Students’ mental health and recovery

We are tired of this sh*t! — SUS calls for students’ right to recovery

Take part in our advocacy work to strengthen students' mental health and ensure a study environment with balance, recovery and less stress.

A good study environment and health among students are a prerequisite for good learning. However, consistent studies show that students continue to feel significantly worse than working adults of the same age. One of the main problems is the opportunities for recovery, something students are systematically denied.

Here we highlight the issues surrounding recovery and present the work we are doing to create a more sustainable study time and education. Our ambition is to influence, inform and contribute to a future where student health is taken very seriously.

SUS meets experts and students

To shed light on these topics from multiple perspectives, we have spoken with both experts and students. In the interviews, they share knowledge, experiences and concrete advice that can contribute to increased understanding and support in everyday student life.

• SUS meets the Student Health Services

  Student Health Services is a resource for students that offers support and guidance regarding both mental and physical health. The activities work preventively and exist to help students feel good and manage the demands of their studies.

  SUS met Ingemar Dahlgren to talk about Student Health Services, student stress, anxiety and recovery. Read the interview below.

  What types of mental health problems do you most often encounter among students?
  Stress, worry, depression, anxiety.

  What do you see as the biggest reasons for lack of recovery among students?
  It varies. What is highlighted is the stress that you have about completing your studies and that you need to study more and more. You don't take breaks. The demands from yourself and from the teaching make you feel that you can't take breaks. We work on this quite a lot in the conversations with students, the importance of taking breaks, even though it feels like you have to study more. Especially before exams. You forget and think that it will work better if you stay up two nights in a row. It doesn't.
  
  Then there is the time between the final exam of a course and the start of a new course. Some people experience that stress. Especially if you fail an exam and need to redo it and then have to study twice, which makes it difficult to recover.

  And then we have those who work, they work a lot. That is also a group of students we meet. And they can have a hard time accepting that it (the stress) is due to studying and working. If you also have children and support requirements, it is an extra burden. Having to pick up and drop off children and make it work.

  How does the pace and structure of studies (e.g. exam on Sunday, new course on Monday, no paid study breaks) affect students' well-being?
  We do not see that this is something students bring up specifically or exclusively. We ask more about their situation. We know that some institutions schedule courses this way and I can imagine that students who study at several departments experience it more. The institutions at SU schedule their own courses and do not see the whole picture.

  The reasons are individual and are several for lack of recovery.

  We haven't seen anything in particular being said in relation to paid leave, but the way we work and think, is that students need to take breaks. And during the summer, for example, you have to work. So it's clear that we see a stress factor there.

  Taking a walk is important. A half-hour walk is enough. Many people think that they have to study that half hour, but it's important to get the rest.

  If you get a longer, continuous rest, it's obviously better.

  What role do financial stress and the need to work alongside studies play?
  It is not an unusual combination when we meet students and try to understand what their situation is like. It is a common combination that they work on weekends, for example.

  Many student who come to us work at the same time. We don't meet that many students, if you think about the total number of students, but of those we meet, many are working. We don't keep statistics on these issues, but I notice that employees highlight that many people work alongside their studies. We ask why they have to work so much during the semesters and it looks different, whether you have a family or not, live at home or not. But they want more money to be able to live a good life.

  What do you think is the biggest challenge for your work with students' mental health and recovery today?
  We do the best we can. We don't meet all students. We also know that we can't meet all students who want to meet us. Especially in the form of individual conversations (groups are no problem). I would say that there is a lack of resources, unfortunately.

  “It's not just the working methods, but we are quite few in relation to how many students there are, and since we see that bad mental health is increasing among younger people in society, the pressure on us is obviously increasing as well.

  We don't have statistics on how many we can't accept, we don't have the resources for that, but we are working to accept as many as possible.

  If you had more resources – what actions would you take and prioritize?

  • Receive more individual conversations. It is number one so that we can meet more students.

  • More dialogue with teaching staff. Working with study environment issues in study situations - the teacher-student meeting. Sometimes unnecessary stress arises because teachers do not understand, do not have time or do not listen. They are not used to meeting students who are stressed, or have disabilities and ill health in general. You are not used to that group of students and may treat them in an inappropriate way. We hear this from students who experience a certain level of vulnerability. So I would like to work more with teachers.

  • We work with 10 universities. We would like to be more visible on site at the universities, which we don't have time for. And that's something universities often bring up and ask if we can come there and do something with them, and it's quite difficult to achieve.

  If you had to give concrete suggestions to improve students' recovery - what would it be?

  • Review the scheduling in the departments and become aware that it is good to have breaks between one course and another. Going from exam directly to the next lecture is not optimal, exam on Sunday evening and starting the next course Monday morning.

  • Knowledge and absorbing knowledge. The brain is tired after two hours of studying. Not more alert after three hours. Learning when your brain works best for you. Everyone is different. Some study great in the evenings and nights, others don't and study best in the morning or early morning. But you shouldn't study for 12 hours straight.

  • Recovery is to relax and do something else, go to the cinema and meet friends, do something else. Let your brain do something else because that's when it sinks in. Sleeping well is also very important. Sleep is important for passing the exam.

  • We at Student Health Services, Academic Writing Services and Pedagogical support can help out.

  Is there anything you would like to add?
  Recovery is an important topic. Going to our workshops and groups is a good way to prevent and stop stress because that's where you learn. It's good to go to such groups before you are stressed so you don't get stressed.

• SUS meets teacher student Maya

  What are you studying and how long have you been studying?
  I am studying to become a preschool teacher and I am currently in my third semester. I will be switching to the primary teacher education programme for grades 4–6 this spring.

  Can you tell us a bit about your study situation when the problems began?
  During my first semester, I took a course with compulsory seminars. I missed two of them; you are only allowed to miss one (due to illness). This was a difficult time for my family, my grandfather fell and suffered a brain hemorrhage. I am from Finland and my family still lives there, so the distance also became an additional strain at that time.

  What did your everyday life look like – study pace, courses, any work on the side?
  At that time, I was taking the course Performance and Rhetoric. I was studying full-time (100%) and did not have a job alongside my studies.

  When did you start to feel that the stress became unmanageable?
  During my second semester. I had contacted student guidance regarding the course Performance and Rhetoric. They re-registered me for the course but did so during my teaching placement (VFU). I didn’t think much of it and trusted that they knew what they were doing. As the VFU approached, I was informed that it is not possible to retake courses during a VFU. At that point, I didn’t even know whether I would be allowed to start semester three.

  During this same period, my grandfather passed away and I had to travel to attend the funeral, which caused me to miss a compulsory component in the course I was taking at the time. Since the funeral took place in Finland, the travel time is about 16 hours one way—around 32 hours in total. It was therefore completely impossible for me to attend without travelling on a weekday. My grandmother also passed away during this time, and I had to travel to Finland again. Because of this, I missed the opportunity to retake the compulsory component I had missed and was told that there was no way to resolve it, and that I would have to retake the course the following semester, a semester I didn’t even know if I was allowed to attend.

  What were the first signs that you noticed that you were heading toward exhaustion?
  Everyday tasks like brushing my teeth or taking a shower felt almost impossible. I constantly forgot things and felt generally very scattered and overwhelmed mentally.

  How did this affect your life – both your studies and your private life?
  I felt my anxiety growing stronger and stronger. It became increasingly difficult to make myself go to campus. It felt like the study counsellor and my teacher had not taken my situation into account, or cared about me or my academic progress at all.

  How did setups like having an exam on Sunday and a new course starting on Monday affect your ability to rest?
  That has not happened to me.

  What did the lack of longer, paid leave mean for your situation?
  I was constantly stressed about money. I was looking for work and applied to over 100 jobs. Eventually, I did get a job, but it only lasted for two weeks.

  Did you seek help from student health services or other support resources? How did that work?
  I sought help from my primary healthcare centre, including seeing a psychologist. However, this did not lead anywhere. I felt extremely stressed about school, and having to miss something or reschedule something to make time for this felt impossible. I also could not afford to pay 250 SEK per visit. Student Health Services felt very difficult to approach—unsuitable opening hours, among other things. I have also had very poor experiences with student health services at other universities, which made me reluctant to go there, even though I don’t know what it is like specifically at Stockholm University.

  What kind of measures or improvements would you like to see to reduce stress and increase recovery for students so that this does not have to happen?
  I would like to see study counsellors do a better job, actually being aware of students’ situations and what will happen before providing incorrect information. I know this has happened to others and that it has affected their studies. If there are compulsory components in a course, students should be given a real opportunity to make them up. And I don’t mean the day after or even within a week, that is unreasonable. Especially if you miss something due to illness; a common cold often lasts a week.

• SUS meets professor Göran Kecklund

  Can you tell us a bit about who you are and about your research on stress and recovery?

  I am a professor at a university, at the Department of Psychology, and my name is Göran Kecklund. My research area concerns stress and recovery, with a particular focus on the importance of sleep - from a working life perspective. I have been researching these issues since the 1980s, so for almost 40 years.

  I studied and completed my PhD at Stockholm University (SU). After my dissertation, I worked at other institutions, among them the Karolinska Institute, but I have been at SU since 2007, so for almost 20 years.

  To be honest, it was largely coincidence that led me to start researching these areas. I was interested in research in general. I think you have to be a bit of a nerd to be a good researcher. If you are a good researcher, you want to take a closer look at things and really dig deep. That suited me well. I think I’ve been a bit of a nerd my whole life, and then research is a good job. That was more my driving force: the opportunity to go deep into something.
  
  What impact does lack of recovery have on mental health?

  All of us are exposed to demands in life, we experience stress. If you are a student, this can involve your studies but also your private life. Stress is unavoidable in everyday life. A life completely without stress would involve no challenges, and you would miss out on much of what makes life enjoyable. But for this to be sustainable in the long run, you need to find a balance so that you have periods of recovery between periods of stress.
  
  Recovery means winding down, relaxing, and allowing the biological stress systems to shut off.

  Sleep plays an important role in recovery. Sleeping too little or almost always having disturbed sleep makes it difficult to meet one’s need for recovery.

  If recovery is successful, you can cope with the demanding requirements of being a student. That is the significance of recovery— and it is crucial for our ability to manage stress.

  Often, I think that as a student you cannot simply go to a course coordinator and say that a course is too demanding: “I want you to adapt the course and reduce these requirements.” In order to meet course demands, there must be time for recovery. At the same time, I believe that recovery is not only about the individual and the student’s own responsibility.

  I think universities, students, and the student union as a representative of the students should join forces on these issues. Supporting students’ recovery is a typical win–win situation that can improve academic performance as well as students’ health and well-being. There are great advantages to having students with stable mental health, as this creates good conditions for learning.
  
  How does long-term stress and anxiety affect future well-being? Can it lead to long-term problems after graduation? And how does it affect society?

  Many people in working life suffer from long-term stress that, in the worst case, leads to sick leave. One can become so worn down and exhausted that one is unable to work. The same probably applies to students. Long-term stress without sufficient recovery can mean that it takes longer to complete one’s education, results in poorer academic performance, and makes it more difficult to start working after graduation. In short, one is not as well prepared for working life.

  Sick leave is something that costs society a great deal of money and resources, money that could be used for other purposes. One could imagine, for example, that student unions would like to use some of those resources to increase student financial support.

  There is much for society to gain by reducing mental ill health, such as long-term stress. On an individual level, reduced mental ill health can mean increased quality of life, feeling satisfied with life, and feeling well.

  I believe this is an important societal issue. It is a societal challenge for Sweden and for most European countries, I would say. One may wonder whether politicians prioritize this issue enough. I feel that it is somewhat underprioritized. I would like to see a collective effort and a clear decision that now we are going to do something about the imbalance between stress and recovery. It is good that you are running this campaign, but one can also ask what authorities responsible for stress, mental health, and public health are doing to prevent these problems. I think more could be done, especially for young people in society, including university and college students.

  Being able to manage demands and stress in life is largely about life skills, trying to achieve a good balance between challenges, “things that must be done,” and recovery. This knowledge involves setting boundaries and learning how demanding periods in life should be managed so that you still feel well. If demands and challenges are associated with a great deal of discomfort and negative thoughts, there is an obvious risk of experiencing stress around the clock, even during sleep. I believe that if you have a reasonable understanding of how to handle the challenges that are part of your life, you have better conditions for avoiding long-term stress.

  You could say that not sufferiring from mental ill health is good, but really I think the goal should be to feel well - to have good well-being. This goal aligns with the WHO’s definition of health, which is not about the absence of disease but about feeling that one has a meaningful life and feels well.

  How long does it take to recover if one is close to burnout or has burned out? What interventions are required?

  If you become truly exhausted, to the point where you feel unable to cope with anything, where even getting out of bed in the morning is a challenge and extremely demanding, you may go on sick leave. Stress-related sick leave due to exhaustion often involves a long recovery period before one functions normally again. I believe this is partly because healthcare has not been very successful in developing optimal and effective treatments.

  Evidence-based treatments are now beginning to emerge that may shorten stress-related sick leave and speed up recovery. I still believe that many people with stress-related diagnoses are prescribed antidepressant medication. However, much suggests that psychological treatment, where one learns to manage thoughts, emotions, and behaviors related to stress is more effective than pharmacological treatment. It should not have to take at least a year to recover from stress-related mental ill health.

  Not everyone who experiences long-term stress goes on sick leave. If early warning signs of serious stress can be identified, increased knowledge about how long-term stress can be managed may help prevent exhaustion. I imagine that students could have something like “The Little Recovery Book,” which addresses the causes of stress, how stress can be managed (for example, by prioritizing recovery), and when one needs to seek help from healthcare services.

  It is important to emphasize that short-term stress is fundamentally positive for us and an important resource in everyday life. Creating excessive worry around everyday demands and stress will not help people affected by long-term stress; on the contrary, a negative attitude toward stress may actually intensify the stress response.

  I also agree, as you write in your proposal, that student health services play an important role in supporting students who show signs of serious stress. Student health services can, for example, promote simple preventive measures such as self-help books, lectures, and short informational videos available online. At the same time, it is unrealistic to expect that serious and long-term stress can be prevented solely through information found online or in brochures, but informational campaigns may contribute to increased stress awareness and support individuals who are on the brink but still managing their daily lives.

  The “joining forces” perspective can be important in preventing student stress, and it is crucial that all parties recognize that this is a shared responsibility. Individuals affected by mental ill health, such as persistent stress reactions, have their own responsibility, motivation, and desire to recover. That said, I want to move away from the idea that stress is solely an individual’s responsibility.

  Student health services have an important role in preventing serious stress and mental ill health. In theory, student health services could gather all new students and inform them about the services and resources available, not from an alarmist “the wolf is coming” perspective, but in a more constructive way.

  How would you say that a high pace of study (e.g., an exam on Sunday and a new course starting Monday) ?

  Most courses are more demanding toward the end, especially in connection with examinations. The workload peak at the end of a course often entails stress and sometimes insufficient recovery. However, stress at the end of a course is short-term and not necessarily harmful provided there is a calmer period after the exam, a recovery break.

  Often, things are somewhat calmer at the beginning of a new course, but there are also programs with an almost constantly high pace of study. A lot of teaching can be demanding, but active participation in teaching facilitates learning. Prioritizing recovery over teaching is not a sustainable strategy in academic studies.

  Being able to schedule a recovery break when switching courses could likely reduce stress. SUS proposes 36 hours - I think one could consider two days (48 hours). In working life, there are regulations regarding weekly rest, and if academic studies are considered work, it is not unreasonable to have two days off before starting a new course. This gives students the opportunity to rest and distance themselves from their studies, instead of moving directly from exam-related anxiety into the next course. From a recovery perspective, I think it is a good proposal, but the question is whether it is realistic. There is no strong tradition in higher education of viewing studies as work with regulated working hours and recovery.

  There is also the teacher’s perspective: a great deal of content must be covered, and often a course must start immediately to meet learning objectives. Perhaps the best solution would be not to schedule exams on weekends. However, this is difficult in practice, as exams must be held in special facilities. But if an exam is held on a Saturday, it would be good if the next course did not start until Tuesday, and that exams are scheduled Monday to Friday whenever possible.

  I do not dare to say that recovery regulations are the most effective measure for reducing student stress, but for some individuals who are under great pressure, having a guaranteed right to recovery time and a pause in study work can be beneficial.

  I also believe that many students take it a bit too easy at the beginning of a new course. One way to prevent stress is to plan one’s time and avoid procrastination, menaning consciously postponing important tasks that must be done. Delaying reading course literature and not participating in mandatory activities, instead completing supplementary assignments, can disrupt the balance between stress and recovery.

  How do you view the proposal for a paid winter break, and how does working alongside studies affect students’ mental health?

  From a recovery perspective, it seems reasonable. However, there may be other obstacles that prevent free time from being used for recovery, for example, the need to work in order to make ends meet. American research shows that recovery is impaired for students who have to work a lot, especially during intensive study periods.

  That said, working during one’s studies is not necessarily only negative. Work can also be restorative, it involves doing something other than studying, which can facilitate winding down and letting go of study-related thoughts. Recovery is not only about resting and being passive; on the contrary, recovery can be facilitated by being active, for example by socializing with friends, exercising, or engaging in an enjoyable hobby. However, active recovery should not be associated with excessive demands and obligations.

  If you could advise universities and decision-makers on improvements, what should be done to improve students’ mental health?

  I think it would be wise to invest more in strengthening knowledge about recovery, both among students and teaching staff. I know that recovery is a prioritized area in preventive work environment efforts to reduce staff stress at Stockholm University. A concrete tool could be to develop a policy that defines what can be done to strengthen students’ recovery. Student unions and universities could collaborate and agree on such a policy, clearly outlining how stress-related problems can be prevented and highlighting, for example, the central role of student health services.

  I also think that the campaign you are running is good, but could other initiatives be undertaken as well, for example, developing a handbook on stress and recovery or disseminating knowledge through lectures and online resources? There is likely a need for preventive measures at all universities and colleges in Sweden, and this is something that institutions could collaborate on. It could become a way to engage and demonstrate a willingness to improve students’ study environment.

  When you are a student - and this applies all the way from primary school onward - I wish that part of education focused on how to take care of and lead oneself. As a student, you are essentially your own manager. You must lead yourself, make the right decisions, know when to invest effort and when to prioritize recovery.

  Placing all responsibility on students alone is probably neither a sustainable nor an effective solution, and I believe that new proposals and ideas are needed. It may therefore be worth considering whether regulations that support recovery could be a possible organizational measure to reduce the risk of students developing serious and long-term stress, which harms both their mental health and academic performance.
  
  Students’ study environment simply deserves more attention.
  
  

Read our joint article with Stockholms studentkårers centralorganisation (SCCO) on the importance of students’ right to rest and recovery.

Find the article HERE.