Tag: Health

  • Podcast: Dundee, student health, international

    Podcast: Dundee, student health, international

    This week on the podcast we discuss the financial crisis at the University of Dundee, as a revised recovery plan reduces proposed job cuts while requesting additional funding. Is this a sustainable solution for institutions facing similar challenges?

    Plus we look at concerning new Wonkhe and Cibyl polling on student health, and we examine how international student policies have become political battlegrounds in global elections.

    With Chris Shelley, Director of Student Experience at Queen Mary University of London, Rachel MacSween, Director of Partnerships and Stakeholder Engagement (UK and Europe) at IDP, Michael Salmon, News Editor at Wonkhe and presented by Mark Leach, Editor-in-Chief at Wonkhe.

    Read more

    Dundee: An alternative pathway to financial recovery, Scottish Government statement

    Latest from Belong – students’ health is not OK, and that’s not OK

    Canada: The Deeper Meaning of Election 2025

     

     

     

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  • Latest from Belong – students’ health is not OK, and that’s not OK

    Latest from Belong – students’ health is not OK, and that’s not OK

    It’s hard to learn if you’re ill – good health is one of the classic prerequisites to learning.

    But one of the most frustrating things about the debate around student health in the UK is that there isn’t one.

    Anecdotally, poor access to preventative healthcare and health services tends to be justified either by NHS pressure from an ageing population or by expectations that universities should do more with less.

    Both arguments have merit, but they leave the crucial link between health and academic success stuck in that Spiderman meme, while the public and the press blames students for “boozing it up” or “inventing ADHD.”

    Mental health is well, almost over-researched – but health concerns for students go far beyond the usual talking points. Gonorrhoea diagnoses are at record levels, with the UK Health Security Agency identifying students as a key factor, drugs are the subject of many a survey, disordered eating among students is largely ignored, and sleep deprivation seems to be an issue. Some surveys say dental issues are increasingly common – as one expert notes, “dental health is mental health.”

    The question is whether any of these issues are unique to students – and to the extent to which they are, what sorts of policy interventions might address them.

    In the latest wave of Belong, our polling partnership with Cibyl (which our subscriber SUs can take part in for free), we examined everything from general health perceptions and healthcare access to specific areas like sleep quality, alcohol consumption, sexual health confidence, and experiences with the NHS.

    The results come from our early 2025 wave, with responses from 1,055 students across 88 providers. The data has been weighted for gender and qualification type (undergraduate, postgraduate taught, and postgraduate research) to ensure representativeness. There’s also analysis of various free-text questions to illustrate what’s going underneath the headline results.

    Yeah, I’m OK

    First of all, we asked students a standard question used in national surveys asking them to rate their own health. Only 20 per cent of students rate their health as “very good” compared to 48 per cent of the general population.

    Combined figures show that while 61 per cent of students report “good” or “very good” health (compared to 82 per cent in the general population), a full 32 per cent describe their health as merely “fair” – nearly two and a half times the rate in the general population.

    Qualitative comments illuminate what lies beneath. Many students clearly differentiate between their physical and mental wellbeing:

    My physical health is generally good, whereas I have faced some struggles in mental health (which can also at times impact my physical health).

    Physical is usually good but sometimes a little bit hungry after trying to save some food for other days. Mentally I am ok but I don’t fill very fulfilled.

    My physical health is immaculate however my mental health is the worst it’s ever been.

    Several respondents directly connected their health status to the pressures of university life:

    Could be better, I’m finding learning incredibly stressful as part of a full-time job.

    Almost died from an overdose of caffeine trying to work on a essay and had two breakdowns.

    Feel very tired due to uni, aware my health could be better, but do not have the time.

    For others, university has provided structure and support:

    Being at uni has helped me focus more on my self care and mental health to improve

    My health is generally good because I prioritise self-care, balance my studies, part-time work, and rest, and use available support when needed.

    Many respondents described their health as variable and requiring ongoing management:

    I am physically keeping fit, mental health I am working on, some days are better than others.

    My everyday health is a constant battle that I have to take a multitude of medications. I have good days and bad days and am lucky if I get a decent amount of sleep.

    Everyone gets their bad days and good.

    A significant number of students also reported living with chronic physical health conditions or disabilities:

    I’m disabled. I always feel bad.

    I am a full time wheelchair user with ME and fibromyalgia, so I am in a lot of pain and fatigue.

    I had a diagnosis of a rare cancer called Leiomyosarcoma in 2023. The cancer has gone but it’s left me with a whole range of health problems.

    Overall, the narrative accounts reveal complexity – where mental and physical wellbeing are often experienced differently, academic pressures can both harm and support health, daily fluctuations in health status are common, and chronic conditions create persistent challenges that require constant navigation of university life.

    Correlations or causations?

    We wanted to know if there are relationships between health and key elements of student experience. The data shows strong correlations between student health perceptions and their sense of belonging – among students reporting “very good” or “good” health, 85 per cent feel part of a community, compared to just 68 per cent among those reporting “bad” or “very bad” health:

    This pattern extends to whether students feel free to speak – 93 per cent of those with better health feel free to express themselves, compared to only 77 per cent of those reporting poorer health conditions:

    On teaching quality, 91 per cent of students with “very good” or “good” health report positive teaching quality, while 84 per cent of students with “fair,” “bad,” or “very bad” health still rate teaching quality positively:

    Correlation is not causation – though it’s technically possible that poor teaching or poor belonging is making students ill, to the extent that the free text offers clues, it suggests that the causation is the other way around – poor health appears to be robbing students of the ability to take advantage of the academic and social opportunities on offer.

    Are you registered?

    The good news in our polling is that most students (93 per cent) are registered with a GP. The problem is that only 65 per cent are registered near their place of study. A quarter (25 per cent) remain registered elsewhere in the UK, while five per cent maintain registration in another country:

    The qualitative comments reveal several distinct reasons for not registering locally. Many students commute to university and maintain their home GP registration:

    Because I don’t live at uni. I commute. So it would make sense to have my GP in my home town

    As I do not live on campus, it is easier for me to stay registered with my GP, who is closer to home.

    Even students who do live at university often cite proximity to home as a reason not to change registration:

    It’s only an hour to my home town so easier just to stick with them.

    Don’t feel I live far enough away from home to register with another GP.

    Continuity of care emerges as another significant concern:

    If I sign up for a local GP here, I would be de-registered from my home GP. Since I prefer to stay with my home GP for continuity of care and I only need healthcare support when I’m at home, I haven’t registered with a GP at uni.

    Because I am waiting for talking therapies which I can only get if I am registered with a GP in Somerset so registering in Plymouth will take me off of the waiting list.

    I have been on a waiting list for migraine treatments in my home town and don’t want to start again and wait even longer.

    Home GP knows about my disabilities and there back history.

    And some students express concerns about quality of care:

    They are useless.

    I’ve heard some horror stories about the GP here, and when my friend was too sick to eat or sleep, they wouldn’t even talk to her.

    Dental registration shows a more concerning pattern, with a third of students (33 per cent) reporting they are not registered with a dentist at all. Only 17 per cent are registered near their place of study, while 31 per cent maintain registration elsewhere in the UK and 12 per cent in another country:

    Despite the low registration rate, 56 per cent report having had a dental check-up in the past 12 months – almost identical to rates found in the general population, although that’s hardly a corks-popping moment for the country.

    Students cite NHS availability and cost as major barriers:

    There is no NHS dentist available in the county!

    There are no dentist mine is private.

    NHS is underfunded so it’s impossible to access these services. Private dentists are unaffordable.

    It is literally cheaper for me to travel to my country for a dentist appointment where there is healthcare than doing it here.

    Many students also note that dental appointments can be scheduled during visits home:

    Dental care is something that is tended to like every 6 months or so. So it makes sense to just keep the appointments whenever I am back home.

    Only visit once every 6 months so can plan to go home when the appointment is approaching.

    As with GP services, commuting students typically maintain their home dentist:

    I commute rather than live on campus, so it was more convenient to stay with my dentist closer to where I live.

    Loyalty to existing dentists also emerged as a significant factor:

    I’m with an NHS dentist at home and I don’t want to lose my NHS dentist by moving to a different one as it’s difficult to find NHS dentists.

    I go home enough to see my home dentist who has known me for 20 years.

    Can’t get no

    In early April, the long-running British Social Attitudes survey told us that public satisfaction with the NHS had hit a new low – just 21 per cent said they were satisfied with the NHS in 2024, with waiting times and staff shortages the biggest concerns.

    So we wanted to know what students think. In our polling nearly half (49 per cent) reported being either “very dissatisfied” (12 per cent) or “quite dissatisfied” (37 per cent) with the NHS. In contrast, only 31 per cent expressed satisfaction, with a mere three per cent indicating they are “very satisfied”:

    Many respondents expressed frustration with the difficulty of getting appointments and lengthy waiting times:

    12 hours wait time at A&E is scandalous, people die waiting for ambulances, good luck getting an appointment.

    It takes too long to get anything sorted.

    I have waited long periods to have health checks and it has taken months to get in to see anyone.

    Can’t seem to get a same day appointment.

    A significant number attributed NHS problems to systemic underfunding:

    It is underfunded, there is too much stress on all the services so they can’t take care of patients properly.

    It’s massively underfunded and unsupported by the government. The Tories ripped it to shreds.

    As an international student I pay £776 for this shit shower, joke of a country really is.

    It isn’t the fault of the nurses, doctors hospital staff etc. It’s that the NHS is criminally underfunded.

    Many highlighted specific concerns about mental health services:

    You have to be attempting to kill yourself for the NHS to help you with mental health problems.

    I’m diagnosed with anxiety and it’s been the worst mistake of my life I wish I just kept it between me and my therapist they don’t listen to a word I say.

    The NHS cannot take the strain of the sheer number of mentally ill young people.

    Mental health services and waiting times just to have initial appointments are terrible.

    Respondents also expressed frustration with a lack of communication between different parts of the system:

    Nobody talks to each other and waiting lists are long.

    Lack of communication between hospitals, staff members within the same hospital.

    Less continuity of staff – like you’re on a conveyor belt passed along looking at the surface issue – not the deeper.

    Long waiting times and lack of communication between various departments. Over complicated administration processes.

    And some had specific concerns about the quality of care they received:

    When I went to an emergency dentist in the UK, they left something in my tooth that rotted and I had to have the tooth removed.

    I’ve been to 4 different hospitals about my knee which keeps dislocating and popping. They don’t care to be honest.

    A male consultant kept refusing to answer my questions before a medical procedure and complained when I refused to let him touch me.

    I feel like I treat myself rather than being treated.

    Drugs, alcohol and food

    Plenty of press stories surround the idea that Gen Z is more likely to be clean living and teetotal than previous generations. Our polling suggests that 26 per cent of students never consume alcohol – a slightly higher abstention rate than the general adult population, where according to the latest NHS data 19 per cent report not drinking in the past year.

    For those who do drink, consumption patterns are distributed across different frequencies:

    This pattern suggests lower regular drinking among students compared to the general adult population, where 48 per cent report drinking at least once a week. When students do drink, most report moderate consumption (the below graph only includes those who indicated they drink):

    It’s worth noting that 7 per cent of respondents chose not to answer the question about quantity consumed, which may indicate some hesitancy to report higher levels of consumption.

    We also asked about drugs – specifically asking students about illegal drugs or prescription drug misuse within the past month. The results show that a small minority of students (seven per cent) reported using illegal drugs or misusing prescription medications in the past month, a rate much lower than is often perceived.

    Back in 2023 we also carried out polling on disordered eating amongst students, having spotted some pilot polling that the ONS did on the issue the previous year. Little has changed.

    In the ONS work, our 2023 poll and this wave, we used the SCOFF questionnaire – a validated screening tool for detecting potential eating disorders – to assess students’ relationships with food and body image. The results show concerning patterns:

    • Nine per cent reported making themselves sick because they felt uncomfortably full
    • 26 per cent worried they had lost control over how much they eat
    • Eight per cent reported significant weight loss in a three-month period
    • 19 per cent believed themselves to be fat when others said they were thin
    • 19 per cent reported that food dominates their life

    When these responses are analysed according to SCOFF scoring criteria:

    • 49 per cent showed no sign of possible issues (compared to 50 per cent in the ONS national sample)
    • 25 per cent demonstrated possible issues with food or body image (compared to 23 per cent in ONS)
    • 24 per cent showed possible eating disorder patterns (compared to 27 per cent in ONS)

    The findings suggest that the UK student population closely mirrors national trends in disordered eating and problematic relationships with food and body image. The particularly high percentage of students who worry about losing control over eating (26 per cent) and who perceive themselves as fat when others say they’re thin (19 per cent) – and the relationship we found between those issues and mental health in 2023 – suggest significant work to yet be done, that could have very positive impacts.

    No snooze, you lose

    Sleep and rest is a huge part of health. Our results show a mixed picture over quality and quantity. While 47 per cent of students report “very good” (10 per cent) or “fairly good” (37 per cent) sleep quality, nearly a quarter (24 per cent) describe their sleep as “fairly poor” (15 per cent) or “very poor” (nine per cent). More than a quarter (28 per cent) fall into the middle category of “neither good nor poor.”

    When it comes to sleep duration, half of students (50 per cent) report getting six to seven hours of sleep per night on average, with an additional 26 per cent getting eight to nine hours. However, a concerning 21 per cent are sleeping fewer than six hours per night, with 20 per cent getting just four to five hours and one per cent less than four hours.

    The findings show a potential improvement compared to the polling we carried out a year ago, which found students were getting just 5.4 hours of sleep per night on average. Our current data suggests a higher proportion of students are now achieving six-plus hours of sleep – but it’s still not nearly enough.

    The 2024 exercise saw strong relationships between sleep duration and both life satisfaction and anxiety levels. Students getting 8-8.9 hours of sleep reported significantly higher life satisfaction scores (6.9 versus the average of 6.3) and lower anxiety scores (4.7 versus the average of 5.0) compared to those sleeping less.

    Students in that survey clearly recognised the importance of sleep:

    I need more sleep!

    Could probably do with more sleep, just trying to get 8 hours a week would be nice.

    But the qualitative data highlighted several factors affecting student sleep patterns:

    • Academic pressures: “Currently, the workload is too big.”
    • Employment demands: “Being in my overdraft monthly, long hours at work cuts into my sleep time.”
    • Irregular timetables: “What would help? A more consistent timetable.”

    Housing a problem

    Governments love their public policy silos – but one of the things SUs wanted us to look at was the relationship between housing and health. In this data, nearly half of respondents (49 per cent) reported that housing does affect their health – with 27 per cent noting a positive impact and 22 per cent experiencing negative effects:

    Many students reported health concerns related to poor physical conditions in their accommodation:

    Student houses have mold and have usually been untouched from when they were bought 12 years prior. My house has plenty of mold which no doubt hasn’t helped things when I have been unwell.

    I live in a very mouldy flat that I have to spray at least once a fortnight to tackle the mould. It is damp and mouldy, but the landlord just tells me to open a window.

    My window doesn’t open and was reported to reception before I even arrived in September I have gone back to report it to them multiple times and they still haven’t done anything about it. I also do not have an extractor fan which works in my bathroom this means I have no airflow in my room.

    Housing affordability emerged as a significant stressor affecting mental health:

    Every year when my rent is rised it impacts my mental and physical health hugely as it causes me a lot of stress and forces me to cut things that make me feel better.

    It’s Cornwall so the housing situation is abysmal… Landlords and estate agents take advantage of this to a disgusting degree and overcharge students to the point of spending all or the vast majority of your student loan just on rent.

    After rent I have no money. Landlords know how much student loans we get and scalp accordingly.

    The social environment created by housemates significantly influences mental wellbeing, with both positive and negative experiences reported:

    My flatmates are incredibly unclean and disrespectful.

    My housemates are rude and disrespect and leave a mess everywhere and they smoke weed despite me asking them to stop loads. It makes me not want to be at home.

    Although on the positive side:

    My housemates are lovely people to talk to and I get along with them really well.

    I love my housemates, we cook and eat dinner together every day and it’s nice to just hang out.

    Insecurity about housing arrangements creates significant stress:

    I rent privately, so the expensive rent combined with low-quality housing and anxiety around the permanence of my home significantly affect my anxiety.

    I recently had my housing group fall apart and will need to give my ESA up to a friend of my partner in Essex due to inability to find student housing that will allow me to keep her.

    Landlord left us with no heating or hot water for 2 months.

    And some students reported significant benefits from supportive housing environments:

    It has been beneficial moving out of a toxic home environment. I have become very close with a few of my flatmates here.

    I recently got my own place after being in a house where I was abused. It’s more difficult financially but at least I don’t have someone else hurting me on purpose.

    I have found moving to a house away from campus with people I am close with has had a positive effect due to the home/uni balance I now have.

    It’s another classic silo issue. The failure of any of the four governments to cobble up a student housing policy is a housing issue – but it’s also an educational issue and a health issue. And because it’s a student issue, it ends up being an issue that is not handled or planned as an issue by anyone. And so it just gets worse every year.

    Not so free periods

    We were also asked to look at menstruation and sexual health. On the former, the results suggest that most respondents find menstrual products reasonably accessible – save for an important minority:

    When asked whether menstruation impacts their daily life, respondents were fairly evenly split:

    The relatively even division suggests that menstruation-related challenges continue to affect a significant proportion of the student population, potentially influencing their academic performance, social engagement, and overall university experience.

    Then on sexual confidence and health, the results show generally high levels of self-reported confidence:

    The standout is that approximately 18 per cent lack confidence in accessing NHS sexual health services – the highest area of uncertainty among those surveyed.

    The findings present an interesting contrast to a 2021 HEPI survey on sex and sexual health among students. That research found significant variations in consent understanding and confidence levels, particularly when examining school background and gender.

    In that work, privately educated males were a key issue:

    • Only 37 per cent felt “very confident” in understanding what constitutes sexual consent (compared to 59 per cent of students overall)
    • Only 34 per cent were “very confident” in how to communicate sexual consent clearly (versus 47 per cent overall)
    • Only 41 per cent were “very confident” in how not to pressure others for sex (versus 61 per cent overall)

    Our polling in this wave doesn’t have a large enough sample to offer similar demographic breakdowns, but the overall high confidence levels suggest either an improvement in students’ understanding since 2021 or – importantly – potential overconfidence in self-assessment.

    For better or worse

    Finally, we wanted to know whether students’ health had changed since coming to university. While 39 per cent reported their health has improved (with three per cent saying “much better” and 36 per cent “better”), 27 per cent indicated their health had worsened (23 per cent “worse” and four per cent “much worse”) – and a significant proportion (34 per cent) chose not to respond to this question.

    Many students reported deteriorating mental health since beginning their studies:

    Mental health has declined and physical health/pain got worse as well.

    Academic pressure has made me feel depressed.

    My mental health is no better and I have panic attacks at least two times a week.

    Anxiety levels are higher, I feel socially overwhelmed after a day at uni.

    Financial pressures emerge as a significant factor negatively impacting both physical and mental wellbeing:

    I can’t afford a lot of things. I struggle to buy food period products, and other healthcare. I’m inclined to work when I’m sick because I need to cover tuition and rent.

    I can’t afford basic nutrition.

    Many students reported having less time or opportunity for physical activity:

    Too tired to workout/run most days.

    I feel I have less time to exercise. I spend more time on a computer which affects my hands and back.

    I was much more physically active before starting university.

    Changes in eating habits were commonly mentioned as negatively affecting health:

    My diet is a lot worse, and I tend to be generally less healthy.

    I put on a lot of weight due to staying in my room all day and not having enough money to afford a good diet.

    As I am now living alone, so my eating issues have become worse as I am the one to control what I eat – so I will eat nothing for a month, and then gain all the weight back by giving up and binging.

    It’s not all bad news. For those in the “improved” camp, increased physical activity (“I’ve been going to the gym since first year and have really enjoyed doing so”), better nutrition habits (“I have more control and time over my diet”), improved mental wellbeing (“Well at collage I was suicidal but at uni I don’t really have that inkling anymore”), greater autonomy over health choices (“Being more independent and in control of my life has done wonders for my physical and mental health”), and beneficial routines (“The routine has enabled me to keep in touch with my health a lot better”) were all key themes.

    The positive experiences suggest that for a significant proportion of students, university can provide both the freedom and structure to develop healthier lifestyles and improved wellbeing.

    If it was up to me

    When, at the end of the survey, we asked students what they would change about health services if it was up to them, they offered a wealth of practical suggestions.

    Mental health services emerged as a top priority, with clear calls for “more therapy sessions,” “expanded mental health services,” and “shorter waiting times or support whilst on waiting lists.” Many emphasised the need for greater coordination: “Less pressure to do so well academically. Student union need to put more pressure on the uni to allocate funds towards mental health services.”

    Financial barriers to health featured prominently in student concerns. Suggestions included “lowering the cost of the university gym,” “free prescriptions till you finish uni,” and broader recommendations to “improve student finance so that students can afford to eat healthily.”

    Improving access to NHS services was another key theme, with students recommending “a GP on campus perhaps or someone you can talk to before having to go to the GP” and “easier GP registration, shorter wait times for appointments.” Some highlighted specific needs for marginalised groups: “Fast tracking marginalised students who are already forced through forms and waiting list just to access their healthcare.”

    Sexual and reproductive health resources were frequently mentioned, with calls for “free condoms across campus,” “free period products,” and “more information about sexual health/like events centred around that, including sexual health for trans people and using inclusive language.”

    Many also stressed the need for better information and outreach, suggesting “having a known place to access in a casual manner,” “health advice given in more accessible areas,” and “making clear where and how to access it with a focus on helping international students navigate a new system.”

    And several comments addressed broader cultural and systemic issues: “Stop encouraging mid-week drinking, university alcoholism culture is insane”, “More conversations about loneliness, it’s weirdly normalised at uni” and “Address systemic bias in medicine, especially impacting women.”

    An agenda for change

    There are bits of good news – but the big picture that emerges from our findings is stark and troubling. 20 per cent of students reporting “very good” health compared to 48 per cent in the general population is a disparity that would prompt immediate intervention in any other population group. But that problematic place in the policy Venn that students are in – both largely young and belonging to DfE, not DHSC – leaves them ignored. This student offers a damning indictment of a system where basic physiological needs compete with academic demands:

    I literally went to university at the wrong time with how much it currently costs. It’s impossible to concentrate on my studies without the constant fear of how am I going to eat tonight.

    Another speaks of “black mould and damp” while their landlord’s sage advice is to “open a window.” Is this really the backdrop against which we expect student success to happen?

    The data reveals a healthcare system fundamentally misaligned with student life realities. Only 65 per cent are registered with a GP where they study, just 17 per cent with a local dentist. And why should they bother? With 49 per cent expressing dissatisfaction with NHS services – “12 hours wait time at A&E is scandalous, people die waiting for ambulances, good luck getting an appointment” – the friction in accessing care hardly seems worth the effort. That we ask international students to pay for it is even more scandalous.

    The answers lie partly in our addiction to departmental silos and short-term thinking. No Westminster department champions students as a distinct population with specific health needs deserving of targeted interventions. Universities focus on student retention while the NHS prioritises acute care – and students fall through the gap between.

    The South African model of mandatory health modules covering mental, physical and sexual wellbeing offers an interesting approach – yet here we continue treating student health as an afterthought rather than a core educational function, something else that used to be developed in the gap between lectures that’s now filled with the demands of long commutes and punishing part-time work.

    What might a solution look like? Perhaps it starts with recognising that today’s “horizontal generation” won’t respond to top-down health messaging. Their peer networks and digital platforms represent not just challenges but opportunities for intervention. Digital solutions that personalise support, peer-to-peer health models, and practical education around cooking and nutrition align with how today’s students actually engage with information. But there’s another critical factor – our lack of comprehensive national data on student health.

    The current patchwork of institution-specific surveys and occasional national sampling is simply inadequate. How can we design effective interventions without a robust, longitudinal understanding of student health patterns? A dedicated national student health and wellbeing survey – tracking mental health, food insecurity, nutrition, sleep patterns, and their impact on academic outcomes – isn’t a luxury, it’s a fundamental prerequisite for evidence-based policy. Surely the NSS could take a year off every few years?

    Then when it comes to delivery, the answer won’t be found in Whitehall but in our regions and cities. Manchester’s integrated approach to student mental health – where university health services, local NHS trusts, and city council public health teams collaborate on shared priorities – demonstrates what’s possible when student health is approached as a citywide asset rather than an institutional burden. It should both be broadened beyond mental health, and replicated.

    And whatever is done really needs to be underpinned by rights – encompassing dual GP registration, affordable healthcare, timely disability diagnosis, health-supporting university policies, and integrated NHS partnerships.

    The alternative is to continue watching talented students struggle unnecessarily, their potential diminished by preventable health challenges. A student eating so poorly they “can’t afford basic nutrition” or sleeping in accommodation where “mould grew on my campus room’s walls before I even came in” isn’t just experiencing personal discomfort, they’re living the consequences of policy failure – and paying for it, in more ways than one.

    You can download the full deck of our findings from this Belong tranche on student health here.

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  • The State of Student Mental Health at HBCUs

    The State of Student Mental Health at HBCUs

    Title: Flourishing: Bolstering the Mental Health of Students at HBCUs and PBIs

    Source: United Negro College Fund (UNCF)

    Student mental health is often a chief concern for university administrations and faculty alike, with institutions working to develop strong mental health resources for students. Mental health concerns, however, can vary drastically from student to student, requiring dynamic responses to support the ever-changing challenges students face.

    Over the course of two semesters in 2023, over 2,500 students at 16 HBCUs and two Predominantly Black Institutions were administered the Health Minds Survey (HMS) to determine the unique mental health challenges and provide insights into the college experience for Black students. A report by UNCF, in partnership with the Healthy Minds Network and The Steve Fund, found that Black students at HBCUs demonstrate more positive mental health outcomes compared to students overall. The report also highlights potential areas for schools to further support students. The key takeaways are listed below:

    • HBCU students are flourishing: 45 percent of HBCU students report flourishing mental health, in comparison to the national HMS sample of students (36 percent) and Black students at small predominantly white institutions (PWIs) (38 percent). These figures were determined by students agreeing with statements such as “I am a good person and live a good life” and “I am confident and capable in the activities that are important to me.”
    • HBCU students report a greater sense of belonging (83 percent) and lower levels of high loneliness (56 percent) than their peers when compared to Black students at PWIs, of whom 72 percent report feeling a sense of belonging and 58 percent report high loneliness.
    • HBCU students report less anxiety, less substance use, and being less at-risk for developing an eating disorder than both the national HMS sample of students and the sample of Black students at PWIs.
    • Financial stress plays a significant role in mental health for students at HBCUs, with 52 percent of students reporting that their financial situation is “always” or “often” stressful.
    • More than half of students at HBCUs report unmet mental health needs (54 percent), which can be defined as “exhibiting moderate to severe symptoms of anxiety or depression and reporting no mental health treatment within the past year.” Findings indicate that this may stem in part from HBCU students reporting stigmas around seeking out mental health services. 52 percent of HBCU students reported experiencing these stigmas, compared to 41 percent of the national HMS sample.
    • Nearly 80 percent of HBCU students agree that student mental health is a top priority for their school, and 55 percent of students report feeling that their campus supports open discussions regarding mental health.

    In response to the survey findings, the report supplies several recommendations to further support and increase research on HBCU mental health resources. UNCF states that producing longitudinal studies regarding mental health at HBCUs and exploring the intersecting factors that impact mental health may allow institutions to better react to the ever-changing mental health needs of their students. Further data support would provide means to measure outcomes for mental health programs and resources, allowing institutions to fine-tune their services to best support student flourishing.

    To read more, click here to access the full report.

    Julia Napier


    If you have any questions or comments about this blog post, please contact us.

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  • ShareWell Offers Free Mental Health Support to University Students Nationwide

    ShareWell Offers Free Mental Health Support to University Students Nationwide

    ShareWell—the first peer-to-peer mental health support platform—is now offering free, unlimited memberships to all university students across the U.S.

    With 70% of college students reporting mental health challenges, ShareWell aims to fill critical gaps in care by providing live, virtual peer-led support groups on topics like anxiety, depression, academic pressure, and life transitions. Students can join as many sessions as they want—completely free—by signing up with their university email at www.sharewellnow.com.

    It’s a simple way to access community support during what can be some of the most overwhelming years of life.

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  • Promoting Student Engagement, Health Innovation With Grants

    Promoting Student Engagement, Health Innovation With Grants

    This past fall, Elon University in North Carolina offered students an opportunity to positively impact the campus community’s well-being through grant-funded projects.

    The Andrew G. Bennett ’08 Student Wellness Innovation Grants recognized four student-led projects this winter, which will be implemented over the next year and beyond. The initiative supports student leadership in well-being work and also helps university leadership glean insight into what could impact student health and wellness.

    How it works: Funds for the grant were previously endowed to support a safe ride program at the university, but the rise of ride-hailing apps has reduced the need for funding in that area, explains Anu Räisänen, director of HealthEU initiatives. University leaders worked with the donor to realign funds to spur innovation among students.

    To be considered, the project had to align with HealthEU goals and address at least one of six dimensions of wellness—community, emotional, financial, physical, purpose and social.

    The grant committee—chaired by Räisänen and supported by two graduate apprentices, a counselor and a professor of education—reviewed seven proposals this cycle. Each proposal was submitted by a student as an individual or as part of a group. Students were encouraged to find a department or student organization to co-sign the proposal to promote sustainability and continuation of efforts beyond the individual’s time at the university, Räisänen says.

    Prior to submitting an application, students could opt to meet with Räisänen for a consultation to flesh out their idea, including brainstorming campus partners to support the effort after the individual graduates.

    Applicants also provided a summary of how funding will be used and the intended impact on the community’s well-being.

    The committee accepted and reviewed applications within Qualtrics, grading each proposal with a rubric that weighed feasibility, innovation and impact.

    What’s next: Four proposals received $500 each in funding, the maximum amount available, including a puppy yoga event, an arts and crafts service initiative, a peer support program for nursing students, and renovation of the philosophy suite in the Spence Pavilion, an academic building on campus.

    There was no one ideal project, and each grantee differed in terms of length of project and target population, Räisänen says.

    This spring, students will submit an impact report describing the project status and the effects so far. Grant recipients will also present at HealthEU Day, which celebrates ongoing efforts to promote integrated wellness through fun events and education.

    Students still enrolled will be asked to attend, and those who have graduated may provide a video discussing their project and the innovation fund.

    “The goal is that students come and share their experience, like they would do with undergraduate research as well, and then we build that momentum” for student interest and engagement, Räisänen says. “The best way to get a message to students is word of mouth; you just need to find the right students to spread the word.”

    In the future, Räisänen and her team are considering ways to provide larger grant awards to encourage students to think bigger about ways they could impact well-being on campus.

    Seeking stories from campus leaders, faculty members and staff for our Student Success focus. Share here.

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  • Mental Health and Financial Barriers Threaten College Student Success (TimelyCare)

    Mental Health and Financial Barriers Threaten College Student Success (TimelyCare)

    Seven in 10 students have considered taking a break or dropping out.

    FORT WORTH, Texas, March 12, 2025
    /PRNewswire/ — Mental health struggles and financial pressures are
    jeopardizing college students’ ability to complete their education,
    according to a new study by TimelyCare, higher education’s most trusted virtual health and well-being provider,

    “Many students are slipping through the cracks due to unmet financial, academic, and emotional needs.”

    The
    survey, which gathered responses from 740 students attending two- and
    four-year colleges across the U.S., exposes significant barriers to
    student success and calls for specific action by educational
    institutions to address pressing concerns.

    Key Findings:

    Students at Risk of Stopping – More than half (53%) of current
    college and university students said they had considered taking a break
    from school, and 17% considered dropping out and not returning.

    Financial Strain – Nearly one-third (31%) of respondents cited
    financial strain as a primary reason for considering withdrawal.
    Additionally, a significant portion of students reported relying on a
    combination of financial aid, scholarships, and part-time or full-time
    work to cover costs.

    Success Barriers – An overwhelming 95% identified at least one
    obstacle impacting their success. Mental health (53%) and finances
    (49%) were the top challenges, followed by physical health (33%),
    academics (28%) and social belonging (26%).

    Gaps in Support Access – While 90% of students had used at
    least one school-provided resource such as academic advising, tutoring,
    or mental health counseling, issues like lack of awareness, inconvenient
    office hours, and inaccessible locations kept many from getting the
    needed help.

    Success Defined
    Students identified GPA, gaining knowledge,
    and graduating or completing their coursework as their top measures of
    success in line with a 2024 survey. Interestingly, non-traditional students placed graduating and gaining knowledge above GPA.

    “This study makes it crystal clear that many students are slipping
    through the cracks due to unmet financial, academic, and emotional
    needs,” said Nicole Guerrero Trevino,
    PhD, Vice President for Student Success, TimelyCare. “Our institutions
    must rise to the occasion to ensure no student is left behind.”

    What Can Be Done?
    In an open-ended question, students identified several ways institutions can better support their success, including:

    Promoting Awareness of Resources: Students called for more
    accessible and transparent communication about resources like tutoring,
    counseling, and career services.
    “Make a comprehensive list of all resources in one place.”
    “Talk about these services more openly. I didn’t know they existed when I needed them.”

    Tailoring Support for Non-Traditional and First-Generation Students: Develop
    targeted programs and policies, such as childcare options and
    evening/online classes, to support students balancing multiple roles.
    “Offer different hours for people who work full time during regular work hours.”

    Engaging Faculty and Staff: Train educators and advisors to proactively identify struggling students and provide personalized support.
    “Make
    it feel more normal that all students are impacted in some way and
    encourage all students to look into getting the help they need. It still
    feels almost taboo to seek out help in most situations.”

    Expanding Mental Health and Financial Well-Being Resources: Increase
    counseling availability, destigmatize mental health challenges, and
    offer virtual and flexible options for access. Streamline communication
    about scholarships, grants, and emergency funding while providing robust
    financial literacy resources.
    “Give access to virtual services or anonymous services”

    TimelyCare virtual success coaching
    supplements on-campus academic preparedness, career readiness, and
    financial wellness support with an integrated 1:1 care and coaching
    model.

    A complete list of questions and responses from the February 2025 survey may be found here. Click here to download a related infographic.

    About TimelyCare
    TimelyCare
    is the most trusted virtual health and well-being solution for learning
    communities, offering personalized, clinically proven care that fosters
    student success and delivers life-changing outcomes. With an unmatched
    range of service options on one seamless, easy-to-access platform,
    including mental health counseling, on-demand emotional support, medical
    care, psychiatric care, health coaching, success coaching, basic needs
    assistance, faculty and staff guidance, peer support and self-guided
    wellness tools, we extend the efforts of 400+ campus wellness teams,
    ensuring millions of students have direct, anytime access to our
    culturally competent and diverse care providers. Recognized as a
    Princeton Review Top 5 Need to Know Organization for Mental Health
    Awareness, TimelyCare drives measurable and meaningful improvements in
    depression and anxiety, empowering every student on their wellness
    journey while strengthening learning environments.

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  • Study Shows Positive Mental Health for HBCU Students

    Study Shows Positive Mental Health for HBCU Students

    Students at historically Black colleges and universities and predominantly Black institutions are happier and feel a greater sense of belonging, on average, than both Black students at small, predominantly white institutions and college students over all, according to a new report commissioned by the United Negro College Fund.

    The report, “Community, Culture and Care: A Cross-Institutional Analysis of Mental Health Among HBCU and PBI Students,” utilized findings from two years’ worth of data from the Healthy Minds Study, a large annual survey of college students nationwide, to create what the researchers believe is the most comprehensive analysis to date of HBCU and PBI students’ mental health.

    “HBCUs have a long tradition of being centers of excellence and academic achievement,” said Akilah Patterson, the lead researcher on the study and a Ph.D. candidate in the University of Michigan’s Department of Health Behavior and Health Equity. “But this work also highlights that HBCUs are much more than that. They’re cultivating an environment of affirmation and belonging and support.”

    Among the study’s sample of HBCU and PBI students, 45 percent demonstrated positive mental health according to the Flourishing Scale, a series of eight statements—such as “I am a good person and live a good life”—that are used to determine whether a respondent is “flourishing” mentally. The three statements most commonly selected by students in the sample were “I am a good person and live a good life,” “I actively contribute to the happiness and well-being of others,” and “I am confident and capable in the activities that are important to me.”

    Meanwhile, only 36 percent of college students in general and 38 percent of Black students at PWIs indicated positive mental health. HBCU and PBI students also reported lower rates of anxiety, depression and eating disorders than college students broadly.

    HBCU and PBI students also demonstrated a greater sense of belonging on campus, with 83 percent agreeing with the statement “I see myself as part of the campus community,” while 73 percent of all Healthy Minds respondents said the same. High numbers of HBCU and PBI students reported having close connections with others on campus; 54 percent said they have a social group or community where they feel they belong, and 60 percent said they have friends “with whom I can share my thoughts and feelings.”

    Serena Butler-Johnson, the director of the counseling center at the University of the District of Columbia, a public HBCU, said that those findings seem especially noteworthy as mental health professionals increasingly warn of the dangers of loneliness and isolation, which have been associated with physical harms, like increased risk of stroke. Vivek Murthy, the U.S. surgeon general under former president Joe Biden, declared loneliness a public health emergency in 2023, calling community and connection its “antidotes.”

    Butler-Johnson also noted that the findings tie in with the field of Black psychology, which focuses on Black people’s lives, history and experiences.

    “Black psychology emphasizes community, connection, rituals, traditions, which are all very much part of an HBCU experience, whether it’s homecoming or stepping or band,” she said. “Just in general, the concept of Black psychology is mirrored in the findings.”

    Though the findings did not necessarily show causation between the high rates of belonging and the other positive mental health outcomes of HBCU and PBI students, previous research has linked a sense of belonging with high academic achievement and mental well-being.

    Mental Health Concerns

    Despite the mostly positive findings, the sample did report higher rates of suicidal ideation among HBCU and PBI students (17 percent) than the general student population (14 percent). It also highlighted two areas of stress for many HBCU and PBI students: financial instability and, despite feeling high rates of belonging on their campuses, loneliness. The respondents experienced similar levels of stress (56 percent) to the national sample (55 percent) but higher rates of financial stress; 52 percent said they are always or often stressed about finances, compared to 43 percent of the national sample.

    Butler-Johnson said that HBCUs should take extra steps “outside of the four walls of the therapy room” to address these issues; at UDC, that has included opening a new Office of Advocacy and Student Support, which partners with the counseling center to connect students with financial assistance and case management. UDC’s counseling center also offers informal, nonclinical group meetings where students can drop in and talk with others, no paperwork required, as a way to address loneliness.

    Another concerning finding: HBCU and PBI students with mental health challenges are significantly less likely to receive mental health support than Black students at PWIs and students over all. The report notes that this could be due to those institutions having fewer resources, leading to less availability of clinicians on campus. The perceived stigma of going to therapy could be a factor as well; while only 8 percent of respondents said they would judge someone else for getting treatment—slightly above the national rate of 6 percent—52 percent said they feared they would be judged if they sought out treatment. That’s 11 percentage points higher than the national sample.

    Patterson said these findings indicate that HBCUs and PBIs are doing an incredibly successful job supporting students’ mental well-being despite barriers like lack of resources and concerns about stigma. And while she said many HBCU students can benefit from traditional counseling, the results indicate that it’s also important to recognize that therapy is “not the be-all, end-all” of mental health support on HBCU campuses.

    “Knowing and providing multiple options for all students is really important,” she said.

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  • Resilience is a matter of national health

    Resilience is a matter of national health

    With ongoing shortages of some 40,000 nurses and a 26 per cent drop in applicants to nursing degree courses in the last two years the staffing crisis in the NHS is set to get more acute.

    There is the backdrop of strikes, the legacy of Covid, low pay, the costs of studying along with the cost of living crisis.

    It is, perhaps, little wonder that around 12 per cent of nursing students in England fail to complete their degrees – twice the average undergraduate drop out rate. As health students tell us, “there are times when the NHS is not a nice place to be.”

    The constant cycle of coursework and clinical placements is “a treadmill, hard graft.” Students talk about feeling isolated, particularly during placements.

    The pressure to succeed and the fear of judgment from peers and professionals over not being able to “tough it out” can get in the way of students accessing support. The emotional toll of the work, coupled with the expectation to maintain a brave face, leads to compassion fatigue, burnout and a sense of depersonalisation.

    “It’s not,” students tell us, “what I thought it would be.”

    The resilience narrative

    Of course, the notion that healthcare is inherently tough and that only the most resilient can survive is not new. In fact, it’s something of a badge of honour.

    As one student told us, “there is this echo chamber. Students all telling each other about how tough it is, about the pressure, the volume of work, how it is non-stop and overwhelming.”

    But tying students’ worth to their ability to withstand adversity, that it is up to them to make up for something lacking in themselves instead of focusing on their capacity to thrive and grow, can be disempowering and debilitating.

    It’s time to change this corrosive resilience narrative, to bury the notion that it is the student who is somehow coming up short, who needs fixing. Resilience is not about survival and just getting through. It’s about coming back from set backs and thriving. It is about learning and growing. And it’s about something that is fostered within a supportive community rather than an ordeal endured alone by every student.

    So resilience becomes about putting in place support, about gathering what you need to be a success instead of simply finding a lifeline in a crisis.

    It is community that becomes a building block of resilience: the pro-active building of strong networks among students that enable and encourage them to support each other; building a wider support network of academic staff, supervisors in placements, of family and friends. It is here you find fresh perspective, the space to come back from setbacks.

    A midwifery student describes the: “WhatsApp group to keep in touch, check in and support each other. We’ve got a real sense of community;” a nursing student talks about how “it turned out that other students were just as terrified and felt like they were starting from scratch with every new placement.

    Sharing our feelings and experiences really helped normalise them;” and the medical student who suddenly “realised that everyone else was struggling. I wasn’t the only one who didn’t have confidence in themself and their abilities.”

    And by challenging negative interpretations of themselves, the “I can’t do it”, “I don’t belong”, “I’m the only one who’s struggling,” students begin to see new choices. Resilience becomes about developing the sense of agency and the confidence to respond differently, to challenge, to get the support you need to navigate towards your own definition of success.

    What matters

    So, to be resilient also means making the space to reflect on what truly matters to you when the norm, as a health student, is to focus only on the patients.

    Our medical student talks about how:

    …I spend a lot of time focused on looking after others and have seen myself as a low priority. This lack of self care used to result in things building up to breaking point. I needed a place to reflect, away from all the academic pressures. A time to focus on myself.

    It can take courage to do different, to do what is right for you rather then what people expect you to do. It takes courage not to join in with the prevailing culture when it doesn’t work for you. So resilience is also about bravery.

    The midwifery student again:

    I’m stopping negative experiences being the be all and end all of my experience.

    Disruptors and modellers

    What we’re talking about here is a cultural shift, about redefining the resilience narrative so it is about enabling students to discover their strengths and navigate their challenges with confidence.

    The role of staff is critical – as disruptors of the prevailing narrative in healthcare; in modelling behaviour; and re-inventing their everyday interactions with the practitioners of tomorrow.

    By using coaching tools and techniques, those of whose job it is to support students can:

    • Create a supportive environment that mitigates against self-stigma and provides students with permission and opportunities to be proactive in disclosing needs and unconditional reassurance that they feel they will be heard and valued;
    • Work in relationship with the whole student, supporting students to reflect on who they are and where they are going, and to make courageous choices;
    • Foster a sense of community to create a more supportive and effective learning environment

    We know there are places where this work has already getting results.

    A Clinical Skills Tutor describes how this approach:

    …has made me rethink my relationship with students, opened me up to working with students in a way I’d not thought about. I’ve seen how empowering it can be. I’m much more effective at making sure they get the support they need.

    Empowering students to redefine “resilience” on their own terms makes it a platform for learning and growth, rather than a burden to bear. There are more likely to succeed in their studies and will be better prepared for the challenges in their professional lives.

    As our student nurse puts it:

    “Grit turns your thinking on its head. I’ve been happier, calmer, better able to cope. I ask for help and support when I need it. I don’t bottle things up to breaking point. Things just don’t get to crisis point any more.

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  • The National Institutes of Health shouldn’t use FIRE’s College Free Speech Rankings to allocate research funding — here’s what they should do instead

    The National Institutes of Health shouldn’t use FIRE’s College Free Speech Rankings to allocate research funding — here’s what they should do instead

    In December, The Wall Street Journal reported:

    [President-elect Donald Trump’s nominee to lead the National Institutes of Health] Dr. Jay Bhattacharya […] is considering a plan to link a university’s likelihood of receiving research grants to some ranking or measure of academic freedom on campus, people familiar with his thinking said. […] He isn’t yet sure how to measure academic freedom, but he has looked at how a nonprofit called Foundation for Individual Rights in Education scores universities in its freedom-of-speech rankings, a person familiar with his thinking said.

    We believe in and stand by the importance of the College Free Speech Rankings. More attention to the deleterious effect restrictions on free speech and academic freedom have on research at our universities is desperately needed, so hearing that they are being considered as a guidepost for NIH grantmaking is heartening. Dr. Bhattacharya’s own right to academic freedom was challenged by his Stanford University colleagues, so his concerns about its effect on NIH’s grants is understandable.

    However, our College Free Speech Rankings are not the right tool for this particular job. They were designed with a specific purpose in mind — to help students and parents find campuses where students are both free and comfortable expressing themselves. They were not intended to evaluate the climate for conducting academic research on individual campuses and are a bad fit for that purpose. 

    While the rankings assess speech codes that apply to students, the rankings do not currently assess policies pertaining to the academic freedom rights and research conduct of professors, who are the primary recipients of NIH grants. Nor do the rankings assess faculty sentiment about their campus climates. It would be a mistake to use the rankings beyond their intended purpose — and, if the rankings were used to deny funding for important research that would in fact be properly conducted, that mistake would be extremely costly.

    FIRE instead proposes three ways that would be more appropriate for NIH to use its considerable power to improve academic freedom on campus and ensure research is conducted in an environment most conducive to finding the most accurate results.

    1. Use grant agreements to safeguard academic freedom as a strong contractual right. 
    2. Encourage open data practices to promote research integrity.
    3. Incentivize universities to study their campus climates for academic freedom.

    Why should the National Institutes of Health care about academic freedom at all?

    The pursuit of truth demands that researchers be able to follow the science wherever it leads, without fear, favor, or external interference. To ensure that is the case, NIH has a strong interest in ensuring academic freedom rights are inviolable. 

    As a steward of considerable taxpayer money, NIH has an obligation to ensure it spends its funds on high-quality research free from censorship or other interference from politicians or college and university administrators.

    Why the National Institutes of Health shouldn’t use FIRE’s College Free Speech Rankings to decide where to send funds

    FIRE’s College Free Speech Rankings (CFSR) were never intended for use in determining research spending. As such, it has a number of design features that make it ill-suited to that purpose, either in its totality or through its constituent parts.

    Firstly, like the U.S. News & World Report college rankings, a key reason for the creation of the CFSRs was to provide information to prospective undergraduate students and their parents. As such, it heavily emphasizes students’ perceptions of the campus climate over the perceptions of faculty or researchers. In line with that student focus, our attitude and climate components are based on a survey of undergraduates. Additionally, the speech policies that we evaluate and incorporate into the rankings are those that affect students. We do not evaluate policies that affect faculty and researchers, which are often different and would be of greater relevance to deciding research funding. While it makes sense that there may be some correlation, we have no way of knowing whether or the degree to which that might be true.

    Secondly, for the component that most directly implicates the academic freedom of faculty, we penalize schools for attempts to sanction scholars for their protected speech, as tracked in our Scholars Under Fire database. While our Scholars Under Fire database provides excellent datapoints for understanding the climate at a university, it does not function as a systematic proxy for assessing academic freedom on a given campus as a whole. As one example, a university with relatively strong protection for academic freedom may have vocal professors with unpopular viewpoints that draw condemnation and calls for sanction that could hurt its ranking, while a climate where professors feel too afraid to voice controversial opinions could draw relatively few calls for sanction and thus enjoy a higher ranking. This shortcoming is mitigated when considered alongside the rest of our rankings components, but as discussed above, those other components mostly concern students rather than faculty.

    Thirdly, using CFSR to determine NIH funding could — counterintuitively — be abused by vigilante censors. Because we penalize schools for attempted and successful shoutdowns, the possibility of a loss of NIH funding could incentivize activists who want leverage over a university to disrupt as many events as possible in order to negatively influence its ranking, and thus its funding prospects. Even the threat of disruption could thus give censors undue power over a university administration that fears loss of funding.

    Finally, due to resource limitations, we do not rank all research universities. It would not be fair to deny funding to an unranked university or to fund an unranked university with a poor speech climate over a low-ranked university.

    Legal boundaries for the National Institutes of Health as it considers proposals for actions to protect academic freedom

    While NIH has considerable latitude to determine how it spends taxpayer money, as an arm of the government, the First Amendment places restrictions on how NIH may use that power. Notably, any solution must not penalize institutions for protected speech or scholarship by students or faculty unrelated to NIH granted projects. NIH could not, for example, require that a university quash protected protests as a criteria for eligibility, or deny a university eligibility because of controversial research undertaken by a scholar who does not work on NIH-funded research.

    While NIH can (and effectively must) consider the content of applications in determining what to fund, eligibility must be open to all regardless of viewpoint. Even were this not the case as a constitutional matter (and it is, very much so), it is important as a prudential matter. People would be understandably skeptical of, if not downright disbelieve, scientific results obtained through a grant process with an obvious ideological filter. Indeed, that is the root of much of the current skepticism over federally funded science, and the exact situation academic freedom is intended to avoid.

    Additionally, NIH cannot impose a political litmus test on an individual or an institution, or compel an institution or individual to take a position on political or scientific issues as a condition of grant funding.

    In other words, any solution to improve academic freedom:

    • Must be viewpoint neutral;
    • Must not impose an ideological or political litmus test; and
    • Must not penalize an institution for protected speech or scholarship by its scholars or students.

    Guidelines for the National Institutes of Health as it considers proposals for actions to protect academic freedom

    NIH should carefully tailor any solution to directly enhance academic freedom and to further NIH’s goal “to exemplify and promote the highest level of scientific integrity, public accountability, and social responsibility in the conduct of science.” Going beyond that purpose to touch on issues and policies that don’t directly affect the conduct of NIH grant-funded research may leave such a policy vulnerable to legal challenge.

    Any solution should, similarly, avoid using vague or politicized terms such as “wokeness” or “diversity, equity, and inclusion.” Doing so creates needless skepticism of the process and — as FIRE knows all too well — introduces uncertainty as professors and institutions parse what is and isn’t allowed.

    Enforcement mechanisms should be a function of contractual promises of academic freedom, rather than left to apathetic accreditors or the unbounded whims of bureaucrats on campus or officials in government, for several reasons. 

    Regarding accreditors, FIRE over the years has reported many violations of academic freedom to accreditors who require institutions to uphold academic freedom as a precondition for their accreditation. Up to now, the accreditors FIRE has contacted have shown themselves wholly uninterested in enforcing their academic freedom requirements.

    When it comes to administrators, FIRE has documented countless examples of campus administrators violating academic freedom, either due to politics, or because they put the rights of the professor second to the perceived interests of their institution.

    As for government actors, we have seen priorities and politics shift dramatically from one administration to the next. It would be best for everyone involved if NIH funding did not ping-pong between ideological poles as a function of each presidential election, as the Title IX regulations now do. Dramatic changes to how NIH conceives as academic freedom with every new political administration would only create uncertainty that is sure to further chill speech and research.

    While the courts have been decidedly imperfect protectors of academic freedom, they have a better record than accreditors, administrators, or partisan government officials in parsing protected conduct from unprotected conduct. And that will likely be even more true with a strong, unambiguous contractual promise of academic freedom. Speaking of which…

    The National Institutes of Health should condition grants of research funds on recipient institutions adopting a strong contractual promise of academic freedom for their faculty and researchers

    The most impactful change NIH could enact would be to require as a condition of eligibility that institutions adopt strong academic freedom commitments, such as the 1940 Statement of Principles on Academic Freedom and Tenure or similar, and make those commitments explicitly enforceable as a contractual right for their faculty members and researchers.

    The status quo for academic freedom is one where nearly every institution of higher education makes promises of academic freedom and freedom of expression to its students and faculty. Yet only at public universities, where the First Amendment applies, are these promises construed with any consistency as an enforceable legal right. 

    Private universities, when sued for violating their promises of free speech and academic freedom, frequently argue that those promises are purely aspirational and that they are not bound by them (often at the same time that they argue faculty and students are bound by the policies). 

    Too often, courts accept this and universities prevail despite the obvious hypocrisy. NIH could stop private universities’ attempts to have their cake and eat it too by requiring them to legally stand by the promises of academic freedom that they so readily abandon when it suits them.

    NIH could additionally require that this contractual promise come with standard due process protections for those filing grievances at their institution, including:

    • The right to bring an academic freedom grievance before an objective panel;
    • The right to present evidence;
    • The right to speedy resolution;
    • The right to written explanation of findings including facts and reasons; and
    • The right to appeal.

    If the professor exhausts these options, they may sue for breach of the contract. To reduce the burden of litigation, NIH could require that, if a faculty member prevails in a lawsuit over a violation of academic freedom, the violating institution would not be eligible for future NIH funding until they pay the legal fees of the aggrieved faculty member.

    NIH could also study violations of academic freedom by creating a system for those connected to NIH-funded research to report violations of academic freedom or scientific integrity.

    It would further be proper for NIH to require institutions to eliminate any political litmus tests, such as mandatory DEI statements, as a condition of grant eligibility.

    The National Institutes of Health can implement strong measures to protect transparency and integrity in science

    NIH could encourage open science and transparency principles by heavily favoring studies that are pre-registered. Additionally, to obviate concerns that scientific results may be suppressed or buried because they are unpopular or politically inconvenient, NIH could require its grant-funded research to make available data (with proper privacy safeguards) following the completion of the project. 

    To help deal with the perverse incentives that have created the replication crisis and undermined public trust in science, NIH could create impactful incentives for work on replications and the publication of null results.

    Finally, NIH could help prevent the abuse of Institutional Review Boards. When IRB review is appropriate for an NIH-funded project, NIH could require that review be limited to the standards laid out in the gold-standard Belmont Report. Additionally, it could create a reporting system for abuse of IRB processes to suppress, or delay beyond reasonable timeframes, ethical research, or violate academic freedom.

    The National Institutes of Health can incentivize study into campus climates for academic freedom

    As noted before, FIRE’s College Free Speech Rankings focus on students. Due to logistical and resource difficulties surveying faculty, our 2024 Faculty Report looking into many of the same issues took much longer and had to be limited in scope to 55 campuses, compared to the 250+ in the CFSR. This is to say there is a strong need for research to understand faculty views and experiences on academic freedom. After all, we cannot solve a problem until we understand it. To that effect, NIH should incentivize further study into faculty’s academic freedom.

    It is important to note that these studies should be informational and not used in a punitive manner, or to decide on NIH funding eligibility. This is because tying something as important as NIH funding to the results of the survey would create so significant an incentive to influence the results that the data would be impossible to trust. Even putting aside malicious interference by administrators and other faculty members, few faculty would be likely to give honest answers that imperiled institutional funding, knowing the resulting loss in funding might threaten their own jobs.

    Efforts to do these kinds of surveys in Wisconsin and Florida proved politically controversial, and at least initially, led to boycotts, which threatened to compromise the quality and reliability of the data. As such, it’s critical that any such survey be carried out in a way that maximizes trust, under the following principles:

    • Ideally, the administration of these surveys should be done by an unbiased third party — not the schools themselves, or NIH. This third party should include respected researchers across the political spectrum and no partisan slant.
    • The survey sample must be randomized and not opt-in.
    • The questionnaire must be made public beforehand, and every effort should be made for the questions to be worded without any overt partisanship or ideology that would reduce trust.

    Conclusion: With great power…

    FIRE has for the last two decades been America’s premier defender of free speech and academic freedom on campus. Following Frederick Douglass’s wise dictum, “I would unite with anybody to do right and with nobody to do wrong,” we’ve worked with Democrats, Republicans, and everyone in between (and beyond) to advance free speech and open inquiry, and we’ve criticized them in turn whenever they’ve threatened these values.

    With that sense of both opportunity and caution, we would be heartened if NIH used its considerable power wisely in an effort to improve scientific integrity and academic freedom. But if wielded recklessly, that same considerable power threatens to do immense damage to science in the process. 

    We stand ready to advise if called upon, but integrity demands that we correct the record if we believe our data is being used for a purpose to which it isn’t suited.

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  • The role of embedded mental health counselors

    The role of embedded mental health counselors

    Mental health challenges are among the greatest threats to student persistence and retention in higher education, but providing large-scale preventative and responsive mental health care is a looming challenge for colleges and universities.  

    In addition to having sufficient clinicians and trained professionals to support students in crisis, finding ways to deliver wellness support to students before they’re in crisis is critical

    One strategy is embedding mental health counselors into student spaces or academic departments. By integrating services into a physical location, such as a student center, clinicians can connect with students in informal and intentional ways, gaining their trust and supporting specific pockets of the campus community.  

    In this episode of Voices of Student Success, host Ashley Mowreader spoke with Estevan Garcia, chief wellness officer at Dartmouth College, to learn more about public health approaches to mental health support on college campuses. Later, hear from Casey Fox, associate director of integrated services from the University of South Carolina, who leads the university’s integrated mental health program, about how efforts have scaled.  

    Listen to the episode here and learn more about The Key here

    Read a transcript of the podcast here.

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