Any student starting university knows the thrill of the initial college days, where you have boundless freedom, come across a new crowd, and are finally pursuing the career you grew up dreaming about. However, university days can also be equally daunting. You have tests almost every month and tonnes of assignments, which will often completely throw you off your sleep schedule and social life. The high tuition fee of private universities will coerce you to take loans and part-time jobs. Yet, the job market and future ahead is uncertain. Sometimes, you have to move to a new city or stay in hostels for college, away from your family and solid support systems. The stronger among them manage to cope, while some people struggle a lot more than others.

Students suffering from mental health issues like clinical depression and anxiety disorder struggle a lot more in adjusting to a ruthless education system that is obsessed with productivity. So, in this cut-throat university culture where students are skipping dinners and staying up all night just to get an extra edge on their curriculum vitae, what should the universities do to accommodate students who are struggling with the bare minimums?

First-ever survey

The first-ever field survey on the prevalence of mental health illness in Nepal, conducted in 1984, estimated mental health issues to be approximately 14 percent. Today, suicide is the third leading cause of death among women of the reproductive age group, which inevitably entails college-going women, and suicide rates for women are higher than men in Nepal. Women who battle gender discrimination at home and belong to low socioeconomic backgrounds are more predisposed to mental health issues. Impostor syndrome is also more rampant among women, who tend to constantly devalue themselves for not being good enough. After many years, the National Mental Health Survey by the Ministry of Health and Population and World Health Organisation is being carried out and has been partially completed across Provinces 1 and 2 and Bagmati.

The lack of research and negligence of universities in accommodating mental health are results of the stigmatisation of mental health issues. People generally tend to look at mental health patients with fear, disgust, confusion and embarrassment. Nepali people have even resorted to jhakri and traditional medicine for treatment. Such perception harms people suffering from mental health issues to reach out and seek help. Students suffering from depression often struggle with the most menial tasks like getting out of bed, eating three meals a day, taking showers and brushing their teeth. Such students tend to take breaks, which often results in an overwhelming amount of work to catch up on; this again increases the tendency to want breaks, creating a vicious cycle. Thus, students struggling with mental health face difficulty meeting the attendance threshold required to sit for exams.

Also, universities fail to acknowledge mental health illnesses with the same severity as physical illnesses like accidents or being bedridden due to fever. Thus, there are no sick leaves for panic attacks or depressive episodes, which results in labelling such students as "lazy" and invalidates their struggles. Similarly, exams and demanding deadlines often lead to stress and rampant panic attacks. Some students are even gut-wrenched and on the verge of throwing up before entering the exam hall. Even in an era of virtual learning, the mandate to turn on videos, virtual participation in college events and group projects are crippling for students dealing with social anxiety.

The impact of an unaccommodating education system for students battling with mental health illness is a decrease in GPA, rankings and attendance. Many anxious students become reclusive; they get through college by only going to classes and sitting for tests without engaging in personal and career development activities. The intellectual value and passion of learning are removed, and the learning experience is confined within stressful deadlines.

The best way colleges could help is by providing free, certified and accessible counsellors and psychiatric services on campus. A therapist in Kathmandu costs around Rs1,000-4,500 per hour. Such rates make therapy elitist and inaccessible to students from working-class backgrounds. Similarly, the ratio of psychiatrists to patients is an absurd proportion of 1 to 200,000 in Nepal. This goal of accessibility of mental health services for everyone was one of the five objectives of the National Mental Health Policy 1996, which is yet to be effectively implemented. Such facilities, however, require an increase in the funding for mental health programmes.

Some inexpensive alternatives could be establishing peer support groups where trained students can provide support, link to counsellors, talk to each other and even chat anonymously through apps. Well-being sessions and workshops like mental health awareness, meditation weeks, yoga and art competitions could be conducted, which would open dialogues on mental health. This would help destigmatise mental health issues, promote those suffering to reach out, and sensitise those who are not. Such workshops also promote self-care.

Flexible schedules

Further, the academic schedules could be made more flexible. Alternatives to the high-pressured annual board exams should be present through supplementary assignment submissions or by allowing students to sit for tests at a later date. The attendance mandate for such students should be waived, and professors should not dismiss mental health illness as an invalid excuse or laziness. Lastly, colleges should actively disseminate national suicide prevention hotline numbers, train staff for first aid, and have an ambulance on stand-by for attempts of suicide and self-harm.

It has been long overdue to recognise that mental health disorders are often the result of a failed education system obsessed with performance and productivity. The onus should not be on the student who silently suffers every day, and we ought to recognise that the problem is rather systemic. Suffering from mental health issues does not mean that we cannot succeed in life. Sometimes we meet our goals slower than others because of unaccommodating education systems. But, despite our daily struggles, we can succeed. However, our universities need to start giving us the space to not be okay.