Adopting the principles and practices of learning health systems in universities and colleges: recommendations for delivering actionable data to improve student mental health

References

• Abreu, M., Hillier, A., Frye, A., & Goldstein, J. (2017). Student experiences utilizing disability support services in a university setting. College Student Journal, 50(3), 323–328.
   Google Scholar
• Agency for Healthcare Research and Quality. (2019, May). About Learning Health systems. https://www.ahrq.gov/learning-health-systems/about.html
   Google Scholar
• Alang, S. M. (2019). Mental health care among blacks in America: Confronting racism and constructing solutions. Health Services Research, 54(2), 346–355. https://doi.org/10.1111/1475-6773.13115
   PubMed Web of Science ®Google Scholar
• Auerbach, R. P., Mortier, P., Bruffaerts, R., Alonso, J., Benjet, C., Cuijpers, P., Demyttenaere, K., Ebert, D. D., Green, J. G., Hasking, P., Murray, E., Nock, M. K., Pinder-Amaker, S., Sampson, N. A., Stein, D. J., Vilagut, G., Zaslavsky, A. M., Kessler, R. C., & WHO WMH-ICS Collaborators. (2018). WHO world mental health surveys international college student project: Prevalence and distribution of mental disorders. Journal of Abnormal Psychology, 127(7), 623–638.
   PubMed Web of Science ®Google Scholar
• Ayón, C., Ellis, B. D., Hagan, M. J., Enriquez, L. E., & Offidani-Bertrand, C. (2022). Mental health help-seeking among Latina/o/x undocumented college students. Cultural Diversity and Ethnic Minority Psychology. Advance online publication. https://doi.org/10.1037/cdp0000573
   PubMed Web of Science ®Google Scholar
• Bantjes, J., Hunt, X., & Stein, D. J. (2022). Public health approaches to promoting university students’ mental health: A global perspective. Current Psychiatry Reports, 24(12), 809–818. https://doi.org/10.1007/s11920-022-01387-4
   PubMed Web of Science ®Google Scholar
• Bantjes, J., Hunt, X., & Stein, D. J. (2023). Anxious, depressed, and suicidal: Crisis narratives in university student mental health and the need for a balanced approach to student wellness. International Journal of Environmental Research and Public Health, 20(6), 4859. https://doi.org/10.3390/ijerph20064859
   PubMedGoogle Scholar
• Barkham, M., Bewick, B., Mullin, T., Gilbody, S., Connell, J., Cahill, J., Mellor-Clark, J., Richards, D., Unsworth, G., & Evans, C. (2013). The CORE-10: A short measure of psychological distress for routine use in the psychological therapies. Counselling and Psychotherapy Research, 13(1), 3–13. https://doi.org/10.1080/14733145.2012.729069
   Google Scholar
• Barkham, M., Broglia, E., Dufour, G., Fudge, M., Knowles, L., Percy, A., Turner, A., Williams, C., & SCORE Consortium. (2019). Towards an evidence‐base for student wellbeing and mental health: Definitions, developmental transitions and data sets. Counselling and Psychotherapy Research, 19(4), 351–357. https://doi.org/10.1002/capr.12227
   Web of Science ®Google Scholar
• Barkham, M., De Jong, K., Delgadillo, J., & Lutz, W. (2023). Routine outcome monitoring (ROM) and feedback: Research review and recommendations. Psychotherapy Research, 33(7), 841–855. https://doi.org/10.1080/10503307.2023.2181114
   PubMed Web of Science ®Google Scholar
• Barnett, P., Saunders, R., Buckman, J. E., Cardoso, A., Cirkovic, M., Leibowitz, J., Main, N., Naqvi, S. A., Singh, S., Stott, J., Varsani, L., Wheatley, J., & Pilling, S. (2022). Are students less likely to respond to routinely delivered psychological treatment? A retrospective cohort analysis. Comprehensive Psychiatry, 119, 152348. https://doi.org/10.1016/j.comppsych.2022.152348
   PubMed Web of Science ®Google Scholar
• Biasi, V., Patrizi, N., Mosca, M., & De Vincenzo, C. (2017). The effectiveness of university counselling for improving academic outcomes and well-being. British Journal of Guidance & Counselling, 45(3), 248–257. https://doi.org/10.1080/03069885.2016.1263826
   Web of Science ®Google Scholar
• Brewster, L., Jones, E., Priestley, M., Wilbraham, S. J., Spanner, L., & Hughes, G. (2022). ‘Look after the staff and they would look after the students’ cultures of wellbeing and mental health in the university setting. Journal of Further and Higher Education, 46(4), 548–560. https://doi.org/10.1080/0309877X.2021.1986473
   Web of Science ®Google Scholar
• Broglia, E., Millings, A., & Barkham, M. (2017). The counseling center assessment of psychological symptoms (CCAPS‐62): Acceptance, feasibility, and initial psychometric properties in a UK student population. Clinical Psychology & Psychotherapy, 24(5), 1178–1188. https://doi.org/10.1002/cpp.2070
   PubMed Web of Science ®Google Scholar
• Broglia, E., Millings, A., & Barkham, M. (2021). Student mental health profiles and barriers to help seeking: When and why students seek help for a mental health concern. Counselling and Psychotherapy Research, 21(4), 816–826. https://doi.org/10.1002/capr.12462
   Web of Science ®Google Scholar
• Broglia, E., Nisbet, K., Bone, C., Simmonds-Buckley, M., Knowles, L., Hardy, G., Gibbon, L., & Barkham, M. (2023). What factors facilitate partnerships between higher education and local mental health services for students? A case study collective. British Medical Journal Open, 13(12), e077040. https://doi.org/10.1136/bmjopen-2023-077040
   PubMedGoogle Scholar
• Broglia, E., Ryan, G., Williams, C., Fudge, M., Knowles, L., Turner, A., Dufour, G., Percy, A., Barkham, M., & SCORE Consortium (2021). Profiling student mental health and counselling effectiveness: Lessons from four UK services using complete data and different outcome measures. British Journal of Guidance & Counselling, 51(2), 204–222.
   Web of Science ®Google Scholar
• Cage, E., Jones, E., Ryan, G., Hughes, G., & Spanner, L. (2021). Student mental health and transitions into, through and out of university: Student and staff perspectives. Journal of Further and Higher Education, 45(8), 1076–1089. https://doi.org/10.1080/0309877X.2021.1875203
   Web of Science ®Google Scholar
• Campbell, F., Blank, L., Cantrell, A., Baxter, S., Blackmore, C., Dixon, J., & Goyder, E. (2022). Factors that influence mental health of university and college students in the UK: A systematic review. BMC Public Health, 22(1), 1778. https://doi.org/10.1186/s12889-022-13943-x
   PubMed Web of Science ®Google Scholar
• Cao, Q. T., Vuong, Q. H., Pham, H. H., Luong, D. H., Ho, M. T., Hoang, A. D., & Do, M. T. (2021). A bibliometric review of research on international students’ mental health: Science mapping of the literature from 1957 to 2020. European Journal of Investigation in Health, Psychology and Education, 11(3), 781–794. https://doi.org/10.3390/ejihpe11030056
   PubMed Web of Science ®Google Scholar
• CCMH Annual Report. (2022). Center for Collegiate Mental Health 2022 annual report. https://ccmh.psu.edu/annual-reports
   Google Scholar
• Cheung, K., Tam, K. Y., Tsang, M. H., Zhang, L. W., & Lit, S. W. (2020). Depression, anxiety and stress in different subgroups of first-year university students from 4-year cohort data. Journal of Affective Disorders, 274, 305–314. https://doi.org/10.1016/j.jad.2020.05.041
   PubMed Web of Science ®Google Scholar
• Constantino, M. J., Boswell, J. F., Coyne, A. E., Swales, T. P., & Kraus, D. R. (2021). Effect of matching therapists to patients vs assignment as usual on adult psychotherapy outcomes: A randomized clinical trial. JAMA Psychiatry, 78(9), 960–969. https://doi.org/10.1001/jamapsychiatry.2021.1221
   PubMed Web of Science ®Google Scholar
• Crane, C., Ganguli, P., Ball, S., Taylor, L., Blakemore, S. J., Byford, S., Dalgleish, T., Ford, T., Greenberg, M., Kuyken, W., Lord, L., Montero-Marin, J., Sonley, A., Ukoumunne, O. C., & Williams, J. M. G. (2020). Training school teachers to deliver a mindfulness program: Exploring scalability, acceptability, effectiveness, and cost-effectiveness. Global Advances in Health and Medicine, 9, 1–15. https://doi.org/10.1177/2164956120964738
   Google Scholar
• Cuijpers, P., Auerbach, R. P., Benjet, C., Bruffaerts, R., Ebert, D., Karyotaki, E., & Kessler, R. C. (2019a). Introduction to the special issue: The who world mental health international college student (WMH-ICS) initiative. International Journal of Methods in Psychiatric Research, 28(2), e1762. https://doi.org/10.1002/mpr.1762
   PubMed Web of Science ®Google Scholar
• Cuijpers, P., Auerbach, R. P., Benjet, C., Bruffaerts, R., Ebert, D., Karyotaki, E., & Kessler, R. C. (2019b). The world health organization world mental health international college student initiative: An overview. International Journal of Methods in Psychiatric Research, 28(2), e1761. https://doi.org/10.1002/mpr.1761
   PubMed Web of Science ®Google Scholar
• de Beurs, E., Boehnke, J. R., & Fried, E. I. (2022). Common measures or common metrics? A plea to harmonize measurement results. Clinical Psychology & Psychotherapy, 29(5), 1755–1767. https://doi.org/10.1002/cpp.2742
   PubMed Web of Science ®Google Scholar
• De Jong, K., Conijn, J. M., Gallagher, R., Reshetnikova, A. S., Heij, M., & Lutz, M. C.(2021). Using progress feedback to improve outcomes and reduce drop-out, treatment duration, and deterioration: A multilevel meta-analysis. Clinical Psychology Review, 85, 102002. https://doi.org/10.1016/j.cpr.2021.102002
   PubMed Web of Science ®Google Scholar
• Delgadillo, J., Rubel, J., & Barkham, M. (2020). Towards personalized allocation of patients to therapists. Journal of Consulting and Clinical Psychology, 88(9), 799–808. https://doi.org/10.1037/ccp0000507
   PubMed Web of Science ®Google Scholar
• Doherty, M., McGuire, A., Martin, R., & Gillieatt, S. (2021). Disrupting ‘expertise’: Learnings from a grassroots lived experience and social work academic partnership. Advances in Social Work and Welfare Education, 22(2), 39–55.
   Google Scholar
• Duffy, M. E., Twenge, J. M., & Joiner, T. E. (2019). Trends in mood and anxiety symptoms and suicide-related outcomes among US undergraduates, 2007–2018: Evidence from two national surveys. Journal of Adolescent Health, 65(5), 590–598. https://doi.org/10.1016/j.jadohealth.2019.04.033
   PubMed Web of Science ®Google Scholar
• Ebert, D. D., Mortier, P., Kaehlke, F., Bruffaerts, R., Baumeister, H., Auerbach, R. P., Alonso, J., Vilagut, G., Martínez, K. I., Lochner, C., Cuijpers, P., Kuechler, A. M., Green, J., Hasking, P., Lapsley, C., Sampson, N. A., Kessler, R. C., & WHO World Mental Health-International College Student Initiative Collaborators. (2019). Barriers of mental health treatment utilization among first-year college students: First cross-national results from the WHO World Mental Health International College Student Initiative. International Journal of Methods in Psychiatric Research, 28(2), e1782. https://doi.org/10.1002/mpr.1782
   PubMed Web of Science ®Google Scholar
• Ecclestone, A., Linden, B., Monaghan, C., & Zheng, S. (2023). Canada’s student mental health network: Protocol for a comprehensive program evaluation. JMIR Research Protocols, 12(1), e41521. https://doi.org/10.2196/41521
   PubMedGoogle Scholar
• Eisenberg, D., Hunt, J., & Speer, N. (2013). Mental health in American colleges and universities: Variation across student subgroups and across campuses. The Journal of Nervous and Mental Disease, 201(1), 60–67. https://doi.org/10.1097/NMD.0b013e31827ab077
   PubMed Web of Science ®Google Scholar
• Evans, C., Connell, J., Barkham, M., Margison, F., McGrath, G., Mellor-Clark, J., & Audin, K. (2002). Towards a standardised brief outcome measure: Psychometric properties and utility of the CORE–OM. British Journal of Psychiatry, 180(1), 51–60. https://doi.org/10.1192/bjp.180.1.51
   PubMed Web of Science ®Google Scholar
• Evans, C., Margison, F., & Barkham, M. (1998). The contribution of reliable and clinically significant change methods to evidence-based mental health. Evidence Based Mental Health, 1(3), 70–72. https://doi.org/10.1136/ebmh.1.3.70
   Google Scholar
• Fajgenbaum, D., Chesson, B., & Lanzi, R. G. (2012). Building a network of grief support on college campuses: A national grassroots initiative. Journal of College Student Psychotherapy, 26(2), 99–120. https://doi.org/10.1080/87568225.2012.659159
   Google Scholar
• Guise, J. M., Savitz, L. A., & Friedman, C. P. (2018). Mind the gap: Putting evidence into practice in the era of learning health systems. Journal of General Internal Medicine, 33(12), 2237–2239. https://doi.org/10.1007/s11606-018-4633-1
   PubMed Web of Science ®Google Scholar
• Gulliver, A., Farrer, L., Bennett, K., Ali, K., Hellsing, A., Katruss, N., & Griffiths, K. M. (2018). University staff experiences of students with mental health problems and their perceptions of staff training needs. Journal of Mental Health, 27(3), 247–256. https://doi.org/10.1080/09638237.2018.1466042
   PubMed Web of Science ®Google Scholar
• Gulliver, A., Farrer, L., Bennett, K., & Griffiths, K. M. (2019). University staff mental health literacy, stigma and their experience of students with mental health problems. Journal of Further and Higher Education, 43(3), 434–442. https://doi.org/10.1080/0309877X.2017.1367370
   Web of Science ®Google Scholar
• Gunawardena, H., Voukelatos, A., Nair, S., Cross, S., & Hickie, I. B. (2023). Efficacy and effectiveness of universal school-based wellbeing interventions in Australia: A systematic review. International Journal of Environmental Research and Public Health, 20(15), 6508. https://doi.org/10.3390/ijerph20156508
   PubMedGoogle Scholar
• Hazell, C. M., Chapman, L., Valeix, S. F., Roberts, P., Niven, J. E., & Berry, C. (2020). Understanding the mental health of doctoral researchers: A mixed methods systematic review with meta-analysis and meta-synthesis. Systematic Reviews, 9(1), 1–30. https://doi.org/10.1186/s13643-020-01443-1
   PubMed Web of Science ®Google Scholar
• Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), 169–183. https://doi.org/10.1037/a0018555
   PubMed Web of Science ®Google Scholar
• IOM. (2001). Crossing the quality chasm: A new health system for the 21st century. National Academy Press.
   Google Scholar
• Jacob, R., Li, T. Y., Martin, Z., Burren, A., Watson, P., Kant, R., Davies, R., & Wood, D. F. (2020). Taking care of our future doctors: A service evaluation of a medical student mental health service. BMC Medical Education, 20(1), 172. https://doi.org/10.1186/s12909-020-02075-8
   PubMed Web of Science ®Google Scholar
• Jacob, J., Rae, J. P., Allegranti, B., Duncan, C., & Cooper, M. (2023). Enhancing mental health and well‐being outcomes for psychotherapy and counselling through idiographic analysis: A four‐quadrant approach. Counselling and Psychotherapy Research, 23(4), 956–964. https://doi.org/10.1002/capr.12645
   Web of Science ®Google Scholar
• Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12–19. https://doi.org/10.1037/0022-006X.59.1.12
   PubMed Web of Science ®Google Scholar
• Karyotaki, E., Cuijpers, P., Albor, Y., Alonso, J., Auerbach, R. P., Bantjes, J., Bruffaerts, R., Ebert, D. D., Hasking, P., Kiekens, G., Lee, S., McLafferty, M., Mak, A., Mortier, P., Sampson, N. A., Stein, D. J., Vilagut, G., & Kessler, R. C. (2020). Sources of stress and their associations with mental disorders among college students: Results of the world health organization world mental health surveys international college student initiative. Frontiers in Psychology, 11, 1759. https://doi.org/10.3389/fpsyg.2020.01759
   PubMed Web of Science ®Google Scholar
• Knapstad, M., Sivertsen, B., Knudsen, A. K., Smith, O. R. F., Aarø, L. E., Lønning, K. J., & Skogen, J. C. (2021). Trends in self-reported psychological distress among college and university students from 2010 to 2018. Psychological Medicine, 51(3), 470–478. https://doi.org/10.1017/S0033291719003350
   PubMed Web of Science ®Google Scholar
• Kuyken, W., Ball, S., Crane, C., Ganguli, P., Jones, B., Montero-Marin, J., Nuthall, E., Raja, A., Taylor, L., Tudor, K., Viner, R. M., Allwood, M., Aukland, L., Dunning, D., Casey, T., Dalrymple, N., De Wilde, K., Farley, E. R. … Williams, J. M. G. (2022). Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: The MYRIAD cluster randomised controlled trial. Evidence-Based Mental Health, 25(3), 99–109. https://doi.org/10.1136/ebmental-2021-300396
   PubMed Web of Science ®Google Scholar
• Lambert, M. J., Burlingame, G. M., Umphress, V., Hansen, N. B., Vermeersch, D. A., Clouse, G. C., & Yanchar, S. C. (1996). The reliability and validity of the outcome questionnaire. Clinical Psychology & Psychotherapy, 3(4), 249–258. https://doi.org/10.1002/(SICI)1099-0879(199612)3:4<249:AID-CPP106>3.0.CO;2-S
   Web of Science ®Google Scholar
• Lee, J., Jeong, H. J., & Kim, S. (2021). Stress, anxiety, and depression among undergraduate students during the COVID-19 pandemic and their use of mental health services. Innovative Higher Education, 46(5), 519–538. https://doi.org/10.1007/s10755-021-09552-y
   PubMed Web of Science ®Google Scholar
• Limone, P., & Toto, G. A. (2022). Factors that predispose undergraduates to mental issues: A cumulative literature review for future research perspectives. Frontiers in Public Health, 10, 831349. https://doi.org/10.3389/fpubh.2022.831349
   PubMed Web of Science ®Google Scholar
• Lipson, S. K., Lattie, E. G., & Eisenberg, D. (2019). Increased rates of mental health service utilization by US college students: 10-year population-level trends (2007–2017). Psychiatric Services, 70(1), 60–63. https://doi.org/10.1176/appi.ps.201800332
   PubMed Web of Science ®Google Scholar
• Lipson, S. K., Zhou, S., Abelson, S., Heinze, J., Jirsa, M., Morigney, J., Patterson, A., Singh, M., & Eisenberg, D. (2022). Trends in college student mental health and help-seeking by race/ethnicity: Findings from the national healthy minds study, 2013-2021. Journal of Affective Disorders, 306, 138–147. https://doi.org/10.1016/j.jad.2022.03.038
   PubMed Web of Science ®Google Scholar
• Locke, B. D., Buzolitz, J. S., Lei, P. W., Boswell, J. F., McAleavey, A. A., Sevig, T. D., Dowis, J. D., & Hayes, J. A. (2011). Development of the counseling center assessment of psychological symptoms-62 (CCAPS-62). Journal of Counseling Psychology, 58(1), 97–109. https://doi.org/10.1037/a0021282
   PubMed Web of Science ®Google Scholar
• Lukenga, M. P., Billonnet, L., Gaugue, J., & Denis, J. (2023). Exploring female students’ perceptions of the use of digital technologies in managing academic stress. Frontiers in Psychology, 14, 1199038. https://doi.org/10.3389/fpsyg.2023.1199038
   PubMed Web of Science ®Google Scholar
• Mackenzie, K., & Williams, C. (2018). Universal, school-based interventions to promote mental and emotional well-being: What is being done in the UK and does it work? A systematic review. British Medical Journal Open, 8(9), e022560. https://doi.org/10.1136/bmjopen-2018-022560
   PubMed Web of Science ®Google Scholar
• Mair, D.(2016). Short-term counselling in higher education: Context, theory and practice. Routledge.
   Google Scholar
• Margrove, K. L., Gustowska, M., & Grove, L. S. (2014). Provision of support for psychological distress by university staff, and receptiveness to mental health training. Journal of Further and Higher Education, 38(1), 90–106. https://doi.org/10.1080/0309877X.2012.699518
   Google Scholar
• McKenzie, K., Murray, K. R., Murray, A. L., & Richelieu, M. (2015). The effectiveness of university counselling for students with academic issues. Counselling and Psychotherapy Research, 15(4), 284–288. https://doi.org/10.1002/capr.12034
   Web of Science ®Google Scholar
• Mellor-Clark, J., Cross, S., Macdonald, J., & Skjulsvik, T. (2016). Leading horses to water: Lessons from a decade of helping psychological therapy services use routine outcome measurement to improve practice. Administration and Policy in Mental Health, 43(3), 279–285. https://doi.org/10.1007/s10488-014-0587-8
   PubMed Web of Science ®Google Scholar
• Montero-Marin, J., Hinze, V., Crane, C., Dalrymple, N., Kempnich, M. E. J., Lord, L., Slaghekke, Y., Tudor, K., Farley, S., Fletcher, M., Foulkes, S., Kuyken, M., Blakemore, S.-J., Casey, T., De Wilde, D., Ahmed, E.-R., Allwood, K., Ball, L. … Bennett, W. (2023). Do adolescents like school-based mindfulness training? Predictors of mindfulness practice and responsiveness in the MYRIAD trial. The Journal of the American Academy of Child & Adolescent Psychiatry, 62(11), 1256–1269. https://doi.org/10.1016/j.jaac.2023.02.016
   PubMed Web of Science ®Google Scholar
• Murray, A. L., McKenzie, K., Murray, K. R., & Richelieu, M. (2016). An analysis of the effectiveness of university counselling services. British Journal of Guidance & Counselling, 44(1), 130–139. https://doi.org/10.1080/03069885.2015.1043621
   Web of Science ®Google Scholar
• O’Brien, N., Lawlor, M., Chambers, F., & O’Brien, W. (2020). Mental fitness in higher education: Intervention mapping programme design. Health Education, 120(1), 21–39. https://doi.org/10.1108/HE-09-2019-0042
   Web of Science ®Google Scholar
• Olaniyan, F. V., & Hayes, G. (2022). Just ethnic matching? Racial and ethnic minority students and culturally appropriate mental health provision at British universities. International Journal of Qualitative Studies on Health and Well-Being, 17(1), 2117444. https://doi.org/10.1080/17482631.2022.2117444
   PubMed Web of Science ®Google Scholar
• Osborn, T. G., Li, S., Saunders, R., & Fonagy, P. (2022). University students’ use of mental health services: A systematic review and meta-analysis. International Journal of Mental Health Systems, 16(1), 1–34. https://doi.org/10.1186/s13033-022-00569-0
   PubMed Web of Science ®Google Scholar
• Oswalt, S. B., Lederer, A. M., Chestnut-Steich, K., Day, C., Halbritter, A., & Ortiz, D. (2020). Trends in college students’ mental health diagnoses and utilization of services, 2009–2015. Journal of American College Health, 68(1), 41–51. https://doi.org/10.1080/07448481.2018.1515748
   PubMed Web of Science ®Google Scholar
• Pacheco, J. P., Giacomin, H. T., Tam, W. W., Ribeiro, T. B., Arab, C., Bezerra, I. M., & Pinasco, G. C. (2017). Mental health problems among medical students in Brazil: A systematic review and meta-analysis. Brazilian Journal of Psychiatry, 39(4), 369–378. https://doi.org/10.1590/1516-4446-2017-2223
   PubMed Web of Science ®Google Scholar
• Paton, L. W., Tiffin, P. A., Barkham, M., Bewick, B. M., Broglia, E., Edwards, L., Knowles, L., McMillan, D., & Heron, P. N. (2023). Mental health trajectories in university students across the COVID-19 pandemic: Findings from the Student wellbeing at Northern England universities prospective cohort study. Frontiers in Public Health, 11, 1188690. https://doi.org/10.3389/fpubh.2023.1188690
   PubMed Web of Science ®Google Scholar
• Priestley, M., Broglia, E., Hughes, G., & Spanner, L. (2022). Student perspectives on improving mental health support services at university. Counselling and Psychotherapy Research, 22(1), 197–206. https://doi.org/10.1002/capr.12391
   Web of Science ®Google Scholar
• Priestley, M., Hall, A., Wilbraham, S. J., Mistry, V., Hughes, G., & Spanner, L. (2022). Student perceptions and proposals for promoting wellbeing through social relationships at university. Journal of Further and Higher Education, 46(9), 1243–1256. https://doi.org/10.1080/0309877X.2022.2061844
   Web of Science ®Google Scholar
• Ramsberg, J., & Platt, R. (2017). Opportunities and barriers for pragmatic embedded trials: Triumphs and tribulations. Learning Health Systems, 2(1), e10044. https://doi.org/10.1002/lrh2.10044
   PubMedGoogle Scholar
• Rolland, F., Hadouiri, N., Haas-Jordache, A., Gouy, E., Mathieu, L., Goulard, A., Morvan, Y., & Frajerman, A. (2022). Mental health and working conditions among French medical students: A nationwide study. Journal of Affective Disorders, 306, 124–130. https://doi.org/10.1016/j.jad.2022.03.001
   PubMed Web of Science ®Google Scholar
• Sagar-Ouriaghli, I., Brown, J. S. L., Tailor, V., & Godfrey, E. (2020). Engaging male students with mental health support: A qualitative focus group study. BMC Public Health, 20(1), 1–14. https://doi.org/10.1186/s12889-020-09269-1
   PubMed Web of Science ®Google Scholar
• Scruggs, R., Broglia, E., Barkham, M., & Duncan, C. (2023). The impact of psychological distress and university counselling on academic outcomes: Analysis of a routine practice-based dataset. Counselling and Psychotherapy Research, 23(3), 781–789. https://doi.org/10.1002/capr.12640
   Web of Science ®Google Scholar
• Shahaf-Oren, B., Madan, I., & Henderson, C. (2021). “A lot of medical students, their biggest fear is failing at being seen to be a functional human”: Disclosure and help-seeking decisions by medical students with health problems. BMC Medical Education, 21(1), 1–10. https://doi.org/10.1186/s12909-021-03032-9
   PubMed Web of Science ®Google Scholar
• Shapiro, M. B. (1961). A method of measuring psychological changes specific to the individual psychiatric patient. British Journal of Medical Psychology, 34(2), 151–155. https://doi.org/10.1111/j.2044-8341.1961.tb00940.x
   Web of Science ®Google Scholar
• Shapiro, M. B. (1969). Short-term improvements in the symptoms of affective disorder. British Journal of Social and Clinical Psychology, 8(2), 187–188. https://doi.org/10.1111/j.2044-8260.1969.tb00606.x
   PubMedGoogle Scholar
• Sheldon, E., Simmonds-Buckley, M., Bone, C., Mascarenhas, T., Chan, N., Wincott, M., Gleeson, H., Sow, K., Hind, D., & Barkham, M. (2021). Prevalence and risk factors for mental health problems in university undergraduate students: A systematic review with meta-analysis. Journal of Affective Disorders, 287, 282–292. https://doi.org/10.1016/j.jad.2021.03.054
   PubMed Web of Science ®Google Scholar
• Smoyer, W. E., Embi, P. J., & Moffatt-Bruce, S. (2016). Creating local learning health systems: Think globally, act locally. The Journal of the American Medical Association(JAMA), 316(23), 2481–2482. https://doi.org/10.1001/jama.2016.16459
   Web of Science ®Google Scholar
• Solomon, E., Nielsen, S. L., & Hardy, S. (2020). Predictors of Client Distress at a University Counseling Center. Undergraduate Thesishttps://scholarsarchive.byu.edu/studentpub_uht/136/
   Google Scholar
• Sorkhou, M., Rashid, T., Dere, J., & Uliaszek, A. (2022). Psychological distress in treatment-seeking university students: An intersectional examination of Asian identity and gender identity. Journal of College Student Psychotherapy, 1–21. Advance online publication. https://doi.org/10.1080/87568225.2022.2145252
   Web of Science ®Google Scholar
• Tollefsen, T. K., Darrow, S. M., Lohne, V., & Berg-Nielsen, T. S. (2020). Experiences with using an idiographic assessment procedure in primary mental health care services for adolescents. International Journal of Qualitative Studies on Health and Well-Being, 15(1), 1763741. https://doi.org/10.1080/17482631.2020.1763741
   PubMed Web of Science ®Google Scholar
• Vallianatos, H., Friese, K., Perez, J. M., Slessor, J., Thind, R., Dunn, J., Chisholm-Nelson, J., Joober, R., Boksa, P., Lal, S., Malla, A., Iyer, S. N., & Shah, J. L. (2019). ACCESS Open Minds at the University of Alberta: Transforming student mental health services in a large Canadian post-secondary educational institution. Early Intervention in Psychiatry, 13(Suppl 1), 56–64. https://doi.org/10.1111/eip.12819
   PubMedGoogle Scholar
• Van Hoy, A., & Rzeszutek, M. (2022). Burnout and psychological wellbeing among psychotherapists: A systematic review. Frontiers in Psychology, 13, 928191. https://doi.org/10.3389/fpsyg.2022.928191
   PubMed Web of Science ®Google Scholar