The relatively recent ‘commodification’ of higher education in UK culture has consequences for the overall mental wellbeing of university communities. Students arrive with differing levels of financial confidence. Many graduate with increased financial stresses. Debt and financial concern are associated with poorer mental health and academic under-performance at university and lower levels of well-being after graduation. It is worth sensitively asking troubled students – and staff - about financial worries. More than 40% of UK students with a mental health disorder reported being in debt, compared with 17.5% of those without a diagnosis. Debt is associated with depression, suicide, self-harm, problem drinking, drug dependence, neurotic and psychotic disorders, and eating disorders. The combination of financial stress with maladaptive coping strategies such as gambling, sex working and drug dealing can lead to damaging association with criminal sub-cultures. Students experience vicious spirals as mental disorder and financial concerns interact over their university career. They are more likely to seek timely support when they perceive financial advisors as sympathetic and supportive rather than angry and blaming. Financial ‘savvy’ can be explicitly taught and supported, with benefits for mental health.

This introductory chapter sets out the need for a handbook of university mental health. It considers the health of staff alongside that of students, and that does not presume American systems of education and healthcare. Far more of the UK population expects to attend university, with a consequent expansion in the size and numbers of institutions. Financial constraints mean that universities can no longer run as elite communities of self-governing scholars, but are now governed according to business models, with implications for the wellbeing of all involved. In the context of population-wide increases in mental disorder and demand for treatment, more students than ever now disclose a psychiatric diagnosis. The recent COVID pandemic and lockdown disproportionately threatened the well-being of students and may have changed for good some of the ways in which education and healthcare are delivered. The author summarises her own personal and professional of UK university life and describes the motivation for embarking on the production of a single author handbook on this topic. A wide readership is welcomed to the book, which will provide a series of interlinked but standalone chapters to be consulted piecemeal as well as read as a whole.