Higher Education Research & Development

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How universities can enhance student mental

wellbeing: the student perspective

Chi Baik, Wendy Larcombe & Abi Brooker

To cite this article: Chi Baik, Wendy Larcombe & Abi Brooker (2019): How universities can
enhance student mental wellbeing: the student perspective, Higher Education Research &
Development, DOI: 10.1080/07294360.2019.1576596

To link to this article: https://doi.org/10.1080/07294360.2019.1576596

Published online: 11 Feb 2019.

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HIGHER EDUCATION RESEARCH & DEVELOPMENT
https://doi.org/10.1080/07294360.2019.1576596

How universities can enhance student mental wellbeing: the

student perspective
a
Chi Baik , Wendy Larcombeb and Abi Brookerc
a
Melbourne Centre for the Study of Higher Education, The University of Melbourne, Parkville, Australia;
b
Melbourne Law School, The University of Melbourne, Parkville, Australia; cSchool of Psychological Sciences,
The University of Melbourne, Parkville, Australia

ABSTRACT ARTICLE HISTORY

The growing prevalence and severity of mental health difficulties Received 3 May 2018
across university student populations is a critical issue for Accepted 2 October 2018
universities and their wider communities. Yet little is known about
KEYWORDS
student perspectives on the stressors in university environments Student wellbeing; mental
and the steps that universities could take to better support health; psychological distress;
student mental wellbeing. This article reports on a study that student experience
collected and analyzed 2776 student responses to the question:
What can be done to improve student wellbeing? Students made
diverse recommendations that fell into seven categories:
Academic teachers and teaching practices; student services and
support; environment, culture and communication; course design;
program administration; assessment; and student society
activities. The findings from our study offer important insight to
university educators and administrators about the role they can
play in better supporting student wellbeing and preventing the
high rates of psychological distress. We argue that the process of
seeking and acting on students’ suggestions fosters students’
sense of inclusion and empowerment, and this is critical given
that the goal of improving student mental wellbeing can only be
achieved through an effective partnership between students and
institutional actors.

Introduction
The mental health of university students has been a public health issue of increasing
concern in recent years with a growing body of empirical research showing that university
students are a ‘very high risk population’ for psychological distress and mental disorders
(e.g., Eisenberg, Hunt, & Speer, 2013; Larcombe et al., 2016; Orgyen, 2017; Royal College
of Psychiatrists, 2011; Stallman, 2010). A study of nearly 6500 students at two major Aus-
tralian universities found elevated levels of generalized psychological distress (as assessed
by the Kessler 10) in 84% of the participants, where only 29% of Australian population
samples report such levels (Stallman, 2010). More particularly, a survey of over 5000 stu-
dents at a large Australian university found that 13% of students reported severe or extre-
mely severe depressive symptoms and 18% reported severe or extremely severe anxiety

CONTACT Chi Baik cbaik@unimelb.edu.au Melbourne Centre for the Study of Higher Education, The University of
Melbourne, Parkville, Victoria 3010, Australia
© 2019 HERDSA
2 C. BAIK ET AL.

symptoms (as assessed by the 21-item Depression Anxiety and Stress Scales), where only
5% of Australian population samples report such levels (Larcombe et al., 2016). While the
high prevalence of psychological distress is partly explained by the fact that many students
commence university as school-leavers in the age group with the highest prevalence of
mental health difficulties, there is also evidence to suggest that academic study at univer-
sity has a negative impact on wellbeing for some students (Larcombe et al., 2016; Stallman,
2010; Wierenga, Landstedt, & Wyn, 2013), and that some groups of students – namely
young women and sexual minorities – are at increased risk for anxiety and stress (Lar-
combe et al., 2016; Said, Kypri, & Bowman, 2013).
This issue is not unique to Australian higher education. Studies in the United States,
(Dyrbye, Thomas, & Shanafelt, 2006; Eisenberg et al., 2013) and the United Kingdom
(Kerr, 2013; Royal College of Psychiatrists, 2011) have identified a higher prevalence
and significant burden of mental health difficulties among tertiary students. Of note,
the Healthy Minds Study (HMS), a survey routinely conducted in the US since 2005,
has shown evidence not only of an increase in the prevalence of mental health difficulties
in college populations, but also a higher prevalence of anxiety among women, and a higher
prevalence of mental health problems among students from lower socioeconomic back-
grounds and those with minority sexual orientations or gender identities (Eisenberg
et al., 2013). Moreover, reports from university health and counseling services in both
the US and the UK show that not only is the demand for these services increasing, but
more students are presenting with increasingly severe psychological problems (Blanco
et al., 2008; Erdur-Baker, Aberson, Barrow, & Draper, 2006; Locke, Bieschke, Castonguay,
& Hayes, 2012; Royal College of Psychiatrists, 2011).
The high prevalence of mental health difficulties among university students is a critical
issue for universities as well as their wider communities. Psychological distress can have a
powerful impact on every aspect of students’ physical, cognitive, emotional and interper-
sonal functioning (Kitrow, 2003). In particular, prolonged psychological distress impacts
their capacity to learn and academic participation by impairing information processing,
attention, memory, decision-making, motivation, and impulse control (American Psy-
chiatric Association, 2013; Maslach, Schaufeli, & Leiter, 2001; Marin et al., 2011). Analysis
of data from the recent Healthy Minds Study conducted across four universities in the US
also showed that mental health difficulties are strongly associated with lower self-efficacy,
motivation and academic dissatisfaction (Lipson & Eisenberg, 2018). Students experien-
cing mental health difficulties are thus less likely to persist when faced with challenges
and more likely to drop out of their courses. This helps to explain research into the
first year experience which shows that the most common reason students give for seriously
considering deferring or dropping out is their wellbeing or ‘emotional reasons’ (Baik,
Naylor, & Arkoudis, 2015).
Not only does psychological distress negatively affect the individual student, emotional
or behavioral problems can sometimes manifest in disturbing, disruptive or aggressive
behavior that affects student peers and university staff (Brooker, Baik, & Larcombe,
2017; Kitrow, 2003). At the extreme end, severe psychological distress can lead to self-
harm and suicide. On ethical grounds alone, universities have a responsibility to
support and ensure the safety and wellbeing of all students and staff. Supporting
student wellbeing is also essential for fulfilling universities’ core mission of providing
high-quality educational experiences and positive graduate outcomes.
 HIGHER EDUCATION RESEARCH & DEVELOPMENT 3

Given that a substantial proportion of students will experience mental health difficulties
during their time at university, it is important to ask: how can universities ensure they
provide supportive and ‘health-promoting’ environments (Dooris, Cawoon, Doherty, &
Powell, 2010)? To date, much of the research on university student wellbeing has
focused on investigating the prevalence of psychological distress and on the use of
support services by students experiencing mental health difficulties. There has been less
research on the measures that universities could take to reduce environmental stressors
and promote protective factors in the university environment. In particular, little is
known about student perspectives on the stressors in university environments, and the
steps that universities could take to better support student mental wellbeing. This is sur-
prising given that students are, arguably, experts in the student experience (Busher, 2012).
Their active participation in health promotion programs is also essential to the effective-
ness of such programs (Griebler, Rojatz, Simovska, & Forster, 2017).
This article contributes to filling that gap in the research literature. It reports on a study
that collected and analyzed 2776 student responses to the question: What can be done to
improve student wellbeing? The question sought feedback on aspects of the university
experience (teaching, curriculum, student services and university administration) that
could be changed to better support student wellbeing. Importantly, the Deans or Associate
Deans (Teaching and Learning) of the participating academic programs had undertaken to
act on students’ suggestions and also to inform students of the steps taken in response to
the survey findings. In this way, it was hoped that the research itself would be a positive
step in helping empower students to shape health promotion activities within their fac-
ulties/programs.

The role of universities in supporting student mental wellbeing

The unique potential of universities to support the mental health of students has been
recognized through a variety of projects and initiatives targeting students with programs
to improve mental health literacy, develop skills to self-identify and manage stress, and
promote help-seeking (Kelly, Jorm, & Wright, 2007; Stallman, 2011). These initiatives
are extremely important, but the evidence of their reach (in terms of student participation)
and effectiveness is limited. In addition, the ability of individuals to cope with and manage
stress only addresses one part of the picture of student mental health; it is also important
to promote protective factors in the university’s social and academic environment. An
environmental or ‘settings’ approach to mental health understands wellbeing and distress
to be products of individuals’ resources in combination with the positive experiences and
stressors in their environments (WHO, 1986). In a university context, this approach
recognizes the importance of the teaching and learning environment to students’
mental health and wellbeing.
Orme and Dooris (2010) point out that rethinking learning environments to become
health-promoting is not easy, and involves changes to syllabus, curriculum, and university
culture itself. Two examples of a successful adoption of the settings approach are the Mind
Matters project, which focuses on mental health promotion, prevention and early inter-
vention in secondary schools (Sheehan et al., 2002) and the Healthy Universities
program in the United Kingdom (Dooris et al., 2010). More recently, an Australian
national project, Enhancing University Student Wellbeing, proposed a whole-of-university
4 C. BAIK ET AL.

settings approach to promoting mental health and wellbeing in the university environ-
ment focusing on five strategic action areas: fostering engaging curricula and learning
experiences; cultivating supportive social, physical and digital environments; strengthen-
ing community awareness and actions; developing students’ mental health knowledge and
self-regulatory skills; and ensuring access to effective services (Baik et al., 2016). The
authors emphasize the importance of involving students in the co-creation of university
policies, programs and activities related to student mental health given that ‘user empow-
erment’, self-determination and autonomy are key elements of successful health pro-
motion programs (WHO, 2010). Several scholars writing on ‘students as partners’ (e.g.,
Cook-Sather & Luz, 2015; Healey, Flint, & Harrington, 2016), also note the benefits of
involving students and positioning them as ‘consultants in pedagogical explorations’.
Not only can this lead to transformed thinking about teaching and learning, and
‘inspire and support engagement and responsibility’ (Cook-Sather & Luz, 2015,
p. 1097), it can, as Healey et al. (2016) put it, lead to ‘awareness of one’s own role and
agency in the wider academic learning community.’
While universities regularly collect student feedback on various aspects of their edu-
cational experience, there are few empirical studies that have examined student perspec-
tives on how their mental wellbeing could be better supported at university (see, e.g.,
Townes O’Brien, Tang, & Hall, 2011). As Busher (2012) notes, gaining insight into
student perspectives and experiences is critical to understanding the full reality of an edu-
cational context. This is because students hold the most intimate understanding of their
learning experiences and they have access to insights that researchers do not (Bland &
Atweh, 2007; Cook-Sather, 2006; Flynn, 2015). The few published studies that have incor-
porated student voices have come from the health sciences field and legal education, but
these have either been small-scale studies examining the experience of students with
mental health difficulties (e.g., Tinklin, Riddell, & Wilson’s, 2005, case study of 5 students),
focus group discussions exploring students’ perceptions of discipline-specific stressors
(e.g., Larcombe, Tumbaga, Malkin, Nicholson, & Tokalitidis, 2013; M. O’Brien, 2011 ),
or studies of student experiences with help-seeking (Chew-Graham, Rogers, & Yassin,
2003; Lee & Graham, 2001). This article aims to extend that body of research on
student perspectives by providing the first large-scale, cross-disciplinary study of
student suggestions about what university administrators and academic educators could
do to better support and enhance their mental wellbeing. We report themes in students’
recommendations about actions that university teachers, service providers and adminis-
trators could take to better support student wellbeing. We also investigate whether
there were differences in those themes for students in different fields of study (disciplinary
cohorts).

Method
The study reported in this article was part of a larger research project administered in
2013, at a large, campus-based metropolitan university in Australia. The Student Well-
being and Course Experience Survey generated quantitative data about students’ levels
of psychological distress (DASS-21; Lovibond & Lovibond, 1995) and positive wellbeing
(Ryff’s Psychological Well-being Scales; Ryff & Keyes, 1995), as well as qualitative data
about aspects of their university experience that could better support student wellbeing.
 HIGHER EDUCATION RESEARCH & DEVELOPMENT 5

The prevalence and socio-demographic correlates of students’ psychological distress have

been reported elsewhere (Larcombe et al., 2016).

Participants
The full sample in the larger study (Larcombe et al., 2016) comprised 5061 students
recruited from six faculties and graduate schools within the university. Participants
included undergraduate students in Arts, Biomedicine, Science, Veterinary Medicine,
Engineering, and Coursework Masters students in Law, Engineering and Veterinary Medi-
cine. They were invited to participate in an email from the faculty Dean or Associate Dean,
with an embedded link to the online survey. Over half (57%) of the respondents were
female and the majority were aged 21 years or less. One in five reported speaking a
language other than English at home. This is broadly representative of the student popu-
lation at the university. Full details of the participation rate for each disciplinary area and
participants’ demographic characteristics have been reported elsewhere (Larcombe et al.,
2016).
Over half of the sample from the larger study (2776) responded to the open-ended
question analyzed in this study. Respondents who offered suggestions were similar in
demographic characteristics to the sample from the larger study. Table 1 shows the disci-
plinary cohorts as a proportion of the current study sample.

Analysis
Students’ responses to the open-ended question (described above) were coded by three
researchers. Of the 2776 students who responded to this question, 251 students made
comments about their experiences at university or their mental health without offering rec-
ommendations. These 251 comments were excluded from our analysis of recommen-
dations. All suggestions from the remaining 2525 respondents were coded separately and
through an iterative process of comparison and classification, the codes were grouped
into seven categories reflecting different dimensions of the student experience. Over ten
hours of coding meetings were held among the three researchers to facilitate cross-checking
and ensure consistency in coding. Each theme included between 3 and 10 sub-themes iden-
tifying substantive recommendations. For example, consider the following excerpt from a
student response (italicized text indicates the coded elements of the response):

My wellbeing would be improved if: there were consistently explicit criteria for assignments,
and more notice about expectations for assessments, and if there was less weight of marks on
the end of semester written exams.

Table 1. Disciplinary Cohorts as proportion of sample.

Faculty % Sample (n = 2776)
Science 37.2
Arts 25.0
Biomedicine 12.8
Engineering 10.5
Law 7.1
Veterinary science 7.4
6 C. BAIK ET AL.

All three (italicized) suggestions made here fall within the theme “Assessment”. Two rec-
ommendations speak to the sub-theme of “clarity and fairness” and the last speaks to
“weighting”. In this article, we focus on the major themes (rather than sub-themes), to
demonstrate the proportions of the sample who made recommendations falling within
each of the seven aggregate themes. The seven major themes and sub-themes that captured
all 3732 discrete recommendations are outlined in Table 2.
To explore whether field of study affected students’ suggestions, we used seven Chi
square analyses to investigate differences in patterns of recommendation (the seven
coded themes) across the six disciplinary cohorts. As Larcombe et al.’s (2016) study
showed, students’ disciplinary cohort accounted for some of the variance in their reported
levels of psychological distress. Considering such differences in levels of distress, and the
differences among faculties’ resources and expectations of students, it was important to
investigate the differences between disciplinary cohorts in students’ recommendations
for supporting their wellbeing in order to determine the extent to which student rec-
ommendations for wellbeing might be generalizable.

Results
What do students suggest would improve their wellbeing?
Students made diverse recommendations about what could be done to improve their well-
being. Table 3 shows the percentage of respondents in each cohort and overall whose rec-
ommendations fell within each of the seven themes. It shows that a high proportion of
students in each cohort made recommendations related to academic teachers and teaching
practice, indicating that academic teachers can play an important role – perhaps more
important than previously recognized – in supporting student wellbeing. The other
topics of general concern were ‘student services and support’, and ‘environment, culture
and communications’. The recommendations in these categories are explored below.

Academic teachers and their teaching practice

Across the combined sample, most recommendations (made by over 37% of all students)
related to academic teachers and teaching practices. In particular, teachers’ attributes such
as approachability and empathy, and their communication skills were considered to

Table 2. Coding scheme for respondents’ suggestions for improving wellbeing.

Theme
Academic teachers and teaching
practices
Student services and support
Environment, culture and
communications
Course design
Program administration
Assessment
Student society activities
Sub-themes (Description of theme)
Teaching practice, attributes, individual support, and student-teacher relationships for
teachers and tutor/demonstrators.
Awareness, availability and range of services, advice about post-graduate careers/
study, coursework, internships, and finances, and peer or professional mentoring.
Student spaces, facilities, and the digital learning environment, mental-health
promotion, diversity of student circumstances, and sense of community.
Study groups / tutorials, practical learning opportunities in and beyond the classroom,
pre-requisites, subject choices, and supervised placements.
Teaching quality, class size, course cost, timetabling (e.g., more flexibility), special
consideration, and SSAF fees.
Clarity and fairness, timing, weighting, and choice of assessments.
Inclusivity, variety, and frequency of activities, and promoting activities.
 HIGHER EDUCATION RESEARCH & DEVELOPMENT 7

Table 3. Student recommendations for improving wellbeing by Cohort (% of respondents).

All cohorts Science Arts Biomed Eng Law Vet
Theme (n = 2525) (n = 935) (n = 619) (n = 324) (n = 271) (n = 182) (n = 194)
Academic teachers and 37.2% 37.5 38.1 47.5 32.5 27.5 31.4
teaching practices a
Student services and support 27.3 28.1 28.9 26.9 24.7 25.3 24.7
Environment, culture, and 24.7 26.5 22.5 13.0 28.4 35.7 27.3
communications a
Course design a 15.5 12.9 8.7 21.0 16.2 16.5 38.7
Program administration a 11.3 9.7 8.6 7.1 13.7 20.3 23.2
Assessment a 10.1 7.1 8.6 4.6 12.5 24.2 22.7
Student society activities a 9.3 10.8 9.4 14.5 5.2 4.9 3.1
Note: aIn Chi square analyses of this theme across cohorts, p < .0005.

impact student wellbeing. Many students (n = 161) commented that their wellbeing would
be improved if academic teachers – both lecturers and tutors – were more approachable
and understanding of diverse student circumstances, as illustrated in the representative
quotes below:
My general sense of wellbeing would be enhanced if teachers would understand that some
students support themselves outside of university, and therefore do not have as much time
as those students who live at home and do not work. I am a hard-working student but I
only have so many hours in which to try to complete my studies. Teachers, however, some-
times assume in the language they use that everyone is simply lazy and apathetic towards
their studies. I do not like to feel pigeonholed in that group just because I sometimes struggle
to complete all of the set readings, for example. (Arts student)

I’ve found one of the biggest issues is that teacher/lecturer commitment to student wellbeing
has been very shaky. Some teachers care deeply and some not at all, and depending on the
commitment of the teacher to that really impacts on the way the class runs, the dedication
of the students and the approachability of the teacher. (Law student)

In addition to approachability and empathy, students (n = 86) made recommendations

about teachers’ communication skills, particularly in relation to being more explicit
about their expectations of students and the clarity in presenting information and
materials, especially in lectures:
If teachers would slow down and reiterate information. It often seems like there is an over-
whelming amount of material to know and some lecturers don’t deliver it in a user friendly
manner. (Vet student)

If teachers would be able to communicate better in lectures the ongoing assessment tasks that
needed to be completed. (Science student)

Another important theme that emerged from our analysis of students’ comments (n =
167) related to how teachers facilitated and fostered interactions, both teacher-student
interactions and peer interaction:
If tutors took more time to get to know their students. Even learning their names. (Arts student)

If lecturers try to be more interactive with students instead of limiting the approach of teach-
ing by simply reading out facts from the slides it would be extremely helpful. (Engineering
student)
8 C. BAIK ET AL.

More activities to encourage students to interact would be extremely beneficial as I find Bio-
medicine is a course where it is difficult to find friends. (Biomedicine student)

Other major sub-themes included improving student engagement in learning by using a

variety of activities (recommended by 109 students) and increasing the level of individual
support for student learning (recommended by 169 students) – for example, by providing
more feedback on assessment or advice on academic skills development:
I feel my general sense of well-being would be enhanced if teachers would develop more ways
to teach topics with the students, whether it be non-assessed sample quizzes, tests online or
interactive CALs. (Biomedicine student)

If in first year subjects, the tutor takes possibly the first two tutorials to give advice to the
students as to how to approach their readings, lecture note-taking and topic-based study.
(Arts student)

Student services and support

After ‘teachers and teaching practice’, the next most common theme for the combined
sample was ‘student services and support’. Over a quarter of the students (27.3%) made
recommendations about student services and support. These recommendations broadly
fit into two sub-themes: increase awareness and promote the use of services (n = 224)
especially counseling, academic skills, and student advising services; and improve the
availability, range, and quality of services (n = 177), as shown in the representative
quotes below:
The most effective way to promote wellbeing is to publicise support services and encourage
students to utilise them. (Law student)

… [if] there were more counsellors/psychologists working at the counselling services, because
it’s really hard to get an appointment when you really need one. (Science student)

A number of students also raised the importance of improving advice about course plan-
ning and guidance on post-graduate career or study options (n = 123):
Student wellbeing would be improved if students would be able to get individual career and
academic appointments before they start studies. (Engineering student)

More details about what kind of jobs/career pathways are available after the Bachelor of Bio-
medicine. We had a few lectures on this topic towards the end of last year, but I felt as though
all the speakers somehow ‘got lucky’ and managed to meet the manager of some big company
who offered them employment … but what about the general graduate, who doesnt ‘get
lucky’- where do they go?? (Biomedicine student)

Environment, culture and communications

Close to a quarter of all respondents (24.7%) made recommendations about the environ-
ment and culture in their school/program. One hundred and five students suggested that
their wellbeing would be improved if their school/program demonstrated greater under-
standing of students’ diverse circumstances and commitments and were more accommo-
dating of these:
 HIGHER EDUCATION RESEARCH & DEVELOPMENT 9

I feel that I would better deal with stress and anxiety if law school was not viewed as an
activity in insolation. I often feel like many teachers, faculty, staff and other students do
not understand that many students have to work, support family, have children and have
massive financial difficulties that infringe on ability to study/deal with stress. (Law student)

The university should try to understand the students and their difficulties and situations indi-
vidually instead of sticking firmly to the rules and saying that because the other students do
this, you must do this too. (Biomedicine student)

Many students (n = 138) also suggested the importance of fostering a more inclusive and
caring sense of community among the student body, as illustrated by these students’
comments:
I think if you want student well-being to be better you need to make a community of students,
not a situation students feel treated like a number and not a person, where most have to
commute for hours each day because they cannot afford to live nearby. (Arts student)

Build upon the existing structure that fosters a sense of community and family amongst the
students. For example, allowing cohort mates the option of staying together in the same class
in the degree can foster strong student relationships. (Law student)

Other recommendations related to this theme included enhancing student wellbeing

through promoting positive mental health practices more broadly within the faculty or
school, such as stress management strategies or mindfulness workshops (n = 118), and
through improved student spaces for relaxation and study (n = 111). Examples of these
suggestions included: ‘Getting other mental health services and initiatives on board
(such as headspace, Beyond Blue and ‘R U OK?’ day)’; and ‘More seating and work
space [in the student resource centre]’.

Differences among disciplinary cohorts

As shown in Table 3 there were different patterns of response for each of the six discipline
cohorts. For example, compared to the four cohorts who were most concerned about tea-
chers and teaching practice, law students were most concerned about the faculty environ-
ment, culture and communications (creating a less competitive, more inclusive student
body and improving student spaces), while Veterinary Medicine students were most con-
cerned about course design, especially the workload in the course and the lack of infor-
mation about and support for clinical placements. Chi-square analyses also found
differences between the discipline cohorts for each theme of recommendation, with one
exception: there was no statistically significant difference across discipline cohorts for
student services and support (χ 2 (5, 2525) = 3.09, p > .05).
The different emphases among the six student cohorts indicate that initiatives for better
supporting student wellbeing are best developed and implemented at the program/school
level, notwithstanding the importance of coordination and resourcing by the university
executive and central services. The variations also indicate the value of consulting students
at the program/school level – otherwise wellbeing programs and initiatives to support
student mental health may not address the local environmental stressors and factors
that students perceive as impacting their wellbeing. The method reported in this article
is an efficient means of exploring students’ perspectives, and it would not be difficult to
replicate in any educational setting.
10 C. BAIK ET AL.

Discussion and conclusion

Students’ responses to the question of what can be done to improve their wellbeing
referred to a variety of experiences within the broader university setting, including curri-
cular activities, social life, student services, and physical spaces. The range of their sugges-
tions is consistent with Dooris et al.’s (2010) insistence that all aspects of university life are
relevant to – and have a role to play in supporting – student health and wellbeing. Of par-
ticular note, our analysis shows that, from the student perspective, academic teachers can
play a critical role in reducing stressors in the learning environment, not only in terms of
their teaching skills and practices, but also through their attitudes to teaching and to stu-
dents. This supports Wells, Barlow, and Stewart-Brown’s (2003) research in the UK which
found that the importance of teachers cannot be overstated: their ability to foster wellbeing
through their attitudes and actions is critical to the success of any mental health interven-
tion. This is not to say that academics need to become mental health experts, either in
diagnosing mental health difficulties, or in counselling students experiencing psychologi-
cal distress. Instead, our analysis reveals that most students’ recommendations were
appropriately related to fundamental teacher attributes and skills . On the whole, students’
recommendations about teachers and teaching practice are consistent with the qualities of
‘good teaching’ identified in educational research (e.g., Biggs & Tang, 2011; Ramsden,
2003) suggesting that ‘good teaching’ practices would reduce the stressors that students
experience in the learning environment.
Students also emphasized the protective value of regular interactions with their peers
and teachers. Again, students did not suggest that teachers go beyond their professional
role – only that they give more attention to the social dimensions of learning that are
within their role. And, again, students are right to identify social interactions in the teach-
ing and learning environment as an important resource for student wellbeing. Wyn,
Cahill, Holdsworth, Rowling, and Carson (2000), for example, report that interactions
between students and teachers through the curriculum have been shown to be just as
important in addressing student wellbeing and mental health as individual psychosocial
interventions and professional treatment.
Another important issue that students identified was the need to improve access (and
remove barriers) to services and support such as counselling, academic skills and careers
advice. This means both raising awareness about these services and ensuring that they are
adequately resourced to meet growing demand. Most universities already offer a range of
programs, activities and resources to support student wellbeing, but little is known about
the effectiveness of these programs (Orygen, 2017). To ensure that limited resources are
being allocated most appropriately, it is essential that universities systematically evaluate
the efficacy of their current offerings. As part of this process, seeking advice and feedback
from students is critical, given they are the intended beneficiaries of these programs and
services.
Involving students in the design and implementation of university programs and ser-
vices is valuable for two main reasons. First, it recognizes that students are ‘the experts’ of
their experience and that they have access to information that staff do not (Bland & Atweh,
2007; Cook-Sather, 2006; Flynn, 2015). As noted earlier, co-creating programs with stu-
dents can also lead to greater awareness and sense of agency in the wider academic learn-
ing community (Healey et al., 2016). Second, acknowledging and empowering students to
 HIGHER EDUCATION RESEARCH & DEVELOPMENT 11

be involved in university efforts to support their wellbeing can help to raise awareness and
reduce the stigma around mental health issues. Several authors have noted that many stu-
dents are unaware of where or how to ask for help (McLachlan & Justice, 2009; Quinn,
Wilson, MacIntyre, & Tinklin, 2009), and among international students in particular, it
is common to ‘suffer quietly and not seek assistance’ (McLachlan & Justice, 2009, p. 30).
Our study also suggests that there are discipline-cohort differences in students’ needs
and preferences so there is a strong case for developing and implementing wellbeing ini-
tatives at the faculty or school level. This is particularly the case for support around career
and course advice, an area of concern for many students. As mentioned earlier, the com-
temporary university experience is extremely challenging for many students, particularly
in the context of an increasingly competitive and uncertain employment market (Orygen,
2017; Wierenga et al., 2013). Moreover, the expansion of Australian higher education has
seen increased participation from students with diverse educational backgrounds, includ-
ing more students with low levels of academic preparedness (Baik, Naylor, Arkoudis, &
Dabrowski, 2017). These students not only face significant academic pressures, but
because many have ended up in less sought after courses and institutions, they often
have lower intrinsic interest in their subjects and a weaker sense of purpose (Willcoxson,
Cotter, & Joy, 2011). The role of institutional support through course planning and career
advice is thus crucial in helping all students make individual connections with their course
and helping them see the future relevance of what they are learning, as well as in assisting
them to develop clear and reasonable future goals (Mikkonen, Ruohoniemi, & Lindblom-
Yianne, 2013). This theme came across clearly in the student suggestions in our study.
The findings from our study offer important insights to university educators and
administrators about the role they can play in better supporting students’ psychological
wellbeing and preventing the high rates of psychological distress that are now common-
place in university student populations (as described above). It is clear that, from the
student perspective, university teachers and their teaching practice have the potential to
enhance and support student mental wellbeing (and conversely, to have a negative
effect on wellbeing). However, to be effective in promoting student wellbeing, teachers
require support and assistance in their own professional practice. Our previous study
with academic educators found that most educators were engaging in issues of student
wellbeing in their everyday practice, but felt they needed better support from their faculties
and institutions to do so effectively (Brooker et al., 2017). When teachers’ and students’
perspectives are considered side by side, it is clear that what is needed is a whole-of-uni-
versity approach (see Baik et al., 2016) that not only supports students experiencing
mental health difficulties, but also supports their classmates, academic educators and
service providers.
While the recommendations offered by the students in the present study would be likely
to benefit university students if implemented at other universities, the main aim of this
study is not to provide educators and administrators with a prioritized list of strategies
that they could implement in order to improve student wellbeing. Rather, we have also
aimed to describe a simple and replicable method for involving students (on a large
scale) to inform the design and evaluation of wellbeing strategies and services, and to
assist in identifying both stressors and protective factors in learning environments. It is
the process of seeking, analyzing and acting on students’ suggestions that helps to
foster their sense of inclusion and empowerment, making it evident that the goal of
12 C. BAIK ET AL.

improving student mental wellbeing can only be achieved through an effective partnership
between students and institutional actors. Addressing the factors that your students ident-
ify as causing stress and impacting their wellbeing is vitally important because when we do
that, students have the experience of us listening to them and taking their concerns
seriously. That demonstration of care and concern by teachers and other university
staff can itself change the experience of what it is today to be a university student. And
it is only by changing the student experience that we will ultimately see improvements
in student mental wellbeing.

Acknowledgements
The authors would like to thank the students who participated in the research, and Samantha Mar-
angell for her assistance with the literature review on the student voice.

Disclosure statement
No potential conflict of interest was reported by the authors.

ORCID
Chi Baik http://orcid.org/0000-0002-0480-5522

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