“Was I the only one who felt so rotten?”

Student wellbeing on the agenda at UM


They have to perform. Be the very best. Do a great internship, get high marks, graduate cum laude. Oh, and sit on a student board if at all possible. Little wonder that students are crumbling under the pressure and end up depressed. Walking around like zombies, if we’re to believe the newspapers. Are things in Maastricht, too, all that bad? There are no figures, but the long waiting lists for the UM psychologists point to the need for action.

Even as his own daughter Jip spent months suffering from burnout, Peter Muris, professor of Developmental Psychopathology at Maastricht University, didn’t notice a thing. She was studying history in Leiden, had her own life and did her best not to bother others, including her parents. In a documentary made by the public broadcaster NOS last autumn, the then 23-year-old said she found it difficult to admit to her “double life”. “I hope at some point things will be good again. Then they’ll never know that things weren’t going too well for a while.” Muris was shocked by the confession. “Jip has always been very stable and calm, with a rich social life, but she’s also a girl who likes to do well, who works hard. She asked too much of herself.”

Jip had regular panic attacks. In the documentary she compares them with “a storm, a hurricane of thought, with all the negativity and things that aren’t working.” When she arrives at the university library at half past nine and finds that there are no more computers available, she is distraught. “How am I supposed to write my thesis now, and why didn’t I get up earlier?” she says. “Then you just go back to bed, crying, and you can’t get out for two days.” Only to then pull yourself together and carry on again.
The term burnout comes from occupational psychology and is not a diagnosis in itself, says psychologist Muris. “Put simply, it means you can no longer bear the load you’ve taken on. You want to do it so well that eventually it becomes too much for you.”
At times of stress, which everyone experiences at some point in life, a vulnerability bubbles up to the surface which can lead to panic or anxiety. Particularly so among many young adults, Muris explains. “Especially young people who have previously suffered from a social anxiety disorder or depression. If they’re not treated properly, they can resurface during stressful events.”

Risk of suicide

Early this year the newspaper Trouw published an article on “perfectionism, the epidemic of a new generation”, following a British study showing that in recent decades the social pressure on people in their twenties to be perfect has increased by 30 percent. Here in the Netherlands, a study conducted at the Windesheim University of Applied Sciences in Zwolle recently gave rise to the ominous headline in the Volkskrant: “Students reduced to a generation of zombies”. More than three thousand students at Windesheim filled in a survey between December 2017 and March 2018 with questions on their wellbeing, covering alcohol consumption, anxiety, burnout and risk of suicide. The conclusions: one quarter of the respondents suffered from burnout or felt emotionally exhausted, mainly because of pressure to perform. Almost 15 percent had “very serious anxiety and depression complaints”, and one in five were even at risk of suicide.
Elma Drayer, a columnist at the Volkskrant, took a swipe at the researcher. “It’s always fun (…) to take a look at the response rate. As we can see, of the more than 18,000 Windesheim students approached, 3,134 decided to take part. A non-response rate of no less than 83 percent.” She suggests that self-selection played a role: students who are particularly affected by the subject matter are more likely to fill the questionnaire in.

Safety net

“If we’re to believe the newspapers, all students are burdened by severe stress”, responds Mieke Jansen, team leader student psychologists and career services at Maastricht University. She doesn’t mean to trivialise the problems, she says, but stress is part of life – “we all have it sometimes” – and most people are “just fine”. In Jansen’s view, stress cannot be avoided. “What we need to work on is helping students learn to deal with it. We have to make them more resilient, let them know when and where they can get help.”
Uncertainty is a normal part of this phase: “You go to university, you move away from your parents, you have to build up a new social network, learn to study. For students from abroad it’s even harder because they speak a different language and can’t just go home every weekend.”
UM student Miriam Zimmer, from Germany, started studying psychology in Dutch, but “didn’t feel welcome” in the tutorial group. She spoke with the study adviser, but that didn’t help either; she didn’t feel understood. “I kept wondering if I was the only one who felt so rotten.” Eventually she switched to the English-language track, where she feels more at home. “Looking back, I would have liked to speak with a student. They could perhaps have understood my situation better.”
Together with law student Julia Bacci Aggio, Zimmer recently launched the initiative Heart to Heart, following similar projects at the university colleges in Utrecht and Leiden. It is a peer-coaching system through which students (after being trained by student psychologists) provide help to other students. “You can think of it as a safety net for those who need it.” And there is no shortage of them; Zimmer and Bacci Aggio have heard enough stories from students struggling with panic attacks, anxiety, homesickness or feelings of depression. “Foreign students in particular don’t know where to turn, have no one to talk to. The come to the Netherlands, are going through culture shock and are immediately swept up in student life and their studies.”

Showing up angry

Why is it specifically millennials who feel under pressure? The aforementioned British researchers point to our changing culture, suggesting that things have become more individualistic and materialistic. Psychologist Muris – who also questions the “very high” Windesheim percentages – notices that young people have enormously high expectations of their studies: “Everyone wants to get high marks, graduate cum laude, go abroad, have a rich social life, sit on a board, play sport. I see it with my own research master’s students. Recently they had the opportunity to inspect their exams. I’d marked them strictly but fairly. Twelve of the sixteen students complained, saying their mark was too low. They showed up at the inspection crying, even angry. One of them literally said, ‘You’re torpedoing my cum laude.’ They’re all students, they work together if they have to, but when it comes down to it they’re very focused on their own opportunities and grades.”
The role of parents should not be underestimated. “They want their child to be important, exceptional even, and in that sense they stimulate that competitive element”, Muris says. Not to mention the influence of social media: “You can constantly see what others are doing and compare yourself to them. People send all kinds of upbeat messages and beautiful photos out into the world, as though nobody’s ever having a bit of a dip. To match up to that picture of others you put more pressure on yourself. Of course, you can decide not to participate, but that’s hard. It starts as early as puberty. It’s natural to want to be part of the group.”
Finally, students are under pressure to choose the right study programme. With binding study advice and student finance that needs paying back, there’s no time to make the wrong decision.

Waiting time

For thirty parties, including the student organisations ISO and LSVb and the mental health service 113 Zelfmoordpreventie, enough is enough. They have joined forces in a national network and are calling for an action plan. Education institutions are responsible for ensuring a safe study climate and an adequate provision of support, they wrote in a joint press release. Lecturers and study counsellors needs to be trained to pay more attention to student wellbeing. And students themselves should be offered an annual mental health check-up.
How does Maastricht measure up? Is there adequate support on offer, and are there enough UM psychologists? Niels van der Sangen, student member of the University Council, got the ball rolling by getting in touch with Mieke Jansen. Last Wednesday, the head of student counselling gave a presentation on student wellbeing to the University Council. Despite the appointment of additional staff, the waiting time for an individual consultation with a student psychologist has climbed to seven weeks, she says. Jansen has no explanation. “Is the number of students with problems increasing, or are they getting better at finding us? Have they become more open? We don’t know.”
She calls for more hard numbers; reliable statistics that show whether psychological complaints are as common as they are made out to be, and if so, which. “Because otherwise, what are we talking about? This will also give direction to what you have to do, what you need to address.” She draws attention to the existing group workshops and training courses in stress management, fear of failure, self-confidence and assertiveness, and to the possibility to speak with one of the psychologists by phone; lines are open twice a week for half an hour. But that’s not enough, says Pia Harbers, study adviser for Arts and Social Sciences and member of the University Council. Students call in vain, she’s been told, or they have to spend too long waiting. During the meeting of the board of the University Council, rector Rianne Letschert says money shouldn’t come into it – if Jansen needs more people, she should come to the Executive Board.

A fail

Despite the long waiting lists, many students are unaware of the services provided by the university. This was the conclusion of a survey among almost by almost 130 bachelor’s and master’s law students last autumn by Mark Kawakami, assistant professor at the law faculty. A quarter had no idea that there were study advisers, psychologists or group training courses available to them. Jansen is aware of the problem. “PR is not our core business, although we recognise that visibility and findability are important.”
Ultimately, the 130 students gave an average mark of 5 for the level of support provided. A fail, in other words. “It’s unfortunate to have to wait a month if you’re anxious and depressed. Especially when you consider how big a step it is to reach out for help”, one master’s student wrote. Respondents also indicated that lecturers should pay more attention to students’ problems. This is one of the aims of the action plan of the national network: to train lecturers to coach their students, including on psychological matters, in order to prevent their situation from deteriorating. Small-scale experiments with mentor training are being conducted at UM, including at the faculties of Arts & Social Sciences and Psychology & Neuroscience. According to Sibren Fetter, a careers counsellor at UM, “Most lecturers are already very engaged, but they’re not coaches; that’s an entirely different thing. Conversations with students shouldn’t concern only their study progress. Ask first how someone’s doing. After that it’s mainly a matter of really listening to them. Of course, sometimes the discussion becomes emotional or it turns out you can’t help the student. Then you need to refer them and it’s useful if you know what the options are.”
The Heart to Heart initiative also seeks to make support providers easier to find. Its website will be launched soon and will serve as a guide, not only within but also outside Maastricht University: What is his or her expertise? Who speaks English? Is it covered by health insurance?

Future possibilities

Mieke Jansen hopes UM will join the Caring Universities project, which is part of the World Health Organisation. Four universities are currently participating: VU University Amsterdam, KU Leuven, the University of Erlangen-Nuremberg, and Harvard University. “It has a questionnaire on students’ wellbeing, and membership provides access to a large network of e-health programmes on anxiety, depression, and drug and alcohol consumption.” Joining the club would set UM back 50 thousand euros per year. Jansen is also hoping for more funding to improve communication and the Wellbeing Week (see box). 

To return to Jip Muris. Two housemates accidentally uncovered her “double life” and she is now seeing a psychologist. She’s had to learn about time management in particular, says her father, UM professor Peter Muris: “She has to learn to set limits, not put too much pressure on herself, not try to be everywhere all the time. But these are things she has to work on constantly.”

Care plan in Amsterdam
Researchers from the University of Amsterdam are working on a plan called UvA Care to improve the mental health of both students and PhD candidates. A pilot will soon be conducted among first-year students. The project was initiated by Reinout Wiers, professor of developmental psychology and former employee of Maastricht University. Students are asked to fill in a questionnaire on stress, depression, anxiety, study and work pressure, and the use of (addictive) substances, according to Folia, the UvA journalists’ website. From October, UvA Care will gradually be rolled out for all students and PhD candidates.
For individual respondents, the questionnaire results will be translated into red (you’re in bad shape and will be referred to the student doctors or psychologists), orange (dubious mental state) or green (good mental health). Dubious cases will be invited to take part in an e-health programme.
UvA has also offered an online health test for students since 2011. The report for 2015/16, during which 5169 students from UvA and the Amsterdam University of Applied Sciences took the test, shows that 45 percent “indicate having some current health problem or another”. And this group appears to be increasing, the report concluded. The problems typically concern time management, concentration, self-confidence and fear of failure.

Wellbeing Week Maastricht
UM’s first ever Wellbeing Week was held last autumn. The event saw University College Maastricht, the psychology faculty and the student counselling team join forces to prevent health problems and inform students who they can turn to with their physical or mental problems. The idea was that if this pilot event succeeded, it would be repeated. The 50-thousand-euro Comenius grant recently awarded by the Netherlands Organisation for Scientific Research (NWO) will make this possible for the coming year at least. There is also room for expansion and professionalisation; for example, a website is currently being developed. “In the future we would like to involve all faculties”, says psychologist Petra Hurks, who applied for the grant together with Mieke Jansen, team leader student psychologists and career services, and the study advisers Aimee Coenen and Tessa Vanheeswijck. “Sounding the alarm about stress early and getting tips on studying, time management, mindfulness and nutrition are important for everyone.”

“Was I the only one who felt so rotten?”