The nature and context of education have changed dramatically in recent decades. The increased prioritisation of standardisation, performance indicators and metrics often means that holistic, affective and wellbeing education are seen as less important in the educational endeavour. The value of education for education's sake is under siege. Previous emphasis on the education of the whole person (i.e., moral and creative aesthetic development) is often replaced by a more functionalist perspective of education as servicing economic need and global capitalist interests. Marketization of education has increased at an exponential rate and has had an adverse impact on the health and well‐being of both educators and students. This chapter elucidates how the triad of assessment, student well‐being and academic well‐being intersects in the ever increasing performative and neo‐liberalist cultures of higher education. It demonstrates the reciprocal dynamic of stress that is becoming more and more evident among educators and students. The chapter makes the case for more empowering and human‐centred educative contexts in order to facilitate better educational outcomes for students and healthier outcomes for all involved in the educational endeavour.
- higher education
- academic stress
- student stress
Education is a site of significant change and is without a doubt under siege from external and economically driven forces . Recent years have seen increased prioritization of standardization, performance indicators and metrics (see, for example, the prominence now given to the results of international testing such as the Programme for International Student Assessment (PISA) , Trends in International Mathematics and Science Study (TIMMS) and the Progress in International Reading Literacy Study (PIRLS) , at the expense of broad and more liberal education agendas). In Ireland, for example, as a result of less than optimal performance in PISA , a national literacy and numeracy strategy  was swiftly introduced despite other equally pressing societal needs, such as the mental health crises in schools and suicide rates of 9.9 per 100,000 of young people aged between 15 and 24 . There is some irony in the fact that the Organisation for Economic Cooperation and Development (OECD), responsible for PISA, is an organization driven by an economic and human capital agenda. The OECD has, in effect, created international league tables and in so doing has exerted overarching influence on national educational polices. This raises significant challenges with regard to the changing nature of the purpose of education. In 1948, at the height of political upheaval in the United States, Martin Luther King, in his speech at Morehouse College, evoked the function of education as to teach one to think – to think both intensively and critically. More pressingly, he advocated that education, which stops with efficiency, might indeed prove the greatest menace to society. He saw the prioritization of intelligence without attention to character formation and societal responsibility as deeply problematic. Despite strong critique of the growing trends of performance, measurement and narrowly focused accountability, neo‐liberalist trends have continued to exert ever‐increasing influence in education [1, 7]. These trends are worrying for several reasons, not least of which is the increasing pressure it places upon students and teachers, but also and even more worryingly, it has served to disempower teachers with adverse consequences on their agency and autonomy. Once cited as having legendary autonomy by the OECD , Irish teachers are increasingly deprofessionalized and disenfranchised in terms of their professional confidence and agency . This is not limited to teachers in primary and post‐primary schools; similar trends are also evident in higher education .
2. Higher education context
It would be naïve to state that at any juncture the perfect or utopian education system has existed. However, in past decades, Irish schools had more freedom in terms of the time available to attend the holistic development of their students. Schools in Ireland are now placed on league tables that are ordered by the number of students who progress to university. These league tables are published yearly in the national newspapers and are discussed across the national media (radio and television). This increased pressure on schools to educate students for university has meant that many schools have narrowed their focus and now tailor their content and pedagogy exclusively to the terminal exam, which is called the Leaving Certificate . Similar to matriculation, results of this exam are high stakes for schools because the number of successful students to gain a university place (based on this exam) determines their place on the league tables. The results are also high stakes for students because their results determine access to a university course. This has resulted in exclusive concentration on exam performance in the latter years of schooling. The trend then continues into higher education, where neo‐liberalism has radically changed higher education globally [11, 12].
Mercille and Murphy  identify the pervasive nature of neo‐liberalism in the higher education sector in Ireland. According to Lipman [14, p. 6], ‘Put simply neo‐liberalism is an ensemble of economic and social policies, forms of governance, and discourses and ideologies that promote individual self interest, unrestricted flows of capital, deep reductions in the cost of labour, and sharp retrenchment of the public sphere’. It is not a new ideology and has been, according to Lipman  among others, ‘the defining paradigm social paradigm for the past 30 years’ (ibid). Inherent in neo‐liberalism is the rise of individual competition, the destruction of the welfare state, control of the public space (i.e., controlling the right to protest), the privatization of services, marketization of education and control of the public intellectual (see Giroux ). Mercille and Murphy  draw attention to global studies that have discussed the impact of neo‐liberalism on higher education. Among others, they cite Aronowitz  and Ball  who point to increasing commercialism and privatization agendas  and to consequent narrowing and elitism of higher education [18, 19]. Bousquet  has advocated that neo‐liberalism in higher education is supported by a view of education that supports more standardization, more managerial control, a teacher‐proof curriculum, top down control of curriculum, tenured management and the reduction of faculty to part time and temporary employees. The result is disenfranchised and disempowered intellectuals. Universities are now clearly experiencing significant challenges specifically related to budget cuts, tailoring of curriculum to meet the needs of the market [21–23], and the destruction of faculty agency. The pressures experienced by national public funding cut result in need to secure funding from private sources, from student fees (both national and international), from philanthropic donations  and from national and international research funding. Liefner [24 p. 269] identifies that ‘A high proportion of funding for higher education institutions is now provided by private factors, for example, in the form of tuition and fees, gifts, grants, or research contracts. Their demand drives many activities of universities, faculty, and staff’. Indeed, Liefner's research identified that the performance demands associated with funding pressures (publications and citations) have meant that faculty tend to stay within their academic fields and avoid projects with uncertain outcomes. Faculty will in effect avoid what they see as risk (ibid). Consequently, universities find themselves positioned as having to provide services, research and labour to the corporate sector [13, 25]. Dependence on such indentured service provision comes at a high cost to traditional values such as academic freedom. The capacity for academics to freely offer societal critique is a capacity fast becoming a thing of the past . So much so that Giroux cites Washburn [25 p. 227] who notes:
In the classroom deans and provosts are concerned less with the quality of instruction than with how much money their professors bring in. As universities become commercial entities, the space to perform research that is critical of industry or challenges conventional market ideology—research on environmental pollution, poverty alleviation, occupational health hazards—has gradually diminished, as has the willingness of universities to defend professors whose findings conflict with the interests of their corporate sponsors. Will universities stand up for academic freedom in these situations, or will they bow to commercial pressure out of fear of alienating their donors?
These pressures exacerbate heavy workloads for many academics. Meeting performance measures such as research output and successful tendering for external funding are now indicators that academics must content with in addition to teaching. In Ireland, for example, the new managerialist monitoring of performance (evident in the recent instigation of performance appraisals) places ‘research output’ (colloquially synonymous for paper publication in high quartile high‐impact journals) on the performance agenda. In Irish universities, faculty now contend with balancing these new expectations of ‘research output’ with teaching and learning commitments. In addition, they grapple with increased post‐graduate supervision duties through the proliferation of structured doctorate programmes and more and more administrative expectations. This model is, however, going through surreptitious modification with the nature of recent changes to academic work in Irish Universities such as the employment of College Teachers rather than Lecturers whose duties are teaching only. In itself this creates interesting hierarchies in terms of what is valued (research versus teaching debate). The increased appointment of non‐tenured or contingent faculty erodes academic freedom even further . This trend is not limited to European universities as Washburn  cites Bradley  of the American Association of American Professors who points to the ‘silent self censorship of thousands of professors holding temporary, insecure appointments’. Washburn explains that in the United States between 1998 and 2001, full time non‐tenure track appointments rose by 35.5% and by 2006, 60% of all college and university faculty held non‐tenure track positions. Lack of tenure and precarious employment are powerful disincentives to discuss controversial issues or to express unorthodox views and is, according to Washburn, a troubling prospect for those who care about academic freedom . The trend to disenfranchise academic staff has continued unchecked, so much so that on 15 March 2017, several education trade unions mobilized for the World Action Day against Precarity in Higher Education and Research .
For some institutions, accountability is now propelled by an ‘output driven’ corporate style of managerialism taken from the business world and from neo‐liberal models of organizational governance [28, p. 46, 13]. Lynch  identifies that ‘universities are increasingly under pressure to change from being independent centres of higher education and critical scholarship, maintaining their distance from powerful vested interests (commercial, political or other) to being service‐delivery operations for the market economy’. The stress experienced by higher education professionals in recent years has been linked with the rise of neo‐liberalism . It is fuelled by the cumulative emphasis on quality, efficiency, accountability and performativity, which have occurred simultaneously with decreased resources and funding. Dowling‐Hetherington  provides some useful insight into the changing demands faced by Irish academics in a case study of the School of Business at University College Dublin which is the largest university in Ireland. The case study identifies increased demands in terms of publications and research output in addition to increased administrative roles. These spiralling demands and expectations on academics occur in the context of eroded professional autonomy, a consequence of managerialism  and government cuts in funding for higher education . Furthermore, linking of funding with outcomes as advocated by the Hunt report  (the policy document for higher education in Ireland) increases the potential for stress among academics.
A consequential and worrying trend of neo‐liberalism in higher education is evidenced in the report of an expert group on fixed‐term part‐time employment in lecturing at third level in Ireland in 2016 . The results indicate that up to two‐thirds of lecturing staff in some higher education institutions are not full‐time or permanent . Unions have argued that this constitutes strong evidence that precarious work is propping up much of the third‐level sector . This trend is not specific to Ireland, with similar trends reported in the United Kingdom. Such precarious employment increases stress for untenured academics and serves to silence potential dissent for fear of adverse contractual consequences. Lynch  warns of what is at stake. ‘When success is judged exclusively by measurable performances (rankings and league tables of colleges, schools and people) what cannot be numerically recorded becomes inconsequential. The outcome is that the ethic of care for students (and for staff) is subordinated to market success’. She further warns that institutionalizing market values over‐rides and weakens other values in education. She explains that social and moral values are relegated in importance, with trust, integrity, care and solidarity becoming subordinated to monitoring, control and competition. It is in this cultural context that individualism and the pursuit of economic self‐interest and credentials among students and personal career interests among staff thrive. She further indicates that both student and staff idealism to work in the public interest are implicitly and, sometimes, explicitly discouraged .
The audit and performativity culture that has invaded university professional life  means that health and well‐being of students and staff is in danger of becoming eclipsed. McDermott et al. [37 p. 248] note that ‘in a performance‐oriented culture, there is a pressure on individuals, organizations and sectors to engage in work that is visible and measurable, work that can be exteriorized and translated into results, so that one set of results can be measured and compared to another’. Highlighting the importance of some aspects of academic work (for example, research outputs in Institute for Scientific Information (ISI) journals) results in the non‐audited elements of lecturer work becoming almost invisible (for example, personal tutoring or service activities) with potentially adverse consequences for individual well‐being, resilience and career development . The negative impact of the performative culture on space for the promotion of emotional health is clearly articulated by Ball [39 p. 30] ‘The first‐order effect of performativity is to reorient pedagogical and scholarly activities towards those which are likely to have a positive impact on measurable performance outcomes and are a deflection of attention away from aspects of social, emotional or moral development that have no immediate measurable performative value’. In this context, performance appraisals and mechanisms of new management can be seen as detrimental to staff well‐being because they can cause undue stress which impacts negatively on an essential criterion of academia, cognitive thinking . There is little doubt that these factors among others cohere to make the academic work environment increasingly performative, individualistic, competitive and consequently stressful. It is important to acknowledge that learning in itself is also stressful and stress makes learning, the goal of higher education, even harder to achieve because stress has been associated with impaired cognitive performance .
3. Stress among academics
Stress is an inherent feature of the work life of many higher education professionals and is a serious concern in higher education . The available evidence suggests that academics are experiencing increased stress levels [30, 42, 43]. This is of concern given that ‘work‐related stress has significant costs for the well‐being of academics, their families, their colleagues, and their university and more broadly for the quality of higher education’ [30, p. 231]. The combined responsibilities of teaching, research and community service coupled with work overload are reported as the most significant determinants of stress among this population . Other significant stressors include emotion work ; email related stress ; work‐life conflict [30, 47, 48] job insecurity/lack of tenure and bullying cultures. Increased student numbers and student diversity coupled with decreased student staff ratios  and increased student expectations can make it difficult for academics to balance competing demands. The increasing number of students with mental health issues  and the growing suicide rates among young people in Ireland  also added to the burden. For some academics, the prioritization of student needs over their own well‐being, which may be linked to fear of having their teaching poorly evaluated by students, further exacerbates their stress.
This constellation of conflicting pressures and demands on academics has translated into longer working hours [42, 50]. Research conducted in Australia found that academics tend to work longer hours than most other professional groups . In the United Kingdom, a national study of academics found that 36% regularly work in excess of the 48‐hour weekly limit set by the European Union's Working Time Directive, with almost one respondent in three working more than 50 hours . High levels of workaholism are also evident in the Irish academic population . The drive for an ever‐enhanced student experience also adds to the stress and workload of academics. ‘Universities put considerable time and effort into enhancing the student experience, and rightly so, but little consideration appears to be given to the implications for exhausted, demoralized and dissatisfied academics’ [30, p. 231]. The emotional cost of the caring component of the academic role is often overlooked. Furthermore, the lack of risk assessment for stress by education institutions and the shifting of responsibility for self‐care away from higher education providers to the individual academic suggest that institutions are neglecting their occupational health and safety responsibilities. In this context, it is increasingly challenging for academics to engage in self‐care with potentially deleterious impact on their professional work and personal welfare. Deasy et al.  alert us to the tensions that exist between self and other forms of care in professional programmes such as nurse education  and initial teacher education  and which may provide some explanation for the neglect of self‐care by these professionals. What is of deep concern is that sustained exposure to pressures can result in burnout , or negatively impact the well‐being of academics . Indeed, there is evidence of high levels of psychological distress (as measured by the GHQ12) among academics. For example, Kinman et al.  reported caseness (significant levels of psychological distress) rates of 50% in a UK sample and Winefield et al.  reported similarly high levels of caseness (43%) among Australian academics. A systematic literature review to evaluate the prevalence of burnout among university teaching staff found that burnout in this professional group was comparable to that experienced by school teachers and healthcare professionals . There are increasing demands on academics that expand the pastoral care dimensions of the teaching role; for example, higher education students in the United Kingdom clearly articulated their perceptions of the role of academic staff beyond pedagogical development by asserting that lecturers ‘are not there just to teach the subject’ [59, p. 680]. However, academics in demanding working environments are less likely to be in a position to create optimum outcomes for students when they themselves are unduly stressed [45, 57]. Furthermore, Deasy et al.  argue that the increased workload and greater expectations on academic staff in terms of research outputs make it increasingly difficult for academics to dedicate time to developing and supporting students. The adverse consequences of increasing competitiveness and of greater demands and expectations on the health and well‐being of academic staff [60, 61] raise queries with regard to their potential as role models for health. Indeed, we argue that conversely the high expectations of overworking and high tolerance of the stressed environment are actually sowing the seeds of workplace stress and burnout in the initial education experience of higher education students . Burnout has been cited as having some genesis in the undergraduate education experience [63, 64], therefore programmes known to be stressful (especially those with vocational preparation components such as nursing and teaching) must incorporate effective coping skills to equip students with effective coping skills for use in their future careers to prevent engendering and sustaining cycles of distress and poor coping.
4. Stress among students
Stress is not limited to the academic work environment. Stress and coping have been identified as important variables affecting health [65–67]. The evidence points to increased stress and distress as adversely impacting the health of higher education students also . Recent research by Deasy et al. [52, 68] found that 39% of higher education students were identifiable as ‘cases’ (scores > 5 on the GHQ) i.e., having distress levels indicative of poor mental health. Clearly, higher education students are vulnerable to psychological distress [68, 69]. Frequent reports of stress and psychological distress in student populations may have led to some acceptance of distress as a normal part of student life [70, 71]. Such acceptance precludes efforts to address the issue. Yet, the evidence suggests that significant numbers of students are experiencing psychological distress at a level that can adversely impact their mental and physical health , their lifestyle behaviours , their academic performance , retention  and ultimately their future professional careers. Furthermore, acceptance of student stress as normal serves to exacerbate reluctance of students to seek help  with potentially adverse consequences not only for students but also for higher education institutions in terms of student success and retention .
In the same way as the changing nature of the workplace has increased stress for academics, stress among students also results from a combination of academic and other demands that exceed a person's adaptive resources. Stress inducing factors include financial uncertainty, poor employment prospects, increased pressure to do well and technological overload . Research indicates that the current economic climate has led to increased financial stress for students . In Ireland, the changing higher education landscape has resulted in substantial increases in student registration fees and reduced student grants. Less employment opportunities post‐graduation also exacerbates the distress . However, it is noteworthy that workload (similar to academics themselves) is the dominant stress‐inducing factor. There is an interesting reciprocal synergy at play here. Assessment is the main stressor reported by students . Assessment related workload is also a core stress flashpoint for academics. It is perhaps surprising that higher education fails at an effective level to address or even at minimum to engage in any discourse on the reciprocal nature of stress. Recognition of stress as structurally embedded and as deleterious to both staff and student health is clearly warranted if it is to be addressed in any meaningful manner.
The interaction of the many and varied stressors experienced by higher education students have been linked with a myriad of negative outcomes on achievement and academic performance [41, 71, 76, 78]. Cognitive deficits linked with high stress levels including difficulty concentrating and paying attention in class, which has the potential to impede learning and performance, have also been identified as problematic . Clearly, stress negatively impacts student's judgement, their ability to think, to learn, to make decisions and to concentrate .
The nature of what it is to be a student is clearly changing also. Many students now combine their studies with work and family commitments, resulting in a significantly increased workload . How students understand their workload is also an interesting concept as they often correlate workload with the number of assignments that they are required to complete rather than to the actual amount of work they do  which in itself is an interesting commentary on the Bologna process and the European Credit Transfers (ECTs) conceptualization of workload as envisaged by most European universities. European Credits are the credits associated with hours spent on module study. They vary somewhat between countries but on average, one ECTs credit equals between 25 and 30 study hours. In Ireland, as in Spain and Italy, one ECTs equates with 25 hours study approximately; in Finland, they generally equate to 27 hours; and in the Netherlands, 28 hours. This notwithstanding, some programmes of study remain the most heavily timetabled and workload heavy offerings, in particular teacher and nursing education feature predominantly. The potential adverse impact on both student well‐being and learning suggests the need for action. It is perhaps not unrelated then, that these professions feature as among the most vulnerable to burnout in the future. Our recently published research [52, 62, 81] that listened to students voice their experiences resulted in some data that were quite stark. For example, one student explains:
‘It’s difficult sometimes, last week I had a lot of things so I found myself being up until 3 o’clock… four o’clock in the morning trying to finish off things and then you go into labs during the day and you’re just wrecked, especially if it’s a three hour lab where you have no breaks, you’ve been up until about three or four in the morning and nothing is going in and then when you try to reproduce the stuff from that Lab you found that you haven’t really learned a huge amount’. (Interview 12) [68 p. 1328]
Another student also discussed a similar experience with clearly adverse impact upon learning:
‘I get so much work to do all of the time it can get you down…It is hard… I don't like the idea that you don't have time to study what you are learning because you are constantly doing work, so you still feel lost and you still feel behind because you are after spending a few hours doing an essay but you don't actually understand what you did in another class that might be more theory based you know, harder…that is really annoying because you are actually working I don't know what else you can do (Interview 19)’. [68 p. 1328]
Students are clearly not immune to the increasingly individualistic and competitive nature of higher education. The desire to secure a ‘good’ degree created competition between students.
‘Stress, especially in third year and now because the QCA (Quality Credit Average) counts I’ve noticed like everyone seems to be in competition, which is different to like second year, first year…We used to all rely on each other… we shared our work and now we don't share our work (Interview 26)’. [68, p. 1328]
The potential of workload to build up and overwhelm students was identified.
‘It just develops and develops and develops and it's like a stack of books, eventually they’re going to all fall down on top of you… there's way too much workload (Interview 37)’. [52, p. 10]
What was interesting in the data was that students actually perceived lack of lecturer appreciation of the workload that they shoulder: ‘I don't think lecturers understand that you’ve other modules as well; they don't seem to understand that at all’ (Interview 2) [52, p. 184]. However, without doubt, lecturers themselves are feeling the same overwhelming build‐up of work tasks and pressures, and yet in some instances, lecturer behaviour was an actual stressor for students
‘My FYP my tutor was a big source of stress because I didn't find him helpful… I did not have a notion how to analyse any of my results and he wasn't any help for me… he just said look it up on you tube or Google to find out how to do it. There was another guy, a post grad that was working with him that helped me and only for him I’d still be trying to do my FYP at this stage (Interview 26)’. [62, p. 8]
‘I had a Lecturer there last year, he really stressed me out big time…He failed a lot of the course…I thought he was just acting up getting on a power trip…. it was stressful enough…. I didn't know if I was going to be able to go on teaching practice (Interview 25)’.[62, p. 8]
Evaluation in terms of examinations and assessment were significant stressors experienced by these students and appeared to create an unhealthy imbalance and to fuel a performativity agenda. This is problematic on a number of levels, not least because recent discourses in education are cautioning against the unhealthy and counterproductive over emphasis on assessment. Types of assessment were clearly problematic as illustrated in the following student narratives
‘Presentations are very stressful…I had mine this day last week and for the week before I was waking up in a sweat over it… I get really, really bad panic attacks…. I actually had to start taking medication for it… college was a trigger I am not good with dealing with stress… I love college but it is stressful but if I didn't love it I probably would have given it up because it made me not feel well (Interview 56)’. [62, p. 8]
‘I find around exam times it's stressful, the guilt of trying to manage the time you need for your exams and trying to manage home life as well…. in the couple of weeks coming up to exams I have the stress of the exams and the stress of feeling so guilty that I feel the kids are practically driving themselves around (interview 34)’. [62, p. 8]
It is evident that workload stress is getting in the way of optimal learning for several students.
5. Meaningful engagement with stress in higher education
Clearly, there is space for meaningful discourse to occur with regard to the impact of stress. We are not advocating a naïve stance with regard to academic stress for students and lecturers. We clearly acknowledge the impossibility of a stress‐free experience for all. We also acknowledge that positive stress actually has a motivating role to play here. However, the voices of students in our research clearly call for a more thoughtful and ‘care‐full’ educative experience for both staff and students in higher education. We were surprised by the students’ responses to the stressful nature of group work and group assessment, given the increasing (often even overzealous) prioritization of collaboration in teaching and learning. The pedagogical over emphasis on working in groups was identified as significantly increasing pressure on students. Clearly, the nature of assessment is directly related to the stress experienced by students , including group work such as group presentations in professional‐based programmes such as teaching and nursing that is deemed important (even essential) as they are perceived to provide a wealth of learning opportunities  and promote collaborative working, a valued graduate attribute. Nevertheless, the adverse consequences of group work must also be deliberated. Finding and managing the time required to work with several different groups is stressful for students. The potential negative impact of group work on student grades and the issues highlighted by students in relation to free riding need to be acknowledged and addressed in the interests of equity. One might be tempted to think that increased lecturer workload and higher student numbers  might mean that there are pragmatic as opposed to pedagogical reasons for the increased use of group assessment. It is possible that for some academic staff, group work is a means of reducing workload  or managing their large numbers of students to be assessed. In the current high stress academic climate, reducing the burden of assessment for both students and academic staff is critical . However, it is also important to strike a balance between pedagogy and pragmatism so that students are exposed to a variety of assessment methods, which cater for different learning preferences and styles. It is also critical that lecturers using this method of assessment put strategies in place to minimize ‘free riding’  and performance anxiety (easier said than done); however, these are key determinants of stress and therefore need to be addressed. Assessment processes need to be created cognizant of ensuring that students are not disadvantaged in terms of their grade potential by repeated exposure to the same assessment process, which has the potential to disadvantage them repeatedly .
At a practical level in order to break the cycle of assessment and performativity, university educators need to take an innovative and health enhancing approach to assessment. A greater balance between continuous and summative assessment and coordinated efforts to ensure that assignment submission dates do not coincide with end of semester examinations may serve to alleviate key stress flashpoints. A more holistic approach could be achieved by greater co‐operation and linkage between those teaching and assessing different modules within programmes . Student voices in our research suggest that a coordinated approach to assessment would go some way towards addressing stress triggered by having multiple assessments due for submission simultaneously. Students acknowledge that they contribute to their own stress by not balancing their work over the semester and should be supported to develop effective time management, stress management and life skills so that they can better manage their workload and time. However, academic staffs have a duty to carefully plan and structure assessment and submission dates across modules to minimize unnecessary stress. At a macro level, more critical engagement with how stress has become embedded in and manifest in higher education and the deleterious consequences for all, both staff and students clearly require significant consideration. It is not beyond the bounds of society's creative thinkers (if they are not overstressed in the first place) to create a culture that supports themselves and their students to deliver a relatively stress free and enhanced quality of educational experience.
Healthier students learn better and have better educational outcomes . Promoting health and well‐being and proactively engaging with stress are important for health as well as for educational attainment. Increasingly, institutions of higher education are perceived as important settings for health promotion and are committed to address health as part of the health promoting university initiative [87, 88]. A health promoting university framework uses an ecological model and a systems perspective to promote a learning environment and culture that enhances the health and well‐being of both students and staff . The momentum for the healthy university approach is strengthened with the 2015 launch of ‘The Okanagan Charter: An international charter for health promoting universities and colleges’  which replaced the initial Edmonton charter . The Okanagan Charter ‘calls upon higher education institutions to incorporate health promotion values and principles into their mission, vision and strategic plans, and to model and test approaches for the wider community and society’ [90, p. 5]. Antonovsky's theory of salutogenesis is a useful theory to guide the Health Promoting University approach  as it evolved from his work on how people manage stress and stay well. There is increasing acknowledgement that universities need to focus on what is needed to create a well‐being environment . However, almost 20 years have passed since the healthy university concept was initially introduced  yet there has been limited progress in enhancing the health promoting ethos and culture of many higher education institutions and conversely the well‐being of both students and staff appears to continue to deteriorate. To comprehensively address stress among the student population, educators need to critically analyse the structuring of their education provision and its potential to exacerbate stress among students and for themselves . A review of curriculum, which genuinely considers student voice and which identifies opportunities to infuse health and well‐being into curriculum, is warranted. There is a need to embed within curriculum, preventative strategies such as life skills, stress management and time management, along with promotion of self‐care and resilience building activities to enhance students’ personal resources in order to help them cope with current and future stressors .
Higher education educators need to adopt a more holistic approach to assessment as this is an integral but often overlooked determinant of student health . Over emphasis on assessment, over reliance on particular assessment strategies and their potential to impact student health need consideration. The fact that assessment can be quite stressful for academics also needs to be part of the thinking. Self‐care skills are as important for the academic as for the student. It is important to identify student needs from the student perspective and to incorporate recognition of the reciprocal stress dynamic at play rather than simply engaging in normative support provision targeted at students alone. Proactive rather than reactive support provision is warranted. Providing resources and facilities, on their own, is not enough . Educators need to be mindful of their potential to add to student and to their own distress and should carefully examine their curricular demands, especially the potential for academic overload of students  and of themselves. While this may be new territory for many, pastoral care does not cease at the gates of the university and it is not only student focused. The potential to institute the stressed perspective early in the professional formation of young people clearly warrants further discourse and intervention. Stronger recognition is required that excessive managerialism is counterproductive and is damaging the health and well‐being of academic staff in the sector.
The challenge here is to reshape the higher education environment and to develop structures that enable both educators and students to flourish in educatively supportive cultures. Huyton  argues that failure to recognize the importance of emotional labour can have a detrimental effect on educators and the pastoral support service they provide to students. We argue that recognition of care for academics themselves and not just their capacity to provide emotional support for others is essential. While some argue that workload allocations must include ‘emotion work’ , it is difficult to see in the current climate of performativity how this could actually gain traction. However, turning a blind eye to it is not the answer either. Higher education institutions need to become more supportive, empowering and healthy places where both students and staff can develop personally, socially and intellectually. Given the once traditional academic freedom of the academic (albeit clearly currently under siege), who if not academics will stand as the final bulwark against the insidious and pervasive problem of neo‐liberalism and new managerialism in education and in particular the clearly stressful and adverse consequences it is having on the educational experience of all.
- ‘Caseness’ is defined as whether or not a subject has the condition of interest based on the score they gain (in this instance on the GHQ). A cut of score (usually 5 or above in the GHQ 28) denotes a significant level of psychological distress, for example, and is referred to as ‘caseness’.