The Utopianism of ‘Mental Health’ | Eastern North Carolina Now

    Publisher's Note: This post appears here courtesy of The James G. Martin Center. The authors of this post are Michael C. Behrent and Martha McCaughley.

    "Mental health" has become a catchphrase of our time. In 1976, Raymond Williams, the British literary scholar, published Keywords, in which he analyzed nearly 200 words that, in his view, comprised the core vocabulary of modern Western societies. Among the terms that Williams identified were "democracy" and "capitalism," "utilitarian" and "unconscious," "reform" and "revolution." If a new edition of Keywords were to appear, it would almost certainly include an entry on "mental health."

    The term "mental health" seems to have become mainstream after the Second World War, when the first International Congress on Mental Health was held in London in 1948. Yet, in current usage, its meaning has begun to sprawl. It refers, of course, to the traditional concerns of psychologists, psychiatrists, and counselors, but it also covers much more. In many ways, the rhetoric of "mental health" has become one of the major utopian discourses of our time. This becomes apparent in the way college students use mental-health discourse, as well as in the way administrators invoke it to appeal to students.

    Consider the recent initiatives by the UNC Board of Governors and the UNC-System Office relating to mental health. In September 2020, the Board tasked the UNC System with making an assessment of the state of student mental-health provisions and proposing recommendations. The outcome of this request was a report, published in May 2021, entitled "Healthy Minds, Strong Universities: Charting a Course to More Sustainable Student Mental Health Care." System officials updated the board on the status of these efforts at a meeting last May.

    These initiatives have earned bipartisan support. Governor Roy Cooper has helped to fund them, providing $5 million through the Governor's Emergency Education Relief fund in 2021 and another $7.7 million this year. For the most part, the initiatives provide commonsense solutions to improving student access to mental-health services, in ways that reflect the evolving needs of today's students. For instance, the UNC System introduced, in 2020, a system-wide, 24-hour crisis hotline. Campuses also have been asked to establish a comprehensive referral system for students whose needs cannot be met by campus services. (These have been introduced at NC State, UNC Charlotte, UNC Wilmington, and elsewhere.)


    More ambitiously, the System Office launched, in fall 2022, a shared telepsychiatry pilot program at six campuses (Western Carolina, Winston-Salem State, UNC Greensboro, UNC Pembroke, Fayetteville State, and NC A&T). As the System Office recently informed the Board, the program's goal is to provide "psychiatric services, including neuropsychological testing and medication evaluation and management, to students who otherwise would have no access to the help they need," primarily because they live in rural areas. Finally, the System Office has provided grant funding to constituent institutions to encourage them to develop innovative programs for dealing with mental-health needs. UNC Pembroke, for example, was awarded $78,000 to hire a "full-time counselor [to] live in the residence halls and provide counseling services there."

    Like other university leaders across the country, President Hans, officials at the UNC-System Office, and administrators at UNC campuses are eager to signal their concern about student mental health and demonstrate their responsiveness to student demands. While conversations about mental-health issues afflicting the current generation of college-aged youth is not new, the Covid pandemic brought these concerns to a fever pitch. The System Office refers frequently to the fall 2020 Healthy Minds Study, which polled 33,000 students at 36 American universities. President Hans cited this study at a recent mental-health conference at Chapel Hill, noting that it found significant upticks in reported depression rates during the pandemic, with 47 percent of students exhibiting clinically significant depression or anxiety systems.

    Some campuses maintained that their counseling services were strained to the breaking point. During the 2022-23 academic year, seven students committed suicide at NC State, leading the vice chancellor for academic and student affairs to create a mental-health task force in fall '22. At the time, she stated, "The importance of mental health and well-being is on the top of the minds of many in our community." The previous year, UNC-Chapel Hill experienced its own series of suicides and suicide attempts. A statement released on social media by the university's student government on October 10, 2021, requested a "break from instruction" so that students could grieve and seek professional help, declaring, "Students require this immediate action from the university to ensure that their mental health needs are being considered and met."

    Whatever one thinks about the term "mental-health crisis," it is hard to deny that today's students do face significant psychological challenges. Yet this is not all there is to say about the eagerness with which administrators and governing boards-in North Carolina and beyond-trumpet their mental-health initiatives. Rarely has higher education faced as competitive a market for attracting students as at present. If the pandemic endangered student mental health, it also threatened many an institution's bottom line: The reality that universities, even public ones, live and die on student enrollment was one of the pandemic's more sobering lessons. In fall 2022, total enrollment in the UNC System declined for the first time in nine years, including at 12 of the system's 16 universities. In a report to the Board of Governors, the system concluded, "The combined impacts of the COVID-19 pandemic, demographic shifts, and a weakening in the perceived value of a college degree are affecting enrollment at our institutions." Without calling into question the sincerity of administrators' concerns about student well-being, it is hard to deny that the zeal with which they promote this issue is aimed at recruiting and/or retaining students. Perhaps signaling a commitment to mental health is a marketing strategy akin to building state-of-the-art dorms and climbing walls.


    This commitment is, needless to say, positive at many levels. As indicated above, there is considerable evidence that young people are afflicted by depression, anxiety, and thoughts of suicide. Most of the initiatives pursued by the UNC System in this realm represent practical efforts to make mental-health resources more readily available to students in need.

    The problem is that, in its current usage, "mental health" refers to more than merely practical problems. It belongs to a broader discourse and set of beliefs. In many ways, mental health is a new utopian ideology.

    To begin with, mental-health discourse ropes into its domain many issues of broader social concern, most prominently an emphasis on diversity. At UNC-Chapel Hill, Counseling and Psychological Services (CAPS) has a multicultural health program that seeks to "decrease mental health stigma and increase access to services among underrepresented student populations." UNC Charlotte explains that its counseling services may refer a student to an off-campus professional to meet requests relating to "counselor gender and cultural background."

    Psychologists, of course, have long recognized that individual afflictions can be rooted in social problems. It makes sense, consequently, that counseling centers would address the special needs of students who hail from underprivileged or marginalized backgrounds. What is striking, however, is the way in which contemporary mental-health discourse goes beyond these concerns. Chapel Hill's CAPS does not just emphasize special needs but sets complete personal authenticity as its goal. Because "building community is such an important part of the Carolina journey," CAPS declares, it is crucial that it be "intentional about finding and creating spaces where students can bring their whole selves and show up authentically."

    Elsewhere, a recent report by NC State's student-government mental-health task force calls for a "culture of care." This phrase could, in many ways, serve as the slogan for mental-health discourse as a whole. Those who talk about mental health today are, of course, often referring to such illnesses as bipolar disorders and inclinations to self-harm. But they are also, at a more fundamental level, denouncing a type of society in which it is difficult to feel at home. The NC State report calls for "more gathering spaces that cultivate community." At UNC-Chapel Hill, a student organization recently created a mural designed to "uplift spirits and unite students, improving mental wellness and mental health awareness." (The mural is intended, in the words of one student, to highlight "the connectedness of the campus.") At NC State, some 30 students serve as "mental health ambassadors," dedicating themselves to "helping fellow students understand mental health issues." Similar ideas seem implicit in a recent appeal by Pembroke's new counselor-in-residence inviting students to attend "Mindfulness Mondays," which are "dedicated to helping students learn how to be in the 'here and now' and [learn] so much about themselves! All you need to bring is yourself!"


    Such earnestness exposes itself to facile mockery. But this is the wrong attitude. The aspirations expressed in such discourse are, in many cases, all too real. The desire for a "culture of care," community, and connectedness are only natural in a heartless world. What is not clear is whether such idealism can be satisfied by hotlines and referral lists.

    A recent opinion piece in the Daily Tar Heel denounced universities for failing to "provide students with the programs and resources needed to battle the life-threatening reality of today's mental health crisis." The author went so far as to wonder if the solution might not lie in "universal mental health screenings" designed to "look out for students who are struggling and are not reaching out for help." The previously mentioned NC State report requests a new administrative position to help solve the problem. One is reminded of the philosopher Michel Foucault's assertion that the call for improved health care is an "infinite demand" that inevitably encounters a "finite system." In many ways, contemporary mental-health discourse exemplifies this dilemma.

    Furthermore, when university officials-typically, student-affairs professionals-fall all over themselves to assure students that their well-being and sense of belonging are the university's utmost concern, we wind up giving students mixed messages. Once these students wind up in their college classrooms, on the quad, or at a Halloween party, they are inevitably exposed to new ideas and expressions, some of which are unsettling or downright offensive. Students then commonly say that they don't "feel safe," and they can feel bitter resentment that the university failed to keep its promise. Rather than telling students that they should prepare to confront an intellectually challenging environment, universities set them up to expect to be coddled. Stroking students' egos and otherwise refraining from challenging them through open inquiry winds up being one of three trends that are undermining higher education, which Mark Horowitz et al. call "broke/woke/stroke." Instructors are now asked, implicitly or explicitly, to relax their expectations, reduce the rigor of their assessments of student work, and avoid topics that might offend students. Instructors are pressured to put warnings on their course syllabi, lest one of their students get triggered in class and, further, demand that they be fired.

    Making student mental health a weapon in the campus culture wars would not be fair to students. There really is evidence, after all, that students entering college today are more anxious, depressed, and likely to contemplate suicide than those of previous generations. Today's teens and young adults have good reason to be anxious: They face high-consequence risks, environmental chaos, financial instability, and being shot to death (firearms now being the leading cause of death among children in the U.S.).

    We can and should embrace wellness and mental-health services on campus so long as these services enable students to engage in academic inquiry and achieve the real purpose of a university education. But it would be dangerous to lead students to think that self-exploration and self-expression are the point of college.


    Indeed, some have argued that changing the expectations students have of college would improve their mental health. Rather than promising prospective students the "best four years of your life," recruiters could promise them "the most intellectually challenging four (or five, or six) years." A liberal education can be a ticket to mental health. All data point to the fact that getting a college education has long-term health and well-being benefits.

    Michael C. Behrent is a professor of history at Appalachian State University. Martha McCaughey is a professor emerita of sociology at Appalachian State University.