Four ways to make support for student well-being comprehensive and inclusive

Aloha. My name is Luoluo Hong, and I serve as the inaugural vice-president for student engagement and well-being here at the Georgia Institute of Technology in Atlanta. I have a master’s in public health degree, and my first job working in a university was as a health educator.

As a person who has grown up in the public health profession, I thought it would be important to offer some of the insights that I’ve had as I’ve worked in this area and helped to lead and coalesce and coordinate efforts with faculty, staff and students.

There are four areas that I’d like to emphasise that I believe can help us improve our impact and make a better difference for our students.

The first point that’s important to consider is how we talk about well-being. A lot of times when I hear my colleagues, when I hear students, faculty, staff talk about well-being, it’s almost as if we have conflated well-being with mental health. Certainly, mental health is a significant aspect of well-being, but it’s not the only aspect.

Here at Georgia Tech, we’ve decided to adopt the eight dimensions of wellness. We picked eight in particular because we felt that it allowed us to lean into complexity around wellness, and it reflected what we felt were the areas of focus that we wanted to engage with our students.

And so, just to kind of give you an example, emotional wellness, physical wellness, spiritual wellness, these are all different aspects. Can well-being be dependent on mental health? Yes, but it’s often not the only thing. I’ll give you one example. If you have chronic pain, that’s an aspect of physical wellness. That can impact your emotional wellness, hence your well-being.

Same thing with spiritual wellness or social wellness. You think about the US surgeon general’s report about loneliness being a public health crisis.

It’s important that we engage all of these factors and talk about well-being as this complex array of interdependent elements, so that when we’re leaning in to intervene, when we’re talking about how we can improve well-being, we address all eight factors.

The second area has to do with adopting a public-health framework for cultivating well-being and not just a clinical one. Certainly, it’s essential that individuals who are experiencing trauma or significant mental health crises or major challenges to well-being will need and do benefit from clinical care. But clinical care is only one end of the continuum when talking about intervening around well-being, and if we only wait to engage with our students after they need clinical intervention, I think we’re not doing all that we can.

The public-health framework – or, put another way, the socio-ecological framework – requires us to think about this work at two different levels. There’s many levels, but these are the two primary ones.

First is, how do we help foster individual agency? This is prevention work. How do we help give our students a toolkit, a comprehensive toolkit, that they can draw on to help prevent reaching a crisis in the first place? And so this, for many of you, if you’re doing stress-management workshops, if you’re doing workshops about how to have a healthy relationship, those are an example of some of the kinds of things that we’re talking about when we talk about individual prevention strategies. It’s important that we see that when it comes to promoting well-being, that it’s not just showing up and going to a provider or a professional to take care of our well-being, that there are things that we can do every single day, that we can take to empower ourselves and our friends and family to take better care of ourselves.

The second part of a socio-ecological model is for institutions to really do an analysis of what are the factors upstream, if you will, the things that contribute to well-being or the things that serve as barriers to well-being?

And so, if we engage in that systemic analysis and make mindful efforts to address those and tackle those, that’s a really important part. That way the burden is not just on the clinical providers; everyone has responsibility in the institution to look at that.

The third area of work is what I would call changing our culture. This will be different for each campus. Every institution will have to conduct its own analysis and determine what are the areas of their culture that are enabling factors for well-being and what are the ones that serve as barriers?

I do find that one common theme again is related to our language. In an effort to help encourage students to go to counselling and seek assistance and care when they need it, we’ve oftentimes short-handed that message. So, for example, the message on your campus might be what we’ve done here at Georgia Tech, which is if you’re in crisis, go and see counselling. That’s certainly a positive message and a correct message, but it’s also an incomplete message.

The reality of it is this: there’s many types of crises and not all crises need clinical intervention in order to resolve.  

So, this leads to my third point, which is the importance of making sure that we de-pathologise crisis, that we don’t say that [of] all of the negative feelings. So, when I grew up in public health, we boil down feelings to four: mad, sad, glad, scared. Obviously, there are a lot of words that we can use for feelings, but those are sort of the four primary categories.

I think sometimes as we’ve talked about this, we’ve made mad, sad and scared all bad, and the reality of it is those are part of a complete, whole, rich life and existence, and that a life well lived is going to have all four emotions, including mad, sad and scared. So, if we inadvertently or intentionally provide the message that those bad feelings are not appropriate to have, I don’t know that we do justice to our students.

So, it’s important that we normalise that as part of living, you’re going to experience all of those feelings and they will be complicated and messy, and that sometimes one will emerge as dominant and then it’ll go away.

Yes, if you experience one of those negative feelings, like sadness, excessively, and they start to interfere with your activities of daily living, then, yes, you do need to get clinical assistance and get help and support. But the reality of it is that dealing with crises is part of how we actually become more resilient individuals.

So, making sure that we don’t set up feelings as good and bad, and that we’re more discerning [about] which crises actually need clinical intervention and which are the ones that we can go back to our own toolkit, we can reach out to friends and family, and when we can exercise in self-care.

The last area of focus in our efforts to cultivate well-being has to do with promoting health equity. Just as we need to think about and lean into promoting educational equity, health equity is just as important to consider. This requires us to make sure that our programmes and services to cultivate well-being are differentiated and targeted.

We need to be aware that a message about seeking care will be heard differently by different student communities. For some students, there’s a sense of stigma associated with going to a mental-health professional. For other students, because of lived experiences, there’s a sense of mistrust of engaging with any formal institutions, including healthcare.

If we don’t target our messaging and lean into making sure that these differences are addressed, then we’re not going to be comprehensive and inclusive in our efforts to cultivate well-being.

Luoluo Hong is vice-president for student engagement and well-being at Georgia Tech.

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