Research agenda setting in the mental health of neurodivergent students: A qualitative exploration of students perspectives

Imagine the human mind as a vast, bustling city. For most people, the city's roads, traffic lights, and building codes are designed to match their natural way of navigating. But for some, the city is built with a different blueprint entirely. These are neurodivergent people—individuals whose brains work in unique ways, such as those with autism, ADHD, or dyslexia. When they enter a world built for the "standard" blueprint, it can feel like trying to drive a race car on a path full of potholes and one-way signs that don't make sense. This mismatch often leads to stress, exhaustion, and feeling like an outsider.

Now, think of mental health as the city's weather. When the roads are smooth and the signs are clear, the weather is usually sunny. But when the city is full of obstacles, the weather can turn stormy, bringing anxiety and depression. For a long time, scientists and doctors have tried to fix the "weather" by trying to change the driver (the student) to fit the road. This is called the medical model, which views the brain as something that is "broken" and needs to be repaired. However, many people argue that instead of fixing the driver, we should fix the road. This is the social model, which suggests that the problems come from a society that isn't built for everyone.

University is a huge, complex part of this city. It's where young adults go to learn and grow, but for neurodivergent students, it can be a particularly bumpy ride. They often face higher rates of mental health struggles than their peers, yet the research on how to help them has been missing some crucial voices. This paper asks a simple but powerful question: If we want to make university better for these students, what do they say we should study next?

The Roadmap: What the Researchers Did

A team of researchers, led by the Scottish Student Mental Health Research Network (ScotSMART), decided to stop guessing and start listening. They gathered 104 current and former university students who identify as neurodivergent. These weren't just any students; they were the experts on their own lives. The team asked them one big question: "What research do you think we need to do to make your mental health and university experience better?"

The researchers didn't just count answers; they looked for patterns, like a detective piecing together clues from a hundred different stories. They used a method called "thematic analysis," which is like sorting a giant pile of colorful Lego bricks into specific shapes to see what structures emerge. They found six main "structures" or themes in what the students had to say.

The Six Big Clues: What Students Want to Study

1. Stop Fixing the Driver, Start Fixing the Road

The first and loudest message from the students was a call to change the map. They felt that most research treats their brains like broken engines that need a mechanic. One student described this as the "Medical Model," where the brain is seen as "malfunctioning." The students urged researchers to switch to the Social Model.

Imagine a wheelchair user trying to enter a building with only stairs. The medical model asks, "How do we fix the person's legs?" The social model asks, "Why are there no ramps?" The students want research to focus on the ramps—the barriers in society and universities that make life hard. They also want to stop looking only at what's "wrong" and start looking at what's "strong." They want to know how their unique brain wiring can be an asset, not just a deficit. They suggested research should treat them as whole people, not just a list of symptoms.

2. The Maze of Diagnosis

The second theme was about the confusing and often impossible maze of getting a diagnosis. In the UK, getting an official diagnosis can take years. One student mentioned waiting lists of 5-10 years in some cities. Because the public system (the NHS) is so slow, many have to pay for private diagnoses, which is expensive and unfair.

Without a diagnosis, students often can't get the support they need. It's like trying to get a ticket to a concert but having to wait in line for a decade just to prove you exist. The students also pointed out that the rules for diagnosis are biased. Women, for example, are often missed because the "rules" were written based on how men present. They also highlighted the danger of misdiagnosis, where a student is told they have anxiety or depression when they actually have autism, leading to the wrong kind of help and years of suffering. They want research to figure out how to fix this broken gatekeeping system.

3. The Shadow of Stigma

The third clue was about the heavy shadow of stigma. This is the feeling of being judged, misunderstood, or treated as "less than." Students shared that this isn't just from peers; sometimes teachers and staff don't understand either.

This stigma forces many students to wear a "mask." Imagine walking around all day pretending to be someone else, constantly checking your behavior to make sure you don't look "weird." This is exhausting and leads to burnout. The students said this fear of being judged stops them from asking for help. They want research to find ways to smash this stigma, to make universities places where it's safe to be yourself, even if that means "stimming" (moving your body in repetitive ways to calm down) in public. They also noted that this stigma hits harder for people who are already marginalized, like those from racial minorities or the LGBTQ+ community.

4. The Rigid Classroom

The fourth theme zoomed in on the university itself. Students described the university as a factory built for a specific type of brain: one that can sit still for hours, organize tasks perfectly, and take exams under pressure.

They pointed out that inflexible teaching is a major problem. Deadlines that all land on the same day, rigid exam formats, and group work that doesn't account for social anxiety can feel like a trap. One student with ADHD said, "learning is too inflexible and leads students to internalise their challenges as something being wrong with them." It's like being forced to run a marathon in a straight line when you need to zigzag to stay balanced. They want research to explore flexible teaching, better course designs, and how to spread out the pressure so students don't crash.

5. Does the Support Actually Work?

The fifth theme was a reality check on the help that already exists. Universities say they offer support, but students asked: "Does it actually help?"

They described a "grey area" where it's unclear what support works and what doesn't. Sometimes, the help is there, but it's not the right kind of help for the specific person. One student asked how to integrate mental health services with learning support, because right now they often feel like two separate worlds that don't talk to each other. The students want research that doesn't just count how many support services exist, but actually tests if they improve mental health and grades. They want to know what works for whom, because a "one-size-fits-all" approach doesn't fit anyone.

6. The Invisible Students

The final theme was a plea to look at the people who are often left out of the picture. The students said, "Any groups that aren't white men need more research attention."

They highlighted that research often ignores women, non-binary people, older students, and those from ethnic minorities. They also pointed out that people with multiple diagnoses (like being both autistic and having ADHD, known as "AuDHD") or those who are non-speaking are rarely studied. They want research to look at how these different identities mix together. For example, how does being a refugee, a student, and neurodivergent all at once change the experience? They want the research to include the full spectrum of human diversity, not just the most visible parts.

The Bottom Line

This paper doesn't offer a magic cure or a new pill. Instead, it offers a compass. The researchers suggest that future studies need to stop trying to "fix" neurodivergent students and start fixing the environment they are in. They argue that we need to move away from seeing brains as broken machines and start seeing them as different, valuable ways of being human.

The students are clear: they want research that looks at the barriers in the system, not just the people in it. They want to know how to make universities flexible, how to stop the long waits for diagnosis, and how to make sure support actually works. Most importantly, they want their voices to be the ones guiding the way forward. By listening to these 104 students, the paper suggests that the path to better mental health isn't about changing the students to fit the university, but changing the university to fit the students.