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Mindfulness

Fostering Better Student Mental Health Through Mindfulness

Mindfulness-based interventions may help students deal with stress and anxiety.

feelgoodjunkie/Pixabay
Source: feelgoodjunkie/Pixabay

Mental health is top of mind for many of us as we enter the spring semester. A November 2020 survey by the American Council on Education revealed that college presidents are more worried about the mental health of their students than even their college’s enrollment numbers and financial viability. Specifically, 68 percent of presidents cited students’ mental health as one of their top five concerns, up 15 points from the same survey conducted in September 2020.

Their concerns are warranted: According to an October 2020 report by The Jed Foundation, 63 percent of students say their mental health is worse since the start of the pandemic, and 56 percent report difficulty caring for their own mental health. Moreover, four out of five students reported challenges with anxiety in the past month, and two-thirds reported trouble concentrating and challenges with depression.

A popular and well-researched approach to easing anxiety and increasing wellbeing is mindfulness-based interventions. Mindfulness entails “the deliberate awareness of moment-to-moment experience with an attitude of acceptance and non-judgment” (de Vibe et al., 2018, p.2), and is typically developed via guided meditations like mindful breathing and body scans. Mindfulness-based interventions, which leverage mindfulness practices to achieve specific mental, physical, or occupational health outcomes, have been shown to improve psychological symptoms (e.g., anxiety, depression) and curb maladaptive behaviors (e.g., binge eating, substance abuse) across a variety of populations and ages. Could these interventions be a tool for colleges concerned about the mental health of their students?

Testing Mindfulness with College Students

Several recent studies offer support for the use of mindfulness-based interventions with college students. For example, 30 undergraduates were enrolled in a first-year seminar that incorporated eight weeks of mindfulness training led by a certified instructor. Compared to 32 control students enrolled in intro psychology, students who experienced mindfulness training showed better first-year adjustment across academic, social, emotional, and attachment domains, and lower levels of salivary cortisol, indicating lower overall stress. A similar intervention, randomly assigned to over 300 students at the University of Cambridge (UK), produced a significant decrease in distress and an increase in wellbeing compared to control students. In fact, only a third of students who received mindfulness training reported clinical levels of distress, compared to over half of students in the control group.

Mindfulness can also benefit graduate students. 144 Norwegians studying either medicine or clinical psychology were randomly assigned to receive mindfulness training, which consisted of seven weekly, 90-min. sessions, with up to 30 min. per week of home practice and a full day of mindfulness practice at the end. Booster sessions were offered once per term for several years. Compared to control students, those who participated in mindfulness training showed greater increases in problem-focused coping over six years, which predicted a commensurate decrease in avoidance-focused coping, and improved wellbeing.

Mindfulness Training in Students’ Pockets?

Although the mindfulness-based interventions described above sound promising, they can be tricky to implement. Many of these interventions involved scheduled sessions and a hefty time commitment (e.g., 15 hours in the Norwegian study), which are incompatible with many students’ busy lives. Participation was, in fact, an issue in these studies. In the UK study, for example, almost half of the students attended fewer than 50 percent of the trainings and 18 percent quit the program—some without attending a single session.

In addition, certified professionals delivered several of these trainings, further limiting flexibility and driving up costs. One potential solution is to teach mindfulness via mobile technology, which provides greater flexibility, accessibility, anonymity, and standardization of training. Leveraging technology is especially important for those of us still constrained to online classes and interactions. Could app-based mindfulness training work for college students?

The answer is cloudy. In one study, 33 Arizona State students received three months of free access to the mindfulness app Calm. Compared to a no-intervention control group, these students reported significantly lower levels of stress and higher levels of self-compassion at the end of the trial. However, students’ app use was tracked, and those falling short of 30 min./week of meditation were texted reminders. Moreover, students were paid to complete surveys as part of the study, which may have boosted compliance. The average student meditated >30 min./week, with a fifth of students exceeding 1 hr./week. But that level of participation required a heavy-handed approach that is not scalable outside of a research setting.

Two studies of a similar app, Headspace, purposefully did not compel students’ compliance so they could understand the impact of app-based mindfulness training under more natural conditions. The first, which compared a mindfulness-based intervention to quiet breathing exercises (both delivered via Headspace), found no significant differences in students’ critical thinking skills, open-minded thinking, executive functioning, positive and negative affect, or wellbeing. Still, only half of students completed 50 percent of the assigned meditations, with a third never participating at all.

In a comparable study conducted with first-year students at the University of Otago (NZ), only two-thirds of students even accessed the app, and average use over their first semester was twice per month. Only when researchers looked at moderate users (defined as more than eight uses over three months) did they see significantly lower distress and better adjustment.

Implementing Mindfulness-Based Interventions on Campus

Overall, evidence suggests that mindfulness may help students cope with stress, anxiety, and depression. Implementing the best mindfulness-based intervention for your students, however, is where the challenge lies. Like most student supports, the number one barrier is uptake, so consider how to encourage (but not coerce) students to participate.

Finding ways to norm these activities through modeling or student testimonials may reduce stigma or skepticism around mindfulness-based practices. Some researchers had success incorporating mindfulness training into courses, which reduces the burden on students but does take away time from learning other subjects. Access to readings, recordings, websites, and apps may be a viable alternative for students who cannot fit regular mindfulness training into their schedules, but active, sustained participation with these formats is often low without support and/or incentives.

It’s crucial to note that the studies described above were generally underpowered and too homogeneous to examine the impact of mindfulness-based interventions across racial and ethnic groups. While evidence suggests mindfulness helps people of all backgrounds, the most effective programs are adapted to be culturally sensitive to their target population. For example, simply having mindfulness training led by someone from a shared background and in students’ first language, where appropriate, can increase acceptance. More deeply, BIPOC students may be more open to mindfulness if instructors demonstrate how it connects to culturally-relevant values, like helping others and supporting their community, and how it can address culturally-specific challenges, like discrimination and microaggressions.

Researchers must make greater efforts to study mindfulness-based interventions with more varied student groups (e.g., BIPOC students; first-generation students; community college students), and colleges with a diverse student body should carefully consider the use of multiple, culturally-adapted mindfulness-based interventions.

Finally, mindfulness could help support faculty and staff, as well. College presidents listed mental health of faculty and staff as their second greatest concern this year. Although evidence with faculty is scant, mindfulness-based interventions have increased wellbeing and self-efficacy among K-12 teachers. Moreover, workplace-based mindfulness training has been shown to reduce stress and anxiety, and increase wellbeing. If you plan to adopt a mindfulness-based intervention for students, consider a community-wide approach to increasing mindfulness that includes faculty, staff, and administrators.

References

de Vibe, M., Solhaug, I., Rosenvinge, J. H., Tyssen, R., Hanley, A., & Garland, E. (2018). Six-year positive effects of a mindfulness-based intervention on mindfulness, coping and well-being in medical and psychology students; Results from a randomized controlled trial. PloS one, 13(4), e0196053.

Flett, J. A. M., Conner, T. S., Riordan, B. C., Patterson, T., & Hayne, H. (2020). App-based mindfulness meditation for psychological distress and adjustment to college in incoming university students: A pragmatic, randomised, waitlist-controlled trial. Psychology & Health, 35(9), 1049-1074.

Galante, J., Dufour, G., Vainre, M., Wagner, A. P., Stochl, J….Jones, P. B. (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.

Huberty, J., Green, J., Glissmann, C., Larkey, L., Puzia, M., & Lee, C. (2019). Efficacy of the mindfulness meditation mobile app “Calm” to reduce stress among college students: Randomized controlled trial. JMIR mHealth and uHealth, 7(6), e14273.

Ramler, T. R., Tennison, L. R., Lynch, J., & Murphy, P. (2016). Mindfulness and the college transition: The efficacy of an adapted mindfulness-based stress reduction intervention in fostering adjustment among first-year students. Mindfulness, 7, 179-188.

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