Module 2: Designing for inclusivity
2.5 Learner mental health and wellness in virtual courses
Key principles: Unpacking mental health
In society and in PSE contexts, it is common to confuse mental health and mental illness (including mental distress, and mental disorder). That is to say, when we reference “mental health” in common speech, we are frequently referring to a problem, as opposed to a positive state of being and functioning. Contrary to the ways that mental health is commonly discussed, a truism about mental health is that everybody has it, all of the time! This is true whether at any given moment our mental health is well or unwell, stable or unstable. The World Health Organization and the Public Health Agency of Canada, respectively, offer helpful definitions of health and mental health that can help in framing and developing an inclusive concept of mental health.
Definitions
Health: “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” (World Health Organization, n.d.).
Mental health: “the capacity of each and all of us to feel, think, act in ways that enhance our ability to enjoy life and deal with the challenges that we face. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections and personal dignity” (Public Health Agency of Canada, 2014).
Importantly, overall health includes mental health and is not characterized by a lack of sickness, but an active state of well-being that includes mental well-being in relationship with physical and social aspects of well-being.
Here, the Public Health Agency of Canada reinforces the integral connection between mental health and overall health, and emphasizes that mental health does not exist in a vacuum, rather it is intricately connected to the broader socio-cultural landscape in which people exist.
Framing a conception of mental health that is inclusive of all people, and focused on well-being is important for many reasons, but especially for the potential that it offers in reducing the stigma associated with experiencing mental disorders or distress, which results in significant negative life outcomes for people experiencing mental disorders or mental distress.
Definitions
Mental distress: A common condition related to brain function, often caused by a problem or event, usually not severe (but can be), typically short in duration, professional intervention helpful, but not necessarily required.
Mental disorder: A less common occurrence, high severity leading to disruption of life functioning, can be unrelated to particular events or problem as an obvious antecedent, can be long-lasting and require professional resources for resolution.
Definitions derived from Canadian Mental Health Commission (2010) and Mental Health Literacy (Kutcher et al., 2017)
Regardless of whether an individual experiences mental distress or a mental disorder, their situation can be quite disorienting and cause feelings of dis-ease. No matter the severity of someone’s distress or disorder, or the presence or absence of a formal diagnosis, compassion and support are the appropriate response from PSE faculty and staff (Canadian Mental Health Commission, 2010; Kutcher et al., 2017).
In the design of humanized virtual learning environments, this kind of support usually manifests through the intentional design of instructor touchpoints that reference mental health (e.g., predesigned templates for announcements about the importance of self-care at high-intensity parts of the course or term), or strategic inclusion of links to university-based and external resources that support mental well-being (e.g., a mental health resource tab in the LMS that is linked at key places that students visit on a regular basis in each week or module).
Key principles: Destigmatizing mental illness to promote well-being
Note: Content warning – Video begins with jarring footage of a dramatized car accident where a person is struck by a vehicle and knocked unconscious.
Transcript for Healthy Minds Anti-Stigma available on YouTube.
Credit: Healthy Minds Canada, 2013
This video shows a person being hit by a car and then treated like someone with a mental disorder, stating, “Imagine if we treated everyone like we treat the mentally ill.” This dramatic public service announcement draws attention to the fact that mental disorders can be as, or more debilitating than physical illnesses or disabilities, and yet their impacts are often downplayed, discounted, or ignored.
To use another example, imagine that it is shared at a neighbourhood block party that the son of one of the neighbours, a university student, has been diagnosed with cancer that requires aggressive treatment. It is easy to imagine in this scenario that many neighbours would offer genuine heartfelt remarks, ask how they can help the whole family to get through, and possibly drop by with dishes of prepared food for the days or weeks following. Conversely, when it is shared that the same young male university student has been diagnosed with severe anxiety or depression, it is more difficult to predict how the neighbours might respond. Perhaps there would be expressions of remorse or concern, but the likelihood of ongoing and affirming support is more in question (Stuart, 2005).
Stigma hinders access to treatment
Stigmatization of mental illness is deep rooted and long held, and it is a significant problem because beyond the social justice aspects of respecting the dignity of all people, the experience of stigma leads to feelings of shame, guilt, and remorse for people who experience mental illness; these feelings lead to people hiding their distress or disorder, and not reaching out for support and treatment (Martin, 2010).
Key principles: Assessing and developing mental health literacy
A primary reason for the historic and ongoing stigma associated with mental illness is a lack of broad public knowledge related to mental health. Use the following diagnostic self-assessment to assess and develop knowledge related to various aspects of mental health.
Reflect and apply: Mental health literacy self-assessment
The self-assessment is an ungraded learning exercise; each question includes response feedback to help you develop your own mental health literacy. Your answers are not saved by the online quiz tool and cannot be viewed by anyone.
Activity Instructions:
Evaluate whether the following six statements are true or false, After you have selected your response, select the “Check” button to check your answer and reveal feedback. Navigate through the quiz questions using the back and forward arrows.
Credit: All quiz questions adapted from Mental Health Literacy (Kutcher et al., 2017). Response feedback was developed from Mental Health Literacy (Kutcher et al., 2017) and the Canadian Mental Health Commission (2010).
If you achieved strong results on the diagnostic self-assessment, congratulations on your mental health literacy! If not—don’t stress—try to view it as an invitation. Low mental health literacy is very common, and the intention of the self-assessment is to help develop your knowledge and emphasize the importance of growing our collective mental health literacy as PSE professionals, and as human beings.
Going deeper
The Mental Health Commission of Canada hosts a training program called Mental Health First Aid which is designed to prepare community members (lay responders, non-health care professionals) to recognize and react in support to “a person developing a mental health problem, experiencing a mental health crisis, or a worsening of their mental health” (Mental Health First Aid Canada, n.d.). If you are interested in developing your knowledge and skills in mental health first aid, consider one of their virtual or face-to-face courses.
The following resource may be a helpful resource for yourself, or offer it to learners in your syllabus or LMS so they can improve their mental health literacy in a safe manner.
Mental health is strongly associated with food insecurity. This info sheet explores this relationship through quantitative data presentation.
Strategies in action: Designing virtual learning experiences to promote well-being
Often we consider student well-being as an afterthought or secondary consideration that exists outside the central purview of our courses—something that we refer students to other services for rather than planning in a way that is integrated into our courses. Of course, referring concerns around well-being to academic support units like a healthcare or counselling centre can be entirely appropriate, and we are not suggesting that faculty need to take on a role that is best handled by professional counselling or healthcare teams. We are suggesting that course designs that integrate checkpoints for student well-being actually help in achieving the academic outcomes that we aim for in PSE (Keyes et al., 2012; El Ansari & Stock, 2010).
Consider the following:
Belonging and social inclusion: Students’ well-being is supported when they feel connected to their instructors and peers.
Quick tips and tricks: Quick check-ins
In synchronous sessions, try to begin with a few moments of community-focused activity—a check-in on how people are feeling “outside the class” in order to set a context for what will happen “inside the class.” For asynchronous designs, try to use “quick” virtual learning tools (a poll, a “tweet” length report on how people are feeling, etc.) at strategic places in a module or course unit to check in on learner well-being. This can inform decisions that you make in facilitating each part of the course.
Learning well: Learners’ well-being is supported when they are motivated to learn and when they feel that they are learning effectively.
Quick tips and tricks: Positive feedback
Use natural feedback opportunities to provide motivating feedback whenever possible. This could be complimenting and extending an insightful remark a student makes in an online breakout group, or highlighting when a student demonstrates deep thinking in a discussion board post. The public nature of positive feedback has the potential to be collectively motivating for all learners—and can help the instructor be more invested.
Whole student: Well-being is supported when instructors recognize that learners have lives outside academics.
Quick tips and tricks: Engaged instructor, engaged learners!
Design with community engagement in mind! Ask students to respond to course content in ways that draw in their jobs/professional experience, families, and leisure pursuits. Reciprocate with your own personalized examples as appropriate.
Going deeper
Based on research done at UBC, the following well-being checklist interweaves many concepts discussed in this module and in this course; organized into three levels:
- Easier to implement
- Requires some preparation by the instructor
- May require thoughtful preparation by the instructor
Some of the examples are aimed at face-to-face instruction (learning student names, as they are not always available on screen), but others can be easily taken up in virtual contexts.
Can you see any of these opportunities being used in your virtual learning designs?
Strategies in action: Promote course and institutional supports in your course LMS
(Dodge et al., 2012, p. 230)
Fortunately, most institutions have a variety of resources available to learners to access when they identify dips in their well-being. You are not responsible for always knowing how to resolve a learner’s challenge(s), especially if it is outside the scope of teaching your course objectives, however, you do have a responsibility to guide learners to the right supports that may meet their needs.
Consider the resources that could be available to learners at your institution and in your course (list is not exhaustive):
- instructor
- teaching assistant(s)
- peers
- academic advisors
- institutional IT support
- library services
- writing and research services
- departmental staff (coordinators, administrators, etc.)
- athletics and recreation
- student unions and associated services
- threaded video discussions
- video or audio posts to course forums
- synchronous video or audio discussions
- social media
- interactive document collaboration
- emails, texts, and phone calls between students (typically not required but often take place informally)
Reflect and apply: Understanding institutional supports for learner well-being
Consider your learners and how familiar they might be with the resources available to them that can help them succeed in your course. Using the resource list above, respond to the questions below by indicating how you might purposefully promote appropriate resources to your learners.
How to complete this activity and save your work:
Type your response to the questions in the box below. Your answers will be saved as you move forward to the next question (note: your answers will not be saved if you navigate away from this page). Your responses are private and cannot be seen by anyone else.
When you complete the below activity and wish to download your responses or if you prefer to work in a Word document offline, please follow the steps below:
- Navigate through all tabs or jump ahead by selecting the “Export” tab in the left-hand navigation.
- Hit the “Export document” button.
- Hit the “Export” button in the top right navigation.
To delete your answers simply refresh the page or move to the next page in this course.
Your answers to these questions might help you create a list of resources/links that you may wish to promote on a special page of your LMS. Through interactions with your learners and running your course a few times, you might find other resources that learners signal to you as being helpful.
Strategies in action: Managing student workload
Beware virtual course scope creep
It is not uncommon for instructors to struggle a bit with estimating what is an appropriate amount of work for a virtual (online, remote, and blended) course. Without the constraint of dedicated and scheduled lecture time (or having online learning as an additional component/expectation in a blended course) it is easy to include more information than would be included in an in-class version of the same course.
The spirit of this tendency, course scope creep, is almost always about enhancing learning; it comes from a place of really wanting to give learners more. It can be liberating to be able to describe a process in more detail, to do a closer analysis of a concept, add more examples, assessments, and/or provide additional resources in an online component of a virtual course, which one typically can’t get into in an in-person class.
This can enhance learning for some learners; however, if this results in course scope creep (i.e., when we add without cutting elsewhere) it often means some learners simply will not have the time to engage with all the content, resources, activities and assessments for various legitimate reasons (e.g., they may simply be slow/deep processors, have other life commitments, and/or have four other heavy load courses making it impossible to do extra in your course). This means that learners will have to make strategic decisions about what to omit from their learning.
This can be a source of significant stress, and without clear guidance from the instructor (i.e., on what is optional/supplementary), learners can make the wrong choices (e.g., choosing to focus on something that they think is important, but you don’t see as core and will not be assessed).
General guidance on estimating workload and avoiding course scope creep:
- Most PSE undergraduate programs suggest learners should expect to spend between 8–12 hours a week (including activities, assessments, and working through content). For a full-time student with five courses, that is already up to almost 60 hours a week of pretty intense cognitively demanding work (learning is hard work). That’s a lot!
- Use a workload calculator (see the “Going Deeper” resources below) to help you estimate how much you are asking of your learners. It can be helpful to do this for virtual courses as well as typical in-class courses.
- If you already have your course ready to go and don’t have time to make changes to content and assessments this time around, ask your learners in this next offer (using an anonymous survey) how much time they spent on each of the activities, assignments, and modules/weeks of content. This will at least give you an idea of where learners are spending their energy and you can then make tweaks to reduce the load, and or messaging to help them focus on what is critical.
- When calculating workload/time for blended courses, don’t forget to include the duration of time for in-class activities and the time learners may need to prep for activities and assessments before and after the in-class sections. Some instructors choose to shorten in-class sections (shorter than typical lectures) to give learners some time back.
- If you are adding, think about what you can take away or make optional. Ensure you are signaling clearly and consistently to learners what is core, critical, and will be assessed from what is additional and supplementary and won’t be directly assessed.
- If in doubt, go with less rather than more. Don’t be afraid of giving learners some space to process or let them know that you are intentionally giving them extra time to work on activities and assessments, by reducing the load elsewhere. This can send a strong signal when you want them to prioritize an activity or assessment. Significant learning takes time.
Rethinking the value of rigour in PSE
Underlying the debate for more or less workload in PSE is a historical adherence to rigour as a measure of academic quality. Consider, though, that the definition of rigour denotes terms like rigidity, harshness, inflexibility, and severity much more than it does quality of learning (Oxford University Press, 2021). Are these conceptions representative of what a designer would want for the virtual learning experiences that they develop?
Most faculty are hesitant to adjust coursework expectations in ways that promote students spending less time on their course; however, there is a reality that the contemporary PSE learner experience is not what it was even a decade ago (in part because many PSE institutions are now more inclusive than they have been in the past). Many learners have legitimate demands on their time that are external to their life as a PSE learner (e.g., jobs, family caregiving, mental health self-care, etc.). In thinking about management of student workload, we suggest putting aside the legacy of rigour, and focusing on quality delivery of the learning outcomes identified for a particular course or learning experience.
Ask yourself the following questions:
- What are the learning outcomes intended for this unit of learning? What is the core content and required for the delivery of those outcomes? What additional/extension content can be provided to extend or deepen the impact of the identified learning outcomes?
- How exactly are the learning outcomes connected to course content, in particular: session/module content, and course assessments?
- How much time do you estimate that learners will need to spend over a given week/portion of coursework to complete the session content and course assignments for that portion of the course? (See the “Going deeper” resources immediately below for information on student effort and workload expectations in the PSE sector).
- What interactions are the minimum required (learner–instructor, learner–content, learner–learner) interactions with the course that are needed to ensure that the learning outcomes can be achieved with a view to a transformative learning experience (as opposed to mere coverage)?
- What accommodations could you provide that might allow some or all students to spend less time on course elements and still achieve the learning outcomes identified in the course syllabus in a way that is meaningful and has the potential to be transformative?
These last two questions are of the utmost importance. Linking back to section 2.4. Universal Design for Learning and Equitable Access to Content, the ideal course design is one that allows all learners to achieve learning outcomes in a meaningful way, with the potential of experiencing transformative learning. Some learners may be in a position to exceed learning expectations through engagement with additional/extension content, or deeper engagement in core content than is strictly required for achieving the learning outcomes. For students experiencing mental distress or disorder, the opportunity to engage with the “minimum” expectation that has meaningful learning may mean the difference between a humanizing learning experience and an exclusionary push out of PSE.
Going deeper
How much time do your students spend on your course each week? Likely less than you might think. Is it a student’s responsibility to meet our expectations for time on course material? Or do faculty/course designers need to rethink our expectations? In this think piece, Gavan Watson argues the latter.
The following course workload calculator uses research on student work and reading speeds to help instructors estimate how much work they are asking learners to complete:
Strategies in action: Addressing sensitive topics
References and credits
Canadian Mental Health Commission. (2010). Mental health first aid Canada: For adults who interact with youth.
Dodge, R., Daly, A., Huyton , J., & Sanders, L. (2012). The challenge of defining wellbeing. International Journal of Wellbeing, 2(3), 222–235. http://dx.doi.org/10.5502/ijw.v2i3.4
El Ansari, W. & Stock, C. (2010). Is the health and wellbeing of university students associated with their academic performance? Cross sectional findings from the United Kingdom. International Journal of Environmental Research and Public Health, 7(2), 509–527. https://doi.org/10.3390/ijerph7020509
Keyes, C. L., Eisenberg, D., Perry, G. S., Dube, S. R., Kroenke, K., & Dhingra, S. S. (2012). The relationship of level of positive mental health with current mental disorders in predicting suicidal behavior and academic impairment in college students. Journal of American College Health, 60(2), 126–133. https://doi.org/10.1080/07448481.2011.608393
Kutcher, S., Wei, Y., & IWK Health Center. (2017, December). Mental health and high school curriculum guide: Understanding mental health and mental illness. Mental Health Literacy. https://mentalhealthliteracy.org/product/mental-health-high-school-curriculum/
Martin, J. M. (2010). Stigma and student mental health in higher education. Higher Education Research and Development, 29(3), 259–274. https://www.tandfonline.com/doi/abs/10.1080/07294360903470969
Mental Health First Aid Canada (n.d.). Mental health first aid. https://mhfa.ca/
Oxford University Press. (n.d.). Oxford English dictionary Retrieved February 28, 2022, from https://www.oed.com
Public Health Agency of Canada. (2014, May 6). Mental health promotion. https://www.canada.ca/en/public-health/services/health-promotion/mental-health/mental-health-promotion.html
Stuart, H. (2005). Fighting stigma and discrimination is fighting for mental health (Special electronic supplement). Canadian Public Policy, 31, S21–S28. http://mdsc.ca/documents/Publications/Fighting%20Stigma%20and%20Discrimination%20is%20Fighting%20for%20Mental%20Health.pdf
World Health Organization. (n.d.). Constitution of the World Health Organization. https://www.who.int/about/governance/constitution
