Kate Lister
Zoë Allman- 1Faculty of Learning and Teaching, Arden University, Coventry, United Kingdom
- 2Faculty of Computing, Engineering and Media, De Montfort University, Leicester, United Kingdom
The sector-wide challenge of student mental wellbeing within higher education (HE) requires universities to systematically and holistically enhance their practice and approaches. This paper recounts how an interdisciplinary team of academics, senior leaders, professional services and Students’ Union representatives across seven institutions responded to this need by collaboratively identifying definitions, good-practice for replication, and benefits of activity to embed mental wellbeing in the curriculum. Considering and exploring definitions across HE, our study provides clarity and reference points for definitions, particularly around the nature of “embedding” in relation to mental wellbeing for students. Five core themes for mental wellbeing in HE were identified and defined through this study: flourishing or thriving, balance, community and belonging, dynamic, and inclusive. Furthermore, a five-point definition of embeddedness developed; it being modeled in practice, tailored to needs, inherent in values, ethos and culture, a holistic partnership approach, and represented in strategy supported by appropriate resource. These are represented as a Mental Wellbeing Embeddedness Framework. The study sought good-practice examples from across seven HE providers, presented as example resources for replication by others in the sector seeking to address similar challenges within their institutions. Twenty-seven examples were developed into an online open educational resource toolkit, providing clear examples for use in a range of settings and responding to different needs around student mental wellbeing. Each example sharing its original rationale for development and clear list of benefits to be seen from replicating the initiative. Sector feedback to date indicates referencing the definitions activity and expanding this for use in other contexts, replication of good-practice examples in different settings, and support for identification of the benefits that can be achieved from embedding mental wellbeing in the curriculum. This paper is a call to action, shaping the future direction of student mental wellbeing, supported by policy, practice, and constant innovation.
1 Introduction
Student mental wellbeing is one of the most crucial challenges facing the higher education (HE) sector. There are increasing calls for universities to prioritize student mental wellbeing using proactive and holistic approaches (Houghton and Anderson, 2017; Hughes and Spanner, 2019; Universities UK, 2020). However, there is a “lack of consensus” in HE around what such an approach may look like in practice (Hartrey et al., 2017), and this has led to a large number of studies trialing intervention-based approaches such as mindfulness (e.g., Galante et al., 2018), meditation (e.g., Totzeck et al., 2020) or therapy (e.g., Viskovich and Pakenham, 2018). These interventions typically have only limited or short-term impact (Winzer et al., 2018), and do not address the deeper, underlying issues in university cultures and practices that can affect student wellbeing (Tinklin et al., 2005; Markoulakis and Kirsh, 2013; Lister et al., 2021). In Lister (2021) and Lister et al. (2021) identified the need to identify and address the barriers to student health in higher education, for mental wellbeing to be embedded in practice. For this to happen, there is a need for clear shared definitions of what embedding mental wellbeing means, and clear examples of what this can look like in practice.
Whilst this study focuses on mental wellbeing it is important to recognize a definition of mental wellbeing as being different from that of mental health. It is generally accepted that “there is no universally acceptable lexicon” for discussing mental health, and that “language in this field is particularly contested, revisited and innovated” (Davies, 2014, p. 22). The World Health Organization (WHO) defines “mental health” as:
“a state of wellbeing in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community” (WHO, 2013).
This definition is commonly adopted in literature (e.g., Hunter-Jones et al., 2020; Keller, 2020). However, Manwell et al. (2015) problematise the simplicity of this definition, listing others that “include intellectual, emotional and spiritual development” or “positive self-perception.” Galderisi et al. (2015) also critique the WHO focus on wellbeing, arguing instead that “Mental health is a dynamic state of internal equilibrium which enables individuals to use their abilities in harmony with universal values of society.”
The broader term “wellbeing” is also increasingly used in educational contexts, and therefore in this study. At times this is used synonymously with “mental health” (Hughes and Spanner, 2019). However, other researchers say it can, for example, demarcate the territory between “mental wellbeing, which we all have, and a mental health problem which only some of us would identify as experiencing” (Houghton and Anderson, 2017); can express transient senses of wellbeing, even while “living with a diagnosed mental illness” (Mental Wellbeing in Higher Education Working Group, 2015), and can highlight that “well-being is more than the absence of ill-being” (Huppert, 2009). However, the term “wellbeing” has been criticized as being “intangible, difficult to define and even harder to measure” (Davies, 2014).
“Embedding” is a term often used but seldom clearly defined in an educational context. A thematic search of literature (Kennedy, 2007) across different disciplines identifies various core properties of “embeddedness”:
• Practice is “situated” (Green and Meyer, 1991) or “anchored” (Johannisson et al., 2002) in the learning environment or relevant area, not an add-on
• Practice is “ubiquitous” (Moody and White, 2003) and consistent across the institution or relevant area, not isolated incidents
• Practice is “ongoing” (Laud et al., 2015), business-as-usual, not a short-term intervention, and is shaped by the people and factors involved (Dayasindhu, 2002).
Pearson et al. (2019) discuss a practitioner-focused model for accessibility embeddedness in which university systems and processes facilitate inclusive practice, and faculty accessibility coordinators are situated across the university to support this. Weiss et al. (2021) share an interesting contrast to this in their meta study on embeddedness of sustainability in curricula, critically discussing six potential patterns in implementation processes:
1. “collaborative paradigm change
2. bottom-up, evolving institutional change,
3. top-down, mandated institutional change
4. externally driven initiatives
5. isolated initiatives
6. limited institutional change.”
HE providers are being sent a clear message from sector and government bodies, that student mental wellbeing is of utmost importance and that a holistic, embedded approach to student wellbeing is needed. But definitions are contested or intangible, and published works are primarily intervention focused. There is an urgent need in the sector for conceptual definitions of mental wellbeing and embeddedness, and examples of how these concepts can be applied and embedded in practice. This study aims to address this need by sharing the results of a collaborative project funded by the Quality Assurance Agency (QAA). These results consist of collaboratively created definitions of mental wellbeing and embeddedness (presented as a framework in section “2.2 Methodology: framework for embedding mental wellbeing”), and a toolkit of examples of this in practice, sourced from six UK HE providers (examples presented in section “3.2 Examples”).
2 A framework for embedding mental wellbeing in the curriculum
2.1 Study context and framework
Whilst the HE sector has increasingly focused on student mental health and wellbeing relative to learning, teaching and assessment, there were areas around embedding mental wellbeing (EMW) where there remained sector-wide requests for practical examples and guidance about how best to embed wellbeing in practice. In response to a collaborative enhancement project call from the QAA, an interdisciplinary team from seven UK Universities and a Students’ Union proposed an activity that would provide sector definitions, share examples of EMW in HE, and identify the benefits of EMW for students, staff, providers and the sector.
The team members included academics, project managers, senior academic leaders responsible for strategic direction within their organizations, professional services staff supporting student mental wellbeing, and students, aiming to enhance the quality of students’ learning experiences across the sector through highlighting good practice examples from the collaborating institutions. To ensure accessibility and inclusivity, the project outputs would be available for sector use through the creation of a toolkit of online open educational resources (OERs) based on examples from the contributing partners.
Agreeing definitions and sharing examples was intended to support sector-wide enhancement of EMW provision for the benefit of students. Better understanding and articulating the benefits would increase student and staff engagement with wellbeing activity, enhancing student learning experiences across a wide range of disciplines. Students would benefit from enhanced understanding and implementation of EMW in the curriculum, reducing the need for signposting to central services. Producing an OER toolkit for use by academics and academic developers in HE would enhance EMW across the sector.
Led by an academic from De Montfort University, the team included a range of providers: London South Bank University, The Open University, the Universities of Bristol, East Anglia, Greenwich and Reading, and De Montfort Students’ Union. The variety of size and scale of study team providers, the different delivery and study methods, and range of subject disciplines taught provided effective oversight of UK HE provision, ensuring the development of outputs as relevant for a large cross-section of the sector.
Most of the team had originally met through a national Advance HE (a UK sector body) project exploring approaches, opportunities and challenges in EMW in the curriculum across the sector. As such, project members were already actively working on embedding mental wellbeing and had previously discussed definitions and examples of practice.
Appreciative inquiry was used as the overarching methodology in this project, in which positive and collaborative ideas and techniques inform improvements in larger change activity. Appreciative inquiry is a particularly appropriate and relevant methodology for positive change in higher education, as it works to identify the “positive core” of people who are already “working to enhance learning and enhance the mission and purpose of higher education” (Cockell et al., 2020), to share, embed and sustain the positive practices that are already in place. It was, therefore, a highly appropriate method to:
• Collaboratively construct a framework of definitions for mental wellbeing and embeddedness; and
• Identify examples of embedding wellbeing in practice.
2.2 Methodology: framework for embedding mental wellbeing
The first element of the framework is a definition of “mental wellbeing.” There are various definitions around mental wellbeing and “no standard definition in use across the sector” (Pollard et al., 2021). After considering the literature, the project team agreed that to add an additional definition to the landscape would not be helpful; they therefore conducted a thematic review of the literature and selected regularly occurring themes in definitions, with the idea that institutions could be flexible in how they addressed the themes in practice. Five core themes were identified:
1. Wellbeing includes a sense of flourishing or thriving (e.g., Seligman, 2011; Vailes, 2017; Knoesen and Naudé, 2018; Hine et al., 2022)
2. Wellbeing includes a sense of balance (e.g., Waterhouse et al., 2020; Yusuf et al., 2020; Jones et al., 2021; Smith et al., 2022)
3. Wellbeing is strengthened by community and belonging (e.g., Cardwell and Lewis, 2017; Suhlmann et al., 2018; Ahn and Davis, 2020; Morris, 2021)
4. Wellbeing is dynamic; it can change from day to day and over time (e.g., Gall et al., 2000; Bewick et al., 2010; Kuppens et al., 2010)
5. Wellbeing services, activities and strategies should be inclusive, for all students (e.g., Russell et al., 2008; Baik et al., 2019; Brewster et al., 2022; Priestley et al., 2022)
The second element of the framework is a definition of “embedding.” As there was less pre-existing literature to draw on, the project team co-constructed a definition of embeddedness using a mixed methods appreciative inquiry approach, via focus groups, a network activity and a survey. The focus groups were run in seven institutions as part of an Advance HE collaborative project, and the network activity took place as part of an “International Network of Inclusive Practice” (INIP) event. The survey was run with staff in one institution, the Open University, as part of a wider staff survey project, described in Lister et al. (2022a,b). Participants in the events (N = 103) and survey respondents (N = 666) were asked to define what embeddedness meant to them, in the context of mental wellbeing, in recognition and appreciation of their expertise. Transcriptions of focus group data and open comment survey data were analyzed using reflexive thematic analysis (Braun and Clarke, 2019).
Participants identified the need for wellbeing to be:
• Situated or anchored in practice, e.g., “Consider having a section on mental wellness for studying each module embedded into the module handbook with a system of ensuring that this is actually read by every student.”
• Embodied or modeled in practice, e.g., “Providing learning materials in smaller chunks so that they don’t feel too overwhelming and building in more flexibility in assessment deadlines.”
• Tailored to student needs, e.g., “Students face vastly different problems, so a one-size fits all approach seems unlikely to be successful. Support that is tailored to individual student needs that’s delivered by well-trained and supported staff would seem most likely to succeed.”
• A ubiquitous, holistic approach, e.g., “It’s a whole system review” and “this is mission critical and should be an ‘all service’ concern.”
• Inherent in values, ethos, and culture, e.g., “Understanding mental health and ill-health needs to become part of the culture, so that we move toward being student driven rather than systems driven”
• Built into institutional resource and strategy, e.g., “we need to be given time and resource,” “A working group (if one does not already exist) who will continually review and keep on top of this” and “utilizing a digital first strategy”
Embedded through partnerships, e.g., “Have disability experts/disabled students and graduates present at a strategic level when constructing modules” and “Encouraging associate lecturer (AL) participation in the process.”
The project team collaboratively rationalized these themes into a five-point definition, using an iterative approach and drawing on both the literature in the field and practitioners’ understandings of the term. Embeddedness is therefore said to mean:
1. Modeled in practice, as well as situated in it (i.e., that wellbeing is inherent in pedagogy and the design of learning, as well as present in curriculum content)
2. Tailored to students’ needs
3. Inherent in the values, ethos and culture of the institution, as well as ubiquitous across it
4. A holistic, partnership effort
5. Represented in strategy and resourced appropriately, as well as being ongoing practice
These two five-point definitions may be represented as a framework, as shown in Figure 1; an example of the framework for use in mapping an activity is included in Figure 2 later in the article.
Figure 1. The Mental Wellbeing Embeddedness Framework.
Figure 2. Study examples mapped to the Mental Wellbeing Embeddedness Framework.
3 Pedagogical case study examples
3.1 Identifying and collating examples
Recognizing the wealth of examples of EMW from within the contributing providers, examples were sought to share through the online OER toolkit. A three-stage process was developed, covering submission, review, and confirmation. The first stage invited suggestions of good-practice examples for inclusion in the OER toolkit from the seven HE providers in the study team. The team reviewed all submissions using The Mental Wellbeing Embeddedness Framework (Figure 1) and selected examples for inclusion based on the information provided by proposers and in consideration of the effectiveness of the combined resources to create a holistic package of support.
Enabling review and consideration of each submitted proposal, the study team sought to understand the example title or a brief description of the example, the rationale for originally creating the example and details of the need the example was responding to, the use of consultation and stakeholder involvement in the design and development of the example, any measurable impact or outcomes to date, the method through which the example would best be disseminated through the OER, and the most likely beneficiaries of greater information about the example. Considering the holistic coverage of all proposed examples, from the thirty-nine submissions received, twenty-seven were taken forward for development and inclusion in the toolkit.
To facilitate sector access and engagement with examples in the OER toolkit, the team explored methods for categorizing the resources into relevant groups, aiming to support colleagues across the sector looking to access materials in response to individual need. The submissions were reviewed again, to explore thematic areas emerging from the examples, and areas around transitions, work-based experiences, assessment and feedback, for example were identified. Considering how colleagues in the sector might use the OER, it was recognized that those coming to the toolkit would be seeking ideas for swift implementation, usually in response to an identified need from their perspective which would usually be categorized under a heading and with the outcome or benefit in mind. Six thematic groups were developed, under which each of the examples would sit. To provide clear signposting and structure within the OER the six thematic groups used headings applying Kato’s (1986) “question-asking protocol” method to engage the user, guiding them through the resources based on their own contextualized experience needs. The six thematic areas were:
1. Approaches and techniques; What pedagogical approaches and techniques can support embedding mental wellbeing in the curriculum?
2. Providers, programmes, and modules; What approaches can we take to embed mental wellbeing across higher education providers, programmes and modules?
3. Assessment and feedback; How can we best support student mental wellbeing in the design of assessment and feedback?
4. Transitions during the student journey; What initiatives and interventions support students navigating transitions during the student journey?
5. Work-based placements and professional experiences; How does embedding mental wellbeing support student engagement in work-based placements and professional experiences?
6. Relationship-building, connection, and belonging; How can relationship-building, connection and belonging be utilized as approaches to embedding mental wellbeing?
The thematic groupings provided the navigational structure of the OER toolkit. Each of the examples was aligned to the thematic area most appropriate to the original rationale for the development of the example, with three to six examples under each of the thematic areas.
Seeking consistency of presentation across the curated final example materials for inclusion in the OER toolkit, three submission methods were available and the most relevant was to be utilized; (1) written submission of 500–1,000 words including hyperlinks to external sites that were accessible to all (supporting inclusivity and open access), (2) short explainer video/audio of 1–3 min in duration with accompanying resources, or (3) example video/audio without accompanying resources.
In addition to collating examples and the OER toolkit acting as a curated repository, the study sought to support sector colleagues in understanding the benefits to be gained from replicating the individual examples (Zwikael et al., 2018). To do this, each example clearly identified the primary benefits as recognized by the proposing author and study team. The benefits identified for each example were those most relevant benefits to three key stakeholder groups identified by the collaborative team; (1) students, (2) practitioner(s)/programme(s), and (3) institution. The practitioner/programme was explained as being the person or programme implementing the embedding mental wellbeing activity, and the institution may include the University or Students’ Union.
The benefits identified in this project were:
• Student(s): Belonging, communication, confidence, depth of learning, learning opportunity, preparedness, reflection, resilience, satisfaction, study skills, and team working.
• Practitioner(s)/programme(s): Class dynamic, efficiency, enhanced student partnership, practitioner confidence, practitioner preparedness, practitioner wellbeing, student achievement, student engagement, and student retention.
• Institution(s): Award outcomes, engagement, equitable access, policy compliance, reputational impact, and whole university approach.
Each example included in the OER stated two primary benefits for student(s) and practitioner(s)/programme(s), and one key benefit for the institution.
The OER toolkit containing all examples can be found at: https://www.qaa.ac.uk/membership/collaborative-enhancement-projects/learning-and-teaching/embedding-mental-wellbeing.
3.2 Examples
3.2.1 Embedding wellbeing in the classroom: staff workshop
One of the examples featured, from the University of Greenwich, provided a PowerPoint slide deck to facilitate reflection activity individually or in a team development setting, inviting practitioners to explore what embedding mental wellbeing could look like within their teaching context. In the example, Dr. Gilmour and Dr. George start by encouraging the user to consider their own experience as a university student before exploring how student wellbeing is supported through teaching, learning and assessment practices. This reflective exploration is supported by institutionally agreed definitions of mental health and wellbeing as a two-axis continuum, as referenced in Houghton and Anderson (2017). The user is invited to consider affective and social dimensions of learning, with curriculum processes impacting wellbeing outcomes. Navigating and normalizing challenge and achievement is explored, with methods for reflection based on the work of Turner et al. (2017) and Hunter-Jones et al. (2020). A focus on connection building and belonging welcomes reflection on individual teaching practice, with suggestions and ideas for use in teaching sessions. The user is encouraged to design learning approaches that maximize active learning, engagement and partnership, and consider the practical applications in our own context of the thematic areas within the resource.
Feedback from a delegate who had attended the dissemination “launch” event indicated that they were including ideas from this example, “Embedding wellbeing in the classroom: staff workshop,” in their own practice through incorporating new non-graded quizzes at the end of sessions to support student reflection and engagement with examination style questions. This had increased student engagement with the curriculum content, enhanced the sense of belonging, and increased the feeling of accomplishment. These reflections supporting the identified benefits (as stated in the OER toolkit) for students around belonging and resilience.
This example can be found at: https://www.qaa.ac.uk/docs/qaa/members/embedding-wellbeing-in-the-classroom-staff-workshop.pptx.
3.3.2 Navigating challenging times
An example from London South Bank University provides the rationale, method and findings from student sessions responding not only to the pandemic, but also a malicious cyber incident and subsequent IT outage, in “Navigating Challenging Times.” Facilitation details are provided and replicable, enabling sector colleagues to consider how this might be used within their own practice and in response to their own identified need. Delivered as an online session with students, the content and avenues for exploration are presented alongside resources used within the sessions. Whilst only 7.4% of the student session attendees completed the post-event feedback survey, those who did agreed that they now had a better understanding of the support available and had learnt about ways to cope in challenging times, the majority feeling better prepared for coping as a student. The facilitating team reflected on the benefits of offering sessions that enabled students to reflect and share their voices, in addition to the support and strategies shared during the session.
This example can be found at: https://www.qaa.ac.uk/docs/qaa/members/navigating-challenging-times-sessions-for-students-at-lsbu.pdf.
3.3.3 A Mindful LEGO® Meditation
A mindfulness meditation activity is clearly outlined in the example “A Mindful LEGO® Meditation.” Following the worksheet and accompanying audio file, practitioners can apply this technique in various settings, with individuals or groups. Colleagues within the sector have highlighted examples such as “A Mindful LEGO® Meditation” being explored as an ice-breaker activity to provide opportunities to develop a community whilst engaging in a shared activity, and a method that could be replicated by students when needed.
This example can be found at: https://www.qaa.ac.uk/docs/qaa/members/a-mindful-lego-meditation.pdf and https://www.qaa.ac.uk/docs/qaa/members/mindful-lego-meditation.mp3.
These examples are mapped to the Mental Wellbeing Embeddedness Framework in Figure 2, as an example of the framework as a mapping tool.
4 Impact to date/assessment
An online dissemination “launch” event for the OER toolkit hosted by the QAA attracted over 110 delegates. Interest in the event was received from across HE, including academic lecturers and associate deans, wellbeing advisors, assessment center mangers, academic developers, and directors of registry. The event also attracted colleagues from libraries, quality assurance, IT and business development teams. Delegates came primarily from UK HE, with some international representation and a number of colleges in attendance.
Delegate feedback indicated an interest in embedding mental wellbeing, often from a personal perspective and a desire to increase the presence of mental wellbeing awareness within the curriculum. After the event, a sample of thirty delegates provided feedback via a survey, 93% rated the quality of content at the event “good” or “excellent,” and 93% gave a rating between 6 and 10 (10 meaning “certainly”) when asked how likely they were to access and use the OERs.
Four months later a secondary online event, attracting over 80 delegates, facilitated greater guided-exploration of the resources developed, and the developmental journey to curate the OER toolkit, definitions and benefits highlights. Feedback indicated that the resources had been explored and elements were already being incorporated into activity, and relevant literature was being cited during sessions.
Around the same time, within 4 months of launching the online OER toolkit, the landing web page had achieved 3,731 views in total, of which 2,774 were unique page views. The QAA identified the landing page in the top 20 most popular across the whole QAA website for the same period. Closer analysis and tracking identified the OER landing page achieving the greatest interest (as demonstrated through viewing figures), followed by the “Approaches and techniques” thematic group page. Considering the six thematic groups, the number of views corresponds with the order of presentation on the landing page. Web views and page access demonstrate interest in the range of thematic groups available, though a probable link between ordering of the themes and views limits the ability to accurately identify where greatest interest lies.
5 Lessons learned, practical implications, and limitations
5.1 Lessons learned and practical implications
In this section, lessons learned by the project team through this activity are positioned as three recommendations for practice.
Reflecting on the study and particularly the examples shared with the sector through the OER toolkit, the team acknowledge the strength in existing, often isolated and unsung practice, from practitioners quietly working to make positive change without necessarily publishing or having a voice in the politics of higher education (Seale, 2017). The examples submitted for inclusion came from a breadth of disciplinary backgrounds, often developed by colleagues who were compelled by a sense of what felt “morally right,” rather than having a research- or career-related interest in student wellbeing. This aligns to a “quiet activism” approach, where “Modest acts of care, connection and creativity can be collectively and politically significant” (Steele et al., 2021). In HE, where the effect of the emotional labor involved in activism toward positive change is well recognized (Lister et al., 2022a), the collective impact of small-scale examples has potential to reduce the emotional burden on change-makers.
Recommendation for practice 1: There is a need to seek out, scale-up and scale-out examples of existing effective practice, recognizing positive activity that is already in place, celebrating and sharing this with others.
Working across seven HE providers and producing materials for use across the sector heightened awareness that whilst many phrases, key words and terms are commonly used and accepted in HE, these are not always defined. This lack of a shared definition leads to a lack of a shared, common understanding, and this shared understanding is “a vital component to a coherent strategy” (Pollard et al., 2021). Many team members and participants in this project had their own interpretation of “embedding,” but our exploration revealed that these personal definitions, which participants presumed were shared, in fact varied widely. For example, there was a subset of participants who presumed that “embedded” meant “invisible” or “imperceivably integrated,” and a conflicting view from others who felt that embeddedness meant “tangible” and a “clearly demonstrated commitment.” Drawing on existing definitions in literature helped us to clarified these positions. We presume that initial understandings that were thought to be shared must be heavily influenced by personal circumstance and context, and we counsel future practitioners against assumptions of shared understanding.
Recommendation for practice 2: Shared definitions are crucial. People embarking upon the journey of embedding mental wellbeing should work from existing literature or develop their own definitions based upon existing, clear, shared, content-specific definitions.
As the sector increasingly focuses on enhanced support for mental health and wellbeing there is a growing body of literature for practitioners to consider, an ever-expanding corpus of seminal work with which they need to become familiar. This study sought to take action to provide resources that were based on an appreciative approach (Cockell et al., 2020), with examples shared through open resources that were inclusive and accessible to practitioners in a range of academic and professional roles. The team sought to recognize with compassion the challenges facing HE practitioners today, the limitations on these end users’ time, the difficulties they face in developing and enhancing their own approach to EMW, and the impacts of these on their own wellbeing. Staff wellbeing is essential to supporting student wellbeing (Brewster et al., 2022). Our project team adopted an ethos of meeting people where they are, appreciatively and collegiately inviting practitioners in a range of roles to join the movement and conversation around student wellbeing, being compassionate about the struggles they face themselves, and aiming to start the journey wherever they are, rather presenting a barrage of literature and theory, concept and resource, that can create a barrier to inclusivity. When people from different providers are driven by a passion for a topic, in this case EMW, they can work together and make a real change to the sector in which they operate through providing tangible support, guidance and resources for immediate use by others, thereby enhancing the student experience far beyond the initial providers within a team.
Recommendation for practice 3: Embrace and maintain an ethos of “meeting people where they are,” one that echoes buddying and peer support rather than top-down leadership or management. From this, new opportunities, resources and outcomes, led by passionate colleagues with a range of expertise seeking to enhance the student experience, can develop.
5.2 Limitations
Limitations were recognized and considered in the development of this study. The study having been led by a collaborative team from seven UK providers, whilst representative of UK HE, may demonstrate limitations in the international context represented and therefore resources may need to be adapted to suite. Similarly, with contributions of good practice examples from the seven contributing UK providers there is potential for bias in the review activity and content provided through the study. With only one Student Union represented in the study team there were limitations to the examples for inclusion within the final OER directly generated by students.
The study was constrained by time and resource allocations associated with the QAA funded project, and also the time period in which the project occurred. The project commenced in January 2021 and concluded in June 2022, a period largely impacted by the COVID-19 pandemic, meaning all team meetings and dissemination events occurred remotely which may have limited engagement and contribution, delegate participation in events, and awareness raising of the resources available.
Definitions surrounding mental health and wellbeing are numerous and varied, this study has focused on mental wellbeing, potentially seen as a limitation as the study team did not explore mental health, however, this was a deliberate decision by the study team to support focus and clarity in the work.
The study outputs being available as OERs introduces evaluation limitations as it is not possible to track every instance of access, download, inspiration and use of the good-practice examples shared. The study team have relied on feedback provided by users within the sector, alongside quantitative data regarding website access use, to determine engagement.
6 Conclusion
This project aimed to kickstart activity and provide upon which others could build, by providing definitions for embedding mental wellbeing, and a suite of sector resources for use in a range of HE contexts. Sector feedback to date indicates that other institutions are referencing the definitions activity and expanding this for use in other contexts; they are embracing, replicating and adapting good-practice examples in different settings, and that there is support for identification of the benefits that can be achieved from embedding mental wellbeing in the curriculum.
The study team recognize the potential for collaborative working, especially when seeking to share good-practice examples for others to use. Aiming to define embedding mental wellbeing has extended the literature in this area, drawing on thematic approaches to underpin a series of core properties that highlight what it means to be “embedded,” and five core themes for wellbeing, providing enhanced platforms for future activity. The five-point definition framework facilitates structured development of curriculum interventions to support embedding mental wellbeing activity.
In sharing these definitions, good-practice examples, and exploring how they are being used in practice, this paper aims to be a call to action to the sector. It supports the current movement to shape the future direction of student mental wellbeing in higher education, and to influence policy, practice, and constant innovation.
Data availability statement
The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found below: https://www.qaa.ac.uk/membership/collaborative-enhancement-projects/learning-and-teaching/embedding-mental-wellbeing.
Author contributions
Both authors contributed to the study, the data analysis, the drafting, writing and reviewing of the manuscript, and approved the submitted version.
Funding
Funding for this study was provided by the Quality Assurance Agency (QAA), UK. Reference: 30101/001/2021.
Acknowledgments
We would like to acknowledge the Quality Assurance Agency (QAA) who funded the collaborative enhancement project that brought the seven HE providers and a students’ union together to drive this study forward. Particular acknowledgment and thanks are given to fellow study team members Benjamin Smith (De Montfort Students’ Union), Annie Jennings and Nicola Smith (London South Bank University), Fabienne Vailes (University of Bristol), Professor Emma Sutton and Professor Neil James (University of East Anglia), Dr. Alison Gilmour (University of Greenwich, later University of the West of Scotland), and Dr. Alicia Peña Bizama (University of Reading); their passion and commitment to mental wellbeing endeavor are a strength and virtue to be celebrated. We thank Advance HE, recognizing the impact of the Embedding Mental Wellbeing in the Curriculum collaborative project in providing the foundation for future work in this space. All contributors of examples to the OER toolkit are acknowledged in full via the OER toolkit, and in particular we thank Dr. Alison Gilmour and Dr. Rachel George (University of Greenwich), Nicola Smith (London South Bank University), and Julia Reeve (De Montfort University) whose examples are highlighted within this article. Appreciation and gratitude are extended to all delegates who engaged in project events, and all participants, contributors and users of the OER toolkit.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher’s note
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References
Ahn, M. Y., and Davis, H. H. (2020). Students’ sense of belonging and their socio-economic status in higher education: A quantitative approach. Teach. High. Educ. 40, 1–14. doi: 10.1080/13562517.2020.1778664
Baik, C., Larcombe, W., and Brooker, A. (2019). How universities can enhance student mental wellbeing: The student perspective. High. Educ. Res. Dev. 38, 674–687. doi: 10.1080/07294360.2019.1576596
Bewick, B., Koutsopoulou, G., Miles, J., Slaa, E., and Barkham, M. (2010). Changes in undergraduate students’ psychological well-being as they progress through university. Stud. Hig. Educ. 35, 633–645. doi: 10.1080/03075070903216643
Braun, V., and Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qual. Res. Sport, Exerc. Health 11, 589–597.
Brewster, L., Jones, E., Priestley, M., Wilbraham, S. J., Spanner, L., Hughes, G., et al. (2022). “Look after the staff and they would look after the students” cultures of wellbeing and mental health in the university setting. J. Further High. Educ. 46, 548–560. doi: 10.1080/0309877X.2021.1986473
Cardwell, J. M., and Lewis, E. G. (2017). Vocation, belongingness, and balance: A qualitative study of veterinary student well-being. J. Vet. Med. Educ. 44:29–37. doi: 10.3138/jvme.0316-055R
Cockell, J., McArthur-Blair, J., and Schiller, M. (2020). Appreciative inquiry in higher education: A transformative force. Altona, MB: Friesen Press.
Davies, S. C. (2014). Annual report of the chief medical officer 2013, public mental health priorities: Investing in the evidence. London: Department of Health.
Dayasindhu, N. (2002). Embeddedness, knowledge transfer, industry clusters and global competitiveness: A case study of the Indian software industry. Technovation 22, 551–560. doi: 10.1016/S0166-4972(01)00098-0
Galante, J., Dufour, G., Vainre, M., Wagner, A. P., Stochl, J., Benton, A., et al. (2018). A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): A pragmatic randomised controlled trial. Lancet Public Health 3, e72–e81. doi: 10.1016/S2468-2667(17)30231-1
Galderisi, S., Heinz, A., Kastrup, M., Beezhold, J., and Sartorius, N. (2015). Toward a new definition of mental health. World Psychiatry 14, 231–233. doi: 10.1002/wps.20231
Gall, T. L., Evans, D. R., and Bellerose, S. (2000). Transition to first-year university: Patterns of change in adjustment across life domains and time. J. Soc. Clin. Psychol. 19, 544–567. doi: 10.1521/jscp.2000.19.4.544
Green, J., and Meyer, L. (1991). “The embeddedness of reading in classroom life: Reading as a situated process,” in Towards a critical sociology of reading pedagogy: Papers of the XII world congress on reading, eds C. Baker and A. Luke (Amsterdam: John Benjamins Publishing).
Hartrey, L., Denieffe, S., and Wells, J. S. G. (2017). A systematic review of barriers and supports to the participation of students with mental health difficulties in higher education. Ment. Health Prev. 6, 26–43. doi: 10.1016/j.mhp.2017.03.002
Hine, R., Patrick, P., Berger, E., Diamond, Z., Hammer, M., Morris, Z. A., et al. (2022). From struggling to flourishing and thriving: Optimizing educator wellbeing within the Australian education context. Teach. Teach. Educ. 115:103727. doi: 10.1016/j.tate.2022.103727
Houghton, A.-M., and Anderson, J. (2017). Embedding mental wellbeing in the curriculum: Maximising success in higher education. York: Higher Education Academy, 44.
Hunter-Jones, P., Flatt, S., Crolley, L., and Neary, K. (2020). “Mental health and social tourism: Exploring the provider landscape,” in Handbook of Social Tourism [Preprint]. Available online at: https://www.elgaronline.com/view/edcoll/9781788112420/9781788112420.00019.xml (Accessed: 28 August 2021).
Huppert, F. A. (2009). Psychological well-being: Evidence regarding its causes and consequences†. Appl. Psychol. Health Well-Being 1, 137–164. doi: 10.1111/j.1758-0854.2009.01008.x
Johannisson, B., Ramírez-Pasillas, M., and Karlsson, G. (2002). The institutional embeddedness of local inter-firm networks: A leverage for business creation. Entrepreneursh. Reg. Dev. 14, 297–315. doi: 10.1080/08985620210142020
Jones, E., Priestley, M., Brewster, L., Wilbraham, S. J., Hughes, G., Spanner, L., et al. (2021). Student wellbeing and assessment in higher education: The balancing act. Assess. Eval. High. Educ. 46, 438–450. doi: 10.1080/02602938.2020.1782344
Kato, T. (1986). What “question-asking protocols” can say about the user interface. Int. J. Man Mach. Stud. 25, 659–673. doi: 10.1016/S0020-7373(86)80080-3
Keller, S. (2020). What does mental health have to do with well-being? Bioethics 34, 228–234. doi: 10.1111/bioe.12702
Knoesen, R., and Naudé, L. (2018). Experiences of flourishing and languishing during the first year at university. J. Ment. Health 27, 269–278. doi: 10.1080/09638237.2017.1370635
Kuppens, P., Oravecz, Z., and Tuerlinckx, F. (2010). Feelings change: Accounting for individual differences in the temporal dynamics of affect. J. Pers. Soc. Psychol. 99, 1042–1060. doi: 10.1037/a0020962
Laud, G., Karpen, I. O., Mulye, R., and Rahman, K. (2015). The role of embeddedness for resource integration: Complementing S-D logic research through a social capital perspective. Market. Theory 15, 509–543. doi: 10.1177/1470593115572671
Lister, K. (2021). Barriers and enablers to mental wellbeing in distance learning: Staff and student perspectives. Eur. J. Open Dist. ELearn. (in press).
Lister, K., Pearson, V. K., Coughlan, T., and Tessarolo, F. (2022a). Inclusion in uncertain times: Changes in practices, perceptions, and attitudes around accessibility and inclusive practice in higher education. Educ. Sci. 12:571. doi: 10.3390/educsci12080571
Lister, K., Pearson, V. K., McPherson, E., and Gallen, A. (2022b). “Views of inclusion across time and space: five years of perspectives from university tutors on accessibility and inclusion,” in Proceedings of the 15th annual International Conference of Education, Research and Innovation, Seville, Spain, Seville.
Lister, K., Seale, J., and Douce, C. (2021). Mental health in distance learning: A taxonomy of barriers and enablers to student mental wellbeing. Open Learn. J. Open Dist. E-Learn. 36, 102–116.
Manwell, L. A., Barbic, S. P., Roberts, K., Durisko, Z., Lee, C., Ware, E., et al. (2015). What is mental health? Evidence towards a new definition from a mixed methods multidisciplinary international survey. BMJ Open 5:e007079. doi: 10.1136/bmjopen-2014-007079
Markoulakis, R., and Kirsh, B. (2013). Difficulties for university students with mental health problems: A critical interpretive synthesis. Rev. High. Educ. 37, 77–100. doi: 10.1353/rhe.2013.0073
Mental Wellbeing in Higher Education Working Group (2015). Student mental wellbeing in higher education: good practice guide. London: Universities UK, 56.
Moody, J., and White, D. R. (2003). Structural cohesion and embeddedness: A hierarchical concept of social groups. Am. Sociol. Rev. 68, 103–127. doi: 10.2307/3088904
Morris, C. (2021). “Peering through the window looking in”: Postgraduate experiences of non-belonging and belonging in relation to mental health and wellbeing. Stud. Graduate Postdoctoral Educ. 12, 131–144. doi: 10.1108/SGPE-07-2020-0055
Pearson, V., Lister, K., and Coughlan, T. (2019). “Accessibility coordinators: A model for embedded, sustainable change towards inclusive higher education,” in Proceedings of the 12th annual International Conference of Education, Research and Innovation (ICERI), Seville, Spain, Seville, 3127–3136. doi: 10.21125/iceri.2019.0798
Pollard, E., Vanderlayden, J., Alexander, K., Borkin, H., and O’Mahony, J. (2021). Student mental health and wellbeing: Insights from higher education providers and sector experts: June 2021. London: Department for Education.
Priestley, M., Broglia, E., Hughes, G., and Spanner, L. (2022). Student perspectives on improving mental health support Services at university. Counsell. Psychother. Res. 22, doi: 10.1002/capr.12391
Russell, J., Thomson, G., and Rosenthal, D. (2008). International student use of university health and counselling services. High. Educ. 56, 59–75. doi: 10.1007/s10734-007-9089-x
Seale, J. (2017). From the voice of a “socratic gadfly”: A call for more academic activism in the researching of disability in postsecondary education. Eur. J. Spec. Needs Educ. 32, 153–169. doi: 10.1080/08856257.2016.1254967
Seligman, M. E. (2011). Flourish: A visionary new understanding of happiness and well-being. New York, NY: Simon and Schuster.
Smith, J., Fisher, J., and Ramprogus, V. (2022). Adding University to work and life: The work–life balance and well-being experiences of women who combine employment, HE learning and care of the family. Commun. Work Fam. 25, 583–602. doi: 10.1080/13668803.2020.1779662
Steele, W., Hillier, J., MacCallum, D., Byrne, J., and Houston, D. (2021). Quiet activism: Climate action at the local scale. Cham: Springer International Publishing. doi: 10.1007/978-3-030-78727-1
Suhlmann, M., Sassenberg, K., Nagengast, B., and Trautwein, U. (2018). Belonging mediates effects of student-university fit on well-being, motivation, and dropout intention. Soc. Psychol. 49, 16–28. doi: 10.1027/1864-9335/a000325
Tinklin, T., Riddell, S., and Wilson, A. (2005). Support for students with mental health difficulties in higher education: The students’ perspective. Br. J. Guidance Couns. 33, 495–512. doi: 10.1080/03069880500327496
Totzeck, C., Teismann, T., Hofmann, S. G., von Brachel, R., Pflug, V., Wannemüller, A., et al. (2020). Loving-kindness meditation promotes mental health in university students. Mindfulness 11, 1623–1631. doi: 10.1007/s12671-020-01375-w
Turner, M., Scott-Young, C., and Holdsworth, S. (2017). Promoting wellbeing at university: The role of resilience for students of the built environment. Construct. Manag. Econ. 35, 11–12,707–718. doi: 10.1080/01446193.2017.1353698
Vailes, F. (2017). The flourishing student: Every tutor’s guide to promoting mental health, well-being and resilience in Higher Education. London: Practical Inspiration Publishing.
Viskovich, S., and Pakenham, K. I. (2018). Pilot evaluation of a web-based acceptance and commitment therapy program to promote mental health skills in university students. J. Clin. Psychol. 74, 2047–2069. doi: 10.1002/jclp.22656
Waterhouse, P., Samra, R., and Lucassen, M. (2020). Mental distress and its relationship to distance education students’ work and family roles. Dist. Educ. 41, 540–558. doi: 10.1080/01587919.2020.1821606
Weiss, M., Barth, M., and von Wehrden, H. (2021). The patterns of curriculum change processes that embed sustainability in higher education institutions. Sustainabil. Sci. 16, 1579–1593. doi: 10.1007/s11625-021-00984-1
Winzer, R., Lindberg, L., Guldbrandsson, K., and Sidorchuk, A. (2018). Effects of mental health interventions for students in higher education are sustainable over time: A systematic review and meta-analysis of randomized controlled trials. PeerJ 6:e4598. doi: 10.7717/peerj.4598
Yusuf, J.-E., Saitgalina, M., and Chapman, D. W. (2020). Work-life balance and well-being of graduate students. J. Public Affairs Educ. 26, 458–483. doi: 10.1080/15236803.2020.1771990
Keywords: mental health, mental wellbeing, embedded, framework, students, practitioners, belonging
Citation: Lister K and Allman Z (2024) Embedding mental wellbeing in the curriculum: a collaborative definition and suite of examples in practice. Front. Educ. 8:1157614. doi: 10.3389/feduc.2023.1157614
Received: 02 February 2023; Accepted: 18 December 2023;
Published: 11 January 2024.
Edited by:
Julie Prescott, The University of Law, United KingdomReviewed by:
Adrian Nicolae Opre, Babeş-Bolyai University, RomaniaHelena Gillespie, University of East Anglia, United Kingdom
Copyright © 2024 Lister and Allman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Zoë Allman, emFsbG1hbkBkbXUuYWMudWs=