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Abstract

Background:

A growing body of research has indicated the importance of implementing community mental health initiatives in universities to promote student mental health and well-being. Designing and implementing community-based initiatives on campus can facilitate improved student well-being in a cost-effective way.

Purpose:

This paper provides a description of the implementation of a graduate-level university course grounded in a community mental health framework, which gave students the opportunity to become peer-mentors for other students within the university in exchange for course credit.

Approach:

The course took place over two semesters. In the first half of semester one, students engaged with theoretical and practical content that teaches them how to be a peer-mentor and support students’ needs. In the second half of the first semester, and over the course of the second semester, students used what they have learned to engage in experiential learning, where they acted as peer-mentors to their fellow university students.

Conclusion:

This university course provided mental health and well-being benefits to university students in a cost-effective manner while providing hands-on experience to students enrolled on the course to be peer-mentors.

Implications:

Experiential learning opportunities can be used to support student well-being while reducing the need for more specialist forms of mental health service provision.

Keywords

Community mental health education experiential learning peer-wellness well-being

Introduction

University life is a transitional time for many students that may come with several academic stressors, self-discovery, and hardships (Robinson et al., 2016). As a result, university students are at a greater risk of experiencing mental health difficulties (Sheldon et al., 2021).

Mental health is defined as a state of well-being that allows individuals to cope with daily stressors, recognise one’s potentials and contribute to the greater community (World Health Organization, 2022). In Ontario, Canada, almost 40% of university students report having a mental illness (e.g. anxiety, depression, panic disorder), and many students indicate having poor mental health, for example, trouble concentrating, low mood, mood swings, substance abuse and sleep disturbances (Moghimi et al., 2023) during the course of their studies. Despite the high self reported prevalence of mental illness among university students, students report difficulty accessing mental health services (e.g. financial concerns, long waiting times, or not having the resources to address mental health concerns; Cage et al., 2020; Moghimi et al., 2023). Poor mental health in university students can be attributed to physiological (e.g. sleep disturbance) and psychological (e.g. stress, rumination) difficulties, responding to trauma (e.g. negative life events), academic concerns (e.g. increased academic workload), sociodemographic factors (e.g. debt) and relational difficulties (e.g. loneliness; Sheldon et al., 2021). Although university student mental health problems have been shown to be a persistent issue, connectedness to the university (i.e. belonging to the campus and peers) may buffer long-term mental health challenges (Adams et al., 2021).

Community mental health initiatives are partnerships with the community (e.g. school, work) that are designed to address mental health, despite various structural barriers to help-seeking (Castillo et al., 2019). Community mental health initiatives can provide university-based interventions that work by inviting community members with mental health expertise to provide support (e.g. anxiety reduction, problem-solving and emotional regulation management; Skryabina et al., 2016) to promote social and mental well-being among students (Castillo et al., 2019). A growing body of research has indicated that implementing community mental health initiatives may be beneficial in a university setting (Castillo et al., 2019; Fernandez et al., 2016; Pozzulo et al., 2023). Community mental health initiatives may provide hands-on, experiential learning opportunities for students interested in pursuing a career in mental health (Fiedler et al., 2012; Kalafat and Tyler, 1973; Simons et al., 2012). Specifically, students can be trained and supported to become peer-mentors (i.e. a mentor that psychologically supports or provides guidance to a mentee of similar age or power; Kram and Isabella, 1985), which can benefit both the peer-mentees (e.g. psychological and emotional support) and the peer-mentors (e.g. increase self-awareness and professional development; Alonso et al., 2010; Gunn et al., 2017; Marshall et al., 2021).

While some research has investigated the role of training university students through practicums to provide mental health care or peer-support (e.g. Funderburk and Fielder, 2013; Shelton and Hunter, 2016), limited research has demonstrated how a university can implement a course that provides both theoretical (e.g. learning about mental health and well-being theory and practices) and practical learning opportunities (i.e. peer-mentorship) for students using a community-based mental health framework. The goal of this paper is to describe how such a course can be designed and implemented successfully. Key elements include (1) giving students credit towards their degree in exchange for an experiential learning opportunity; (2) promoting the mental health and well-being of the student-body; and (3) providing a community resource that can make a positive impact within the university campus that then extends into the broader community after graduation.

University student mental health

In Canada, the average university student is aged between 17 and 24 (Statistics Canada, 2010), which corresponds to the age group most likely to experience a mental health problem (Solmi et al., 2022). University students also are at risk due to increased use of unhealthy coping behaviours (e.g. disengagement; substance use) and new academic and social (e.g. balancing commitments; obtaining high achievement) stressors (Linden and Jurdi-Hage, 2017).

At a Canadian university, it was found that over 28% of students entering the university were likely to have clinical anxiety or depression, which increased to more than 35% by the end of the first year (Duffy et al., 2020). Suicide is the second leading cause of death among young adults (i.e. aged 15–35 years) in Canada, with approximately 4,500 young adults taking their lives every year, and approximately 12 young adults taking their lives every day (Government of Canada, 2023). Similarly, in the USA, the mental health of students on university campuses has been deemed a crisis (Treleaven, 2022).

Various factors such as academic pressure (e.g. competitive programmes), financial burdens (e.g. increased tuition fees) and lifestyle changes such as increased independence, poor diet and decreased exercise are associated with university life (Flatt, 2013; Othman et al., 2019). Poor student mental health can impact academic performance in terms of lower grades (Bruffaerts et al., 2018) and increase university dropout (Howard et al., 2022; Kessler et al., 1995). Young adults who experience a mental illness are at a greater risk of experiencing mental illness a decade later, which may impact the their life subsequently in terms of educational attainment, ability to work, or to have a family (Gustavson et al., 2018).

Supporting student mental health

Positive mental health (otherwise known as psychological well-being) can be described as having two components: (1) having many positive emotions (e.g. contentment) and (2) functioning effectively (e.g. having purpose, positive relationships; Huppert, 2009). To meet the diverse and growing needs of students, universities have implemented wellness services to support student mental health (Randall and Bewick, 2016) including mental health promotion (e.g. informing students about campus mental health programmes and reducing stigma), support services (e.g. peer tutors, transition programme; Jaworska et al., 2016), counselling services (e.g. short-term counselling), medical and psychiatric services (e.g. medical prescriptions), or referral to s off-campus service provision (e.g. emergency services; 24-hour hotlines; Read et al., 2023).

Over the course of several decades, an increasing number of students have sought psychological help from within their universities (Linden et al., 2021). Moreover, funding opportunities to support student services are decreasing with government restraints, tuition freezes and high inflation rates. Students have reported having good knowledge of mental health, but not having the coping strategies or time to focus on mental health required for optimal wellness (Moghimi et al., 2023). Many students also reported barriers to accessing help-seeking, such as difficulty accessing the appropriate mental health services, lack of resources to address specific needs, stigma surrounding access to services, lack of time to receive help and lengthy waiting lists (Moghimi et al., 2023; Robinson et al., 2016; Weissinger et al., 2024). Even with a diversity of programmes offering student mental health support, the need continues to grow.

The university as a community mental health support

A university campus can be considered a community in which all individuals (i.e. students, staff, faculty) can work together to build positive change on campus, which can in turn be associated with positive student wellness outcomes (Light and Jegla, 2022; Pozzulo et al., 2023). The theory of student involvement (SI; Astin, 1984) posits that active involvement in a campus is associated with greater academic achievement and psychosocial adjustment. More specifically, greater energy put into integrating oneself into a campus’ community (e.g. being involved in extracurricular, creating relationships with others), can promote positive student development (e.g. increased social network, leadership skills, confidence, self-esteem) that goes beyond academic attainment (Rahman et al., 2020). Similarly, social integration theory suggests that for students to complete their programme at a university, they need to feel integrated into the university both inside and outside the classroom (Gershenfeld et al., 2014; Tinto, 1997). Increased student engagement within one’s university’s community (Thomas et al., 2021) and feeling a sense of belonging to one’s school (Stubblebine et al., 2024), can promote mental health and well-being outcomes.

When the demands to meet mental health concerns are insufficient, it is important to draw upon one’s community resources to meet this demand. Hunter and Riger (1986) argued that one way to meet the growing demand of mental health supports is to supplement professional services with ‘natural helpers’ who can provide social support to may help individuals cope with stressors and reduce the need of professional attention. These helpers may also offer a variety of benefits to the students and the university, which will be discussed in further detail below.

Graduate peer-mentoring programmes

Peer-mentorship occurs when a student-mentor (e.g. a more experienced upper-year student) supports a peer-mentee (e.g. a less experienced lower-year student) (Pointon-Haas et al., 2024) in their education in general. A peer-mentor uses their knowledge to enhance the peer-mentee’s academic and personal growth through knowledge translation, skills development, the achievement of academic milestones and personal support (Lorenzetti et al., 2020). Peer-mentors can take on a variety of roles to support a student, such as connecting them to campus resources, motivating them in their academic career, finding ways to increase the mentee’s potential and providing moral or ethical guidance (Sarabipour et al., 2022). Peer-mentorship programmes can offer varying mentorship ratios (e.g. 1:1, structured groups) and range in length from one session to 6 weeks and up to a year (Lorenzetti et al., 2020; Pointon-Haas et al., 2024; Read et al., 2023).

Research indicates that while many universities offer social support programmes and opportunities for community involvement. However, it is less common for universities to provide peer-mentorship (e.g. student-to-student/peer-health educator) programmes (Jaworska et al., 2016). Some institutions offer peer-support online resources, often through a ‘single session’ intervention (Read et al., 2023), which may not allow the mentee to establish rapport with the mentor or receive on-going support. There are some disadvantages of peer-mentorship, however, including the fact that it can be difficult for peer-mentors to learn their role, manage personal boundaries and not take negative feedback personally (Marshall et al., 2021). Peer-mentees also may become overly dependent or emotionally attached to the peer-mentor (Leenstra et al., 2019).

Research has indicated that peer-mentorship can be effective for the student receiving the mentorship (Dixon et al., 2023; Lorenzetti et al., 2019; Oddone Paolucci et al., 2021), the mentor (Gunn et al., 2017; Marshall et al., 2021; Snowden and Hardy, 2012) and the university community more broadly (Eather et al., 2022; Lane, 2020; Pointon-Haas et al., 2024). For the mentee, Hamilton et al. (2019) found that compared to a control group, students with a peer-mentor experienced professional development benefits (e.g. networking, interview skills) and psychosocial support and felt more connected to their university. For peer-mentors, Crisp et al. (2020) found that at the end of the programme, mentors reported having greater confidence and receiving multiple benefits, such as feeling like they had helped others, learned and developed skills, were connected to the greater community and gained experience, as compared to the beginning of the programme. Peer-mentorship has also been found to be a cost-effective way to increase student academic success and retention (Graham et al., 2022).

Development of a mental health and well-being graduate practicum course (PWM)

While a variety of peer-mentorship programmes have been implemented and evaluated in universities (e.g. Crisp and Cruz, 2009; Lorenzetti et al., 2019; Wong et al., 2016), the current paper describes a novel approach and implementation of a peer-mentorship course at the graduate level. Previous research has integrated both the theoretical and practical aspects of mental health promotion into peer-mentorship programmes that can serve students (e.g. Funderburk and Fielder, 2013; Simons et al., 2012) for course credit. However, no course to date that we are aware of has implemented an experiential course focused on well-being that gives psychology students registered on a graduate-level programme focused on research skills development, research design and statistics), ‘softer’ skills that can be transferred to promote the mental health and well-being of their fellow students using a virtual platform.

To fill this gap, this paper provides a demonstration of such a course and its successful implementation in increasing well-being using a virtual platform in a student-body that is cost-effective. A virtual format for peer-mentoring sessions was chosen to help reduce the stigma associated with help-seeking behaviour. We wanted to reduce the barriers, actual and perceived, associated with asking for support. Moreover, we wanted to provide virtual sessions to increase accessibility for student-mentees. Not all students are able to make it to campus outside of class due to other commitments (e.g. employment, childcare, etc.). The setting in which this course was implemented was a large community college with approximately 60% of students commuting to campus primarily for their classes. We did not want to limit who would have the opportunity to take advantage of the peer-mentoring sessions that were offered.

Course development

A graduate-level peer-wellness mentoring (PWM) course was created to allow students to develop their practical skills through mentoring while supporting their fellow students wanting to improve their well-being. The development of the course was informed by a number of other peer-wellness programmes (e.g. Funderburk and Fielder, 2013; Petosa and Smith, 2014; Simons et al., 2012). The course was developed using a community mental health framework, whereby all individuals within the university’s community (i.e. students, staff, faculty) were seen as having a role to play in providing a network of evidence-based support and resources to promote well-being (Light and Jegla, 2022; Thornicroft et al., 2016).

The course spans two terms and provides course credit towards a student’s Master’s degree in a research-based psychology programme at Carleton University in Ontario, Canada. The first part of the course helps graduate students develop their listening skills and receive training on how to provide support and mentoring in the context of health promotion and wellness. Following this initial training, graduate students as peer-wellness mentors apply what they have learned in the seminar portion of the course while working at the Psychology Wellness Centre (PWC) a website created specifically for this course that includes a referral portal). The last day of class is a roundtable discussion for mentors to share their experiences and provide feedback and evaluation of the mentoring programme. This information is used to modify the course in the subsequent year it is offered.

Access to the PWM course

To be eligible to participate in the PWM course, students must be registered at Master’s level in the university’s psychology programme. In our particular institution, the PWM course is the capstone course for students registered for the Mental Health and Well-Being track. This track has several prerequisite courses in the area of health (e.g. advanced topics in psychological health) that must be completed successfully prior to registering for the PWM course. Successful completion of the track requirements and the capstone course permits a Mental Health and Well-Being designation on the student’s Master’s degree.

PWM course structure

First term

During the first term, content sessions prepare students for the experiential learning portion of the course. The topics were selected based on previous peer-mentoring research (Petosa and Smith, 2014), and focus on communication/listening, tolerance, knowledge of resources, solution-focused helping and how to handle unexpected difficulties. Specifically, content topics include (1) ethics, privacy and confidentiality (Johnson et al., 2018); (2) mentorship training and evidence-based training for suicide alertness (i.e. LivingWorks, 2010); (3) an overview of health promotion for improved well-being (Kutsyuruba and Godden, 2019); (4) supporting a friend training (Dillon & Carr, 2007); and (5) mentoring (Tang and Choi, 2007). The sixth and last content session is dedicated to describing the Psychology Wellness Centre and engaging in role-playing (Dundas et al., 2018). The remaining sessions in the term are spent conducting peer-mentorship meetings. See the supplemental online material for a sample course syllabus.

Second term

The second term consists almost entirely of practical experience conducting one-to-one PWM sessions.

Course evaluation

The course is evaluated using a satisfactory/unsatisfactory designation in each of the autumn and winter semesters.

Perceptions of the course

At the time of writing, the course has been implemented with three cohorts of graduate-level university students. Evaluation feedback has been collected via an electronic survey emailed to each cohort of mentors and mentees. The feedback from each cohort has been used to revise the consecutive course offering to improve the educational experience of the mentors and the efficacy of the programme for mentees. In this study, the feedback collected from the mentors/mentees was solely used for educational purposes and because of this a research ethics protocol was not submitted.

Mentors’ perceptions of the course

Over the three different cohorts, over a dozen mentors met with 63 different student-mentees. Mentors met with undergraduate and graduate students, from various disciplines and backgrounds. Mentors reported feeling equipped to support mentees whether this be was recommending the university’s services (e.g. counselling services; career services), or suggesting strategies to promote academic achievement (e.g. time management, goal-setting, addressing procrastination), or wellness more generally (e.g. managing stress, reducing burnout). Some peer-mentors stated that some mentees wanted help with complex needs (e.g. severe psychiatric illness) which required referral. All reported how some mentees failed to show up for their sessions and not all mentors had full bookings.

Mentors felt like they became more competent in their abilities over time and that meeting with mentees was rewarding. Mentors felt like they were making a positive difference in their community and that the skills they had acquired in class (e.g. active listening) could be used in other contexts (e.g. helping a family-member).

Mentees’ perceptions of the course

Some mentees requested only one meeting to get the support they needed. Other mentees requested multiple follow-ups because they felt the mentorship was beneficial for their academic success and overall wellness. Some mentees mentioned not being sure of what to expect or were aware of the qualifications of their mentors. Logistical issues included difficulty maintaining a stable Internet connection while meeting virtually with a mentor and difficulty finding a private place for their meeting (e.g. away from family, roommates). Overall, mentees reported feeling satisfied with their mentorship.

Discussion

Peer-mentoring programmes have become a prominent feature of higher education to promote personal and professional growth among students (Yomtov et al., 2017). However, few opportunities exist for graduate students registered in a research-based programme to gain skills and experiences for peer-mentorship. Thus, a graduate-level PWM course was designed and implemented to provide graduate students in psychology with this experience. Informed by community mental health and peer-mentorship programme research (e.g. Gershenfeld et al., 2014; Read et al., 2023), the course developed could be implemented in a range of higher educational settings. Students were provided with the opportunity to learn about how to support peer mental health and wellness and use the theoretical knowledge acquired in practical one-to-one PWM sessions.

Implementation of the peer-wellness course

The PWM course showed positive outcomes for both the peer-mentors and -mentees. Peer-mentoring can offer opportunities for self-development and to foster confidence (Crisp et al., 2020; Glazzard et al., 2021; Oddone Paolucci et al., 2021). Mentors felt they had the self-efficacy and training to appropriately address mentee problems.

In terms of challenges, it was recognised that sometimes peer-mentees’ difficulties could be too complex for the mentor to help resolve and sometimes resulted in emotional entanglement (Leenstra et al., 2019). On other occasions, mentees may become too reliant on their mentor, undermining their willingness to seek out additional resources and support on their own and having a negative impact on the mentor (Colvin and Ashman, 2010). Mentors may occasionally experience anxiety and reduced confidence from not feeling like they can effectively support students (Marshall et al., 2021). Lundsford and colleagues (2013) found a major cost in a mentorship role was burnout. Despite this, the literature on peer-mentorship demonstrates strong support and benefits for peer-mentors, -mentees and the wider higher education community that may mitigate any costs (e.g. Colvin and Ashman, 2010; Eby et al., 2008; Lorenzetti et al., 2019; Yomtov et al., 2017).

Some mentees had difficulty meeting with the peer-mentees due to barriers such as poor Internet connections and conflicting schedules and some indicated that they did not understand the purpose of the mentoring. Previous research has found similar issues in other programmes (Glaser et al., 2006; Le et al., 2024). A brief, pre-mentoring meeting with mentees may help clarify the purpose of mentoring programme. In line with previous studies, peer-mentorship programme may have a positive impact on the academic achievement (Kalpazidou Schmidt and Faber, 2016; Snowden and Hardy, 2012) and wellness (Gunn et al., 2017) of mentees.

Limitations

Course feedback from peer-mentors and -mentees was received through student assignments and an anonymous survey. Peer-mentors’ perceptions of the PWM were not elicited anonymously and may have been impacted by social desirability effects (Fulham et al., 2022). Conversely, while peer-mentees’ responses were elicited anonymously, only a small number provided feedback thereby raising questions about their typicality. Overall, however, feedback from mentors and mentees suggests the PWM was a cost-effective promising programme in providing support to students.

It must be recognised, however, that the course we have developed may not be relevant to every college/university given the need for extensive collaboration between the instructor and existing support services on campus to ensure mentors are supported and there are more intensive options available for mentees should they need them. Student interest should also be gauged to ensure there are a sufficient number of students wanting to be mentors and students wanting to be mentored. There needs to be on-going promotion of the programme to recruit mentors and mentees to ensure continuity of the peer-wellness programme once set up.

Future directions

Building on the work undertaken so far, future research should identify the specific learning outcomes that a PWM course can provide, such as teaching professional skills such as listening, problem-solving and interpersonal communication that translate outside of the classroom and into the workforce (Foster et al., 2019). The value of peer-to-peer mentorship using a virtual platform should also s be assessed. Effectiveness could be evaluated through satisfaction measures from mentors, mentees and course partners.

Supplemental Material

sj-docx-1-hej-10.1177_00178969251334905 – Supplemental material for Designing a graduate-level peer-wellness mentoring course

Supplemental material, sj-docx-1-hej-10.1177_00178969251334905 for Designing a graduate-level peer-wellness mentoring course by Joanna Pozzulo, Anna Stone and Alexia Vettese in Health Education Journal

Footnotes

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Anna Stone

Supplemental material

Supplemental material for this article is available online.

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