Distinctions and visibilities
University and College Counselling, May 2024

Martin Sutherland was an individual who was musically-gifted, intimidatingly intelligent and perpetually hopeful that humans could be better. However, he also suffered much mental distress across his early adulthood, this being what is believed to be the cornerstone element to his death by suicide¹ on 15 December 2011.*

Martin was, and remains, my brother. Though there is much complexity in his life and death to appreciate (the space here insufficient to relay), important for what I’d like to talk about here is that at the time of his death, Martin was on a deferral from a second undergraduate honours-degree study programme, having previously experienced what might be described as ‘turbulent student experiences’ at both undergraduate and postgraduate levels. Martin’s UK Higher Education (UKHE) experiences (witnessed most acutely by my parents) have become key to my ensuing work² and provide a key lens through which I write here.

Following the initial shockwave after any significant relationship is lost/altered beyond usual recognition via suicide, there can manifest (across time) a myriad of responses, depending entirely upon individual circumstances and grief navigations. My own has involved gravitation back toward education (including self-learning/reflection) and academic research. Having already completed a PhD and a Postdoctoral Fellowship, I realised my strength(s) lay not in running marathons and skydiving for ‘mental health awareness’ and/or fundraising purposes. Rather, my agency in suicide bereavement has taken the form of reading and writing – with an aim of pooling together different knowledges, underpinned by a hope of illuminating learnings able to contribute something meaningful from Martin’s experiences and departure. I have engaged in much reflection on existing literature and research, and have revisited my own (UKHE) experiences in tandem with talking with others and listening to their stories. In light of my ‘lived(ing) experience(s)’ as a suicide-bereaved sister, a student and a UKHE staff member, there are certain areas I regard as in real need of review, deeper consideration and clearer articulation in reference to this issue. 

Subsequent to the personal across-years devouring of all genres and manners of mental health (experience)-related information, I was offered a scholarship to conduct a second PhD, charged with identifying and forming my own focus within a larger project focused on the labelled issue of ‘student mental health’³ (SMH). While completing the final months of this work, I also took on a research role within a project examining intersections of mental health and workloads/work intensification in the experiences of UKHE academics who identify as female.⁴ My purpose here is not to relay the detail of these projects - that may be for another day - but rather to reflect and to comment on my own perspectives and appraisals regarding the topic that is ‘mental health in current UKHE’. 

The numbers are clear – recorded rates of undergraduate students’ mental health difficulties in the UK have been rising⁵ and show no signs of abating.⁶ Student demand for university mental health support services continues to grow,⁷ and the citing of mental difficulty as a primary reason for students to consider leaving their studies has been noted.⁸ Yet, and without belittling or diminishing the very real, felt experience of mental pain at individual level, SMH does now at times present as somewhat of a topic-ofthe- moment label as much as concrete descriptor. There is an accompanying aura of ‘oh we know what that is’ to the collocation, that it is a grouping of words with automatically assumed and known meaning attached. However, if we both pause and consider more deeply the current state of the issue in the context of a longer timeline of development⁹, it becomes clear that the term ‘SMH’, (which often seems to position the issue as a fixed, unchanging entity), is actually far from clear and definitive. This, in turn, has important implications in reference to determining how SMH could/should be approached at the present time. 

Disentangling ‘student mental health’ and ‘student suicide’

I entered my PhD programme feeling some uneasiness about, and having questions regarding, certain public narratives on SMH. For instance, read closely, current public SMH storying can present as actually being about suicide prevention (especially given often employed references to ‘crisis’). There is a blurriness between the two issues that is problematic, even (arguably) to the extent that persisting stigma regarding suicide more generally is (however unintentionally) made visible rather than countered through the way UKHE SMH is publicly storied. 

Reductionist media coverage, lacking in nuance, appears more often than not to insinuate direct links between suicide and university experience(s). Institution and sector-wide initiatives are put forth^10,11,12 but close examination of these can lead to a reading of them in which a key part of their purpose appears to be UKHE-institutional avoidance/limiting of negative publicity, and/or business-related repercussions should a student take their own life. Overall, however implicitly, signposted is UKHE sector/institutional fear of suicide. 

University and College Counselling May 2024

The SMH public-circulating conversations are thus to me not always helpful, progressive, or importantly hopeful because they do not always seem actually to be about SMH – they instead point more to avoidance of ‘the dreaded thing’. This is not said flippantly. I am entirely in agreement with the evasion wish – there are inadequate words to express the awfulness of a suicide’s overall impact¹³, so its avoidance is absolutely something to aim and work for – but from an experience-viewpoint, to my mind, there is a real need to consciously delineate ‘student mental health’ and ‘student suicide’. Put plainly, they are not the same thing, yet common narratives seem to encourage us to regard them as inextricable. Yes, there can be tragic interlinking¹⁴ and it is essential to address these cases carefully and thoroughly. And yes, there is a need to address both, but to have a dominant focus (however unintended) on the latter, subsuming the nuances of the former into the discussions, results in a lack of enabling of students’ agency in reference to their mental selves in their everyday lives.

With such an imbalance, there results limited development and subsequent provision of aiding artefacts and relationships to promote students’ own mental literacy and skills between ‘I’m fine’ and ‘crisis’. Also risked is contribution to the development of an ‘air of normality’ regarding crisis experiences in university settings, raising concerns that all engaged in UKHE might be learning to anticipate, (even live in constant dread of), experiencing intense distress, either their own or that of others, within UK academia. And, more broadly as well as importantly, in light of UKHE having an important role to play in the shaping of overall future citizens and society, the dominant public-narrative framings contribute to perpetuation of misunderstanding in reference to mental health and distress (overlooking and under-appreciating the varied range of mental (ill) health experiences that can be had and lived with) as well as suicide in general. 

As someone who through experience has come to realise I will not complete a day when I am free from thinking about suicide in some capacity, I do think there are steps that need to be taken to really specify careful definitions and actions in reference to SMH and university-context suicide. This is necessary in order to facilitate respect, proactive vigilance and concern in universities, whilst preventing all within their walls from harmful preoccupations that may serve more to stagnate or worsen the issue overall. 

Defining ‘student mental health’

Delving further into this ‘parameters issue’, also important is that there is at present a dominance of particular ways of understanding and approaching SMH. Arguably, there is a hierarchy hiding in plain sight within the language-label of SMH itself – the ‘student’ falls second to ‘mental health’. This has important implications – UKHE institutions, however unwittingly, retain focus on and are guided by an approach to SMH starting from ‘health and illness’ (definitions and terminologies)⁹ rather than the ‘education specific-ness’ of their existence. The result of foregrounding a health and illness as opposed to an education-specific understanding/approach to SMH has led to the dominance of (implicit) deficit^15,16 and individualising emphases¹⁷ in reference to SMH. Correspondingly, there is also a dominance of certain ways of researching and learning about it - there is a noticeable lack of qualitative research¹⁸ and as a result frequently overlooked is student personal agency,¹⁹ as well as the interplay between that agency and the structures (university; societal facets) involved in issues relating to SMH.

Consequently, what we might assume constitutes SMH (and how therefore we think universities should support it) could at present be described as problematic. For example, given the recent context of COVID-19²⁰ and the cost-of-living crisis²¹, alongside the already rapid and continuing diversification of ‘the student body’,^22,23,24 there is necessity to amplify the position of social and relational factors in both defining and aiding SMH. We must be reminded that students are not just students – they are people (first) who happen to have assumed the role of ‘student’ for a short time in their lives. Thus, without increasing attempts to generate and gather in-depth information regarding students’ own understandings, and reflections on SMH as situated in the context of their wider lives, knowledge in reference to the issue will be lacking and/or incomplete (leading to a continuing mismatch between real need and the support offerings proffered by UKHE institutions). 

No ‘student mental health’ without academic staff (mental health) 

The issue of who defines (or gets to define) SMH, leads to what I regard as a further identifiable incompleteness in this topic area. Let me open this aspect by saying a coin has two sides; one does not exist without the other. SMH is rightly requiring of attention. As previously stated, student distress is being experienced and felt acutely; research, actions and initiatives are being conducted as attempts to address the problem. Yet, whilst the weight of focus on students is appropriate, what is overlooked are academic staff members’ experiences and perspectives in relation to SMH.

I say this not to dismiss or minimise students’ experiences, to quieten their voices; I say this from a perspective appraising issues of mental health, distress and wellbeing as interdependent (as opposed to independent). Students are not students alone – their role/position is relationally understood, in connection with/opposition to parallel others: tutor, lecturer, supervisor, teacher, etc. Just as siblings often come to know/define who they are (or parts of their identity at least) based on what their counterpart is or is not^25,26, students recognise their role/experience in a university because of the people who teach/guide/supervise them. In reference to SMH, then, without including/permitting voice to the academic staff members who are very much on the ‘student frontline’, neglected are key actors in the issue and the conversations held/actions taken to tackle the issue are incomplete. 

The ‘academic staff-member experience’, particularly in relation to SMH, is both underappreciated and misunderstood. What working in academia entails remains relatively invisible to those outside universities, open to varied imaginings, and there is a persisting (now unhelpful) mythology regarding what actually constitutes the role ‘academic’. For many, the traditional image of the ivory tower academic whose sole responsibilities are to read, think and impart knowledge endures. Demystification of what an academic needs/has to be now, and correspondingly of how pastoral care is now a core work issue for academic staff members themselves, would perhaps provide a vital and helpful nuance to aid understanding and action in reference to SMH. 

Much work of modern UKHE academics is hidden; academic roles/responsibilities have over recent years become extremely multifaceted. There is not space here to delve into how neoliberalism, with its emphases on individualism²⁷ and the marketisation of education²³ has come to impact (in large part negatively²⁸) upon academic staff members, suffice it to say that tasks and responsibilities of academics have proliferated extensively, with metrics and monitoring across multiple areas of their work omnipresent and, indeed, (emotionally) pressurising.²⁹ For many UKHE academic staff members, insecurity and precarity in their employment are significant issues requiring navigation.^30,31 

Alongside these broader (negatively-impactful) changes to the sector, notable is that, though built on foundational notions of rationality, universities have (had to) become increasingly emotional places for all who enter. I do not say this implying this is a ‘bad thing’ – emotions are human and humans are emotional^32,33 – but as emotions have grown as currency³⁴ in society more generally, so universities and thus their academic staff members are increasingly having to work emotionally³⁵. However, within institutions, this ‘emotional labour’³⁶ for academics appears not to be sufficiently acknowledged as, in fact, work – as is inbuilt in therapeutic professions (via required supervision sessions etc.). Support for academic staff members in their pastoral duties is necessary, yet remains on the whole formally inadequate (if available at all), subject more to self-sourcing via whatever personal channels are available to an individual. Expectations and assumptions that academic staff members have the personal capacity, abilities, and resources to properly care for, support and ultimately carry students’ stories of mental difficulty and distress without appropriate formalised avenues of support for themselves abound. It should perhaps be unsurprising, then, that increasingly coming to the fore are academic staff members themselves struggling^37,29, (many to the point of exiting academia), as the unacknowledged and unsupported everyday emotional labour vital in their relationships with students, layered onto the already-existing immense demands/targets across multiple other fronts, becomes simply too much.

Ultimately, it is crucial that under-pressure, emotionally taxed academic staff are afforded sufficient space in current SMH publicly-circulating conversations; this is important given what Brewster et al. describe as ‘the intrinsic interconnection between staff and student wellbeing.^’38 Put simply, without sector/institutional listening and support, academic staff members, many experiencing their own (mental) deteriorations and suffering^39, cannot (be expected to) support students experiencing difficulties, or aid a turnaround in the rates of recorded student distress – there cannot be ‘student mental health’ without ‘academic staff mental health’. 

With both staff and students appearing to express increasing amounts of mental struggle and distress in university environments, we should perhaps seek to consider and examine the experiences of both groups in tandem, not separately grouped and positioned in opposition. From my perspective, there is a need to retreat somewhat from the categorisation of ‘student’ and ‘academic staff’ as separate entities in reference to mental health and distress, in order to comprehensively understand and respond to, simply, ‘university mental health’ (UMH) in general. 

Closing thoughts

It is not lost on me that since my brother’s death in 2011, the visibility of ‘mental health’, ‘mental illness’, ‘wellbeing’ etc., even ‘suicide’, in public circulation and particularly in relation to narratives of SMH has sharpened massively. This remains something I generally feel positive about. Similarly, that universities are certainly aware that mental health support should at least feature alongside their academic aid provisions is a welcome development. There are good intentions. The caveat to these recent changes, however, is that in the swiftness of growth, dominant UKHE sector and institutional approaches to identifying and ‘knowing’ UMH have produced an overarching way of thinking and talking about it that could ultimately present as counterproductive. The fluidity and diversity (across time) of mental health in all its forms still present as things difficult for university settings on the whole to grasp and respond to. Thus, there persists a lack of appreciation for how UMH elements may shift and interconnect differently over time and in connection with individuals’ broader life circumstances. 

Lastly, one of the big things I have had to contend with and learn to do as a result of losing my brother to suicide is live not just with but in enduring uncertainty. I could perhaps claim an inkling as to the why of Martin’s final action but I will never know definitively. This jars at times, but it also creates openness, to alternative readings, different sources of information and ideas, particularly relating to mental health-related topics and experiences. For instance, it matters not to me from where (which school of thought) research comes so long as the intention of the work is to genuinely prompt conversation and effort to make things better for those who experience/ are experiencing suffering and distress. Applied more broadly to the issue at hand here, fierce dichotomies in discussions and decision making in the name of SMH/UMH need to be proactively challenged if not removed. No single (academic) discipline⁴⁰, (or even approach within single disciplines⁴¹), dispenses certainty of direction and action in and for these issues. Subject-authority spats, power-over-definition wranglings and defending positions are not priorities, and certainly do not mentally healthier students, academic staff and universities make. Ultimately, the priority is a person in a university context not experiencing mental suffering; being inclusive and affording equal space and voice to all manners of mental health/distress knowledge and experience in order to ascertain how they might facilitate this should be the central focus.

*Martin’s death received a formal ‘Open Verdict’ coroner’s ruling; the manner of death and what I knew/ learned of his mental states over the years, however, led to my own identification of it as his having taken his own life. As recorded by ONS, in 2018, the ‘standard of proof’, ie ‘the level of evidence needed by coroners to conclude whether a death was caused by suicide’ was changed from ‘beyond all reasonable doubt’, to ‘on the balance of probabilities’.¹ This may have impacted the verdict given for Martin’s death had this stood in 2011.