Learning objectives

1. To understand the lived experience of students with mental health difficulties and the meaning that these students ascribe to their higher education experience.

2. To identify the day-to-day challenges experienced by university students with mental health difficulties and gain insights into the practical measures students adapt to deal with these challenges.

3. To evaluate the impact of perfectionism on the well-being and university experience of students with mental health difficulties and examine the function of perfectionism for these students.

Introduction

Thus far, this book has focused primarily on the experiences of students with mental health difficulties in terms of the policies, pathways, and provisions designated to support their inclusion and success in higher education. This chapter focuses instead on the experience of students themselves. It examines the nature and meaning of higher education for the students who participated in this study, as well as the day-to-day reality of managing a mental health difficulty. It reflects students’ attempts to come to terms with their distress, “accepting that this is your life”, as Adrianna put it, and “learning how to manage it” (Ella), all while navigating higher education. While undoubtedly challenging, and mired with the reality that “I don’t think it will ever be fixed” (Ashley), many students in this book spoke about the upside of “it” – their particular mental health difficulty or distress.

The nature and meaning of higher education for students with mental health difficulties

This book sought to understand the nature and meaning of higher education for Irish students with mental health difficulties. This ambition reflects its hermeneutic phenomenological orientation and commitment to getting as close as possible to the experience as it is lived. The method by which this is achieved is represented in Appendix, and the broader body of work from which these accounts stem can be seen in its entirety elsewhere (Farrell, 2022b; Farrell and Mahon, 2021). This section presents student descriptions of their experience at university and the meaning they ascribe to higher education in their lives. It provides day-to-day examples of the unique challenges students face in a university setting as well as what higher education, and education in general, means to them.

Beginning with the students’ lived experience of navigating higher education; the students’ accounts were peppered with struggles directly related to their mental health problems. These included the challenge to concentrate and stay focused (Claire, Greg, James); the struggle to attend lectures (Lauren, Claire); the effort required to stir up motivation or interest in their work when their mood was low (Greg, James); and the battle with perfectionism, procrastination, and getting work in on time (Adrianna, Ella, Greg, Robert, Mai, Louise, Joseph, Ashley, James, Claire).

Lauren described the thin line she walks between “not eating” and not failing her continuous assessment assignments and examinations. She described how she “failed [first] year on attendance” even before she reached the end of the first term and took the advice of her tutor who “suggested going off-books and doing medical repeat”. She “got through” first year the second time round and, now, in her second year, says that her anorexia nervosa is presenting “a bit of a problem, but not to the extent – I don’t think I’ll fail. I hope not, because I’m definitely not repeating […] I think I’ll just about make it, I think”.

While for Lauren every day involves a balancing act between the demands of her eating disorder and the demands of her degree, Sophie faces a similar balancing act but in her case it is between her introversion and social anxiety and getting a degree. Sophie says, “I need to get an education, you know?” but describes the “academic setting” and “class situation” as “very daunting”: “Having to socialise and chat to people and stuff, I was very intimidated”. After dropping out of college at her first attempt, Sophie came “back into a situation that I knew I wouldn’t be comfortable in 100 per cent[,] knowing that there wasn’t really a way out for me”. She described how she is “learning all the time how to cope better” with her anxiety but feels she has “no choice” but to do this if she is to get her degree: “I can’t just not do anything for the rest of my life”.

Sophie was one of eight students who described having to drop out or go “off-books” and either repeat a year or come back and start another course the following year. Ella struggled with the transition to college. Moving away from home she lost all her supports and was discouraged from registering with her university support services by her psychologist who felt “admitting to mental illness in the academic field would put a black mark on my name”. She found herself living with strangers, one of whom she thinks “might have had some social issues”, and doing “the wrong course”. Ella also broke up with her boyfriend during this period and says that “everything got terrible and I ended up just not going to college … I got very depressed, very anxious. I got very, very anxious”. Ella dropped out of college before the end of her first year: “it was the first time I’d ever really failed at anything in my life”. Although Ella came back the next year and registered with her university support services, started a course that she enjoys, and found better living arrangements, she says, “I have a lot of insecurities about my academic work now” which she links to “how I dropped out of first year … I’d never failed anything before”.

Greg, a second year PhD student, wonders if “the tendency towards the depression and anxiety is incompatible with academia”.

Greg finds that this pressure, combined with a lack of structure, “takes its toll”. He is currently struggling with depression and becoming increasingly “disillusioned” with academic life. So much so, that at the time of interview, Greg had decided to drop out of his PhD programme.

James, also studying for a PhD, described similar struggles to Greg – particularly when he first started his research. He spoke about feeling “quite depressed, very low motivation, wasn’t working hard at what I was doing, wasn’t interested”. James says that one thing that helped him come out of his low phase was the realisation that, “Of course. Please edit the sentence as follows “if I fail the whole PhD and everything goes out the window, I didn’t have one [a PhD] starting so that’s OK”. He says he “can’t afford to obsess over my PhD” as he “can’t bounce back the way other people can” and feels that maintaining perspective and “awareness” is important for him and his mental health.

Adrianna says she came into college with “a lot of leftover stuff, like you know, throwing up and self-harm and depression and changes in medication”. Now in her third year Adrianna feels that, although “I still have moments where things aren’t great”, ultimately she is “pushing forward”: “It [the distress] comes back but it’s not plaguing me every day”. Adrianna described how she “loves the subject” she is studying and during her time in college has “used the resources” available to her and year by year feels she is becoming “more solid, more able to deal with things”. Higher education appears to have offered Adrianna a supportive environment in which to grow and develop personally as well as academically. Higher education for Adrianna, and for many of the other students, represents much more than a qualification or a career boost.

The meanings students ascribe to their higher education experience are both highly personal and enormously significant. For John, education is the key to breaking the cycle of poverty and abuse he was born into. He says, “I really do see society or life as a kind of circle and it’s very hard to get out of and I’m trying to get out of that circle”. John described how he grew up “at the bottom of the pile” in terms of social class, with both parents unemployed and living on social welfare benefits.

John described his early life as being dominated by “deprivation”, “chaos”, “coldness”, “dampness”, “poverty”, “neglect”, “emotional abuse”, “verbal abuse” and “sexual abuse”. By the time he reached his early 20s John was living alone, away from home, unemployed, “constantly living in really bad accommodation … I had no friends really, isolation and no qualifications or no education”. One friend he did meet along the way was a man who “really emphasised the importance of education”.

John’s friend suggested he wasn’t “able for college” right away but that he should begin with a level 4¹ qualification and “build it up” from there. John successfully completed his level 4 certificate, was offered a place on a one-year university access programme which, in turn, led him onto his honours degree course at that university. He is now in the second year of his degree and says, “I really like this new life”.

Joseph told the story of how he “returned to college to fulfil a lifelong ambition” after almost 20 years out of the classroom. This move took a lot of courage for Joseph, particularly as he had struggled for all of his adult life with crippling anxiety and panic attacks. He described the first day of his one-year pre-college course “thinking oh God can I do it?”.

But Joseph “hung in there” and after the pre-college course started on a four-year degree programme in university. University presented a number of significant challenges for Joseph and he says he gets “totally overwhelmed” at times, but he has a “passion” for his subject and hopes to continue to go a specialist master’s degree in order to fulfil his “dream … to work in a museum”.

Kate described how, even as a young girl, she thought deeply about the world and “questioned the meaning of life and why people are here and why people do what they do”. Developing anorexia nervosa as a teenager curtailed her education, and although she “left school in 5th year” she sat her Leaving Certificate examination: “I failed the Leaving Cert but I did sit it”. At a particularly low point in her early 20s, Kate says she “was very sick and I had tried to kill myself a number of times”. During that time Kate “questioned a lot like the meaning of life and why people are here and why people do what they do” and, on the recommendation of a family friend, decided to travel to Pakistan to speak to a man “that many people go to for help”. One of the things this sage-like man suggested to Kate was that she should pursue her passion for learning and knowledge.

However, Kate “came back and started Googling possibilities and options of what I could study” and within weeks of returning from Pakistan started a degree with the Open University. Kate completed her degree and is currently in the first year of a two-year master’s degree programme. Although she says she feels she is “winging it” and feels “like a fraud”, education and learning for Kate have a much deeper significance: “sometimes I feel in my life I am to learn things intensely”. In returning to education she “wanted to understand, I wanted to understand people, I wanted to understand myself”.

While for Kate higher education offered her a chance to satisfy the deep curiosities and questions that had shaped her life, for Leon it offered him an opportunity to gain “social approval”. He describes himself as “the black sheep”, particularly after he was diagnosed with paranoid schizophrenia at the age of 18. He says, “it has been a long road but I’m getting there” and, after two years at the National Learning Network and one year doing a university access course, Leon is finally in the first year of his undergraduate degree. This offers him “the social acceptance of being a student” at a prestigious university which has “helped my mental health as well, you know, because I have that social approval now”.

This section has examined the challenges faced by students with distress in higher education. Some of these, such as the struggle to attend or to complete assignments on time, were more universal than others. However, each student’s experience is unique and those represented above offer a glimpse into what it is like for certain students as they navigate their way through higher education.

The meaning of higher education extends far beyond the day-to-day challenges for many students. Indeed, it is this meaning that motivates many students to continue in the face of significant adversity. For John, education was his way out of the cycle of poverty and abuse he was born into. For Joseph, it was the chance to “fulfil a lifelong ambition” (p. 15). For Kate, education was a means of answering some of the bigger questions that shaped her life, particularly the question of whether life was truly worth living at all, while, for Leon, being a third level student offered him a chance to earn the social approval that he felt he lacked as a result of having a mental illness. While this section focused on the “what” (nature) and “why” (meaning) of student experience, the next examines the “how”.

Managing a mental health difficulty while at university

One of the more defining features of students’ accounts was the manner in which they managed and accommodated “it”, their mental health difficulty, while at university. It appears the initial, and often most painful, first step in learning to live with and manage “it” was accepting “that this is in your hands” (Adrianna). Adrianna spoke about reaching the realisation that professionals “can only help you when you’re in their office and that you have to get your shit together” [student emphasis].

When Sophie first started “going through severe bouts of depression” as a teenager, she says, “I pitied myself and felt very much like ‘poor me’ – how will I ever cope with this?”. She feels that this was “a perfectly natural response” to the injustice of her situation, “but at the same time I hated myself for not being resilient and for not somehow having the means to cope with it”. Sophie described how she initially believed “everything will work out happily ever after” but “as the months went on” it became clear that this time the ending was unlikely to be quite as happy and straightforward as she hoped.

Sophie says that “for me as a young person it was the first time I was not equipped to handle what came my way and that was a very frightening feeling”. She didn’t realise that coping was “something that you learn”.

Ella, Joseph, Lauren, Marie, Ashley, Claire, and James all spoke, unprompted, about how, once they had come to terms with the reality that “it’s always going to be there” (Lauren), they can then “learn to manage it better” (Lauren).

Marie says, “I’m always going to have to look after myself and I find that frustrating sometimes but I think I just need to learn to deal with it”.

Marie knows “the statistics aren’t great” and feels that mental health problems are “always going to be part of my story”, but she says that “every time it happens I learn a little bit more” and feels that right now she just needs to “keep working on figuring myself out – that’s the plan”.

Like Marie, Ashley says, “I don’t think it’ll ever be fixed” but feels that she needs to “make the adaptations and learn the strategies and things that are going to make things doable” in spite of her bipolar disorder. However, for Ashley, her “main problem is that being consistent gets boring”. She says, “I do miss the element of chaos in my life” and since “things have gotten together” and have “been good recently” she feels she has “lost a chunk of identity”. James also thinks “bipolar’s for life” but he doesn’t “think that means it has to control” him. These words reverberated in the story of Joseph, who says, “I don’t think you can cure anxiety”. He says that when “Bressie, the guy from the Voice of Ireland [TV show], stated that he suffered from anxiety and panic attacks, and it’s gone, I actually felt jealous”. Joseph described all the ways in which he has been “just trying to deal with it as well as I possibly could” since he was a teenager. It has been a long struggle for Joseph, but he says that “every step I took made a difference” and now, after “24 years of suffering”, he is “managing my anxiety as well as it [can] be managed”.

Ella described herself as “a ticking time bomb – there’s always a chance I’ll go bad again”:

One thing that has been hard for both Ella and Mai to come to terms with is the sense of wonder they both have as to what might have been had they not had distress to contend with. Ella says, “I should really get a first[-class]” honours degree but because of her daily struggles with anxiety and depression she says, “I’d be very surprised if I do”: “what will annoy me will be it won’t be a lack of capability, it will be having been so distracted and the mental, I do think the mental illness will have impacted it a lot”. Mai spoke about how she had the opportunity to sit a scholarship exam which, had she been successful, would have meant that she “would have been able to move out of my house, not get verbally abused by my family” any more: “I couldn’t do it in the end, I got too sick”.

Students described a variety of way in which they manage their mental health on a day-to-day basis. These included developing routines and schedules to support their efforts to stay well. Marie identified early on that “structure is really good for me”, and when her mental health really began to deteriorate she “had to get very good at making plans and schedules”. James and Ashley both spoke at length about how “when I lose my structure I start to get stressed”. For Ashley, “stress and alcohol are the two big things” that affect her moods and are the two things she is most learning to keep under control. James spoke about how he finds it “very difficult to establish a routine”.

For James, “bipolar’s for life” but he can “manage it” (“I’ll just continue with the diet, continue with the lifestyle and continue meditating”) in the knowledge that “if you’re not managing it, it could go out of control”. Keeping busy is another important strategy for James, one which Sarah, Lauren, and Marie spoke about too: “it’s probably better to be busy than to be not doing anything at all”. For Lauren, living with “it” meant living within the limits of her eating disorder. She is very aware of “what I can and can’t do” – something that her friends have become aware of too. She knows that, when her friends invite her for lunch, “I can go to Marks and Spencer’s and there’re two things I can have there; there’s one thing I can have in Costa’ that fits the calories I’m willing to have” (Lauren).

Sarah spoke about all the things she does to nurture her mental health: “I love art and I really find when I’m doing that it really helps, but it’s hard to get the motivation to do that”; “I think using your hands really helps, like drawing and painting and I was doing a dressmaking class as well”; “I started basketball last week so hopefully that will help”; “I do keep myself very busy and my father and myself did the couch to 5 km and we go for runs together and I think that is really good”; “I do mindfulness every night, well, me and my mum do it as a ‘workout’”.

Perfectionism

One of the great opportunities afforded by adopting a hermeneutic phenomenological approach was the opportunity to sit with, and listen to, the students as they themselves brought forth aspects of their experience important to them. In doing so they were able to draw “something forgotten into visibility” (Harman, 2007, p. 92). They gave voice to currents of influence often lost beneath the surface of “what happened”. One example of this was the undercurrent of perfectionism in the experiences of 17 of the 27 students in particular.

The motivation for perfection, as described by the students, appeared to come from four, often inter-related, sources: an internal desire/drive for perfection; a desire to meet the perceived/actual expectations of others; a desire to prove themselves or to prove others wrong, and the fear their work, and/or they, were not “good enough”. Each of these four driving factors will be discussed in turn.

A number of the students described how they would have, as Ashley put it, “very high standards” for themselves. Annie described how “growing up I was always the type who wanted good grades and things like that”. She remembers winning her first Irish dancing trophy at the age of six and how she realised “I could actually do this and from then on it became something I wanted to do well in”. Annie says that her parents never pushed her to do well at dancing or school; “It was very much myself, I was very competitive … it was a personal thing for myself, I wanted to do well”.

Fiona also described how her parents “are always like ‘all you can do is your best’ but for me I am like ‘no, I need to do better’”. She says she is “very hard on myself, like, I push myself really hard”.

Ashley’s father “could never understand” why she pushed herself so hard to achieve in dancing and in school: “he just didn’t think it was normal for a child to put themselves under the pressure I did”. Like Annie, Ashley discovered that by working hard she did well in dancing competitions. Before third year in secondary school Ashley says school “wasn’t a big deal” but when she achieved very high marks in her Junior Certificate “I realised I was kind of good at school so then that worry transferred from the dancing to my school [work]”.

James spoke about his “all or nothing” attitude to life: “everything has to be the last thing in the world. You have to win every tackle, you have to win everything, you’re a complete perfectionist”. However, he identified that while this attitude has brought him considerable success in life, it also means “there’s no kind of satisfaction at times”.

All four students identified how their internal drive to succeed was a double-edged sword. On the one hand they are all hugely successful young people but on the other hand the pressure they place themselves under could become “so overwhelming” (Fiona) at times. Annie described how in her Leaving Certificate year she was training for the world championships in dancing, working a part-time job “to fund my dance classes” and, at the same time, working hard in school to achieve the points she needed to get into university. Eventually it all became too much: “I couldn’t really handle it I suppose”.

Fiona has also struggled to keep up with the standards she sets herself. She described how at the end of the term prior to our interview she had to submit a number of big assignments on the same day. She “wanted to do really well in everything” and in the process “just worked way too hard … I did just burn out”.

Ashley also identified how the pressure she puts herself under can be “quite extreme”.

In school she placed herself under such pressure to achieve that when she went into her first Leaving Certificate exam she “had the most extreme panic attack”. She says that the exams went “essentially downhill from there on” and, in the end, Ashley had to repeat the year in school and sit the Leaving Certificate a second time.

While Annie, Fiona, Ashley, and James described having high standards and expectations of themselves, a number of students spoke about feeling some degree of expectation from others. Adrianna said, “there was an expectation, it was probably never really kind of said and shouted at me, but there was an expectation that I’d always do really good at school”. She feels that this expectation has “become so engrained that you don’t even consider that you’re doing it for someone [else]”.

Like Adrianna, Lauren says, “I have this really bad perfectionism complex and it’s such an issue, it’s a ridiculous issue”. She said that high expectations were “in our house” as she was growing up and she is “sure we’re all a little bit like that [perfectionistic]”.

From a very young age Lauren had set her sights on becoming a paediatrician. She says that, even now, she “would still be really interested” in going back to do medicine but during her Leaving Certificate year Lauren became aware that she “wasn’t doing well” in some key subjects and was going to struggle to meet the entry requirements for medicine. Ultimately, she decided to “change the plan”.

Thomas, too, felt the pressure of expectation as he entered his final year of secondary school.

He described feeling a weight of expectation associated with being a high-achieving student in a school where few students go on to third level.

By the second week of his final year, Thomas was leaving classes “in tears”. He wasn’t sleeping, had lost his appetite, and stopped going out and getting involved in his normal activities. Within two months of starting sixth year he had been diagnosed with “severe depression” and prescribed a series of psychiatric medications.

Three students described how their drive to achieve perfection comes as a result of a deep desire to prove others wrong. In Sarah’s case, the person she wanted to prove wrong was her secondary school guidance counsellor. The guidance counsellor suggested Sarah be placed in a lower class as she felt that her dyslexia would prevent Sarah from keeping up in school.

Sarah says, “I think there must be a link there [between] that whole thing of proving people wrong and being a perfectionist”.

For Niamh it was her grandmother, who made it clear that she had low expectations of Niamh from a young age, that she wanted to prove wrong.

Claire described how she “wanted to prove that I could do it”. When she was in school Claire struggled with depression and anxiety to the point that, in her final year, she attended a total of just 33 days “and the days I was in, I left early”. In spite of this Claire says, “I wanted to do well in my Leaving Cert and I wanted to prove myself and I wanted to do the best that I could”. She says that even today she still tries to “overcompensate” and constantly worries that she is “a bit behind people”.

The fourth, and perhaps the strongest, force that appeared to motivate students’ drive for perfection was fear – fear that their work, and/or they, were not good enough.

Greg described how he doesn’t “feel particularly anxious as long as I can, I suppose, compare to other people nearby and convince myself that I am doing better than them”. He spoke about how as an undergraduate he “wanted to be liked” by his lecturers; “I really wanted to be seen to be understanding and doing well”. However, while this desire to be liked and to do well placed him at the top of his class it also led to him experiencing deep anxiety, particularly when it came to submitting assignments:

Greg described immobilising procrastination: “I suppose I have had difficulty with just getting rid of [assignments] at the deadline and instead going ‘oh no, it’s not ready it’s not done’”. By the time he reached his final year Greg struggled to submit anything on time for fear that the “assignments were going to fail”. Assignments and extensions continued to pile up for Greg until eventually he “withdrew from college to repeat”.

Adrianna, too, described how she “wanted to do really well and wanting it [her work] to be perfect because I wanted to show that I was hard working and that I really understood it”.

Like Greg, Adrianna struggled with procrastination: “I mean I survived the first year on extensions. In fact, I think I had extensions for almost every assignment”. She described how she would complete assignments, “freak out over them and I wouldn’t submit them” because, in her eyes, they weren’t good enough.

Both Robert and Marie described how they would rather not submit an assignment at all than submit something they feared wasn’t good enough.

Marie spoke about how “I tie a lot of my self-worth into how I’m doing academically”. She acknowledges that this “isn’t great”:

Louise, too, spoke about how her fear that an assignment was “not good enough” would prevent her from submitting it on time. She gave one example in particular where the thought of it not being good enough caused her to panic: “I just panicked … in my head I was like ‘I’m gone, I’m done, I’m not going to be able to do this course’”.

The pressure “to do well” was also a feature of Mai’s experience: “oh my God I have to do well”. She says this pressure only came about after “I got my first good grade” in her pre-university course and realised she had an opportunity to go to college. Since then she says:

Like the others before her Mai talked about how her fear that she “won’t get a 1:1” has resulted in her procrastinating or, in her own words, “burying my head in the sand”. She admits that “instead of actually doing a bit of study every day”, she’d often “go back to bed, try not to think of it, try and fall asleep until the next day”.

Joseph also describes himself as a “perfectionist – it’s terrible, it’s terrible”. He says that in the job he had prior to returning to full-time education he was “very neat” and everything was “top quality … I’d always do a really, really good job”. While he feels this is a “skill I brought to college” he also feels that it hasn’t served him as well in university as it did in his manual job and instead causes him to feel “stressed”.

Perfectionism is a complex phenomenon that has been linked to both positive (Stoeber and Otto, 2006) and negative (Lunn et al., 2023) mental health outcomes. Defined as the setting of excessively high standards for performance accompanied by overly critical self-evaluations (Frost et al., 1990), perfectionism is reportedly “adaptive”, or helpful, for some and “maladaptive”, or unhelpful, for others. For those whose perfectionism is described as “adaptive”, it facilitates positive outcomes at university such as academic self-efficacy, self-determination, task completion, and internal locus of control (Kayis and Ceyhan, 2015) which, in turn, relate to higher exam performance and scores (Stoeber, Haskew, and Scott, 2015). For those whose perfectionism is described, in research terms, as “maladaptive”, perfectionism is associated with procrastination, excessive levels of self-criticism, and emotional exhaustion. These, in turn, relate to low levels of self-worth, low mood, and high levels of anxiety (Ashby and Rice, 2002; Lunn et al., 2023).

Brown (2015, p. 130) describes perfectionism as “a self-destructive and addictive belief system that fuels this primary thought: If I look perfect and do everything perfectly, I can avoid or minimise the painful feelings of shame, judgement and blame”. This belief system, and the thoughts and behaviours it fuels, was remarkably evident in the stories of the students in this book.

Upside of “it”

In spite of the difficulties presented by their distress, many students were able to recognise the positive impact this “part of me” (Marie) has had on them overall. Ella described how “it’s had its downsides but it’s also taught me a lot and definitely made me more compassionate, made me a lot more humble and made me a lot more willing to accept my own faults”. Ella also clearly articulated the “downsides” to her anxiety and depression but says that that “focusing on the positives, it’s just something you have to do because you have to focus on the positives or else you end up resenting who you are”.

Kate described how

Kate spoke about how much and how “intensely” she has learned as a result of her experience, something that Adrianna also described. Adrianna says, “you learn from it” and that “you know things because” of the type of experiences she and the other students went through. For her there is a difference between knowing and understanding and that her life experience has left her with “a different kind of understanding”. Kingsley, too, feels that “huge experiences like that change you”.

Marie says, “I like what it’s done to me”. She feels her experience has made her “a much more empathic person” with “much more understanding” and a greater “self-awareness”. Claire doesn’t think she “would be the person I am today if I didn’t have it”. She feels it makes her a “more rational” human being and is “sure it’ll stand to me in the future”.

James spoke at length about how his experience has “forced” him to start “appreciating the simplest things” in life. He feels that learning to live with bipolar disorder has meant that he “can look at things a little differently to other people” and gives him a perspective on what’s truly important in life. He feels this perspective and appreciation of life comes from having “been to the very bottom”: “I think if you make it out the other side you’ve a huge advantage in life in terms of you’ve seen the worst of it”.

Millie also described how having come through the worst of times she “can now appreciate when I have it good”. She feels “the mental illness kind of taught me to look at things differently”. However, while many of the students could identify the upside of “it”, they also clearly acknowledged the challenges “it” presents them, particularly as they try to move on in their lives.

Conclusion

This chapter, perhaps more than any other in this book, turned away from the literature, debates, and theories surrounding the inclusion of Irish university students with mental health difficulties and, instead, turned squarely towards the experience itself. It described the nature and meaning of higher education for the students who took part in this research, charting the challenges and opportunities university represented for them personally. It delved into the day-to-day experience of students, and the routines, habits, and behaviours they have developed to manage their mental health while at university. While, as Ella suggests above, “being mentally ill is difficult”, students acknowledged how this experience, and the realities that they have had to face, often at a young age, has offered them strength and resources unavailable to their peers. This “upside” to “it” is offered, not as a silver lining, but as a reflection of the balance and maturity with which students approach their distress. It is with this sense of a “whole” that we enter the final chapter.