Teaching staff as gatekeepers for student mental health in higher education: findings from an exploratory sequential mixed-methods study on mental health promotion, psychological crises, and stigma.

Abstract

Background: Mental health problems among university students are highly prevalent, while stigma and limited help-seeking remain major barriers to support utilization. Teaching staff can act as important gatekeepers who recognise distress, encourage help-seeking, and contribute to psychologically supportive learning environments. However, their role in student mental health promotion remains insufficiently understood.

Methods: This exploratory sequential mixed-methods study combined a qualitative focus group involving five students from two German universities and an anonymous online survey of teaching staff from four German higher education institutions (n = 187). Insights from the focus group informed the development and content of the subsequent survey of teaching staff. Qualitative data were analysed using structured content analysis according to Kuckartz. Quantitative analyses included descriptive statistics and assessment of stigma-related attitudes using the Self-Stigma of Mental Illness Scale Short Form (SSMIS-SF).

Results: The qualitative findings revealed four interrelated areas of expectation: psychologically sensitive communication, mental health literacy among teaching staff, accessible institutional support structures, and a university culture that normalises help-seeking. Among teaching staff, only 30.9% considered student mental health promotion part of their formal professional role, while 45.8% reported uncertainty when interacting with students experiencing psychological crises. Qualitative findings indicated substantial variation in perceived preparedness and support practices. Teaching staff primarily described recognising distress, offering initial support, and referring students to professional services. Personal endorsement of stigmatizing beliefs was low, whereas perceived public stigma was significantly higher (mean difference = 12.42, 95% CI 11.02-13.83; t(131) = 17.51, p < .001; Cohen's d = 1.52, 95% CI 1.27-1.77).

Conclusions: Teaching staff may represent important gatekeepers for student mental health. However, unclear role expectations, limited institutional guidance, and insufficient training may restrict their capacity to support students effectively. Universities should strengthen staff training, establish clear referral pathways, and implement institution-wide mental health strategies.