How do setting-level changes in universities affect mental health and wellbeing? A systematic mixed studies review
Xuan Luu, Christa Keilar, Lorraine Paras, Meredith Tavener, Erica L. James, Natalie Johnson
Abstract
Mental ill health is persistent and pervasive in universities, with calls for setting-level change to improve mental health and wellbeing. However, rather than addressing setting-level factors, most research evaluates individual-level change, and most previous reviews privilege quantitative studies. Research on setting-level change remains limited and under-synthesised. This review addressed three questions: (i) what are the domains of setting-level change evaluated for mental health impacts in universities? (ii) what are the quantified effects of setting-level changes in universities upon student and staff mental health and wellbeing? and (ii) what are the perspectives of students and staff with respect to setting-level changes in universities? A systematic mixed studies review was conducted. APA PsycINFO, MEDLINE via Ovid, and Web of Science were searched twice – on 19 December 2022 and 20 January 2023 – with 3,643 records returned. Peer-reviewed journal articles reporting qualitative, quantitative, and mixed-methods studies on mental health outcomes, perspectives, and experiences arising from setting-level changes in universities were included. Included studies were critically appraised using the Mixed Methods Appraisal Tool. Sixteen studies, reported in 18 articles, were included. All studies evaluated setting-level changes in relation to students’ mental health and wellbeing; none focused on staff. Two domains of setting-level change were identified: (i) learning and teaching, and (ii) student-focused policy. Studies varied in design and methodological quality. Most setting-level changes modify how students are taught. Further research should prioritise impacts upon staff, employ rigorous study designs, and include comprehensive review of the grey literature.