Listening to Youth Voices: Student-Generated Recommendations for Suicide Prevention and Mental Wellbeing in Higher Educational Institutions—A Qualitative Round-Table Dialogue from India

Highlights

Public Health Relevance—How does this work relate to a public health issue?

• Student suicides and mental health difficulties are major public health concerns that require coordinated responses from educational institutions, health systems, and policymakers.
• Colleges and universities represent critical settings for early intervention, mental health promotion, and suicide prevention among young people, yet student perspectives on institutional responses remain underrepresented in research and policy development.

Public Health Significance—Why is this work of significance to public health?

• Drawing on a participatory dialogue with 212 students from 29 colleges, this study captures student-generated policy-oriented recommendations, providing one of the larger youth-informed qualitative datasets examining how students conceptualise suicide prevention and institutional responsibility for mental wellbeing in Indian higher education.
• Students framed suicide prevention as a socio-ecological and systemic issue requiring shared institutional responsibility extending beyond counselling services to include multi-level interventions that strengthen access to professional mental health support, supportive relationships, humane and flexible academic systems, and campus cultures that foster belonging, connection and psychological safety.

Public Health Implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?

• Effective campus suicide prevention may require a shift from reactive crisis management approaches, ad hoc counselling provision, and isolated awareness activities toward whole-campus wellbeing frameworks that integrate mental health promotion into institutional policies, practices, relationships, and environments.
• Policies and programmes designed through meaningful student participation may be more contextually relevant, acceptable, and sustainable than approaches developed without youth engagement.

Abstract

Background: Student suicide has emerged as a major public health concern, particularly in India, where rising suicide rates have intensified calls for higher education institutions to play a central role in prevention. Although whole-university and participatory approaches are increasingly advocated, evidence on students’ priorities for institutional action remains limited. This study explored students’ perspectives on actions that higher education institutions can take to promote mental wellbeing and reduce suicide risk. Methods: An exploratory qualitative study was conducted using document analysis of written group responses generated during a large-scale participatory round-table dialogue on suicide prevention in Bengaluru, India. A total of 212 undergraduate and postgraduate students from 29 higher education institutions participated. Written responses from 19 discussion groups were analysed using reflexive thematic analysis. Results: Four overarching themes and 13 subthemes were identified: strengthening institutional mental health support systems, building mental health capacity across the institutional ecosystem, humanising academic and institutional systems, and creating wellbeing-oriented campus environments and cultures. Students emphasised accessible mental health services, faculty and peer capacity building, compassionate institutional policies, academic reforms, and campus environments that foster belonging and holistic wellbeing. Conclusions: The findings support socio-ecological and whole-university approaches to student mental health and suicide prevention. By centring students’ recommendations, the study provides practical insights to inform participatory, contextually relevant institutional policies and campus-based suicide prevention strategies.

1. Introduction

Suicide is a major global public health challenge and one of the leading causes of death among youth worldwide. According to the World Health Organization (WHO) report published in 2025, an estimated 727,000 people died by suicide in 2021, and suicide was the third leading cause of death among individuals aged 15–29 years globally that year [1]. Mental health conditions account for approximately 15% of the global burden of disease and injury among adolescents aged 10–19 years, and it is estimated that half of all the lifetime mental disorders begin by age 14 and approximately three-quarters by the mid-twenties [2,3]. Adolescence to young adulthood is a critical developmental period characterised by heightened vulnerability to emotional distress, self-harm, and suicidal behaviours [4,5,6]. As mental health concerns among youth continue to rise globally, student mental health has emerged as an increasingly important public health, educational, and policy concern [7,8].

Higher education years are particularly important within this context, as they coincide with this highly vulnerable developmental period, while simultaneously exposing students to academic, interpersonal, and vocational pressures, changing social networks, identity development, evolving family expectations, and uncertainty about the future as they adjust to greater autonomy and responsibility [8,9,10]. The transition into higher education involves leaving familiar support systems and navigating less structured and more diverse learning and social environments, and, particularly, the first year has been identified as a period of increased susceptibility to psychological distress [10]. Higher education institutions are accordingly recognised as critical settings for mental health promotion, early intervention, and suicide prevention among youth [11,12].

The issue is especially urgent in India, given the substantial burden of suicide among young people. Across the 2012–2022 decade, student suicides exhibited a compounded annual growth rate of 4% [7]. Recent National Crime Records Bureau (NCRB) data indicate that 14,488 students died by suicide in 2024, accounting for 8.5% of the 170,746 suicides reported nationally [13]. This was a 4.3% increase from 13,892 student suicide deaths in 2023 despite a largely unchanged national suicide rate (12.3 to 12.2 per 100,000) [14]. In July 2025, India’s highest judiciary recognised the severity of the crisis by issuing binding nationwide directions mandating mental health safeguards and measures across educational institutions, explicitly situating student mental health within the constitutional right to life [15]. Within the Indian educational context, student mental health concerns are closely linked to academic pressure, family expectations, and uncertainty about careers and future employability, with high-stakes hyper-competitive entrance examinations, performance-oriented educational cultures, high parental expectations, and harmful comparisons with peers and relatives contributing to emotional strain and reduced wellbeing among Indian youth [16,17,18]. Parashar [19] argues that student wellbeing is shaped not only by individual vulnerabilities but also by the interacting demands, norms, and structures of educational institutions, families, coaching cultures, labour-market expectations, and broader sociocultural systems. Preventing student suicide therefore requires addressing the wider environments within which young people live, learn, and make sense of their futures.

Consistent with this, contemporary suicide prevention research increasingly emphasises socio-ecological and public health approaches that understand suicidal behaviour as shaped by individual, relational, institutional, environmental, and broader societal influences rather than individual vulnerability to psychopathology alone [20,21]. Theoretical frameworks such as the Interpersonal Theory of Suicide identify social connectedness and belonging as protective against suicidal thoughts and behaviours [22,23], while the Integrated Motivational-Volitional (IMV) Model identifies defeat and entrapment as pathways to suicidal thoughts and behaviour [24]. These perspectives have informed Whole-University and Healthy University approaches, which position mental health and suicide prevention as institution-wide responsibilities embedded across policies, support systems, teaching, campus environments, and organisational culture rather than counselling services alone [25,26,27]. Reflecting these developments, a growing body of research highlights the value of accessible counselling, gatekeeper training, peer support, mental health literacy, anti-stigma initiatives, faculty engagement, and early identification and referral systems [6,28,29]. In India, the National Suicide Prevention Strategy [30] and the Ministry of Education’s UMMEED Guidelines [31] likewise emphasise coordinated, multi-sectoral, and campus-embedded responses through teacher training, life-skills education, early identification, supportive environments, and stronger integration with mental health systems.

Despite these advances, research has focused largely on the prevalence and correlates of student distress or evaluation of specific interventions, with far less attention given to how students themselves conceptualise suicide prevention, the institutional barriers they perceive, and the changes they believe educational institutions could implement to promote wellbeing and reduce suicide risk. This gap is significant because, as the primary beneficiaries, students possess valuable experiential knowledge; yet their perspectives remain underrepresented in mental health policy and programme design [32,33] despite growing recognition that youth participation improves the relevance, acceptability, and effectiveness of mental health initiatives [34,35]. Studies examining students’ perspectives on campus mental health have focused mainly on barriers to help-seeking and counselling services, with a few studies examining peer support, the role of academic staff, and student involvement in institutional decisions [36]. Most of this work is based on small qualitative studies or survey research from high-income countries, and the findings are influenced by the service and cultural contexts in which they were conducted [36,37,38]. We discuss relevant individual studies alongside our findings in the Discussion section. Within India, few studies have systematically foregrounded student-generated recommendations for institutional responses to emotional distress and suicide prevention [16,39,40,41], while much of the evidence informing campus mental health frameworks continues to originate from high-income Global North countries, underscoring the need for culturally grounded evidence from the Global South [6,42,43,44].

The present study addressed these gaps by centring the voices of 212 students from 29 colleges in Bengaluru, India, through a participatory round-table dialogue on how higher education institutions can promote mental wellbeing and reduce suicide risk. As Indian institutions move to implement the Supreme Court’s mandatory directions amid rising student mental health concerns, the findings offer timely, comprehensive, and student-informed actionable insights for campus mental health policy, institutional governance, practice, and suicide prevention while advancing participatory, context-sensitive, and responsive approaches to student mental health.

2. Materials and Methods

2.1. Study Design and Setting

This study used an exploratory qualitative design to analyse group-generated written responses from a participatory world cafe-style round-table dialogue with college students, titled The Round-Table Dialogue on Suicide Prevention: Breaking the Silence and Listening to Youth Voices, conducted as part of the World Suicide Prevention Day observance in Bengaluru Urban District, Karnataka, India, jointly organised by NIMHANS-ICMR Centre for Advanced Research and a Microsoft India-funded project at NIMHANS. This approach is established as a participatory method for collecting qualitative data, in which the group-generated written output constitutes the dataset rather than serving as a proxy record of conversational exchange [45].

The round-table dialogue comprised three thematic discussion rounds: (i) the role of self-help and self-care in emotional wellbeing, including ways to overcome hesitations in seeking help; (ii) the role of peer support and preferred supportive behaviours from peers; and (iii) the role of institutional measures. The present paper is confined to a presentation of findings from the thematic discussion round that focused specifically on students’ collective recommendations regarding institutional actions and policy measures that educational institutions could implement to promote mental wellbeing and reduce suicide risk among college students. This focus is intentionally selected because it offers the most direct and actionable implications within the dataset for campus mental health policy and suicide prevention.

2.2. Participants and Recruitment

A total of 212 students participated in the round-table dialogue, representing 29 higher education institutions across Bengaluru, a metropolitan city in India, of which 6 were government institutions and 23 were private institutions. Participants were recruited through open registration following dissemination of an invitation flyer circulated online via social media platforms. Recruitment was based on voluntary self-selection, and no monetary or material incentives were offered. Participants received a certificate of participation upon completion of the event.

Eligibility criteria required participants to (a) be currently enrolled in an undergraduate or postgraduate programme in a local higher education institution and (b) be between 18 and 25 years of age. Detailed participant characteristics are reported in Section 3.1.

2.3. Procedure

Participants were allocated to 19 discussion tables through a numbered token system administered at the point of entry, ensuring random group assignment, with each discussion table comprising approximately 10–12 students. Group identifiers were assigned from the token numbering system and are therefore non-sequential, ranging beyond the total number of discussion tables. The round-table dialogue consisted of three thematic discussion rounds as mentioned earlier. Approximately 30 min were provided for discussions in each of the rounds.

At the beginning of the round, participants were provided with the relevant theme and structured discussion prompts, displayed at each table. Participants were encouraged to engage in open dialogue, share experiences and perspectives, and collaboratively generate practical recommendations. The full verbatim prompt for the theme discussion—which forms the focus of the present analysis—read as follows:

“Apart from things that students can do for themselves and for each other to tide over emotional distress, educational institutes/campuses may be able to do various things to support student mental health and also for reducing risk of suicides in young people. Imagine you are the Principal/Director of a higher education institute: What are 5–10 new steps/changes you would want to implement to promote student mental wellbeing and reduce risks of student suicides? State them as concrete action steps that could be implemented.”

Time management was facilitated through a structured system: a first buzzer was sounded at approximately 20 min to indicate that discussions should begin moving toward conclusion, followed by a second buzzer at 30 min marking the end of the round. Tables requesting additional time to complete their written summaries were provided with a buffer of five minutes. Following the discussions, all the groups were asked to display their completed charts in a designated area. Additionally, the groups were offered an optional opportunity to present their charts to the larger gathering as a showcase of their discussions, and these presentations were not treated as research data.

Discussions were facilitated by table moderators, one stationed at each discussion table, with two additional moderators overseeing the overall coordination and flow of the event. All moderators were members of the research and organising team and were qualified psychologists holding at least a master’s degree in psychology. All moderators had prior exposure to facilitating group discussions and qualitative enquiry. Prior to the event, moderators were briefed on the discussion prompts, the facilitation protocol, and the boundaries of their role. Their role was limited to clarifying the task, encouraging equitable participation, and maintaining a respectful, inclusive, and non-judgmental environment, while refraining from influencing the content of participants’ responses. The moderators had no prior relationship with the participants.

2.4. Data Collection

Data were collected through group-generated written responses documented during each discussion round. All discussions were conducted in English, and the group-generated written responses were likewise produced in English. Within each group, one group member voluntarily assumed the role of recording the collective discussion on a self-selected basis, without being designated by the research team. Points were noted progressively as ideas emerged during the discussion, with the recorder capturing contributions in real time. Towards the close of each round, the recorded points were cross-verified with other group members to confirm completeness and accuracy to ensure it was truly representative of the whole group. Table moderators additionally provided reminders to groups to ensure thorough documentation of discussed responses. No audio or video recordings were made, as all 19 groups deliberated simultaneously in the same venue, making overlapping audio difficult to interpret. Given the sensitive nature of discussions, avoiding recording also supported open participation. The written group responses were therefore the sole data source and were documented in real time and cross-checked with group members before the end of each round.

The authors’ positionality shaped the study. The research and organising team were based in a Department of Clinical Psychology at a tertiary mental health institution, and their professional backgrounds influenced the framing of discussion prompts toward public health, psychosocial, and institutional factors rather than individual psychopathology. Their experience also informed facilitation, particularly the emphasis on creating a non-judgmental environment. During analysis, their familiarity with clinical and public health approaches to suicide prevention shaped interpretation and was treated as an analytic resource within reflexive thematic analysis. To minimise the imposition of existing frameworks, coding began inductively, analytic decisions were documented through memos, and interpretations were repeatedly checked against the original response sheets. The team’s affiliation with a national mental health institute may also have influenced participants’ expectations of the dialogue.

2.5. Data Analysis

Data were analysed using reflexive thematic analysis [46,47,48], an approach selected for its capacity to systematically identify and interpret patterns of meaning through a primarily inductive process, allowing themes to emerge from the data rather than being imposed through predetermined theoretical frameworks.

The analysis focused on the written group responses generated during the round, which explored students’ recommendations for institutional measures to promote mental wellbeing and reduce suicide risk within higher education settings. The unit of analysis comprised the 19 independently generated table-level response sheets, each representing the collective perspectives of a discussion group of approximately 10–12 participants.

Analysis proceeded through iterative, recursive phases consistent with reflexive thematic analysis. Response sheets were read repeatedly to support immersion in the dataset, with preliminary observations and recurring patterns documented through analytic memos. Initial codes were generated manually and inductively, identifying meaningful units of content relevant to institutional support, mental wellbeing, and suicide prevention without recourse to pre-existing theoretical frameworks before related codes were grouped by conceptual similarity and developed into broader themes through iterative comparison and reflection. Initial inductive coding and development of preliminary themes across all 19 response sheets were undertaken by the first author, with analytic decisions documented through memos. Consistent with reflexive thematic analysis, the second author subsequently acted as a critical reviewer rather than an independent reliability coder [47]. With access to the complete dataset, the second author reviewed the codes and themes for grounding in the data, any overlooked content, and coherence. Differences in interpretation were discussed with reference to the original data until consensus was reached. Theme boundaries were refined and overlapping categories consolidated across multiple rounds of review against both the coded data and the complete dataset, ensuring the final thematic framework remained data-grounded while comprehensively capturing students’ recommendations for institutional action.

2.6. Ethical Considerations

The study forms part of the community engagement initiatives undertaken within a larger research project reviewed and approved by the NIMHANS Institutional Ethics Committee (NIMHANS/45th IEC (BEH.SC.DIV.)/2024).

Informed consent was obtained via the online event registration form, which included a consent declaration that anonymous written responses of participating small groups may be used for research and publication purposes. Through this form, the participants not only consented to participation in the event but also specifically to their responses being analysed and published as research data. It was highlighted during taking consent that their responses would be confidential and the data would be used only in a collective/grouped fashion, and none of their personally identifiable data would be used as a part of the research. Prior to commencement of the event on the event day, students were further reminded about the purpose of the round-table dialogue, the nature of the discussions, the intended use of the information generated, and the measures undertaken to protect anonymity and confidentiality. Participants were informed of their right to withdraw from participation at any point during the event.

The dialogue was conducted within a respectful and supportive environment that emphasised confidentiality, non-judgmental listening, and equal opportunity for participation. Given the sensitive nature of discussions related to emotional distress and suicide prevention, mental health support resources were shared along with helpline numbers that could be used for self and for peer dissemination.

3. Results

3.1. Participant Characteristics

The 212 participating students were drawn from 29 higher education institutions across Bengaluru (6 government, 23 private). The cohort was predominantly female (n = 193, 91.0%), with 19 male participants (9.0%). Participants represented a broad range of academic disciplines, including psychology (n = 96, 45.3%), engineering and physical sciences (n = 61, 28.8%), commerce and management (n = 48, 22.6%), and law (n = 7, 3.3%), and were distributed across different stages of higher education. Discussions generated 19 table-level group response sheets, which constituted the dataset for analysis.

Analysis of the 19 group-generated response sheets yielded four interrelated themes, each comprising a set of constituent subthemes (see

Table 1. Themes and subthemes identified from students’ recommendations for institutional suicide prevention and mental wellbeing promotion.

Theme	Subthemes
Theme 1: Strengthening Institutional Mental Health Support Systems	Professional counselling and psychological services
	Early identification
	Digital and external support mechanisms
Theme 2: Building Mental Health Capacity Across the Institutional Ecosystem	Faculty capacity building
	Peer support and mentorship
	Parent engagement and psychoeducation
	Campus-wide mental health awareness, emotional literacy, and life-skills education
Theme 3: Humanising Academic and Institutional Systems	Academic flexibility and workload reform
	Fair, non-discriminatory and supportive institutional policies
	Positive student–faculty relationships
Theme 4: Creating Wellbeing-Oriented Campus Environments and Cultures	Psychological safety and safeguarded avenues for expression
	Recreation, belonging, and inclusive community building
	Holistic wellbeing and innovative wellbeing spaces

) reflecting student-advocated recommendations for how higher education institutions can promote mental wellbeing and reduce suicide risk. Collectively, findings across the four themes are characterised by institutional actions spanning accessible professional mental health services, supportive relationships, flexible and humane academic structures, and campus environments that foster wellbeing.

The four themes are distinguished by the analytic function of the recommendations they encompass rather than by the stakeholders or settings they involve. Theme 1 concerns the provision of specialist mental health services. Theme 2 concerns the capacity of the wider campus community—faculty, peers, families, and students themselves to recognise distress, respond supportively, and facilitate help-seeking, and therefore encompasses training, education, and literacy-building recommendations. Theme 3 concerns the structure of academic demand and the fairness with which institutional systems are enacted. Theme 4 concerns the lived social, cultural, and physical environment of campus life, and the conditions of belonging, safety, and restoration within it. As a result, the same stakeholder group may appear in more than one theme in a different analytic role: for example, faculty feature in Theme 2 as potential providers of mental health-informed support requiring preparation, and in Theme 3, they feature as agents through whom academic structures and institutional policies are experienced by students.

3.2. Theme 1: Strengthening Institutional Mental Health Support Systems

Participants consistently highlighted the importance of accessible, professional, and trustworthy mental health services within educational institutions. They emphasised that counselling services should move beyond symbolic or tokenistic provision to become adequately staffed by qualified professionals and integrated into campus life.

Across most response sheets, groups called for the appointment of trained, empathetic, and full-time counsellors who could provide ongoing support. Recommendations also included increasing the number of counsellors available on campus, ensuring counsellor accountability through supervision mechanisms, providing gender-diverse counselling staff, and offering services in multiple languages to improve accessibility and comfort for diverse student populations. One discussion group recommended the availability of “trained counsellors who are available full-time, not as a check box in the institutional profile” (Group 2), while another proposed “having multiple, well-trained counsellors” (Group 17). Other groups highlighted the need for “male counsellors to promote safe space for boys” (Group 1) and “having more psychologists specialising in different niches by conducting need analysis surveys with students” (Group 10).

Several groups identified financial constraints as a structural barrier to accessing mental health services. Students recommended financial support schemes to cover counselling costs for those unable to afford external services when these are not available within institutes. (Group 15), alongside pro bono arrangements with external practitioners (Group 17). Calls for an “increase in mental health budget for educational institutes” (Group 8) and stronger linkages between government bodies and educational institutions to support policy implementation and bridge resource gaps (Group 5) were also noted.

Students also emphasised the importance of early identification and intervention. Recommendations included “regular counsellor visits for classroom observations” (Group 6), provisions for “routine mental health check-up” (Group 5), or “free screening for psychological wellness/distress” (Group 19), and conducting periodic wellbeing surveys to assess student needs at regular intervals and enable services to adapt accordingly (Group 14).

Beyond conventional counselling services, participants proposed several digital and specialised approaches to expanding access. These included institution-specific mental health applications, AI-assisted chat platforms, 24-h crisis helplines, and external experts/professionals who could provide support independent of institutional hierarchies. Participants mentioned that collaborating with external counsellors, wellness coaches, and mental health organisations could provide supplementary support while minimising concerns about bias and confidentiality within institutional systems. One group suggested an “institution chat box AI” for supportive conversations (Group 18), while another proposed “college/university mental health apps” as a means of providing accessible and anonymized support (Group 19). Both discussion groups 19 and 21 independently recommended 24/7 crisis helplines for students as a dedicated resource for acute distress management.

3.3. Theme 2: Building Mental Health Capacity Across the Institutional Ecosystem

A second major theme concerned the role of faculty, peers, parents, and the broader educational community in shaping students’ mental health experiences. Participants repeatedly emphasised that promoting wellbeing should not be viewed solely as the responsibility of counsellors, but rather as a shared responsibility distributed across the institutional ecosystem.

Faculty members were identified as particularly influential figures in students’ lives, and training of teaching staff emerged as one of the most consistently raised recommendations across the dataset. Participants recommended comprehensive training for teachers in areas such as mental health awareness, crisis response, active listening, and supportive communication. Several groups emphasised the importance of helping faculty recognise signs of distress and respond empathetically rather than punitively. Suggestions included training faculty to identify non-verbal indicators of emotional difficulties, respond appropriately to acute anxiety or emotional crises, and avoid behaviours perceived as discriminatory, judgmental, or stigmatising. Illustrative recommendations included “training the trainer/teachers to better approach or respond” (Group 2), “training faculty on how to deal with mental health issues that can come up like panic attacks” (Group 14), and ensuring that teachers are “trained how to read body language” and become more attuned to students’ emotional expressions (Group 15).

Several groups went further, recommending not only in-service training but also changes to the teacher education pipeline. Group 8 proposed embedding child psychology as a substantive component of teacher training degrees and induction programmes, arguing that foundational knowledge of mental health and developmental wellbeing should form part of initial teacher preparation rather than being addressed only through post-qualification workshops. Another insightful systemic observation came from Group 17, which suggested reducing pressure on faculty members themselves, noting that unmanaged teacher stress tends to be displaced onto students, thereby becoming a secondary contributor to student distress.

Participants also emphasised the value of peer-based support systems. Recommendations included structured peer mentorship programmes, buddy systems, peer education initiatives, and training students in empathy, observation, active listening, and basic support skills. One group proposed a “peer mentorship programme (buddy programme)” (Group 21), while another suggested “peer support training (empathy, positive assist, observation, reflection)” (Group 19). Particularly notable was Group 3’s recommendation for a structured mentorship model assigning one peer mentor to every 15 students, with mentor–mentee sessions held at least once every three months.

Many students further highlighted the importance of involving parents in mental health promotion efforts. Parent counselling and education were recommended as ways of addressing stigma, improving parental understanding of youth experiences, reducing harmful comparisons between children, and increasing awareness of issues such as LGBTQ+ identities, generational differences, and emotional wellbeing. One group specifically recommended “parent counselling avoiding family stereotypes” (Group 2), while another advocated regular bi-monthly parent meetings focused on reducing academic pressure and the tendency to compare students against siblings or peers (Group 6).

Participants also called for campus-wide mental health awareness initiatives. Suggestions spanned workshops, awareness campaigns, psychoeducation programmes, guest lectures, mental health clubs, emotional intelligence training, life-skills education, and curriculum-based wellbeing content. Students expressed a desire for mental health literacy to become a routine, visible aspect of campus life rather than an occasional or reactive activity. Several groups recommended extending the scope of these initiatives beyond conventional mental health topics. Sex education was identified by multiple groups as an important component of a holistic wellbeing curriculum, with Groups 7 and 14 including it alongside mental health and life-skills programming. Career guidance was raised as a meaningful wellbeing intervention by Groups 7 and 22, reflecting students’ recognition of career-related uncertainty as an important influence on mental health. Group 21 further recommended financial literacy education as a preventive wellbeing measure, observing financial stress as a significant yet under-addressed contributor to student distress.

3.4. Theme 3: Humanising Academic and Institutional Systems

Participants frequently identified academic pressures, rigid institutional structures, and unsupportive administrative practices as contributors to student distress. They therefore advocated reforms that would make educational systems more flexible, responsive, and humane.

Academic workload emerged as a recurring concern across most of the response sheets. Students recommended reducing excessive workloads, introducing more realistic deadlines, spacing assignments appropriately, shortening class durations where necessary, prioritising practical exposure over theoretical learning, and improving coordination among faculty to prevent students from becoming overwhelmed. One group proposed “an app-based system” through which faculty could coordinate assignment schedules and monitor students’ existing workload (across faculty/departments) before assigning additional tasks to students (Group 2). Another suggested that institutions should actively “listen to students when they negotiate about workload” (Group 6).

A particularly salient recommendation concerned the institutional framing of academic achievement and failure. Group 21 proposed that entrance examinations should stop being positioned as definitive turning points in students’ lives: “not pressurising entrance exams as an end of life or start of career journey”.

Participants also called for greater flexibility in attendance policies, dress codes, examination systems, and other institutional regulations. A group highlighted that the “Grading system should not be influenced by favouritism” (Group 2). Several groups advocated policies that would accommodate individual circumstances and support students experiencing mental health difficulties. Recommendations included recognising psychiatric emergencies as legitimate grounds for medical leave, avoiding punitive responses to psychological struggles, and ensuring institutional procedures prioritised student wellbeing over administrative compliance.

Students further emphasised the need for fairness, impartiality, non-judgement, and freedom from discrimination and humiliation within academic environments. Concerns were raised regarding favouritism, public disclosure of grades with names, moral policing, and differential treatment of students based on academic ability. Participants argued that educational institutions should actively cultivate cultures of respect, dignity, and equity. A particularly striking recommendation came from Group 16, which called on institutions to stop treating suicide attempts as moral failings of students and instead “cultivate cultures and procedures that treat suicidality as a health matter rather than a disciplinary one”.

Alongside structural reforms, students highlighted the manner in which academic relationships are conducted, particularly around evaluation, feedback, and academic difficulty. They wanted teachers who are approachable, compassionate, and willing to listen. Recommendations included encouraging faculty to actively engage with student concerns and avoid discouraging students following poor academic performance. One group emphasised the importance of “mutual respect between every person in an institution, regardless of authority” (Group 14), while another suggested “do not discourage students when they score less or fail exams” (Group 3). Participants also stressed that student feedback should not be merely collected, but responsiveness should be demonstrated by visible action on concerns raised by students. As one group noted, institutions should focus on “implementing changes, not just merely collecting feedback” (Group 16).

3.5. Theme 4: Creating Wellbeing-Oriented Campus Environments and Cultures

The final theme reflected participants’ recognition that mental wellbeing is shaped not only by services and policies but also by the broader social and physical environment of the campus. Students emphasised fostering campus cultures that promote belonging, connection, inclusion, and holistic development. A group firmly asserted that campuses must have a “zero-tolerance mechanism for harassment/bullying” (Group 8).

Participants frequently recommended creating safe spaces where students could express themselves, connect with others, and seek support without fear of judgement. Suggested initiatives included wellbeing clubs, sharing circles, support groups, and anonymous mechanisms for emotional expression such as feedback boxes, enquiry boxes, catharsis boxes, and anonymous venting systems.

Students also emphasised the value of recreational, cultural, and extracurricular activities in promoting wellbeing. Recommendations included sports, yoga, art, music, journaling, cultural programmes, professional networking events, and opportunities for creative expression. One group advocated for “spaces within campus that are well-maintained and with relaxing activities like sports, painting, etc., for students to channelize their emotions into” (Group 17), while another recommended encouraging “recreational activities for student bonding” (Group 14). Group 1 also proposed beginning the academic day with short but meaningful mental health activities—such as brief mindfulness exercises or group check-in rituals—reflecting students’ understanding that wellbeing support can be woven into everyday institutional routines rather than confined to designated programmes or crisis services.

Several groups highlighted the importance of inclusive campus environments that respect diversity and foster community belonging. Students recommended validating multiple regional and cultural identities, creating opportunities for social connection, and ensuring that campuses actively address bullying, ragging, and harassment. Suggestions included implementing strong anti-ragging mechanisms, creating inclusive student communities, and establishing policies that promote psychological safety. A distinctive community-building recommendation came from Group 10, which proposed creating a dedicated experiential space where mental health professionals and individuals with personal experience of navigating mental health challenges could share their stories, enabling students to listen, relate, and connect.

Participants proposed a wide range of innovative wellbeing-oriented spaces and initiatives. These included quiet low-stimulation spaces, emotional check-in circles, World Cafés for networking, prayer rooms, and expressive arts-based programmes. One group suggested a “coping café” where food items would be linked to emotional states and access to a counsellor would be available (Group 21), while another proposed “therapeutic rooms” where students could engage in relaxation, mindfulness, and recreational activities (Group 19). Group 15 recommended quiet rooms—low-stimulation, calm spaces designed to offer students respite from the social and sensory demands of campus life. Several groups also advocated for expressive and experiential therapeutic modalities within campus programmes: Group 14 recommended “unconventional therapy models” that allow students to engage expressively, while Group 10 explicitly named theatre as a modality suitable for campus wellbeing programming, reflecting interest in creative, engaging, and non-stigmatising pathways to wellbeing support within campus environments.

Table 2. Summarising student-generated recommendations for institutional mental wellbeing promotion and suicide prevention.

Recommended Actions	Action Domains	Related Themes
Increase institutional mental health budgets and establish linkages with government bodies to bridge resource gaps; recognise psychiatric emergencies as legitimate grounds for medical leave; adopt non-punitive, health-oriented responses to suicidality in place of disciplinary action; enforce zero-tolerance mechanisms for ragging, bullying, and harassment; ensure grading is free from favouritism and grades are not publicly disclosed by name; demonstrate visible action on student feedback.	Policy and governance	1, 3, 4
Appoint qualified, full-time counsellors in adequate numbers with supervision and accountability mechanisms; provide gender-diverse and multilingual practitioners; subsidise counselling costs and establish pro bono arrangements with external practitioners; introduce periodic wellbeing surveys; provide 24-h crisis helplines; offer digital mental health tools; enable access to external professionals.	Mental health services	1
Train faculty to recognise distress, respond to acute crises, and communicate supportively; embed mental health and developmental psychology within pre-service teacher education and induction; coordinate assignment scheduling across departments to regulate cumulative workload; set realistic deadlines and negotiate workload with students; avoid discouraging or punitive responses to poor academic performance; address faculty workload and stress as a determinant of student wellbeing.	Faculty and classroom	2, 3
Establish structured peer mentorship with defined mentor-to-student ratios and minimum contact frequency; train peer supporters in empathy, active listening, observation, and referral; support student-led wellbeing clubs, sharing circles, and support groups; incorporate lived-experience sharing into campus mental health initiatives.	Peer and student community	2, 4
Provide parent counselling and psychoeducation addressing stigma, academic pressure, and comparison between siblings and peers; hold regular parent meetings on realistic expectations; raise parental awareness of generational differences and LGBTQ+ identities.	Family	2
Create quiet, low-stimulation rooms and therapeutic and expressive spaces; provide recreational, cultural, sporting, and creative programmes; establish anonymous channels for emotional expression such as feedback and catharsis boxes; build inclusive environments that validate regional and cultural diversity; incorporate brief wellbeing practices into everyday institutional routines.	Campus environment	4

summarises the student-generated recommendations in condensed, action-oriented form, organised by the level at which institutional action would be required. This organisation is complementary to the thematic structure: whereas the themes reflect the analytic function of the recommendations, Table 2 groups them according to the stakeholders and institutional levels responsible for enacting them.

4. Discussion

The present study explored college students’ perspectives on institutional actions to promote mental wellbeing and reduce suicide risk within higher education. Overall, the findings suggest that students view suicide prevention as a proactive, systemic, and shared institutional responsibility embedded into the texture of everyday campus life rather than reactive crisis management responses, isolated awareness programmes, or clinical interventions targeted at distressed individuals alone. Across the four themes of findings, participants conceptualised student wellbeing and suicide prevention as emerging from an interconnected institutional ecosystem, comprising accessible mental health services, supportive relationships, humane academic systems, and campus environments that foster psychological safety, belonging, and holistic wellbeing.

Participants’ recommendations on strengthening professional mental health services reflected a nuanced vision of institutional support to encompass quality, accessibility, trustworthiness, accountability, and sustained institutional investment. Their strong emphasis on full-time rather than symbolic counselling provision corroborates Indian evidence that mental health services in educational settings often exist in reactive or tokenistic forms rather than as visible, proactive systems of support [39].

Students also appeared attuned to several barriers well-documented in the help-seeking literature and proposed targeted responses to address them. Their preference for gender-diverse counselling staff likely reflects awareness that prevailing masculine norms discourage emotional disclosure among young men, underscoring the need for help-seeking pathways that feel safe and relatable across different student groups [49]. Similarly, recommendations for external mental health professionals suggest concerns about privacy, confidentiality, and perceived fit—consistent with evidence that young people avoid seeking support when they anticipate judgement, doubt confidentiality, or perceive services as culturally mismatched to their needs [16,18,41,43]. The recommendation for subsidised counselling access reflects a view that institutions should actively reduce structural barriers to care rather than place responsibility for accessing support solely on individual students.

Students’ emphasis on service quality and acceptability further reflects evidence that trust, stigma, perceived usefulness, and expected outcomes strongly influence help-seeking behaviour [28,50]; expanding services alone is therefore unlikely to suffice unless these factors are also addressed. Their interest in AI-assisted chatbots and digital platforms aligns with growing evidence of high acceptability for digital mental health interventions among college students in India specifically [51,52], particularly for those reluctant to seek face-to-face support because of stigma, privacy concerns, or logistical barriers [6,16,53]. Likewise, recommendations for routine mental health screening, albeit while ensuring confidentiality and avoiding negative repercussions, as well as proactive outreach, reflect the need for a shift from reactive, crisis-driven services toward preventative, population-level care approaches consistent with university mental health literature for institutional student wellbeing [8,12]. Collectively, these findings suggest that students view effective campus mental health provisions as requiring sustained institutional resource commitment that extends beyond the symbolic appointment of a counsellor.

A second key finding was students’ emphasis on faculty, peers, parents, and the wider educational community as contributors to student mental wellbeing. Rather than locating responsibility solely with mental health professionals, participants advocated a distributed support ecosystem in which those who regularly interact with students are equipped to recognise distress, respond supportively, and facilitate timely access to help, consistent with socio-ecological models of suicide prevention that locate protective influences within everyday relationships and community structures [21].

Faculty occupied a particularly prominent place in students’ recommendations. Calls for training in mental health awareness, active listening, crisis response, and supportive communication reflect evidence that position teachers as relational gatekeepers who shape whether campus environments feel safe and conducive to help-seeking [54]. These recommendations align with gatekeeper models of suicide prevention, including QPR (Question, Persuade, Refer) and ASIST (Applied Suicide Intervention Skills Training) [29,55], which equip non-specialist community members to identify, support, and refer individuals in distress [18,56,57]. Notably, participants also advocated embedding mental health competencies within pre-service teacher education itself, reframing mental health awareness as a core professional competency rather than an optional form of continuing professional development. Their recognition that educator wellbeing influences student wellbeing adds an insightful systemic dimension to faculty capacity building, aligning with evidence that unmanaged teacher stress, burnout, and exhaustion can undermine student–teacher relationships, classroom climate, and ultimately student mental health outcomes, thereby inviting institutions to consider parallel investment in educator welfare as an essential lever for strengthening student wellbeing [58].

Students similarly endorsed peer-based support systems, suggesting a layered model of early intervention in which trusted peers, perceived as more relatable, are often the first to be turned to rather than professionals, thus lowering the threshold for disclosure and potentially facilitating a gateway to professional support [4,28,43]. Importantly, participants did not assume that peers naturally possess these skills; instead, they advocated structured training in supportive communication and referral skills, recognising that good intentions alone may be insufficient. These recommendations resemble models like Sources of Strength and broader Social Network Intervention approaches, which strengthen connectedness, promote positive mental health, and shift help-seeking norms through trained peer supporters [59,60,61,62,63,64]. The operationally specific mentor-to-student ratios and contact frequencies recommended further suggest that students value sustained, structured support over informal or ad hoc arrangements. At the same time, some evidence shows that although students endorsed mentorship in principle, many were reluctant to confide in assigned mentors because of concerns about trust and confidentiality [39], highlighting the importance of carefully planned confidentiality safeguards and relationship-building rather than formal assignment to mentoring structures alone. These recommendations focus on preparing peers to provide support, rather than on peer relationships themselves; students’ views on connection, inclusion, and belonging as protective factors are discussed under Theme 4.

Participants’ emphasis on parent counselling and psychoeducation similarly reflects recognition that mental health and suicide prevention efforts need to extend beyond campus boundaries. Concerns regarding parental comparison, academic pressure, criticism, stigma, and generational misunderstandings align with Indian evidence demonstrating that supportive family communication promotes wellbeing, whereas unrealistic expectations, persistent comparison, family conflicts, and emotional invalidation contribute to psychological distress [64,65]. These findings reinforce calls for parent sensitisation programmes that encourage a “cost–benefit analysis” of excessive expectations, performance pressure, and peer comparison to foster greater parental reflection on their potential harms [19].

Finally, participants endorsed campus-wide psychoeducation and life-skills initiatives that extended beyond conventional mental health awareness to include emotional intelligence, sex education, career guidance, and financial literacy. Together, these recommendations reflect a broad conceptualization of determinants of mental health encompassing practical, interpersonal, developmental, and life-management skills and competencies that strengthen protective factors, resilience, and support long-term wellbeing, consistent with contemporary conceptualisations of mental health literacy [66,67]. Collectively, these findings suggest that students view mental wellbeing as a shared responsibility involving the entire institutional community rather than mental health professionals alone.

A third major finding concerned students’ calls to humanise academic and institutional systems. Rather than focusing solely on strengthening support services or individual coping skills, participants directed attention to the institutional conditions within which distress emerges. Their recommendations reflect growing recognition that student mental health is shaped not only by individual vulnerabilities but also by structural determinants, including academic pressure, assessment practices, organisational culture, and perceived institutional support [27,68]. In this regard, students positioned institutions as active contributors to creating conditions that either support or undermine psychological health.

Participants expressed particular concern about academic pressure and performance-oriented educational cultures. Academic stress is a well-established contributor to student psychological distress globally [69] and is especially significant in India, where educational achievement is closely linked to family expectations, social mobility, social status, and future employment opportunities [17,41,65,70]. Their recommendations suggest that academic pressure becomes particularly harmful when institutions respond to student struggles through rigid regulation, unsupportive administrative practices, public scrutiny, or humiliation. It resonates with the Integrated Motivational-Volitional Model of suicidal behaviour, which identifies experiences of defeat, humiliation, and entrapment as key pathways to suicidal ideation [25]. Similar dynamics have been documented in India, where coaching cultures, family expectations, and labour-market pressures often combine to produce chronic performance pressure and fear of failure [19]. Self-Determination Theory offers a complementary explanation, proposing that controlling educational environments undermine students’ needs for autonomy, competence, and relatedness, with consequential costs to motivation and wellbeing [71].

Notably, rather than advocating lowering academic standards or diluting educational rigour, students called for more humane and flexible educational systems that are designed reasonably and thoughtfully, challenging the common assumption that wellbeing initiatives are incompatible with academic excellence. The proposal for realistic deadlines and an integrated workload allocation system visible to all faculties exemplifies this perspective—rather than asking individual students to cope better with excessive demands, it asks institutions themselves to coordinate and regulate schedules, shifting responsibility for avoidable stressors from individual students to structural reform.

Students also challenged narratives that frame examination outcomes as defining personal worth or future success. This is particularly relevant within India’s highly competitive educational landscape, where high-stakes entrance examination-related stress and fear of failure have well-documented links to suicidal behaviour among young people [7,18,70]. Rather than advocating stress-management interventions alone, participants questioned the broader societal narrative and cultural messages surrounding success and failure, suggesting that institutions can reduce the perceived “high stakes” of examinations by promoting more flexible and multifaceted understandings of achievement, failure, and life trajectories, and legitimising diverse, alternative, and non-conventional educational and career pathways [19]. Viewed in this way, suicide prevention extends beyond identifying individuals at risk to reshaping institutional narratives about success, failure, identity, and human worth.

Students’ recommendations for non-publicised grading, recognition of psychiatric conditions as legitimate grounds for medical leave, faculty approachability, impartiality and responsiveness, and non-punitive responses to psychological and academic difficulties further reflect a desire for institutions that respond to students as people rather than administrative subjects. These recommendations align with trauma-informed and student-centred educational approaches that emphasise flexibility, psychological safety, dignity, and responsiveness to varying student capacities, circumstances, and support needs [72]. Particularly noteworthy was the recommendation to move away from punitive or law enforcement-oriented responses to suicide attempts and instead treat suicidality as a health concern requiring care and support. Although suicide attempts have effectively been decriminalised in India under the Mental Healthcare Act, 2017, through the presumption of severe stress, survivors may still encounter stigma and punitive responses that compound rather than alleviate distress of those already in crisis [73]. Similar attitudes are starkly illustrated by findings that common descriptions of college students who attempt suicide included terms such as “stupidity,” “attention-seeking,” and “weak heart” [39]. Together, these findings highlight the need to reinforce that institutional climate itself—whether characterised by respect, compassion, equity, and responsiveness or by rigidity and punitive practice—can function as either a protective or risk factor for student mental health.

The final theme captures students’ recognition that mental wellbeing is shaped not only by services, support systems, and policies but also by the lived physical, social, and cultural campus environment. Participants positioned belonging, connection, inclusion, psychological safety, and opportunities for restoration, recreation, and self-expression as central protective factors rather than peripheral add-ons, conceptualising suicide prevention not only as risk-reduction but also as active cultivation of conditions that promote connection and wellbeing. This shifts the conversation from a deficit-oriented crisis-response model toward a strength-based model of mental health promotion.

Whereas earlier recommendations focused on preparing students to support peers in distress, these recommendations focus on the relational climate itself, like belonging, mattering, and inclusion as protective conditions. This is consistent with suicide prevention literature. The Interpersonal Theory of Suicide identifies thwarted belongingness as a central contributor to suicidal desire [22,23], while connectedness is repeatedly identified as one of the strongest protective factors against suicide across educational settings [60]. Rather than referring simply to the count of social ties, connectedness reflects a broader sense of mattering, care, trust, respect, and inclusion within one’s community [60]. Further, bio-ecological models of human development and theoretical traditions across attachment, social support, resilience, social capital, and sense-of-community literature all converge in support of its key role [60], which is reinforced by recent evidence identifying erosion of meaningful social connectedness as a key contributor to worsening youth mental health globally and positions its strengthening as a priority target for prevention efforts [63]. Viewed through this lens, students’ recommendations for wellbeing clubs, emotional check-ins, sharing circles, support groups, and opportunities for meaningful peer interaction can therefore be understood not merely as social activities but represent preventative strategies that strengthen interpersonal connectedness, belonging, and community integration known to protect against emotional distress and suicidality.

A particularly distinctive recommendation was to incorporate lived-experience sharing into campus mental health initiatives. Unlike traditional information dissemination-based awareness campaigns, personal narrative-based approaches foster relatability, reduce stigma, normalise help-seeking, enhance hope, and foster a sense of connection, consistent with evidence supporting lived-experience and recovery-oriented community models [74,75,76]. Students’ endorsement of such initiatives suggests a preference for mental health conversations grounded in authentic lived realities rather than solely expert-led discourse.

Participants also highlighted psychologically safe and inclusive campus environments as fundamental to wellbeing. Recommendations addressing bullying, ragging, harassment, and multi-cultural inclusion suggest that students view the campus climate—and whether they experience it as safe and welcoming—as a major determinant of mental health rather than merely a backdrop against which mental health difficulties unfold. This aligns with evidence linking belonging, inclusion, and institutional support to improved wellbeing and student engagement [77,78].

Finally, rather than viewing wellbeing as something that occurs only within clinical settings, participants envisioned support initiatives that were holistic, innovative, experiential, and non-stigmatising, woven into the everyday fabric of campus life, accessible through multiple pathways. This aligns with emerging evidence that many young people engage more readily with dimensional, strength-based, and experiential approaches than with narrowly diagnostic or pathology-focused frameworks [49].

Importantly, the range and variety of physical environments proposed—from social networking spaces to reflective spaces, creative spaces to low-stimulation quiet zones, to community-oriented therapeutic and expressive spaces—demonstrates a nuanced appreciation that different types of support are required at different moments, and that a single-format wellbeing space is unlikely to meet the breadth of student needs. Collectively, these findings point toward a campus culture in which wellbeing is cultivated proactively through everyday relationships, practices, and environments rather than addressed only after significant distress has emerged.

Students’ concerns regarding stigma, confidentiality, and the acceptability of formal services closely mirror the barriers to help-seeking documented among college students internationally [36]. More directly comparable are participatory studies in which students themselves have generated recommendations for institutional response: UK students, consulted through co-creation panels, similarly called for coordinated, accessible provision embedded within a whole-university approach to structural and cultural change rather than expanded counselling capacity alone [79], while participatory work with international students in Australia has likewise demonstrated the value of involving students directly in adapting suicide prevention initiatives to their own contexts [80]. Comparable priorities have been identified in cross-national work eliciting young people’s views on mental health resources [43].

The present study has several notable strengths. It is one of the larger qualitative explorations foregrounding student perspectives on institutional recommendations for suicide prevention within an Indian higher education context, with representation from multiple academic disciplines and educational settings. The participatory round-table methodology generated rich, implementation-oriented recommendations grounded in students’ lived experiences and insights. The collaborative nature of the dialogue further allowed participants to build upon one another’s ideas and collectively deliberate, refine, and generate concrete solutions, yielding a robust roadmap of valuable findings with direct relevance for institutional policy and practice.

Certain limitations should also be considered. Although the round-table format encouraged collaborative discussion, it may have reduced the visibility of dissenting or highly personal perspectives by encouraging consensus-building and collective negotiation of viewpoints. The participant cohort was predominantly female (91.0%). Although the findings reflect collective group discussions, the limited representation of male students may affect the transferability of the findings across more gender-diverse student populations. Reliance on group-generated written summaries rather than verbatim audio-recorded discussions limits the scope to capture some nuances and minority viewpoints. Participant verification of findings (member checking) was not feasible, given the single-day format of the dialogue. Participation was voluntary, and attending students may have been more interested in mental health topics than the broader student population. Recommendations from such a cohort may reflect the perspectives of students who may be well aware of mental health and mental health services. The study was conducted in a single metropolitan city, limiting transferability to other geographical, cultural, and institutional contexts. It should also be considered that, since this paper reports findings only from the third of three sequential thematic discussion rounds, participants’ recommendations may have been influenced by reflections from the two preceding rounds, potentially shaping the framing or salience of issues raised. However, this interrelationship is consistent with the original design and objectives of the round-table dialogue format, which sought to encourage progressive reflection across multiple levels of influence on student mental health. We therefore view this as a contextual feature of the data generation process rather than a source of bias, and one that may have facilitated the systems-oriented recommendations observed in the findings.

Several directions for future research are also implicated. Replication across diverse geographical, cultural, and institutional contexts—including rural and semi-urban settings with varying resource availability—would help establish the transferability of these findings, as well as identify context-specific needs. Future studies should evaluate the feasibility, acceptability, implementation, effectiveness, and scalability of student-generated recommendations to identify barriers, facilitators, costs, and sustainability. Comparative perspectives from faculty, administrators, parents, counsellors, and other stakeholders could identify areas of convergence and divergence, thereby informing more collaborative and contextually appropriate campus mental health strategies. Longitudinal research examining whether institutional initiatives produce sustained improvements in wellbeing over time may further strengthen the evidence base for student-centred campus mental health and suicide prevention initiatives. In doing so, future participatory work could use targeted recruitment through academic departments, student unions, and student residences to improve disciplinary and gender diversity. Framing participation around student life or campus improvement, rather than mental health alone, may also appeal to a more heterogeneous group of students and thus broaden the range of perspectives that emerge. Future research should also continue making greater use of participatory and co-design approaches that position students as critical knowledge-holders rather than merely passive recipients of mental health programmes. Studies in the future could also explore the perspectives of youth, taking gap years to prepare for competitive examinations, who may experience distinct pathways to distress and barriers to support, beyond the reach of traditional campus-based services.

The present study carries implications for institutional policy, governance, and practice. The findings indicate that student mental health must be embedded across the routine functioning of higher education institutions rather than positioned as an auxiliary concern confined to counselling services or discrete awareness activities. Institutions therefore need to transition from fragmented or symbolic efforts toward comprehensive campus mental health ecosystems spanning services, faculty and peer capacity, family engagement, academic systems, and overall campus environments, as set out in Table 2. In addition, a regular critical review of academic policies and institutional practices is required to identify and mitigate sources of overload, humiliation, discrimination, helplessness, or barriers to help-seeking. Collectively, these domains underscore the need for systemic reform that integrates mental health considerations into academic calendars, curricula, policies, governance processes, and campus environments [16,26,27].

Viewed through a broader theoretical lens, the findings align with socio-ecological models of suicide prevention, which emphasise coordinated action across institutional systems, interpersonal relationships, and environmental contexts [20,21]. Advancing student mental health thus necessitates transformation across the full breadth of institutional life, with wellbeing considerations incorporated into institutional planning, governance, quality assurance, and routine decision-making.

The round-table dialogue further highlights the significance of meaningful youth participation in mental health policy development. Student participants generated sophisticated, contextually grounded, and implementation-oriented recommendations, demonstrating the value of sustained mechanisms through which student perspectives and lived experience can inform the design, implementation, and evaluation of campus mental health initiatives. Institutionalised opportunities for dialogue, feedback, and co-design are likely to enhance the relevance, legitimacy, uptake, and long-term sustainability of campus mental health systems.

5. Conclusions

This large-scale qualitative study provides a youth-informed account of how higher education institutions in urban India can promote student wellbeing and reduce suicide risk. Students framed suicide prevention as a shared institutional responsibility and envisioned an integrated campus ecosystem characterised by accessible support, humane academic systems, and environments that foster dignity, belonging, and psychological safety. The findings suggest that institutions must move beyond reactive or isolated initiatives and intentionally cultivate campus cultures in which wellbeing, participation, and connection are embedded in everyday student life.