REFLECTIVE PRACTICE

 

Peer helpers at the forefront of mental health promotion at Nelson Mandela University: Insights gained during Covid-19

 

 

Angélique McConney

Nelson Mandela University, Gqeberha, South Africa. Email: angelique.mcconney@mandela.ac.za. ORCid: 0000-0002-8741-7129

 

 

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ABSTRACT

Student counselling centres are struggling to meet the demand for mental health services, which has intensified in recent years. This challenge calls for innovative ways to address the mental health needs of students. During the Covid-19 pandemic the peer helpers at Emthonjeni Student Wellness at Nelson Mandela University facilitated innovative psycho-educational workshops, virtually. In reflecting on our journey, we realise our peer helpers were at the forefront of mental health promotion initiatives at a time when many of our students were in dire need of support. The workshops sensitised students to the importance of their mental health. Furthermore, the content discussed in the workshops offered valuable insights and tips on how students could manage various challenges. These tips could be applied, by participating students, to improve their coping and overall well-being before their mental health deteriorated. These peer-led initiatives expanded our reach and capacity during a period of great stress brought by the Covid-19 pandemic, and they will continue to do so beyond the pandemic. This reflective article shares the details of our virtual workshops and the insights gained from the process.

Keywords: Covid-19, online counselling, peer support, reflective practice, student affairs, student counselling, student mental health, well-being

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RÉSUMÉ

Les centres de conseil aux étudiants éprouvent des difficultés à répondre à la demande croissante de services de santé mentale, qui s›est intensifiée ces dernières années. Ce défi exige des méthodes innovantes de répondre aux besoins des étudiants en matière de santé mentale. Pendant la pandémie de Covid-19, les assistants pairs du service Emthonjeni Student Wellness à l'université Nelson Mandela ont animé des ateliers psycho-éducatifs innovants, virtuellement. En réfléchissant à notre parcours, nous réalisons que nos assistants pairs étaient à l'avant-garde des initiatives de promotion de la santé mentale à un moment où de nombreux étudiants avaient un besoin urgent de soutien. Les ateliers ont sensibilisé les étudiants à l'importance de leur santé mentale. En outre, le contenu abordé dans ces ateliers a offert des connaissances précieuses et des conseils sur la façon dont les étudiants pouvaient gérer divers défis. Ces conseils pouvaient être appliqués par les étudiants participants afin d'améliorer leur capacité d'adaptation et leur bien-être général avant que leur santé mentale ne se détériore. Ces initiatives dirigées par des pairs ont élargi notre portée et notre capacité pendant une période de grande stress due à la pandémie de Covid-19, et elles continueront à le faire au-delà de la pandémie. Cet article réflexif présente les détails de nos ateliers virtuels et les enseignements tirés de ce processus.

Mots-clés: Bien-être, conseil aux étudiants, conseil en ligne, Covid-19, œuvres estudiantines, santé mentale des étudiants, services étudiants, soutien entre pairs

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Introduction

Student mental health has been of global concern in recent years (Macaskill, 2013). Student counselling centres have been battling to cope with the increased demand for mental health services (Lattie et al., 2019), and in some instances an increase in the complexity of mental illness (Williams et al., 2015). This challenge is observed in countries internationally (Brown, 2018; Oswalt et al., 2020; Lattie et al., 2019), of great concern given the importance of mental health in the overall well-being, quality of life and academic performance of students (Oswalt et al., 2020). It is, therefore, imperative that this challenge be addressed, to ensure that students in need of mental health services have access to support, to mitigate the impact mental health problems could have on their overall well-being and academic performance, as this may affect student success.

At many student counselling centres, the traditional mode of mental health support takes the form of individual counselling (Brown, 2018) offered by registered professionals (psychologists and counsellors). However, the individual counselling model does not seem sustainable, as it is unable to address the increased demand for services. Brown (2018) argues that if we are to reduce mental health problems, we need effective, scalable interventions that are attractive to students. In this article I argue that student peer helpers could play a valuable role in offering mental health promotion initiatives. I argue this based on the insights gained from peer-led interventions that the peer helpers at Emthonjeni Student Wellness, at Nelson Mandela University, implemented during the Covid-19 pandemic. This, in turn, could afford professional staff more time to attend to students in need of remedial intervention, and it could potentially reduce the number of students in need of individual counselling from professional staff.

 

Increased demand for mental health services at higher education institutions

Concerns for the mental health of students are on the rise (Brown, 2018; Macaskill, 2013), as the number of students presenting for mental health support at student counselling centres are increasing (Oswalt et al., 2020; Brown, 2018; Xiao, et al., 2017; Williams et al., 2015). There are numerous factors contributing to the increase in students presenting for mental health support. At a systemic level, broadened participation has increased enrolments of previously underrepresented groups, and consequently this may have increased mental health conditions amongst students to be similar to that of the general population (Macaskill, 2013). Students from previously underrepresented groups are often first-generation students (Tinto, 2012). As first-generation students, their adjustment difficulties are heightened by social factors such as their educational backgrounds, family backgrounds, financial circumstances and even language barriers (Jehangir, 2010), which could make them more vulnerable to mental health problems (Macaskill, 2013).

Students' attitudes toward mental illness have also shifted. A study done by Eisenberg et al. (2012) found that stigma was not a barrier to students' help-seeking behaviour. This was supported by findings from a study done by Czyz et al. (2013), who found that only 12% of the students mentioned stigma as a barrier. The reduction in stigma has, therefore, seen a shift in help-seeking behaviours with more students being open to utilising counselling services (Oswalt et al., 2020; Williams et al., 2015). From a developmental perspective, students are at an age where symptoms of mental health conditions often appear. Half of serious adult psychiatric illnesses, including depressive and anxiety disorders, start by age 14, with 75% presenting by age 25 years (Kessler et al., 2005). Some students, thus, enter the higher education environment with an existing diagnosis (Williams et al., 2015), or, as seen in our context at Emthonjeni Student Wellness, while symptoms may have been prevalent prior to enrolment, many students only present for treatment once they are enrolled as students due to the easy access they now have to counselling services compared to their hometowns/rural villages.

In spite of the increase in students presenting for mental health support, some students struggling with mental health conditions still do not seek professional support (Eisenberg et al., 2012; Oswalt et al., 2020) due to various barriers. Barriers to seeking treatment include a perception that their problems are not serious enough to warrant treatment (Brown, 2018; Czyz et al., 2013), a perceived lack of time (Czyz et al., 2013), a preference for self-management (Brown, 2018; Czyz et al., 2013) etc.. This suggests that the demand is probably underestimated as many students do not seek help (Brown, 2018). Even with some of these barriers prevalent, more students are reaching out for support.

Resources have not necessarily matched the increase in demand and consequently, student counselling centres are struggling to manage the increased demand for mental health services (Oswalt et al., 2020; Williams et al., 2015). This challenge is exacerbated by the traditional one-on-one counselling primarily being offered at many student counselling centres. Generally, individual counselling is the most common form of support offered, but this format may not be able to reach the large numbers of students presenting for support. Alternative approaches and methods of delivery, therefore, need to be explored (Brown, 2018). One such alternative, I argue, is peer-led mental health support.

 

Peer-led mental health support initiatives

Peer-led support can expand the capacity for mental health support, and it can offer an alternative to interventions offered by professional staff (Byrom, 2018), which might be more attractive to students who are reluctant to speak to a professional. Some studies have found that young people prefer to talk to friends and family rather than professionals (Rickwood et al., 2005; Czyz et al., 2013). Friends are a major source of support to students (Williams et al., 2015), offering significant informal support to one another on a daily basis. Given the significant role friends and peers play in the lives of students, many higher education institutions offer formal peer-led support programmes.

Peer-led programmes, in the higher education context, generally take the form of peer mentoring and peer tutoring. Peer mentoring programmes are generally implemented as a means of improving retention (Collings et al., 2014; Ward et al., 2012), by assisting first-year students with their adjustment. Peer tutoring, on the other hand, aims to improve academic performance through support with course content (Colvin & Ashman, 2010). While these peer-led programmes tend to focus on first-year student adjustment and course content, other focus areas are also emerging. Formal peer-led mental health support is on the increase, either jointly developed with students, (Campbell et al., 2022; Williams et al., 2015), or completely student-led (Campbell et al., 2022), for example, being offered by student societies (Williams et al., 2015). This reflects the valuable role students themselves can play in mental health initiatives. Byrom (2018), for instance, evaluated a 6-part peer-led support group for depression, across multiple universities in England, and found that it improved the mental well-being of students who optimally participated in the group sessions offered. Peer-led mental health support initiatives could therefore be an effective alternative offered to students.

 

The Nelson Mandela University context

Nelson Mandela University (NMU) is a higher education institution in South Africa. The institution has seven campuses. Six of its campuses, including its main campus, are situated in Gqeberha in the Eastern Cape, with the seventh campus in George in the Western Cape. The institution, previously known as Nelson Mandela Metropolitan University (NMMU), opened on 1 January 2005, the result of a merger of three separate institutions, namely University of Port Elizabeth (UPE), PE Technikon, and the Port Elizabeth campus of Vista University (Vista PE) (NMU, 2022b). This merger was part of the transformation agenda of the higher education sector in a democratic South Africa (Jansen, 2004), which has also been met with significant transformation at the institution itself. The institution was officially renamed Nelson Mandela University on 20 July 2017 (NMU, 2022b). This name change has been significant to the university's identity, academic mission, and strategic priorities (NMU, 2022a).

Social justice is at the core of the institution's academic mission, as it strives to promote the public good in the service of society (NMU, 2022a). The institution is, therefore, very intentional in the role it needs to play in the development of South Africa through access to higher education, as guided by the national agenda. In line with this agenda, the institution has systemically increased access for first-generation students from quantile one to three schools, which was at 53% in 2020 (NMU Office for Institutional Strategy, 2021), most of these students being Black African students from low-income backgrounds. In 2022 a total of 32,472 students were enrolled at the university, 83% being Black African, 9% Coloured, 8% White, and 1% Indian (NMU Office for Institutional Strategy, 2022). The institution also appreciates that access needs to be accompanied by success and subsequently extensive support is offered to facilitate the academic success of all students gaining access. A range of support strategies is prioritised including holistic psychosocial and mental health support.

 

Emthonjeni Student Wellness (Nelson Mandela University)

Emthonjeni Student Wellness, formerly known as the Student Counselling, Career and Development Centre, is part of the Learning and Teaching Collaborative for Success (LT Collab). We offer psychological services aimed at alleviating psychological distress, enhancing student wellness, improving academic performance, and optimising mental health. These services include assessments, individual counselling, group counselling, psycho-educational workshops, and projects in collaboration with our internal and external stakeholders. All registered students, from our seven campuses, have free access to our services. Additionally, we offer career counselling to both registered and prospective students (at a cost) (NMU Emthonjeni Student Wellness, 2020).

Our services focus on a broad range of interventions that include remedial, developmental, and preventative interventions. Figure 1 illustrates the spectrum of services we offer:

 

 

As seen in Figure 1, we offer remedial interventions on the one end of the continuum, to developmentally focused interventions at the other extreme, also including preventative interventions along the spectrum (NMU Emthonjeni Student Wellness, 2020). Our remedial services aim to alleviate psychological distress/symptoms of mental illness and to improve functioning. Our remedial services include individual counselling sessions and therapeutic group counselling sessions, all offered by our professional staff (i.e. registered psychologists and counsellors). It could also include referral for pharmacological intervention and/or hospitalization. For our preventative work we offer a range of psycho-educational initiatives such as psycho-educational workshops, e-pamphlets, radio talks etc. These initiatives aim to promote overall wellness through these psycho-educational platforms, giving it a mental health promotion focus. Our developmental initiatives focus on the development of the student to enhance graduate attributes and student success. Our peer help programme, for example, has a major developmental focus in terms of the development of graduate attributes of our peer helpers themselves, in preparation for the world of work.

While our services include the spectrum of interventions illustrated in Figure 1, we are, like many other student counselling centres globally, experiencing a greater demand for mental health support that requires remedial intervention. To meet this demand, our primary model of support has been individual counselling offered by one of our registered psychologists/counsellors. Like many other student counselling centers we, too, are battling to meet this demand, which requires us to be innovative with our limited resources. To expand our reach and capacity, we also offer peer-led support through our Emthonjeni peer help programme, specifically in our preventative and development initiatives.

 

Peer-led psycho-educational initiatives at Emthonjeni Student Wellness during Covid-19

As mentioned, most of our students are first-generation students from low-income backgrounds. As first-generation students, they experience a range of challenges, which make them vulnerable to higher levels of stress/depression (Stebleton et al., 2014). The Covid-19 pandemic brought additional stressors to many of our students who were already experiencing a range of challenges. As coordinator of our Emthonjeni peer help programme I wanted to expand our reach through our peer helpers during the national lockdown brought on by the Covid-19 pandemic, as our peer helpers shared in the student experience and they had greater access to students (via social media platforms), at the time.

Emthonjeni Student Wellness has a rich history of peer helping. However, the Covid-19 pandemic brought challenges to the role peer helpers played prior to the pandemic as well as our training practices. Prior to the lockdown, peer helpers were physically facilitating some of our psycho-educational workshops and they were involved in projects such as our Career Stall at the university's open day to prospective students, face-to-face. As activity on campus was suspended, we had to go back to the drawing board to rethink how our peer helpers could offer support to our student community in this new context. We also had to adjust our training material as we moved the training to a virtual platform (i.e. Microsoft (MS) Teams). The model we used to select our peer helpers guided my decision-making through this process.

As the coordinator of the programme, I adopted the model for intentional peer mentoring proposed by McConney and Fourie-Malherbe (2022) when I started this role. Their proposed model for intentional peer mentoring underscores selection practices aimed at recruiting peers that will be intentional in their role, peers who care about the students they support, who are genuinely interested in helping fellow students and who are open and empathetic (McConney & Fourie-Malherbe, 2022). This is what we did during our selection process. The intentionality highlighted by McConney and Fourie-Malherbe (2022) also guided me throughout the training and planning phases. We included the primary themes of our existing training, but the content had to be shortened and some group activities had to be replaced with activities suited to the virtual platform (e.g. personal reflective exercises). The following themes were included in our peer help core training: the role of the peer helper within the context of ubuntu; listening and responding with empathy; the decision-making process; ethics and referral practices; and facilitation skills.

During these trying times, it was imperative for us to offer support to students that would assist them in navigating the complex challenges they were confronting in our efforts to minimise the adverse effects these may have had on their mental health and academic performance. As coordinator, I had to venture into unchartered territory, and I appreciated that I needed support along this journey as I attempted to adjust our programme to be relevant and responsive to the Covid-19 context. I partnered with our newly recruited peer helpers as we attempted to support our students. We had to think out of the box to create a programme that would be suited to a context that was new and volatile, marked by great stress and pain, and one that challenged how our peer helpers previously offered support. Unfortunately, only half of our 50 newly recruited peer helpers could get on board, due to their own struggles with connectivity, remote learning, and other challenges.

Responding to the context, the peer helpers and I created a series of psycho-educational workshops that would provide participating students the opportunity to engage in topics that could affect their wellness and mental health; and to offer tips on how they could manage the stressors they were confronting. Figure 2 shows the list of workshops we offered:

 

 

We offered a total of seven workshops. Each workshop focused on a specific theme. The workshops were offered via MS Teams on Mondays from 15:00 to 16:30. All the workshops were led by a group of four to five peer helpers, co-facilitated by the programme coordinator. The workshops were well attended: the number of participants ranged from 25 to 35 for each workshop. We offered each workshop twice, once per semester.

Workshop 1: Mental health and stigma

While studies have shown a decline in mental health stigma amongst students, and we have also observed this trend at Emthonjeni Student Wellness, a level of stigma persists. Furthermore, while the students may not hold strong biases, stigma amongst their families and in their communities may affect their help-seeking behaviour. In our planning session, one of our peer helpers articulated the following: "We can have all the initiatives in the world, but if we do not address the stigma that is still attached to mental illness we may find that the students who are most in need of these services may not access it". This peer helper then took the initiative to develop workshop material on this topic. In collaboration with other peer helpers and supervision from me, we finalised material for a workshop on Mental Health and Stigma.

The goals of the workshop were to explore:

• the prevailing stigma around mental illness,

• the impact of stigma on students' willingness to access support,

• myths and facts on mental health and mental illness, and

• information and statistics on mental illness to sensitise students to the prevalence thereof.

Workshop 2: Emotions and healing

The conversation for our workshop Emotions and Healing was initiated by one of the peer helpers. She was particularly concerned about how, from her personal observations, males struggle with emotional expression and the impact this has on their relationships. Her observation has also been underscored by sociologists who have found gender differences in both the experience and expression of emotions (Simon, 2020). In our planning phase, we broadened the focus of the workshop. We expanded the focus to include the complexity associated with emotional regulation and expression, and how this interplays with mental health. However, we still included a section on the role gender plays in emotional expression.

The goals of the workshop were to explore:

• emotions and mental health,

• barriers to expressing emotions,

• gender differences in the expression of emotions,

• the relationship between emotions and healing from painful experiences,

• the importance of emotional expression, and

• healthy ways of expressing emotions.

Workshop 3: Social media and mental health

Social media has become an integral part of modern-day interaction and engagement. As young adults, students are generally very active on social media platforms, and these mediums have become significant influences on how they live their lives, without critically reflecting on the advantages and disadvantages thereof. In one of our planning sessions, one of our peer helpers stated the following: "I think our generation is the most depressed one of all time". This was a very powerful statement that we then explored.

In this discussion, it emerged that social media could be a primary factor influencing the perceived levels of depression that the peer helper was referring to.

Research findings, too, are highlighting the link between social media and mental health. Lin et al. (2016) found social media use to be significantly associated with increased depression amongst young adults. Similarly, Primack et al. (2017) found the use of multiple social media platforms was associated with increased levels of anxiety and depression amongst young adults, while the findings from Lattie et al. (2019) underscored the contribution of social media to the mental health challenges of students, in particular. These research findings suggest there may be some accuracy to the peer helper's observation. Through my discussions with the peer helpers and the literature on the topic, I became more appreciative of the impact of social media on student's mental health and thought it important to start this conversation with our broader student community. We had to tread with caution as we could not deny the value of these platforms. Lattie et al. (2019) propose that interventions aim at distinguishing between healthy and unhealthy use. This is what we set out to do.

The goals of the workshop were to explore:

• social media use amongst students,

• the impact of social media on students' mental health,

• social media as platforms for expression,

• distinguishing between healthy and unhealthy social media use, and

• tips on navigating social media platforms.

Workshop 4: Healthy relationships

Family-related concerns are a primary problem our students present with. Figure 3 on the next page shows a breakdown of the top ten presenting problems recorded from individual counselling sessions offered in 2021:

 

 

Our annual statistics from 2021 showed that relationship challenges were the primary presenting problem, followed by symptoms of anxiety and depression (NMU Emthonjeni Student Wellness, 2022). In many instances, the relationship challenges contribute to the symptoms of depression and anxiety. Family distress, more specifically, is a major source of distress for our students. However, this does not seem unique to our context. A study by Xiao et al. (2017) found that family distress is also increasing amongst students in the United States.

For many of the students being at a residential university, like ours, offers an opportunity to physically separate from stressful home circumstances and some space to better cope with family distress. However, during the Covid-19 lockdowns students were "stuck" at home, confronted with their challenging family realities daily. Some students struggled to cope with being back in their family environment for a prolonged period. The peer helpers and I thought it important to create a platform to discuss relationship challenges and to offer tips on how students could manage these. We were cognisant that relationship challenges amongst students are not limited to the family context and decided to introduce a broader workshop, namely Healthy Relationships.

The goals of the workshop were to explore:

• healthy vs unhealthy relationships,

• the interpersonal dynamics of relationships,

• challenges in relationships with intimate partners, friends and family, and

• tips on improving relationships and managing relationship difficulties.

Workshop 5: Students and substances

Substance use related problems are high in universities, but many students do not recognise the need for supportive interventions or seek support (Caldeira et al., 2009). While students may not recognise the need for support (Caldeiera et al., 2009), substance use amongst students is associated with numerous negative outcomes such as poorer academic performance and increased risk of committing and experiencing sexual assault (Welsh, Shentu & Sarvey, 2019). During the Covid-19 lockdown, I observed an increase in cannabis use amongst students, which made me concerned about the risks involved in excessive substance use as a coping mechanism under the stressful Covid-19 conditions and lockdown restrictions. After raising my concerns with the peer helpers, we agreed to initiate a workshop on Students and Substances: The good, bad, and ugly. The goals of the workshop were to explore:

• students and their use of substances,

• substance use as a coping mechanism,

• substances and students' mental health, and

• ways of managing substance use/misuse.

Workshop 6: Stress, coping, and rising above

The Covid-19 pandemic disrupted the student experience in numerous ways. Academically, students had to rapidly adapt to the online learning experience. In the South African context, this posed massive challenges to many institutions as large proportions of the student population lacked access to mobile devices, data connectivity, electricity, water, and conducive study spaces, which served as barriers to remote learning (NMU Office for Institutional Strategy, 2021). In the Nelson Mandela University context, this was very significant, given the high number of our students who come from low-income backgrounds. Some students had to navigate challenges with online learning amid the threat of infection with the virus, illness, and death of loved ones, and other personal, family, social, and/or financial challenges. Students had to cope with these challenges whilst being physically separated from their friends, who often serve as a primary source of support to them.

During these challenging times, the peer helpers and I thought it important to impart knowledge that would assist our students in coping with the challenges at hand. We introduced a workshop, Stress, Coping and Rising Above, which explored coping with stress in the Covid-19 context.

The goals of the workshop were to explore:

• what stress is,

• stressors confronting students amid the Covid-19 pandemic, and

• ways of managing stress.

Workshop 7: Defying the odds: Nurturing resilience

Given the magnitude of disruption, stress, and losses brought by the Covid-19 pandemic, we wanted to include a workshop that brought hope to our students. We wanted to tap into many of our students' resilience, which has carried them through previous adverse events. We wanted to encourage our students to not become despondent but to rather persevere against the odds. Thus, we included a workshop on resilience. The goals of the workshop were to explore:

• what resilience is,

• what the characteristics of resilient individuals are,

• resilience in the Covid-19 context,

• tips on how students could nurture their resilience, and

• the power of resilience.

Students' reflections on our workshops

In reflecting on the psycho-educational workshops we offered during the Covid-19 pandemic, we realised that the challenges brought by the Covid-19 pandemic offered an opportunity for innovation and creativity in our efforts to serve our students. The workshops we introduced helped us strengthen our peer help programme and our peer-led mental health promotion initiatives, in particular. Anecdotal feedback from students suggests that the content discussed assisted students in two ways: (1) they become more aware of the importance of promoting their own mental health and; (2) they gained insights and tips on how to manage life challenges that could have a negative impact on their mental health. The following quotations are reflections from participating students.

One workshop attendee reflected on the following benefit from attending the Mental Health and Stigma workshop:

The workshop was very informative more especially because mental illness is being ignored by many people and cultures. Joining the session helped me a lot because now I know that if someone next to me is having problems regarding mental health then we can recommend that she/he can see counsellor. I have learned that mental health is not just a disorder but it can cause harm to an individual if not treated or if judged. If I see any change in my life about my mental health I will have to take initiative to get help. I will be checking my sleeping patterns, eating patterns and my behaviours in general.

The above quoted student had become sensitised to the importance of her mental health and that of others, and to address any mental health challenges timeously in the event of symptoms being observed. Another attendee also echoed that she gained a greater appreciation for her mental health and how she can nurture it. She stated:

I've learnt that my mental health is very important and I must prioritise it. I must not allow stigma from people to prevent me from seeking help or talking about what is bothering me.

Students attending the Emotions and Healing workshop were sensitised to the role that emotions can play in their mental health. One student reflected the following:

I've learnt that emotional healing is important even though it is a long process, but its good so that you can be healthy mentally.

Another student reflected:

For me it has been an eye opener on how emotions can affect one's mental health. I found it very interesting.

Other students from the Emotions and Healing workshop reflected that they had gained insight on how to better manage their emotions. One student stated:

I was reminded of some really valuable points about emotional healing. Forgiveness is key, even though it takes time. Emotions are okay to accept, and this process is actually necessary. Going forward I will work on forgiveness.

Another student reflected the following:

It was very informative. I've learnt a lot on how to deal with my emotions and I believe from now on I will deal with it in a better and more mature way.

Students attending the Healthy Relationships workshop also reflected that they had gained insights on how to better manage their relationship challenges, as underscored by the following 2 reflections from students: One student stated:

I felt I related much to it based on its content and it's really fitting especially to students because you find that in most cases the root of most problems or challenges come from relationships. The workshop triggered me in a good way because it would allow me to analyse where my weakest points were in relationships and how to tackle them in a good way.

Another student said:

I took away that sometimes our parents/caregivers have no clue of what they are doing either, all they know and have grown accustomed to is how they were raised. So, we should approach family relationships with a little more grace. We should not try to change people in our families but rather accept them for who they are.

From the insights quoted, the anecdotal reflections support our reflections as facilitators, that participating students were sensitised to the importance of nurturing their mental health and gained insights/tips on how to manage challenges that may negatively impact their mental health. These workshops underscored the importance of mental health promotion initiatives in our efforts to address the increasing demand for mental health support amongst students; and the role that student peers can play in this regard. If we empower our peer helpers to offer more mental health promotion initiatives, we could afford our professional staff more time to respond to the demand for remedial mental health support. Brown (2018) and Czyz et al. (2013) underscore the reluctance of some students to seek professional help due to a perception that their problems may not be serious enough to warrant treatment. Peer-led workshops, like the ones we offered, could be a more attractive alternative to these students and others who may be reluctant to speak to a professional. Furthermore, by including the student voice (that of the peer helpers) we created content that was student-friendly and relevant, and it was implemented by peers who could relate and share experiences. As the programme coordinator, I became more appreciative of the value of the student's voice, both in terms of content creation and implementation and the power of collaborating with students.

 

The way forward

We created the topics covered in the workshops in the context of the Covid-19 pandemic. They will remain relevant post-Covid-19, as these themes reflect challenges that students generally grapple with. We will adjust the content as we go along (e.g. the Stress, Coping, and Rising Above and the Defying the odds: Nurturing Resilience workshops will speak to these topics more generally rather than drawing to the Covid-19 context). As we return to our university physically, we will initially take a blended approach to offering our workshops (i.e. offer it virtually and face-to-face). However, our initial experience, since returning to campus, indicates our students prefer to join our workshops virtually. This seems to be influenced by the distance between the various campuses and the busy schedules of students. Joining virtually affords students from all campuses to join without having to travel, and the convenience of joining from their preferred locations. We are sharing our initiatives in the interest of other institutions who may benefit from similar initiatives. These initiatives should not be hard to replicate, provided the institution has a group of intentional peer leaders and a coordinator driving the programme.

 

Conclusion

The Covid-19 context brought new challenges to student counselling centres which were already struggling to address the mental health needs of students. We had to be innovative in responding to the mental health needs of students remotely, at a time when many students were vulnerable due to the changes, uncertainty, and stress brought on by the Covid-19 pandemic. In navigating this challenge, the Emthonjeni Student Wellness peer helpers and I saw the opportunity for innovation to offer mental health promotion initiatives to our students. In partnering with our student peer helpers, we expanded our peer-led mental health promotion initiatives and in doing so we expanded our capacity to meet the demand for psychological services. Our journey has helped us strengthen our peer help programme and it underscored the power of collaborating with students. As coordinator of the programme, I hope that by sharing our journey and the insights gained from the process, we highlight the valuable role that student peers can play in supporting fellow students and how they can be at the forefront of mental health promotion initiatives.

 

Acknowledgements

I wish to acknowledge the Emthonjeni Student Wellness peer helpers 2020/21 for their passion to serve fellow students, and the great contributions they made to the programme.

Ethics statement

In this article the author reflects on her process of creating and implementing mental health promotion workshops, in collaboration with student peer helpers. This is a personal reflection, and ethical clearance was not required. Some reflections from participating students have been included as anecdotal feedback on how participating students benefitted from participation. Identifying information from the student reflections has been kept confidential.

Potential conflict of interest

The author has no conflict of interest to declare.

Funding acknowledgement

No funding or grants were received.

 

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Received 13 August 2022
Accepted 5 May 2023
Published 14 August 2023