Santa Clara University students call on administrators to increase mental health services (Dai Sugano/MediaNews Group/The Mercury News via Getty Images)


September 12, 2023   5 mins

It’s easy to fall off the radar at university. Exactly 20 years ago — 17 years old, awkward and terribly uncertain of myself — I did just that. Too young to drink legally (and apparently too ill-connected to procure a decent fake ID), I saw everyone off to the bars to make friends while I sat in my Canadian dorm room increasingly isolated. As time passed, I stopped going to lectures and retreated ever more deeply into myself.

It’s not an uncommon experience, especially today when young people feel more comfortable developing relationships online than throwing themselves into the uncertainty and unpredictability of real life. But I was also an early adopter of a nascent but now ever increasingly “important” message: these feelings you have are neither normal nor existential nor simply “growing pains”. They are a health condition, and the only way to overcome it is to seek professional help.

For the past decade, an emerging class of therapeutic entrepreneurs has consolidated this claim, warning that the problems of everyday life are simply too much for the uninitiated layperson to manage with their own resources. While recognising that deep emotional pain is part of life, there is a growing sense that even “normal” feelings require “treatment”, lest they spiral out of control.

This assumption has become most startlingly apparent on university campuses, where young people’s preference for seeking help from “informal sources” such as friends and family is frequently seen as a problem and a risk. Yet the modern education sector has always been a target for expanding professional services, as I detail in my forthcoming book. Since the Nineties, British universities have seen a rise in counselling services, with groups such AMOSSHE and HUCS lobbying heavily for growth. They swiftly joined forces with mental health charities and urged students to lead campaigns for more funding. And as concerns about student mental health grew, a wave of apps, surveillance tools, and other light-touch interventions emerged, offering solutions and even prevention.

Long before there was evidence, therapeutic entrepreneurs were certain that a widespread “mental health crisis” demanded these interventions. In 2013, with this in mind, the National Union of Students (NUS) conducted a survey in collaboration with mental health advocacy groups to push for more funding. The results must have been disappointing. Released during Mental Health Awareness Week, it claimed that “20% of students consider themselves to have a mental health problem” — a figure that combined those suspecting they had a diagnosable condition (8%), those actively seeking diagnosis (2%), and those with a confirmed diagnosis (10%). The only problem? The number was slightly lower than the general population of the same age, despite its conflations and reliance on self-selection and self-reports, known to inflate incidence.

The campaigners, however, continued undeterred. Ignoring the findings that students were at no greater (and probably lower) risk than age-matched populations, Poppy Jaman, chief executive of Mental Health First Aid England, stated that the NUS findings were “unsurprising”. It was proof, she said, that “the student community is considered high-risk for mental ill health, with exams, intense studying and living away from home for the first time all contributing factors”. Perhaps as insurance, the survey also produced the eye-catching claim that 92% of students suffered from “mental distress” — which spanned everything from “feeling unhappy/down” to “suicidal thoughts”. Put this way, it is surprising that 7% of respondents reported no “negative” emotions at all throughout their university experience (1% selected “prefer not to say”).

Still, campaigners highlighted that their “main concern” was the proportion of students preferring their informal networks to professional ones. As one newspaper asked of a recent NUS survey: “Why don’t students seek help from their universities — and how can this be reversed?” Or as one Director for Student Experience warned: “Ultimately, if high-stress situations go unmanaged, they can sometimes develop and even lead to mental illness.” It became common to hear that, no matter how small the problem, only professional support could prevent things from spiralling out of control. And the consequences of failing to seek help could be dire: “They may start to self-medicate with drink or drugs, self-harm, or even take their own lives,” claimed one commentator.

But would they “take their own lives”? Newspapers proclaimed a “university suicide epidemic” and campaigners dangled the threat of student suicides over institutions should they fail to invest sufficiently. The evidence for this was frequently cobbled together from Further Education, Higher Education and young people as a group. However, according to ONS estimates released in 2018 and 2020, the rate at which university students commit suicide appears to be significantly lower than the general population of the same age. For young people up to the age of 24, the rate was 2.7 times higher than those in Higher Education. Headlines might have read: “Going to university significantly lowers suicide risk”.

But they didn’t. When these stats were first released, media coverage maintained mental health advocates’ framing. MailOnline ran with: “Number of university students committing suicide nearly doubles since 2000”. The Sun went for: “SUICIDE UNI SHOCK”. Other papers demanded that the student “mental health crisis” be “top priority”, citing rises between different years. Counsellors were described as working on the “frontline”.

Yet the ONS itself had warned against such conclusions; it’s easy to produce a high rate of increase if you’re dealing with already low numbers. Indeed, a number of conclusions could be drawn depending on the year emphasised — for instance, that the rate had fallen since 2004/5 or that, in recent years, the number has fallen even more and remains low.

Despite years of encouraging young people to seek help for any problem “no matter how small”, increased help-seeking itself thus became a key indicator of the severity of the “student mental health crisis”. And here, campaigners were pushing at an open door. While the majority of students might still take their problems to their friends, they have been seeking help in greater numbers since the early 2000s. Today’s students have been taught through years of therapeutic education; trained in the virtues of constant self-surveillance, they know that as good citizens in the making, they should interpret distress as a potential “symptom” for which they should “seek help”.

These processes are greatly aided by what Nick Haslam has called “concept creep”, or the tendency for psychological concepts of harm and pathology to expand to include new and less extreme phenomena. It’s easy to see how this happens. For instance, two years after the disappointing results of the NUS survey, the organisation put out another which shed the restrictive language of “diagnosis”. Instead, it asked: “Do you believe that you have experienced problems with your mental health in the last year, regardless of whether you have been formally diagnosed?” This produced the headline-grabbing statistic that 78% of university students suffered from “mental health problems”.

At the same time, universities became increasingly receptive to the claims of professionals who promised that they could contain risk and breathe new life into institutions already struggling with their meaning and purpose. Universities, after all, are constantly exposed to the reputational risks that might result from young people’s behaviour. To soften this threat, promises to provide ever greater levels of therapeutic and “wellbeing” support have quickly become part of the “package” sold to eager students and their parents on Open Days.

But they are also selling a way of being and a way of thinking about the self. For all that is invested in myriad new-fangled interventions, they struggle to live up to that great healer: time. The kids might not be all right, but most of them will be eventually.

To say this has become heresy. I’m not discouraging therapy and counselling and no doubt many will need professionals. But they are not helped by being queued behind so many who don’t. Twenty years ago, when I ended up seeing a university counsellor, I realised in that awkward interaction that I didn’t need a stranger, much less some diagnosis into which I could safely place all of my problems. I needed some experiences, some meaning and purpose in my life and some friends to share it with. If I had not had that realisation, I probably would have become dependent on strangers and discouraged from relying on those networks that ultimately provided my release. Today, it’s difficult to avoid the conclusion that this is precisely the point.


Ashley Frawley is an Associate Professor in sociology at Swansea University and author of Semiotics of Happiness.

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