Journal of Student Affairs in Africa | Volume 10(2) 2022, 195-207 | 2307-6267 | DOI: 10.24085/jsaa.v10i2.4368   195

www.jsaa.ac.za
AFRICAN 
MINDS

R eflective practice

Campus Mental Health Revisited
Linda Eskell Blokland* & Hanlé Kirkcaldy**

Abstract
This conceptual, reflective article explores recent innovations in mental health service provision at 
a large urban, residential university in South Africa during the COVID-19 pandemic. Prior to 
the pandemic, mental health services at this university were generally offered through face-to-face 
consultations, with secondary offerings in the form of well-being workshops at student residences and 
faculty houses. The need for mental health support was acute during the pandemic, placing great 
pressure on service provision. At the same time, however, everyone – that is, all staff and students 
– were working remotely as campuses had been closed under national lockdown. In this context, it 
was necessary to connect students to mental health services while they were studying remotely during 
the various phases of lockdown and to revisit the conventional and possibly largely reactive model 
of mental health service provision. Innovation in the promotion and provision of mental health 
services and products at this university, including through corporate partnerships and the responsible 
use of automation and technology, helped to achieve market penetration and widespread utilisation 
of services. In addition, ethical considerations; the factors inhibiting and supporting change; and 
the sustainability of the efforts undertaken during this period had to be addressed. Drawing lessons 
from the experience at this university, it is recommended that, while there will always be a place 
for conventional mental health service offerings, it may be time to expand the model permanently 
on modern campus environments, where there is a need for a caring community; committed 
leadership; the development of resilience in the student body; and the building of personal strengths 
in individuals. 

Keywords 
caring campus, mental health support, pandemic, student counselling, university

Introduction
In March 2020, the South African government instituted a national lockdown in 
response to the global spread of COVID-19. Under the lockdown, staff and students 
at a large urban residential university were instructed that they should work from 
home wherever possible, and all contact classes were suspended for students. Over the 

*   Dr Linda Eskell Blokland is a clinical psychologist in private practice. She is also the chairperson of the 
Clinical Psychology Forum. Email: linda.blokland@gmail.com. ORCID: 0000-0003-2840-4720.

**  Dr Hanlé Kirkcaldy is a clinical psychologist and the head of the Student Counselling Unit in the 
Department of Student Affairs of the University of Pretoria. Email: hanle.kirkcaldy@up.ac.za. 
ORCID: 0000-0001-9797-2655.

http://www.jsaa.ac.za
mailto:linda.blokland@gmail.com
mailto:hanle.kirkcaldy@up.ac.za


196   Journal of Student Affairs in Africa | Volume 10(2) 2022, 195-207 | 2307-6267 | DOI: 10.24085/jsaa.v10i2.4368

next 18 months, the national and international landscape changed continuously, as 
the university, the country, and the world, had to respond and adjust to the profound 
impacts of the global pandemic. 

Conventional Mental Health Service Delivery on University Campuses
Students experience unique demands and challenges while at university. They may need 
to adjust to a new phase of life, while experiencing significant neuro-psycho-social 
development, and possibly encountering adverse and stressful life events. The experience 
can damage students’ wellness and jeopardise their mental health (Eskell Blokland, 2019; 
Gruttadaro & Crudo, 2012; Newman & Newman, 1984). In South Africa, students are 
exposed to mental health problems such as suicidality, depression, and anxiety due to 
pervasive systemic disadvantages in the society (Bantjes et al., 2019). The difficulties 
they may encounter include financial and economic insecurities; historical, societal and 
educational disadvantages; and exposure to personal loss, crime, and trauma (Eloff & 
Graham, 2020; Setlofane, 2019). 

Student counselling and development (SCD) services and programmes on university 
campuses play an important role in helping students respond to the mental health 
and development challenges they face. These services assist students in reaching their 
primary objective at university, namely academic success. Important organisational 
strategic goals of any university, including student success and throughput, are enhanced 
through the professional support functions delivered by SCD service units. The 
inputs delivered by these units include psychotherapeutic and counselling support for 
students for a wide variety of conditions and presenting problems. In addition to such 
counselling services, other support may include academic and remedial interventions; 
career assessments and guidance; trauma interventions; assessments for concessions 
related to students with disabilities; interventions in conjunction with disciplinary and 
transformation committees; and management of psychological emergencies such as 
psychoses or other acute syndromes. In addition, workshops and group interventions 
targeting specific topics of importance to the student population, such as relationship 
and conf lict management; anxiety and stress management; and lifestyle-related themes, 
are regularly provided. 

These services are usually delivered in a conventional walk-in clinic set-up, where 
students request services and are offered appointments in a physical, on-campus location. 
A variety of service providers, including psychologists; counsellors; peer helpers; and 
psychology interns or master’s students, are generally involved in the delivery of these 
services.

Theoretical and Conceptual Frameworks in Student Counselling 
and Development
The conceptual frameworks underpinning the delivery of SCD services may derive from 
a number of theories, including systems theory frameworks such as Bronfenbrenner’s 
ecological systems (1981); and wellness models (Witmer & Sweeney, 1992). 



Linda Eskell Blokland & Hanlé Kirkcaldy: Campus Mental Health Revisited   197

Systems framework

A systems framework focuses on the individual student in relation to various ecologically 
relevant contexts which can be visually represented as concentric circles expanding from 
the student, who is in the centre (Beekman, 2012). The student stands in relation to all 
the systems in his/her/their world, the parts inf luencing the whole, and vice-versa. As 
such, the contexts are bilaterally permeable, with the external context inf luencing all the 
narrower contexts, and with each sub-system comprising a valuable part of the bigger or 
whole system. 

The first context closest to the student (the microsystem) could be conceptualised as 
those structures with which the student has direct contact – these include the immediate 
university environment such as is found on campus, namely the administrative structures; 
the academic faculties; the lectures and lecturers; the university staff; the residence 
environments; and the student bodies, including sport and cultural societies (Beekman, 
2012). The microsystem context also includes relationships with fellow students in 
the immediate environment. The next context (the mesosystem) includes interaction 
with the broader community; inter-university activities; the university’s culture and 
position in relation to other institutions; the geographical location of the institution; 
and the inf luence and role of the media or mass media on the student (Beekman, 2012). 
The broader context of the exosystem includes settings that can bear on the individual 
with greater or lesser intensity (Bronfenbrenner, 1981), such as family and extended 
family structures; the community whence the student came; cultural settings; and 
economic status and occurrences (Beekman, 2012). Then, the macrosystem implies the 
larger society; governmental regulations; and policy or legal changes; while the global 
system implies events and occurrences in the even broader, global environment. These 
systems may have strong inf luences on individual (student) life in direct or indirect ways 
(Bronfenbrenner, 1981). 

Wellness theory

Models based on wellness theory focus on holistic individual development and emphasise 
salutogenic factors – that is, they focus on strengths and enabling and health rather than 
adopting a pathogenic paradigm which has a remedial or reactive focus (Witmer & 
Sweeney, 1992). Under this model, the focus is on the student as an individual, and 
the main concern is to enhance the student’s strengths and resilience. This approach 
emphasises optimal well-being in various life spheres, including the emotional, physical, 
mental-health, environmental, occupational and spiritual spheres. It asserts that balance 
in these areas leads to the best outcome for the individual (Van Lingen, 2012). Thus, 
students are viewed in a holistic way considering their multiple facets and needs as 
individuals. Students are encouraged to attend to and regulate the various spheres of 
their lives, which may be depicted in the form a wheel of wellness, in a proactive way 
(Witmer & Sweeney, 1992). 



198   Journal of Student Affairs in Africa | Volume 10(2) 2022, 195-207 | 2307-6267 | DOI: 10.24085/jsaa.v10i2.4368

Wellness approaches vary, but mainly delineate a number of areas of life, such 
as spirituality; self-regulation; work; friendships; and love, to which the individual 
should attend. Various positive characteristics are associated with each of these areas. 
For instance, efforts at self-regulation may entail cultivating a sense of self-worth; 
self-control; realistic and logical beliefs; spontaneity and emotional responsiveness; 
intellectual engagement; problem solving and creativity; a sense of humour; and 
physical care and fitness (Witmer & Sweeney, 1992). Wellness theory can be readily 
applied in support of student development and success. A well student with an optimal 
lifestyle; positive relationships; self-efficacy; and the capacity for stress management 
and emotional control, stands a better chance of academic success (Horton & Snyder, 
2009; Morris-Paxton et al., 2017). In relation to mental health, positive psychological 
approaches may deploy a wellness frame of reference to focus on developing and building 
individual and group strengths, resilience and mental assets, and foster the creation of 
meaning and authentic happiness (Seligman, 2002; Wissing et al., 2014). In its focus on 
the individual student, wellness theory can also foster acknowledgement of the diversity 
of the student population, encapsulating dimensions such as culture, spirituality, gender, 
sexual orientation and economic factors, among others.1 

Mental Health Impacts of COVID-19
The mental health impacts of the COVID-19 pandemic have been profound. Symptoms 
of anxiety, depression and stress have been commonly reported (Rajkumar, 2020; Hunt 
et al., 2021; Taylor, 2019). Researchers have discussed how students have reported 
fear and worry about their own health and those of their loved ones; concentration 
difficulties; sleep disturbances; a lack of socialising opportuniuties under lockdown; 
and anxiety in relation to academic success (Changwon et al., 2020). In a survey 
study evaluating a group of 5,074 South African students, it was reported that students 
experienced high levels of depression and anxiety and scored low on the mental health 
continuum during lockdown (Visser & Law-Van Wyk, 2021). These students were not 
only worried that they or their families would contract COVID-19, but experienced 
difficulties because they could not attend class. Difficulties came in the form of a 
variety of challenges such as unreliable internet access, family dynamics in the home, 
lack of peer contact and support, and low confidence with regard to self-study. Students 
complained that home life was not conducive to focus and concentration. Some students 
found themselves struggling with distressing domestic events. In addition, they reported 
feeling vulnerable and as if their lives were on hold. Some were victims of crime and 
gender-based violence during lockdown (Visser & Law-Van Wyk, 2021). 

1 For an overview of both the systems framework theory and wellness theory models as applied to the 
SCD arena, see Van Lingen (2012) and Beekman (2012). 



Linda Eskell Blokland & Hanlé Kirkcaldy: Campus Mental Health Revisited   199

The Impact of COVID-19 on Student Counselling and 
Development Services
The disruption produced by the global pandemic highlighted shortcomings in the 
traditional conceptualisation of mental health support systems and service provision, 
and posed challenges to psychotherapists working in the field, both globally and locally 
(McBeath et al., 2020; Nguse & Wassenaar, 2021). Campus mental health services had to 
respond to the increased demand and changing needs (Abrams, 2022). The interactions 
of the various sub-systems in which students function were placed under pressure and the 
homeostasis of these systems was threatened. The usual close and supportive structures 
within the student-life microsystem fell away because of forced campus closures during 
lockdown and were replaced with elements of a mesosystem which were not optimally 
geared to support student life and adjustment. Macro and global system elements curbed 
individual freedoms and choices. 

According to Erikson’s (1968) seminal theory of human development, the optimal 
psycho-social outcome in the development phase of students is to find a sense of 
belonging – that is, intimacy, as opposed to isolation. One could speculate that the 
impact of the protective lockdown measures, and the resulting microsystem restrictions 
felt by individuals in this life phase, would have been immense. This psycho-social 
developmental phase, as discussed earlier, would have been impacted severely by the 
lockdown procedures, as students were forced to isolate from their peers. Students were 
obliged to focus on survival and adaptation, rather than on thriving. This put students at 
risk of academic failure and mental ill health. 

In response to the threat posed by the lockdown measures adopted to manage the 
pandemic, universities sought to redesign their academic programmes to address student 
needs under the circumstances of the “new normal”. They were also required to adopt 
urgent measures to create a new psychological equilibrium for students, promoting and 
protecting their wellness under lockdown. To this end, services had to be delivered into 
a number of shifting spheres and systems in new ways. 

Change and Innovation 
Responding to the imperative to adapt the ways in which student counselling and 
development services should be provided, the Student Counselling Unit at one of South 
Africa’s large residential universities implemented changes in its service provision in 
three main areas: the use of online modes of work; the establishment of new mental-
health offerings to meet the student clients’ evolving needs; and the utilisation of 
internal and external partnerships.

Moving online

As soon as the closure of campuses was considered by the university’s management, the 
Student Counselling Unit at this university transferred its operations to a virtual office 
space, which implied that the provision of all resources and official documentation and 



200   Journal of Student Affairs in Africa | Volume 10(2) 2022, 195-207 | 2307-6267 | DOI: 10.24085/jsaa.v10i2.4368

the management of the practice would now have to be undertaken via the internet. 
Given the sensitive nature of the work being undertaken in the unit, it was necessary 
to address a range of security issues around this move to the internet and to source 
student/client consent for the new virtual form of service provision. A virtual campaign 
was launched to inform the student body of the continued availability of mental health 
services. This campaign was conducted via email; articles and announcements on the 
university’s website and on the unit’s own microsite; advertisements on social media 
platforms; and more conventional methods such as posters and f lyers. Client consent 
forms were updated to inform clients about the provision of telehealth services, outlining 
the relative benefits and risks associated with working online. 

Synchronous and video-supported platforms were chosen as the preferred channels 
for undertaking therapeutic work, since these offered better compliance with the 
guidelines that had been issued in March 2020 by the Health Professions Council 
of South Africa (HPCSA). The aim was to ensure that contact with students would 
remain professional and would resemble conventional “sessions” as closely possible. 
Text messaging, telephone calls, and emails were used to make and cancel appointments 
and to facilitate referrals. A centralised email address was created for students seeking 
to access the services and make service requests. The hope was that the relative ease of 
access offered by email communication might encourage students to continue using the 
service while at home or off campus. The view was, since academic content was already 
being provided via a number of online platforms, the students were already adept at 
using these modalities of communication. In addition, it was hoped that the new online 
form of provision would offer the added benefit of removing a number of the existing 
barriers to seeking mental health treatment; barriers presented by factors such as stigma, 
and time and schedule constraints. 

Staff training in the new system was seen as a priority. Various meetings and 
workshops were held at which the professional expectations of telehealth services were 
discussed with staff. Staff were encouraged to attend webinars on these topics to enrich 
the knowledge base at the university’s Student Counselling Unit. The understanding 
was that the professionals in the unit had to broaden the scope of what it meant to be 
a mental healthcare provider and expand their technological capabilities in providing 
mental health care services. 

Matching the mental health products on offer to student-client needs

As the months progressed and the lockdown continued, it became clear that additional 
mental health services and materials were needed to support the mental health of 
students. The service demands grew, although not all students wanted or needed 
individual therapy. An internal re-organisation and further diversification of services 
were required. A stepped-care approach in the mode of the United Kingdom’s (UK’s) 
improving access to psychological therapies (IAPT) approach (Clark, 2018), was adopted 
as a way of providing a more optimal use of resources.



Linda Eskell Blokland & Hanlé Kirkcaldy: Campus Mental Health Revisited   201

IAPT was developed in the UK as a means of reaching a greater number of patients 
with more effective evidence-based treatments. A stepped-care approach to treatment 
in mental health is intrinsic to the IAPT system. Stepped-care entails three tiers of 
treatment (OCD-UK, 2018). Step 1 is the assessment and recognition of a psychological 
problem. Step 2 provides a low-intensity service for mild to moderate disorders. Step 3 
moves to a high intensity service for severe cases. While in South Africa the triaging of 
patients is currently in place as an aspect of primary, secondary, and tertiary healthcare, 
there is a dearth of professional support for those in need of a lower level of service in the 
field of mental health care. For example, under the traditional model of SCD service-
provision, every student seeking help is generally referred to a formal in-person service, 
such as with a professional psychologist or registered counsellor or in the form of a group 
intervention (Mair, 2021). 

Identifying the gap in service provision at the lower level, the Student Counselling 
Unit at the university which is the subject of this article embarked on a number of 
changes to its service model in line with the stepped-care approach, which entailed the 
adoption of a number of new approaches, which are discussed below.

Tiering the cases among the professionals

The SCU sought to reserve high-intensity professional services for the more acute cases, 
such as when students presented with severe depression; suicidality; and/or severe anxiety 
disorders. Such cases were allocated to the more senior qualified psychologists, working 
within their scope of practice. Milder and more moderate problems were allocated to 
interns working under supervision, or, if it was deemed appropriate, students would be 
referred to a self-help or peer-support group. 

Lower-intensity interventions 

Lower-intensity interventions took a number of forms. These included webinars; 
podcasts; social media messaging; posters; and the use of other media to present 
information. These interventions were designed and implemented by the staff at the 
SCU and, as such, fell within the microsystemic environment of student life on campus. 

In the absence of face-to-face workshops under lockdown, students became 
increasingly isolated and demoralised. In response, the SCU designed and presented a 
series of interactive webinars responding to particular challenges raised by students in 
their communications with the unit which students were able to attend from wherever 
they were based. The topics addressed by these webinars included time management 
during lockdown; managing online examinations and exam stress; effective study 
methods; and studying in the home-environment. In addition, a series of podcasts was 
produced on topics such as combatting anxiety and depression; building resilience; 
creating a routine with online learning and self-compassion; thinking traps; relational 
well-being; and how to live a healthy lifestyle. These podcasts became popular, even 
attracting attention from beyond South Africa. 



202   Journal of Student Affairs in Africa | Volume 10(2) 2022, 195-207 | 2307-6267 | DOI: 10.24085/jsaa.v10i2.4368

Social media messaging was deployed at appropriate moments. For example, 
wishing students well with tests during test week, and acknowledging student events and 
days of national celebration. Posters and other media provided information on similar 
topics were produced. 

A peer support group project established in 2019 took on greater significance, allowing 
students to connect with one another on a regular basis via a monitored, online format.

All the information and messages that were disseminated provided a link to the 
SCU and its services, including information on how to make contact. Information was 
also placed on the SCU’s own website.

The content that was produced as part of the new, increased emphasis on the 
development of online self-help resources addressed the stressors experienced during 
the lockdown period, but also the expected difficulties and topics that students would 
normally encounter. In this regard, topics such as gender-based violence; substance 
abuse; managing anxiety and depression; and developing one’s own study style were not 
neglected. The podcasts proved to be an innovative, exciting way of conveying a range 
of messages related to student life, resilience and coping with mental health difficulties. 
The ease of access of the various online materials, as well as their relevance to the student 
experience, were crucial to the success of this initiative.

Leveraging partnerships

Leveraging external partnerships

Various external partnerships within the mesosystemic environment of the students’ 
lives were expanded in an effort to support and engage the students. Some of these are 
discussed below. 

The South African Depression and Anxiety Group (SADAG) (www.sadag.org), 
has been a mental health partner with the large urban residential university which is 
the subject of this ref lective article for several years. They provide a 24-hour crisis 
and counselling line to assist students, especially students experiencing crises after 
hours. When the demand for mental health services increased during the COVID-19 
pandemic at this large urban residential university, the service provided by SADAG 
became especially important in helping to manage the additional load. The process 
that was followed was that, after initial contact with a SADAG counsellor, more serious 
cases were referred back to the SCU at this university for higher intensity professional 
treatment. Meanwhile, SADAG also arranged and supported peer support group 
processes, including by training student group leaders on a regular basis, and sitting in at 
each group meeting to monitor the process.

Other partners engaged by the large urban residential university included sexual 
health organisations; Alcoholics Anonymous; Narcotics Anonymous; and Sex Addicts 
Anonymous. These organisations provided materials on the topics in which they had 
expertise and also presented talks via the university student radio station on request. 
Students were informed of the existence of these organisations and how they could help.



Linda Eskell Blokland & Hanlé Kirkcaldy: Campus Mental Health Revisited   203

In addition, psychiatric service providers within the community assisted where 
they could, providing medication as necessary. Local clinics opened their doors to help 
students presenting with psychiatric problems at a time when public health services were 
over-stretched by COVID-19 cases. 

Leveraging internal partnerships 

Resources and support for the SCU at the university which is the subject of this article 
were made available from within the microsystemic environment of the university 
itself. Collaboration with a number of internal stakeholders who were already playing 
an important part in assisting students with their well-being was strengthened. These 
stakeholders included faculty staff members seeking information about identifying 
students at risk and where to seek help for them. In this regard, although the primary 
function of faculty student advisors at this university is to assist students with their 
academic problems, many of these staff members can also notice potential serious issues 
and refer students who may be at risk for further psychological help. The SCU at the 
university engaged these faculty stakeholders through training and conversations.

Residence affairs staff can also play a significant role in protecting, helping, and 
referring students with mental health issues. These staff are well-placed to detect 
problems at an early stage; point the student in the direction of the appropriate help; and 
assist with continued care. In addition, staff at the university residences cooperate closely 
with SADAG in relation to the use of the 24-hour careline and in promoting peer-
support structures within the residences. 

Other service units, including the Centre for the Study of Aids and Gender 
(CSA&G); the Transformation Office; and security services at the university also 
engaged in addressing students’ problems and were able to connect students with the 
SCU at the university and the services provided by the unit. 

In addition, student organisations such as the Student Representative Council 
(SRC) and a Student Wellbeing Committee at the university played an important role in 
attending to student problems, particularly in terms of rapidly identifying how negative 
events on campus could contribute to student distress. These student bodies, which are 
generally active on social media, can be useful allies in promoting student well-being. 

During the COVID-19 lockdown, the SCU at the university received significant 
political and financial support for its efforts to deliver its services in new ways from the 
executive structures at the institution, including the director of student affairs and the 
vice-principal of student life. 

Leveraging partnerships to deploy new technologies

In coordination with the university’s information technology (IT) department and 
external service providers, the SCU at the university developed a chatbot in early 2021. 
This artificial intelligence resource provided materials and content to assist students in 
taking a stronger self-help approach to their own well-being. The chatbot, which was 
available only to registered students, focused initially on a number of specified mental 



204   Journal of Student Affairs in Africa | Volume 10(2) 2022, 195-207 | 2307-6267 | DOI: 10.24085/jsaa.v10i2.4368

health issues while taking an overall well-being approach to mental health. It provided 
information, questionnaires, self-help exercises, and links to online videos and other 
external resources.

Gaps in Campus Mental Health-Service Provision
At the exosystemic level, the relative unavailability of psychiatric services for students 
in need has represented a serious gap in mental health-service provision on campus for 
a long time. For example, while psychologists within the SCU at the university which 
is the subject of this article are able to diagnose serious mental health conditions, they 
find it difficult to secure the appropriate medication for students due to financial and 
access constraints. In response and given the significance of students as a vulnerable 
local population, management noted that future consideration should be given to the 
possibility of a partnership of university clinics with the provincial Department of 
Health. Meanwhile, however, students tend to avoid attending public service-provider 
institutions which anyway cannot meet their needs in a timely manner. This has led to 
continual crisis management on campus. In this regard, if university campuses were to 
become sites for public clinics, as has been proposed, many of the crises that emerge after 
delays in treatment may be nipped in the bud. 

Similarly, the various mental health initiatives promoted by Higher Health2 may be 
more effectively deployed if it were acknowledged that universities may be best-placed 
to implement these at a local level. 

In line with the IAPT approach and the understanding that there is a need for 
mental health information to be communicated more widely, units such as the SCU 
could benefit from the services of registered counsellors, who would be able to assist 
with the initial screening of clients; provide counselling; and promote mental-health 
projects within their scope of practice.

Reflections
Some initial, tentative conclusions may be drawn on the effectiveness of the new 
approach in providing mental health services to students which was adopted under 
lockdown at the university which is the subject of this ref lection. 

There was some confusion about the purpose of the new mental-health chatbot 
introduced by the SCU at the university, although it was accessed by many students after 
it was launched. Several students complained that the chatbot was not responding to 
their specific questions and indicated that they had been expecting greater engagement 
from the bot in relation to their needs – rather than seeing it for what it was, namely 
a device for providing mental-health information. In this regard, the communications 
campaign to promote the chatbot could have provided greater clarity on its actual 
purpose and function. At the same time, plans are in place to expand the functionality of 

2 Higher Health is a government organisation that aims to promote comprehensive student well-being 
across all campuses of tertiary institutions in South Africa, as a supplement to academic programmes.



Linda Eskell Blokland & Hanlé Kirkcaldy: Campus Mental Health Revisited   205

the chatbot, although such technological innovation is expensive and time-consuming 
and would necessitate extensive private-sector engagement. 

More generally, efforts to promote the mental health resources and services on offer 
were not entirely effective. For example, the SCU at the university was told on a number 
of occasions that some students appeared to have no knowledge of the mental health 
services that were available to them at the university. In addition, some students seemed 
reluctant to make use of the online mental health services that were made available, 
viewing the provision of virtual forms of assistance as less than adequate. 

Recommendations
Given the global context, in which mental health and general health services are 
increasingly being provided virtually, thought should be given in future as to how 
students and staff may be helped to acclimatise to virtual services as an adjunct to 
conventional face-to-face modalities. 

The various platforms for providing mental health and wellness support should be 
promoted and provided in line with the demand. In this regard, the incorporation of a 
hybrid approach to mental health service delivery, under which online and face-to-face 
services are blended, as well as the establishment of a tiered approach, under which the 
needs for particular kinds of services are matched with what is on offer, can lead to the 
provision of effective, equitable mental health services. 

Throughout the lockdown period it became clear that mental health and wellness 
could not be the sole responsibility of a unit such as SCU. Wellness promotion and 
resilience-building should be an institutional objective, and an aspect of campus culture. 
It must involve students at the grassroots level, as well as all the faculties; the professional- 
and administrative-support units; and the university’s leadership.

Looking to the future, the need to teach the hidden curriculum of life- and self-
management to the next generation of students may be imperative if the next pandemic 
is to be survived. 

Under lockdown at the university, it became clear that the mental health and well-
being of students was not something that could be addressed through the provision of 
conventional counselling services. An innovative, holistic and comprehensive approach 
was required to provide adequate services.

In addition, the delivery of appropriate services depended on self-responsibility 
for well-being among students with the support of staff. In this regard, there should 
be greater acknowledgment of the benefits to be derived from confronting the stigma 
attached to mental health issues and talking about these issues more openly. 

Benchmarking at other university counselling centres and further research should be 
undertaken to provide greater clarity on how best these centres can serve their student 
populations. In this regard, it is noteworthy that the current generation of students is 
generally at ease with digital content and digital platforms, while also appreciating the 
benefits of congruent human interaction. In this regard, institutions need to collect data 
through surveys, focus groups, and anonymised information via service platforms to 



206   Journal of Student Affairs in Africa | Volume 10(2) 2022, 195-207 | 2307-6267 | DOI: 10.24085/jsaa.v10i2.4368

ensure that appropriate forms of professional support are made available in answer to the 
actual mental health needs of student populations. 

The adoption of a wellness model and a stepped-care approach within a systems 
framework proved of great use to the Student Counselling Unit at the university which 
is the subject of this ref lective article, enabling a more optimal use of resources in an 
exosystemic environment characterised by a paucity of resources for promoting mental 
health. This ref lection and its lessons are provided here for the potential benefit of other 
higher education institutions facing similar challenges. 

References
Abrams, Z. (2022). Student mental health in crisis. Campuses are rethinking their approach. Monitor on 

Psychology, 53(7). https://www.apa.org/monitor/2022/10/mental-health-campus-care.
Bantjes, J., Lochner, C., Saal, W., Roos, J., Taljaard, L., Page, D., Auerbach, R. P., Mortier, P., Bruffaerts, 

Kessler, R. C., & Stein, D. J. (2019). Prevalence and sociodemographic correlates of common mental 
disorders among first-year university students in post-apartheid South Africa: Implications for 
a public mental health approach to student wellness. BMC Public Health, 19(922). https://doi.
org/10.1186/s12889-019-7218-y.

Beekman, L. (2012). Theoretical framework for student counselling and development in higher education. 
In L. Beekman, C. Cilliers, & A. De Jager (Eds.), Student counselling and development: Contemporary 
issues in the South African context (pp. 67-86). Unisa Press.

Bronfenbrenner, U. (1981). The ecology of human development: Experiments by nature and design. 
Harvard University Press.

Changwon, S., Hegde, S., Smith, A., Wang, X., & Sasangohar, F. (2020). Effects of Covid-19 on college 
students’ mental health in the United States: Interview survey study. Journal of Medical Internet 
Research, 22(9). https://doi.org/10.2196/21279.

Clark, D. M. (2018). Realizing the mass public benefit of evidence-based psychological therapies: The 
IAPT program. Annual Review of Clinical Psychology, 14(1), 159-183. https://doi.org/10.1146/
annurev-clinpsy-050817-084833.

Eloff, I., & Graham, M. (2020). Measuring mental health and well-being of South African undergraduate 
students. Global Mental Health, 7(e34), 1-10. https://doi.org/10.1017/gmh.2020.26.

Erikson, E. H. (1968). Identity: Youth and crisis. W. Norton Company.
Eskell Blokland, L. M. (2019, October 11). Are universities pathologising student issues? Mail & Guardian. 

https://mg.co.za/article/2019-10-11-00-are-universities-pathologising-student-issues/.
Gruttadaro, D., & Crudo, D. (2012). College students speak: A survey report on mental health. National 

Alliance on Mental Illness. https://www.nami.org/Support-Education/Publications-Reports/
Survey-Reports/College-Students-Speak_A-Survey-Report-on-Mental-H.

Horton, B. W., & Snyder, C. S. (2009). Wellness: Its impact on student grades and implications 
for business. Journal of Human Resources in Hospitality & Tourism, 8, 215-233. https://doi.
org/10.1080/1533284080226985.

HPCSA (Health Professions Council of South Africa). (2020). Guidelines on telemedicine in South Africa. 
https://www.hpcsa.co.za/Uploads/Press%20Realeses/2020/Guidelines_to_telemedicine_in_South_
Africa.pdf.

https://doi.org/10.2196/21279
https://www.hpcsa.co.za/Uploads/Press Realeses/2020/Guidelines_to_telemedicine_in_South_Africa.pdf
https://www.hpcsa.co.za/Uploads/Press Realeses/2020/Guidelines_to_telemedicine_in_South_Africa.pdf


Linda Eskell Blokland & Hanlé Kirkcaldy: Campus Mental Health Revisited   207

Hunt, X., Stein, J. D., Spaull, N., & Tomlinson, M. (2021). Hunger as a driver of depressive symptoms: 
Optimising responses to mental health aspects of the Covid-19 pandemic. South African Medical 
Journal, 111(7), 604-605. https://doi.org/10.7196/samj.2021.v111i7.15754

Mair, D. (2015). The rise and rise of higher education and therapeutic culture. In D. Mair (Ed.), Short-term 
counselling in higher education: Context, theory and practice. (pp. 7-26). Routledge.

McBeath, A.G., Du Plock, S., & Bager-Charleson, S. (2020). The challenges and experiences of 
psychotherapists working remotely during the coronavirus epidemic. Counselling and Psychotherapy 
Research, 20(3), 394-405. https://doi.org/10.1002/capr.12326. 

Morris-Paxton, A. A., Van Lingen, J. M., & Elkonin, D. (2017). Wellness and academic outcomes among 
disadvantaged students in South Africa: An exploratory study. Health Education Journal, 76(1), 
66-76. https://doi.org/ 10.1177/0017896916650707.

Newman, B. M., & Newman, P. R. (1984). Development through life: A psychosocial approach. Dorsey 
Press.

Nguse, S., & Wassenaar, D. (2021). Mental health and Covid-19 in South Africa. South African Journal of 
Psychology, 51(2), 304-313. https://doi.org/10.1177/00812463211001543.

OCD-UK (Obsessive Compulsive Disorder – United Kingdom). (2018). Improving access to psychological 
therapies – IAPT. https://www.ocduk.org/overcoming-ocd/accessing-ocd-treatment/accessing-ocd-
treatment-through-the-nhs/iapt/. 

Rajkumar, R. P. (2020). Covid-19 and mental health: A review of the existing literature. Asian Journal of 
Psychiatry, 52. https://doi.org/10.1016/j.ajp.2020.102066.

Seligman, M. E. (2002). Authentic happiness: Using the new positive psychology to realize your potential for 
lasting fulfilment. Free Press.

Setlofane, T. (2019, July 31). Tertiary institutions should prioritise mental health. Health-E News. https://
health-e.org.za/author/teboho/

Taylor, S. (2019). The psychology of pandemics: Preparing for the next global outbreak of infectious disease. 
Cambridge Scholars Publishing. 

Van Lingen, H. (2012). Wellness: A model for holistic student development. In L. Beekman, C. Cilliers, & 
A. De Jager (Eds.), Student counselling and development: Contemporary issues in the South African 
context (pp. 106-123). Unisa Press.

Visser, M., & Law-Van Wyk, E. (2021). University students’ mental health and emotional wellbeing during 
the Covid-19 pandemic and ensuing lockdown. South African Journal of Psychology, 51(2), 229-243. 
https://doi.org/10.1177/00812463211012219.

Wissing, M., Potgieter, J., Guse, T., Khumalo, T., & Nel, L. (2014). Towards flourishing: Contextualising 
positive psychology. Van Schaik.

Witmer, J. M., & Sweeney, T. J. (1992). A holistic model for wellness and prevention over the life span. 
Journal of Counselling and Development, 71(2), 140-148. https://doi.org/10.1002/j.1556-6676.1992.
tb02189.x.

How to cite: 
Eskell Blokland, L., & Kirkcaldy, H. (2022). Campus mental health revisited. Journal of Student 

Affairs in Africa, 10(2), 195-207. DOI: 10.24085/jsaa.v10i2.4368

https://doi.org/10.1002/capr.12326
https://doi.org/10.1177/0017896916650707
https://www.ocduk.org/overcoming-ocd/accessing-ocd-treatment/accessing-ocd-treatment-through-the-nhs/iapt/
https://www.ocduk.org/overcoming-ocd/accessing-ocd-treatment/accessing-ocd-treatment-through-the-nhs/iapt/
https://health-e.org.za/author/teboho/
https://health-e.org.za/author/teboho/
https://doi.org/10.1177/00812463211012219
https://doi.org/10.1002/j.1556-6676.1992.tb02189.x
https://doi.org/10.1002/j.1556-6676.1992.tb02189.x