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Volume 12, Issue 2 (2024)
Health Educ Health Promot 2024, 12(2): 215-223 |
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Received: 2024/01/31 | Accepted: 2024/04/4 | Published: 2024/05/21
Received: 2024/01/31 | Accepted: 2024/04/4 | Published: 2024/05/21
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Wahyuni E, Mangestuti R, Rahayu I, Aziz R, Muhid A. Enhancing Mental Health Literacy in University; Interactions between Student Initiatives and Counselor Strategies. Health Educ Health Promot 2024; 12 (2) :215-223
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1- Department of Islamic Education, Faculty of Tarbiyah and Teaching Training, Maulana Malik Ibrahim Islamic State University Malang, Kota Malang, Indonesia
2- Department of Psychology, Faculty of Psychology, Maulana Malik Ibrahim Islamic State University Malang, Kota Malang, Indonesia
3- Department of Psychology, Faculty of Psychology, Sunan Ampel State Islamic University, Surabaya, Indonesia
2- Department of Psychology, Faculty of Psychology, Maulana Malik Ibrahim Islamic State University Malang, Kota Malang, Indonesia
3- Department of Psychology, Faculty of Psychology, Sunan Ampel State Islamic University, Surabaya, Indonesia
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Introduction
The low level of mental health literacy among college students raises significant concerns about the well-being of young individuals. The main factors contributing to this low literacy level are believed to be stigma, limited access to resources, and inadequate understanding of symptoms associated with mental health issues [1, 2]. Furthermore, insufficient literacy skills can lead to the disregard of counselors’ and students’ perspectives in efforts to enhance mental health literacy [3, 4]. The World Health Organization (WHO) surveyed 19 universities in eight countries, revealing that 31% of students were diagnosed with mental disorders, and 35% reported thoughts, plans, or attempts of suicide [5]. A recent study indicated that approximately 20% of students in Southeast Asia experience anxiety, stress, and depression, and show increased suicide rates [6]. The incidence of student suicides in Indonesia is increasing, with at least five reported cases in 2023 [7, 8]. Inadequate knowledge about mental health among students may have led to missed opportunities to prevent severe depression and suicide cases [9, 10]. Therefore, the primary barriers that need to be addressed are the stigma and misconceptions surrounding the responsibilities of counselors, as well as the lack of collaboration in developing mental health education initiatives.
A review of previous studies reveals three trends in students’ mental health literacy. The first area of investigation involves examining various student literacy profiles and their efforts to seek help for mental health issues [11, 12]. Meanwhile, recent scholars have focused on evaluating the effectiveness of different counseling approaches and interventions as remedial actions to enhance students’ mental health literacy [9, 13, 14]. Additionally, another research focus has been on developing reliable tools to assess students’ mental health literacy, aiming to gauge their knowledge and skills related to mental health [15-17]. These three research trends indicate that the interactions between students’ initiatives and counselors’ strategies have not been extensively explored in the context of student mental health literacy.
The foundation of this research lies in the belief that the interaction between student initiative and counselor strategies plays a crucial role in effectively enhancing student mental health literacy. Students who proactively seek to comprehend mental health are inclined to enhance their mental health literacy with the support and guidance of counselors. Moreover, counselor strategies that are targeted and flexible to meet students’ mental health literacy requirements will have a positive influence on students’ understanding and abilities related to mental health, thereby instilling confidence in managing their mental health issues. Hence, the selected methodology will examine this premise and address the research objectives.
This study aimed to address the gap in previous research, which has not thoroughly examined the relationship between student initiatives and counselor strategies to enhance student mental health literacy in higher education settings. Aligned with this objective, three specific goals, including identifying how student initiatives enhance mental health literacy, identifying counselor strategies to improve student mental health literacy, and establishing patterns of interaction between student initiatives and counselor strategies to enhance student mental health literacy were outlined. These three specified objectives are anticipated to offer a comprehensive insight into how students engage in seeking, acquiring, and utilizing mental health resources, as well as how counselor strategies can cater to students’ mental health literacy requirements.
Participants and Methods
Settings and design
This qualitative exploratory research was carried out on students and counselors at the three leading Islamic state universities in Indonesia, which fall under the jurisdiction of the Indonesian Ministry of Religious Affairs in 2023. All three universities have a team of counselors who offer guidance and counseling services to their students. Interviews conducted with counselors at these universities revealed that the advancement of mental health literacy is not optimal due to various barriers and challenges, including policy, resource, and stigma-related issues. It is worth noting that despite the less-than-optimal conditions for enhancing mental health literacy, there are students enrolled at these universities who have taken steps to enhance mental health literacy within the academic setting. This intriguing observation has piqued the researchers’ interest in exploring the relationship between students’ initiatives and counselors’ strategies for improving students’ mental health literacy.
The qualitative exploratory research design was used to delve deeply into the experiential phenomena of research participants, aiming to achieve a comprehensive understanding of the subject under study. Additionally, qualitative research design allows for a limited number of participants, as the emphasis is on the depth of the collected information or data. Therefore, the qualitative research design was in line with our research objectives of thoroughly examining efforts to improve mental health literacy in universities, with a specific focus on the perspectives of students and counselors, while utilizing a constrained sample size selected by purposive sampling.
Participants
The participants were students (coded as I-S) and counselors (coded as I-C) from the three designated universities selected by a purposive sampling technique based on inclusion criteria, including active involvement in mental health activities, experience with counseling services, understanding of mental health development in higher education, and willingness to share experiences and concerns regarding mental health in higher education. Eight students took part in the study, consisting of six undergraduate students and two graduate students. Additionally, six of the participants were professional counselors who also held teaching positions. This dual role enabled them to promote mental health literacy among students. Purposive sampling was employed to ensure that the collected data aligned with the research objectives.
Data collection
The data were collected through interviews, observations, and documentation techniques. By utilizing open interview methods, the researchers delved deeply into the perspectives and personal experiences of respondents regarding mental health literacy. Interviews were conducted using WhatsApp voice notes, chats, and calls. Examples of open-ended questions posed to student respondents during the interviews included: “Have you ever encountered mental health issues? If yes, could you elaborate on that experience?”; “What motivates you to show concern for the psychological challenges faced by others?”; “How do you actively engage in mental health awareness activities or communities on campus?”; “Can you describe how campus counselors respond to mental health initiatives and discuss the factors that facilitate or hinder their response?” Additionally, counselors were asked questions such as “How do you utilize techniques to enhance students’ comprehension of mental health?” and “What strategies do you employ to support and empower students in becoming advocates for promoting mental health awareness?” The researchers also conducted observations to gather data on the activities of both students and counselors. Observations were carried out through direct and indirect means using video recording technology. The collected documents included photos, electronic files, videos, social media posts, and website content. These three techniques were used interchangeably to triangulate the data.
Data analysis
The qualitative data analysis was carried out in four structured steps. Initially, data from interviews, observations, and documentation were meticulously reviewed, and specific thematic patterns were identified, distinguishing between elements of student literacy initiation and counselor strategies for fostering mental health awareness. Subsequently, a thorough analysis was conducted to pinpoint nuances and key concepts that surfaced from the respondents’ accounts. Then, major themes were systematically arranged to investigate relationships and patterns of interaction. Lastly, by employing convergence and divergence approaches, student and counselor viewpoints were scrutinized to gain a deeper insight into how interactions between student initiation and counselor strategies influence each other in enhancing mental health literacy on campus. These two methodologies offer a more comprehensive and profound perspective on the phenomenon being studied. These four steps of data analysis contribute to a comprehensive understanding of the factors influencing student mental health literacy and facilitate the formulation of more effective intervention recommendations.
Findings
The study included students and counsellors at the three leading Islamic state universities in Indonesia (Tables 1 and 2).
Table 1. Demographic characteristics of counselors
![src=./files/hehp/images/HTML_Publish/73661/t1.png]()
Table 2. Demographic characteristics of students
![src=./files/hehp/images/HTML_Publish/73661/t2.png]()
The gathered data were analyzed and categorized into three sub-themes, including student initiatives, counselor strategies, and the correlation between counselor strategies and student initiatives in enhancing mental health literacy.
Students initiating to development of mental health literacy
In the context of mental health literacy, student initiation involves the active engagement of students in initiating or participating in activities to enhance their understanding, knowledge, and skills related to mental health. This study categorized student initiation into three groups: self-initiated, peer-initiated, and collaborative-initiated (Table 3).
Table 3. Student initiation to enhance mental health literacy
![src=./files/hehp/images/HTML_Publish/73661/t3.png]()
The first category, self-initiated, refers to students’ independent efforts to gain knowledge about mental health. All student participants mentioned that their awareness of self-initiation stemmed from the mental health difficulties they encountered. Their personal struggles with mental health concerns inspired them to seek comprehensive information about their issues and effective coping strategies. For instance, I-S1 shared her experiences with mental health challenges and how she sought information to manage them.
“...I once experienced depression that made me unhappy, insecure, and uncomfortable interacting with others. My academic performance was low and my physical condition was unhealthy. Fortunately, I had the spirit to overcome these psychological problems by reading books on stress management, consulting campus counselors, and engaging in activities that produced immediate results...” (I-S1)
Aligned with I-S1, I-S4 also encountered a lack of self-confidence that resulted in feelings of inadequacy, social discomfort, and negative self-talk. These emotions led to isolation and discontent. Seeking assistance from her academic advisor and faculty counselor, she actively gathered information to address these challenges and observed her peers grappling with mental health issues. Through this journey, I-S4 enhanced her self-awareness and acquired skills to manage mental health concerns. In essence, students’ self-initiation can evolve from their encounters with mental health difficulties.
Peer initiation represented another form of student engagement in sharing mental health knowledge with others (Table 3). In practice, peer initiation manifests in various ways, including a willingness to exchange information, openness about mental health struggles, accompanying friends to seek guidance from counselors, and participating in student mental health advocacy groups. I-S3, one of the student participants, said:
“…having mental health issues experience has made me more empathetic towards friends who are going through similar struggles. I am willing to provide listening, offer support during tough times, and assist in finding resources such as on-campus counseling services…” (I-S3)
The study revealed that student peer initiatives can be actualized through the utilization of digital media as a platform for information and education to enhance student mental health literacy and peer counseling. The third form of collaboration-initiation referred to students’ proactive engagement in enhancing their comprehension of mental health through collaboration with campus counselors and mental health organizations off-campus, as articulated by one of the participants, I-S5:
In fact, joining a mental health community will not only increase our understanding of mental health but also network with other activists who are concerned with improving mental health literacy on campus.
Webinar activities conducted in partnership with college counselors and mental health training sessions were among the various forms of student-initiated collaboration.
Consequently, student self-initiation served as the catalyst for the emergence of peer-initiated and collaborative-initiated actions. Student self-initiation had a significant impact on enhancing the mental health literacy of individual participants, their peers, and stakeholders involved in mental health advancement.
Strategies by counselors to enhance students’ mental health literacy
Counselor strategies aimed at enhancing students’ mental health literacy involve counselors’ endeavors to boost students’ comprehension, awareness, and skills concerning their mental well-being and that of those in their surroundings. The study identified at least three types of counselor strategies for improving students’ mental health literacy (Table 4).
Table 4. Counselors’ strategies to improve student mental health literacy
![src=./files/hehp/images/HTML_Publish/73661/t4.png]()
One counselor strategy involves providing information and education on mental health, symptoms of mental disorders, and methods to address them. This approach is executed through various channels, including informal classroom discussions, counselor-led lectures during new student orientation programs, seminars, counseling sessions, and awareness campaigns. Insights from interviews with multiple advisors (I-C1, I-C3, and I-C6) validated that they imparted mental health information and education to students through lectures, seminars, and orientation sessions for new students. As per the participants, these strategies had both preventive and remedial impacts on students’ mental health issues.
Table 4 outlines counseling and mentoring as remedial strategies to assist students in comprehending their issues and cultivating practical skills for managing mental health. Counseling services have proven effective in enhancing students’ mental health awareness and skills, as indicated by the findings from interviews with counselor participants. For instance, one informant (I-C5) stated:
...consultation and counseling services both individual and group are very effective to provide education on understanding and self-awareness of problems and effective problem solving to overcome them... (I-C5)
In addition to counseling, counselors employ mentoring strategies following the conclusion of the counseling process. According to informants (I-C4), the mentoring approach efficiently monitored post-counseling progress and encouraged students to sustain mental well-being while reducing stigma.
The collaborative strategy represents the third approach, involving efforts to boost students’ mental health literacy through collaboration with various stakeholders, including the students themselves. Interviews with counselor informants (I-C4, I-C7, and I-C8) unveiled that engaging in collaboration with students enabled counselors to effectively reach a broader student audience, thereby enhancing their mental health literacy. Collaborating with students also addressed constraints encountered by counseling center staff.
“…collaborating with students is beneficial in addressing the shortage of counselors for improving mental health education. Students who are interested in becoming mental health volunteers will receive training as peer counselors...” (I-C6)
By integrating all three strategies, counselors can establish a comprehensive approach to aid students in overcoming challenges and laying a robust foundation for academic and personal success.
Interacting student initiation and counseling strategies
Within the realm of mental health literacy at universities, the dynamic interplay between student initiative and counselor strategies creates a reciprocal relationship that influences each other. Students serve as the recipients, while counselors act as knowledgeable professionals in the mental health field. This study identified three types of connections (educational, collaborative, and empowering) (Figure 1).
![src=./files/hehp/images/HTML_Publish/73661/f1.png]()
Figure 1. Interaction of student initiation and counselor strategies
The primary interaction observed was the educational interaction, which entailed educating, understanding, and raising awareness about mental health (indicated by red arrow lines). This educational interaction occurred when counselors utilized strategies to educate students on mental health issues. The counselor’s strategies were tailored to meet students’ requirements for acquiring comprehensive mental health knowledge and information. This educational interaction took place during counseling and mentoring sessions, activities within lecture classes, training sessions, and seminars. An informant (I-C5) emphasized the need for continuous efforts to enhance mental health literacy in students through diverse methods, ranging from providing information and counseling sessions to training and seminars.
…My counselor motivated me to learn from different sources and attend seminars, and self-development trainings to gain insight into mental health. It's made me want to help my friends who are having mental health problems... (I-S1)
The second interaction, collaborative interaction, denotes the partnership between students and counselors in enhancing mental health literacy within the campus environment (illustrated by a green dotted line in Figure 1). This interaction was cultivated through activities such as organizing seminars, and training sessions, offering support, peer counseling, and mentoring. Collaborative interaction can establish an atmosphere where both parties play pivotal roles in cultivating a mental health-friendly climate on campus. As per counselor informants (I-C2, I-C5, and I-C6), collaborating with students addressed the challenge of limited counselor resources for implementing mental health service programs on campus. Concurrently, insights from student informants (I-S4, I-S5, I-S7, and I-S8) indicated that the collaboration between students and counselors in mental health initiatives positively impacted the enhancement of their knowledge and awareness of mental health. Active engagement in such endeavors can provide avenues for learning and mutual support, fostering an environment that nurtures a deeper comprehension of mental health among students.
Thirdly, the empowerment interaction represented a mutually empowering dynamic between students and counselors in enhancing mental health literacy. Figure 5 illustrates a blue dotted line surrounding the interaction of student initiative and counselor strategy. One counselor (I-C3) emphasized that all strategies employed by counselors to enhance mental health on campus aimed at empowering students to act as literacy advocates for themselves and their peers. Findings from interviews with counselor informants indicated that all types of strategies utilized by counselors had a significant impact on fostering feelings of empowerment to enhance mental health literacy on campus.
…We appreciate students' experiences and involvement in mental health literacy on campus. We position students as agents of mental health literacy for themselves and other students. We have different ways to help them deal with mental health issues…” (I-C3)
“I feel better when I help my friends with their mental problems. My knowledge grows when I do mental health activities. Especially when the counselor allows me to be a peer counselor for other students... (I-S5)
Accordingly, any student-initiated interaction with counselor strategies, whether educational or collaborative, leads to mutually empowering exchanges. These interactions instill confidence, inspire positive transformations, and bolster mental well-being in st
The low level of mental health literacy among college students raises significant concerns about the well-being of young individuals. The main factors contributing to this low literacy level are believed to be stigma, limited access to resources, and inadequate understanding of symptoms associated with mental health issues [1, 2]. Furthermore, insufficient literacy skills can lead to the disregard of counselors’ and students’ perspectives in efforts to enhance mental health literacy [3, 4]. The World Health Organization (WHO) surveyed 19 universities in eight countries, revealing that 31% of students were diagnosed with mental disorders, and 35% reported thoughts, plans, or attempts of suicide [5]. A recent study indicated that approximately 20% of students in Southeast Asia experience anxiety, stress, and depression, and show increased suicide rates [6]. The incidence of student suicides in Indonesia is increasing, with at least five reported cases in 2023 [7, 8]. Inadequate knowledge about mental health among students may have led to missed opportunities to prevent severe depression and suicide cases [9, 10]. Therefore, the primary barriers that need to be addressed are the stigma and misconceptions surrounding the responsibilities of counselors, as well as the lack of collaboration in developing mental health education initiatives.
A review of previous studies reveals three trends in students’ mental health literacy. The first area of investigation involves examining various student literacy profiles and their efforts to seek help for mental health issues [11, 12]. Meanwhile, recent scholars have focused on evaluating the effectiveness of different counseling approaches and interventions as remedial actions to enhance students’ mental health literacy [9, 13, 14]. Additionally, another research focus has been on developing reliable tools to assess students’ mental health literacy, aiming to gauge their knowledge and skills related to mental health [15-17]. These three research trends indicate that the interactions between students’ initiatives and counselors’ strategies have not been extensively explored in the context of student mental health literacy.
The foundation of this research lies in the belief that the interaction between student initiative and counselor strategies plays a crucial role in effectively enhancing student mental health literacy. Students who proactively seek to comprehend mental health are inclined to enhance their mental health literacy with the support and guidance of counselors. Moreover, counselor strategies that are targeted and flexible to meet students’ mental health literacy requirements will have a positive influence on students’ understanding and abilities related to mental health, thereby instilling confidence in managing their mental health issues. Hence, the selected methodology will examine this premise and address the research objectives.
This study aimed to address the gap in previous research, which has not thoroughly examined the relationship between student initiatives and counselor strategies to enhance student mental health literacy in higher education settings. Aligned with this objective, three specific goals, including identifying how student initiatives enhance mental health literacy, identifying counselor strategies to improve student mental health literacy, and establishing patterns of interaction between student initiatives and counselor strategies to enhance student mental health literacy were outlined. These three specified objectives are anticipated to offer a comprehensive insight into how students engage in seeking, acquiring, and utilizing mental health resources, as well as how counselor strategies can cater to students’ mental health literacy requirements.
Participants and Methods
Settings and design
This qualitative exploratory research was carried out on students and counselors at the three leading Islamic state universities in Indonesia, which fall under the jurisdiction of the Indonesian Ministry of Religious Affairs in 2023. All three universities have a team of counselors who offer guidance and counseling services to their students. Interviews conducted with counselors at these universities revealed that the advancement of mental health literacy is not optimal due to various barriers and challenges, including policy, resource, and stigma-related issues. It is worth noting that despite the less-than-optimal conditions for enhancing mental health literacy, there are students enrolled at these universities who have taken steps to enhance mental health literacy within the academic setting. This intriguing observation has piqued the researchers’ interest in exploring the relationship between students’ initiatives and counselors’ strategies for improving students’ mental health literacy.
The qualitative exploratory research design was used to delve deeply into the experiential phenomena of research participants, aiming to achieve a comprehensive understanding of the subject under study. Additionally, qualitative research design allows for a limited number of participants, as the emphasis is on the depth of the collected information or data. Therefore, the qualitative research design was in line with our research objectives of thoroughly examining efforts to improve mental health literacy in universities, with a specific focus on the perspectives of students and counselors, while utilizing a constrained sample size selected by purposive sampling.
Participants
The participants were students (coded as I-S) and counselors (coded as I-C) from the three designated universities selected by a purposive sampling technique based on inclusion criteria, including active involvement in mental health activities, experience with counseling services, understanding of mental health development in higher education, and willingness to share experiences and concerns regarding mental health in higher education. Eight students took part in the study, consisting of six undergraduate students and two graduate students. Additionally, six of the participants were professional counselors who also held teaching positions. This dual role enabled them to promote mental health literacy among students. Purposive sampling was employed to ensure that the collected data aligned with the research objectives.
Data collection
The data were collected through interviews, observations, and documentation techniques. By utilizing open interview methods, the researchers delved deeply into the perspectives and personal experiences of respondents regarding mental health literacy. Interviews were conducted using WhatsApp voice notes, chats, and calls. Examples of open-ended questions posed to student respondents during the interviews included: “Have you ever encountered mental health issues? If yes, could you elaborate on that experience?”; “What motivates you to show concern for the psychological challenges faced by others?”; “How do you actively engage in mental health awareness activities or communities on campus?”; “Can you describe how campus counselors respond to mental health initiatives and discuss the factors that facilitate or hinder their response?” Additionally, counselors were asked questions such as “How do you utilize techniques to enhance students’ comprehension of mental health?” and “What strategies do you employ to support and empower students in becoming advocates for promoting mental health awareness?” The researchers also conducted observations to gather data on the activities of both students and counselors. Observations were carried out through direct and indirect means using video recording technology. The collected documents included photos, electronic files, videos, social media posts, and website content. These three techniques were used interchangeably to triangulate the data.
Data analysis
The qualitative data analysis was carried out in four structured steps. Initially, data from interviews, observations, and documentation were meticulously reviewed, and specific thematic patterns were identified, distinguishing between elements of student literacy initiation and counselor strategies for fostering mental health awareness. Subsequently, a thorough analysis was conducted to pinpoint nuances and key concepts that surfaced from the respondents’ accounts. Then, major themes were systematically arranged to investigate relationships and patterns of interaction. Lastly, by employing convergence and divergence approaches, student and counselor viewpoints were scrutinized to gain a deeper insight into how interactions between student initiation and counselor strategies influence each other in enhancing mental health literacy on campus. These two methodologies offer a more comprehensive and profound perspective on the phenomenon being studied. These four steps of data analysis contribute to a comprehensive understanding of the factors influencing student mental health literacy and facilitate the formulation of more effective intervention recommendations.
Findings
The study included students and counsellors at the three leading Islamic state universities in Indonesia (Tables 1 and 2).
Table 1. Demographic characteristics of counselors
Table 2. Demographic characteristics of students
The gathered data were analyzed and categorized into three sub-themes, including student initiatives, counselor strategies, and the correlation between counselor strategies and student initiatives in enhancing mental health literacy.
Students initiating to development of mental health literacy
In the context of mental health literacy, student initiation involves the active engagement of students in initiating or participating in activities to enhance their understanding, knowledge, and skills related to mental health. This study categorized student initiation into three groups: self-initiated, peer-initiated, and collaborative-initiated (Table 3).
Table 3. Student initiation to enhance mental health literacy
The first category, self-initiated, refers to students’ independent efforts to gain knowledge about mental health. All student participants mentioned that their awareness of self-initiation stemmed from the mental health difficulties they encountered. Their personal struggles with mental health concerns inspired them to seek comprehensive information about their issues and effective coping strategies. For instance, I-S1 shared her experiences with mental health challenges and how she sought information to manage them.
“...I once experienced depression that made me unhappy, insecure, and uncomfortable interacting with others. My academic performance was low and my physical condition was unhealthy. Fortunately, I had the spirit to overcome these psychological problems by reading books on stress management, consulting campus counselors, and engaging in activities that produced immediate results...” (I-S1)
Aligned with I-S1, I-S4 also encountered a lack of self-confidence that resulted in feelings of inadequacy, social discomfort, and negative self-talk. These emotions led to isolation and discontent. Seeking assistance from her academic advisor and faculty counselor, she actively gathered information to address these challenges and observed her peers grappling with mental health issues. Through this journey, I-S4 enhanced her self-awareness and acquired skills to manage mental health concerns. In essence, students’ self-initiation can evolve from their encounters with mental health difficulties.
Peer initiation represented another form of student engagement in sharing mental health knowledge with others (Table 3). In practice, peer initiation manifests in various ways, including a willingness to exchange information, openness about mental health struggles, accompanying friends to seek guidance from counselors, and participating in student mental health advocacy groups. I-S3, one of the student participants, said:
“…having mental health issues experience has made me more empathetic towards friends who are going through similar struggles. I am willing to provide listening, offer support during tough times, and assist in finding resources such as on-campus counseling services…” (I-S3)
The study revealed that student peer initiatives can be actualized through the utilization of digital media as a platform for information and education to enhance student mental health literacy and peer counseling. The third form of collaboration-initiation referred to students’ proactive engagement in enhancing their comprehension of mental health through collaboration with campus counselors and mental health organizations off-campus, as articulated by one of the participants, I-S5:
In fact, joining a mental health community will not only increase our understanding of mental health but also network with other activists who are concerned with improving mental health literacy on campus.
Webinar activities conducted in partnership with college counselors and mental health training sessions were among the various forms of student-initiated collaboration.
Consequently, student self-initiation served as the catalyst for the emergence of peer-initiated and collaborative-initiated actions. Student self-initiation had a significant impact on enhancing the mental health literacy of individual participants, their peers, and stakeholders involved in mental health advancement.
Strategies by counselors to enhance students’ mental health literacy
Counselor strategies aimed at enhancing students’ mental health literacy involve counselors’ endeavors to boost students’ comprehension, awareness, and skills concerning their mental well-being and that of those in their surroundings. The study identified at least three types of counselor strategies for improving students’ mental health literacy (Table 4).
Table 4. Counselors’ strategies to improve student mental health literacy
One counselor strategy involves providing information and education on mental health, symptoms of mental disorders, and methods to address them. This approach is executed through various channels, including informal classroom discussions, counselor-led lectures during new student orientation programs, seminars, counseling sessions, and awareness campaigns. Insights from interviews with multiple advisors (I-C1, I-C3, and I-C6) validated that they imparted mental health information and education to students through lectures, seminars, and orientation sessions for new students. As per the participants, these strategies had both preventive and remedial impacts on students’ mental health issues.
Table 4 outlines counseling and mentoring as remedial strategies to assist students in comprehending their issues and cultivating practical skills for managing mental health. Counseling services have proven effective in enhancing students’ mental health awareness and skills, as indicated by the findings from interviews with counselor participants. For instance, one informant (I-C5) stated:
...consultation and counseling services both individual and group are very effective to provide education on understanding and self-awareness of problems and effective problem solving to overcome them... (I-C5)
In addition to counseling, counselors employ mentoring strategies following the conclusion of the counseling process. According to informants (I-C4), the mentoring approach efficiently monitored post-counseling progress and encouraged students to sustain mental well-being while reducing stigma.
The collaborative strategy represents the third approach, involving efforts to boost students’ mental health literacy through collaboration with various stakeholders, including the students themselves. Interviews with counselor informants (I-C4, I-C7, and I-C8) unveiled that engaging in collaboration with students enabled counselors to effectively reach a broader student audience, thereby enhancing their mental health literacy. Collaborating with students also addressed constraints encountered by counseling center staff.
“…collaborating with students is beneficial in addressing the shortage of counselors for improving mental health education. Students who are interested in becoming mental health volunteers will receive training as peer counselors...” (I-C6)
By integrating all three strategies, counselors can establish a comprehensive approach to aid students in overcoming challenges and laying a robust foundation for academic and personal success.
Interacting student initiation and counseling strategies
Within the realm of mental health literacy at universities, the dynamic interplay between student initiative and counselor strategies creates a reciprocal relationship that influences each other. Students serve as the recipients, while counselors act as knowledgeable professionals in the mental health field. This study identified three types of connections (educational, collaborative, and empowering) (Figure 1).
Figure 1. Interaction of student initiation and counselor strategies
The primary interaction observed was the educational interaction, which entailed educating, understanding, and raising awareness about mental health (indicated by red arrow lines). This educational interaction occurred when counselors utilized strategies to educate students on mental health issues. The counselor’s strategies were tailored to meet students’ requirements for acquiring comprehensive mental health knowledge and information. This educational interaction took place during counseling and mentoring sessions, activities within lecture classes, training sessions, and seminars. An informant (I-C5) emphasized the need for continuous efforts to enhance mental health literacy in students through diverse methods, ranging from providing information and counseling sessions to training and seminars.
…My counselor motivated me to learn from different sources and attend seminars, and self-development trainings to gain insight into mental health. It's made me want to help my friends who are having mental health problems... (I-S1)
The second interaction, collaborative interaction, denotes the partnership between students and counselors in enhancing mental health literacy within the campus environment (illustrated by a green dotted line in Figure 1). This interaction was cultivated through activities such as organizing seminars, and training sessions, offering support, peer counseling, and mentoring. Collaborative interaction can establish an atmosphere where both parties play pivotal roles in cultivating a mental health-friendly climate on campus. As per counselor informants (I-C2, I-C5, and I-C6), collaborating with students addressed the challenge of limited counselor resources for implementing mental health service programs on campus. Concurrently, insights from student informants (I-S4, I-S5, I-S7, and I-S8) indicated that the collaboration between students and counselors in mental health initiatives positively impacted the enhancement of their knowledge and awareness of mental health. Active engagement in such endeavors can provide avenues for learning and mutual support, fostering an environment that nurtures a deeper comprehension of mental health among students.
Thirdly, the empowerment interaction represented a mutually empowering dynamic between students and counselors in enhancing mental health literacy. Figure 5 illustrates a blue dotted line surrounding the interaction of student initiative and counselor strategy. One counselor (I-C3) emphasized that all strategies employed by counselors to enhance mental health on campus aimed at empowering students to act as literacy advocates for themselves and their peers. Findings from interviews with counselor informants indicated that all types of strategies utilized by counselors had a significant impact on fostering feelings of empowerment to enhance mental health literacy on campus.
…We appreciate students' experiences and involvement in mental health literacy on campus. We position students as agents of mental health literacy for themselves and other students. We have different ways to help them deal with mental health issues…” (I-C3)
“I feel better when I help my friends with their mental problems. My knowledge grows when I do mental health activities. Especially when the counselor allows me to be a peer counselor for other students... (I-S5)
Accordingly, any student-initiated interaction with counselor strategies, whether educational or collaborative, leads to mutually empowering exchanges. These interactions instill confidence, inspire positive transformations, and bolster mental well-being in st