk/research-briefings/cbp-8593/ (Accessed: 15 August 2025). Lewis, J. and Stiebahl, S. (2025) Student mental health in England: Statistics, policy and guidance, House of Commons, London. Available at: https://researchbriefings.files.parliament.uk/documents/CBP-8593/CBP-8593.pdf (Accessed: 15 August 2025). Lister, K., Seale, J. and Douce, C. (2021) ’Mental health in distance learning: a taxonomy of barriers and enablers to student mental wellbeing’, Open Learning: The Journal of Open, Distance and e-Learning. Available at: https://www.tandfonline.com/doi/full/10.1080/02680513.2021.1899907 (Accessed: 15 August 2025). Mason, A. et al. (2025) ‘Prevalence, age-of-onset, and course of mental disorders among 72,288 first-year university students from 18 countries in the World Mental Health International College Student (WMH-ICS) initiative’, Journal of Psychiatric Research, 183, pp. 225–36. Available at: https://www.sciencedirect.com/science/article/pii/S0022395625000950 (Accessed: 15 August 2025). MIND (2022) Student Minds Research Briefing. Available at: https://www.studentminds.org.uk/uploads/3/7/8/4/3784584/2208_public_facing_research_findings.pdf (Accessed: 15 August 2025). National institute for Health and Care Excellence (2025) Mental Health in Students: What are the risk factors?, NICE, London. Office for Students (2019) Mental health: Are all students being properly supported?. Available at: https://www.officeforstudents.org.uk/publications/mental-health-are-all-students-being-properly-supported/ (Accessed: 15 August 2025). The Open University (2020) Student and staff mental health and wellbeing strategy. Available at: https://about.open.ac.uk/policies-and-reports/student-and-staff-mental-health-and-wellbeing-strategy (Accessed: 15 August 2025). Payne, H. (2022) ‘Teaching Staff and Student Perceptions of Staff Support for Student Mental Health: A University Case Study’, Education Science, 12(237). Available at: https://www.mdpi.com/2227-7102/12/4/237 (Accessed: 15 August 2025). Pereira, S., Early, N., Outar, L., Walker, L. and Dzikiti, C. (2019) Student Mental Health Survey 2018: A large scale study into the prevalence of student mental illness within UK universities, The Insight Network, London. Simons, J. and Macaulay, C. (2025) Student perspectives of Associate Lecturer support for students with a mental health difficulty. Available at: https://hdl.handle.net/10779/ou.se.25858912.v2 (Accessed: 2 September 2025). Spear, S., Morey, Y. and van Steen, T. (2021) ‘Academics’ perceptions and experiences of working with students with mental health problems: insights from across the UK higher education sector’, Higher Education Research and Development, 40(5), pp. 1117–1130. Thorley, C. (2017) Not By Degrees: Improving student mental health in the UK’s universities, Institute for Public Policy Research, London. Togetherall (2025) Togetherall. Available at: https://togetherall.com/en-gb/ (Accessed: 15 August 2025). UCAS (2021) Starting the Conversation, UCAS Report on Student Mental Health, UCAS. Available at: https://www.ucas.com/providers/services/news/starting-conversation-ucas-report-student-mental-health (Accessed: 15 August 2025). UUK (2023) Stepchange: mentally healthy universities, Universities UK, London. Winzer, R., Lindberg, L., Guldbrandsen, K. and Sidorchuk, A. (2018) ‘Effects of mental health interventions for students in higher education are sustainable over time: a systematic review and meta-analysis of randomized controlled trials’, PeerJ,. 6, e4598. This free course was written by Joan Simons. Except for third party materials and otherwise stated (see terms and conditions), this content is made available under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Licence. The material acknowledged below is Proprietary and used under licence (not subject to Creative Commons Licence). Grateful acknowledgement is made to the following sources for permission to reproduce material in this free course: All images: © The Open University. Every effort has been made to contact copyright owners. If any have been inadvertently overlooked, the publishers will be pleased to make the necessary arrangements at the first opportunity. Don't miss out If reading this text has inspired you to learn more, you may be interested in joining the millions of people who discover our free learning resources and qualifications by visiting The Open University – www.open.edu/openlearn/free-courses. Safeguarding Team Safeguarding is the actions taken to promote the welfare of children and vulnerable adults and protect them from harm.

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