Guest blog: Sharing my TEDx talk for University Mental Health Day

A few years ago, I was an international student at a university in London, and I was unable to pay for my tuition. I took out a bank loan and paid for the first year, but I was worried about paying for the remaining two years. I felt anxious, I cried a lot, and I could not concentrate on my studies. They were times when I felt I woke up at night in a cold sweat, unable to breathe. That was in 2005, a time when I knew nothing about anxiety, panic attacks and depression, or the symptoms of these mental health problems.

After completing the first year, I couldn’t obtain another loan, so I quit my studies, I worked for a homeless charity where I met men and women who reported similar symptoms to what I used to feel, and more. I did not understand what they were feeling, just like I did not understand what I felt when I was a student. But one thing that I noticed was that most of them cried a lot. One day, in 2010, I Googled 'crying all the time' and read about mental health, and I decided to study for mental health nursing so that I could understand more.

On the first day of induction, I was late to the induction speech. I walked into the hall with four other students and apologised to the lecturer for being late. She looked at me and said, "sorry for yourself" and then, asked me why I was there. I replied that I was there for the mental health nursing induction day. She looked at me up and down, and said, "go to the magazines, you will never be a nurse." I was shocked and felt like crying, but instead, I walked into the hall and sat at the back.

In the second year of my studies to become a mental health nurse, the same lecturer became my tutor, and harassed and bullied me constantly. She would tell me that I was never going to pass or become a nurse. This continuous experience brought back those feelings that I felt years ago.

Fortunately, I was now aware of what I was feeling, and I could name them: situational anxiety, panic attacks and depression. Mental health symptoms brought on by a negative situation.

In addition to the harassment and bullying, I suffered sexual harassment from two qualified male nurses, who were also my mentors. I was a student nurse, and I had to go to placements where I encountered these two male nurses. I was always anxious when I had to go for placements, and I cried a lot because there was nothing I could do to stop them. However, I did not let the bullying and sexual abuse impact on my learning experience. I focused on my studies and achieved a first class honours degree in mental health nursing.

Soon after, I applied to study for an MSc in public health, and I received a scholarship from the same university that I walked away from when I couldn’t afford the tuition. During this time, I noted that most of my classmates were international students and some of them reported similar symptoms to those I experienced years before. I saw myself in them because I have walked their walk, felt their fears, and I am still feeling it in the extremely isolating world of a PhD student. I could not advise them in my capacity as a mental health nurse, so I encouraged to visit their GP and the university wellbeing service.

When I completed the MSc in public health, I worked as a seminar tutor for undergraduate students. On the first day, I introduced myself as a mental health nurse. From that day onwards, students would book appointments to see me. I would prepare tutorials based on the seminar, but I quickly realised that most of the students did not want to talk about their module. They wanted to talk about what they were experiencing: fear, confusion, crying all the time, and insomnia. They said things like: "I can’t stop crying, sometimes I feel like I am choking and I can’t breathe" or "I feel worthless, I feel like walking away, what is the point." I knew that they were feeling things that I too was familiar with: stress, anxiety, panic attacks, insomnia, and depression.

It is important, of course, to highlight here that mental health in higher education is not only about higher education students. It is about their friends, loved ones and family members, and the community that they live, socialise or study in. It is about international students who have travelled thousands of miles to study in countries where they have to learn to adapt to new environments, rent somewhere to live, make friends, as they study to achieve a qualification. Mental health experiences among higher education students is about me, you, us and them.

These are our narratives, our facts and for some of us, they are all the silver linings in our dark cloud. We live it, embody it and they become part of our stories. The problem is, we do not share those experiences or talk about it enough.

Mental health experiences among higher education students should remain a top priority, but my experience is that some higher education institutions perpetuate negative mental health for us, for example, through the type of lecturers they employ, the course content and the capitalist approach of accepting tuition fees without due consideration for student mental health.

We have to applaud some higher education institutions because they have put services in place to support student mental health, but there needs to be internal detoxification of indirect and direct stigma around mental health, to promote an anti-stigma culture. There needs to be a move from the capitalist and assignment-based culture to a system that promotes positive mental health status for higher education students. This will help create a healthy future workforce and better productivity for the country. Being a student is not all about Turnitin, certificates and graduations; it is also about dealing with stressors that trigger mental health problems.

Mental health problems among higher education students are on the rise. Look around you. We are often all that we have to speak to and confide in, but most of us do not know what we feel. We are walking away from our studies, we isolate ourselves in our rooms, we are anxious, we suffer panic attacks, and we take our own lives. In the last ten years, reports of mental health among UK higher education students have risen fivefold, the number of suicide has nearly doubled.

These are some of our class mates, our house mates and friends who have died by suicide: Justin Cheng, 2018; James Thomson, 2017; Daniel Green, 2016; Andrew Kirkman, 2013; Toby Thorn, 2011; Claire Ashing, 2008; Lisa Taylor, 2005. For them, my manifesto is too late, for some of us, it may already be too late as you read this, and for others, there is still time for the higher education institutions, the government and the policymakers to support us better.

I believe that the increasing reports of mental health problems among higher education students is a substantial public health issue that warrants far more attention than higher education authorities, the government and policymakers are willing to give. Therefore, I hope that at some point, the government, higher education institutions and policymakers will shift their focus from treatment to prevention of mental health problems through collective dialogue with higher education students.

In 2025, there will be 262 million higher education students in the world, and 1 in 4 of us currently report symptoms of mental health problems. There is good news and bad. The good news is that 262 million of us will be more aware of what we are feeling and how to seek help. The bad news is that 1 in 4 of the 262 million higher education students will experience mental health problems which may end in suicide.

My manifesto

1. Involve higher education students in the planning, implementation and evaluation of mental health care provision within higher education institutions.

2. Government to introduce policies and strategies on the mental health of higher education students with a mandatory mental health module for all students and all lecturers to receive training on how to recognise and support students with mental health problems.

3. Higher education institutions to employ a diverse workforce to support both home and international students.

This is our story, our experiences and our academic career. For some of us, like me, it has become “All the silver linings in my dark cloud”. I leave you with this quote: “In the absence of positive mental health, higher education student’s experiences are interrupted, and academic achievements may be limited”.

Josephine NwaAmaka Bardi is a qualified mental health practitioner, third year Economic and Social Research Council (ESRC) PhD student on the Mental Health and Wellbeing Pathway at the Unviersity of Nottingham, Associate Staff at the London School of Economics and Political Science and Part-Time Lecturer at the University of East London. Follow her on Twitter: @jobardi and @ramhe

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