The number of students in Higher Education Institutions (HEIs) with mental health problems has risen significantly over the last decade (1, 2, 3, 4) and reportedly worsened due to stressors associated with the COVID-19 pandemic (5, 6). Student counselling and wellbeing services have seen an increasing number of students with more severe mental health problems (7, 8, 9), and there has been evidence of an increase in student suicides (10, 11, 12, 13, 14). Furthermore, government policies aimed at widening access to HEIs of under-represented groups, such as those with no family history of higher education, from socially-deprived areas, mature students and those with vocational rather than academic qualifications, has meant greater demands being placed on support services, with no corresponding increase in resources (15). In addition, growing evidence suggests that only a relatively small proportion of students who experience mental health problems are likely to seek help (16, 17, 18), with lower help-seeking behaviours particularly evident in the international student population (19, 20, 21). Amongst the general student population this appears to be largely due to the stigma surrounding mental health problems and challenges in accessing services (22, 23).
Why focus on the UK context?
The UK education system is unique, as each home nation has its own distinct set of policies, degree structures, student demographics and cultural factors which may influence student mental health differently. The English and Welsh education systems comprise of bachelor’s degree programs that typically last three years, with all students (national and international) paying tuition fees. While the total length of time students spend in primary, secondary and higher education is the same compared to their English peers, Scottish and Northern Irish students spend one year more at university, experiencing a broader and more flexible education as they study a wider array of subjects during the first two years, before specialising in third year.
There is a contextual disparity across the UK in the student academic experience given the differing geopolitical environments and socio-economic contexts of the four nations. For example, Scotland has led the way including students from underrepresented groups and backgrounds via the establishment of a Commission on Widening Access and resultant mandatory Widening Participation (WP) strategies in each institution. (24, 25). At a national level, the spread, diversity and location of the student population (e.g. urban/rural) can influence the operation of student cohorts and pose unique challenges for students’ mental health. The range of diverse student nationalities found in the large student populations of English HEIs pose differing questions about students’ wellbeing, as evidence from other countries suggests that largely diverse student groups may experience more negative emotions and lower levels of belonging during their time within HEIs (26, 27, 28).
Despite the wide and extensive international research focused on student mental health, the literature on student mental health within the different UK national contexts is limited. Existing literature reviews highlight the factors associated with poor mental health and wellbeing of university and college students in the UK (29) and have further aimed to understand the association between financial stress and mental health among HEI students (30). Although helpful, such review pieces do not distinguish among the nuances, risk factors and protective factors that student populations across the four nations experience, thus an adequate research base requires new reviews to compare evidence across the four nations.
A scoping review of students’ mental health across the four nations can help advance our knowledge of student mental health in UK HEI context with a key aim of mapping the available literature on the topic (31). The scoping review will tackle multiple questions to ensure that a broad understanding of current knowledge on student mental health within the UK context is elaborated. The review will help identify how mental health is commonly conceptualised and measured in UK HEIs, will showcase the mental health specificities that each nation holds and will identify which study designs and geographic research settings are primarily used - an important step in designing future research studies which could meaningfully contribute to the body of knowledge. Furthermore, the scoping review will determine areas which require further research. The proposed review will aim to include a broad range of articles from cross- and inter-disciplinary sources and best practice guidelines to ensure rigor, transparency and trustworthiness will be adhered to (32, 33). Overall, this review will deepen understandings of student mental health and help to build a stronger evidence base within the UK context which can be used to design effective policy and interventions to improve student mental health.
Scoping Review Questions
Primary question
(1) How does the literature on student mental health in the UK's four nations compare with a focus on prevalence, risk and protective factors, support systems, and interventions for addressing mental health challenges among higher education students.
Secondary questions
(2) How is student mental health conceptualised in the literature?
(3) Do studies assess the prevalence of mental health problems among students in the UK, and if so, how is it measured?
(4) What are the characteristics of participants included in the sources of evidence identified?
(5) What are the research designs that underpin the literature on student mental health?
(6) What is unique about student mental health issues faced by students in each of the four nations (England, Northern Ireland, Scotland, Wales)?
(7) Which interventions are effective in helping to reduce or prevent mental health problems among student populations?
(8) What gaps are there in the literature about student mental health in the UK context?