Overview of the brazilian scientific literature on mental health at university: a systematic review

Abstract

In order to understand the phenomenon in the work context of Higher Education Institutions, this systematic literature review analyzed the national publications in the period between 2011 and 2021. The survey of the academic production occurred in the CAPES Periodicals, SciELO, Regional Portal of the Virtual Health Library (VHL) and Pepsic. Only 35 articles met the inclusion criteria. The majority addressed subjects related to the mental health of public employees in the academic environment were: productivity and common mental disorders, mental suffering/illness, other mental disorders, burnout syndrome, work context and mental health. Moreover, the results point to a greater number of publications in the year 2020, concentrated in health area journals, empirical, quantitative studies, carried out mostly in public educational institutions, preferably with professors, with predominance in the southeastern region of the country. There are gaps by region, theme and professional category, which requires greater research efforts in the area to better understand the theme.

Keywords:
mental health; public servants; higher education

Resumo

Com o objetivo de compreender o fenômeno saúde mental no contexto de trabalho das Instituições de Ensino Superior, esta revisão sistemática da literatura analisou as publicações nacionais no período entre 2011 e 2021. O levantamento da produção acadêmica ocorreu nos Periódicos CAPES, SciELO, Portal Regional da Biblioteca Virtual em Saúde (BVS) e Pepsic. Apenas 35 artigos atenderam aos critérios de inclusão. Os assuntos mais abordados relacionados à saúde mental dos servidores no ambiente acadêmico são: produtividade e transtornos mentais comuns, sofrimento mental/adoecimento, outros transtornos mentais, síndrome de burnout, contexto de trabalho e saúde mental. Os achados apontam para um maior número de publicações no ano de 2020, concentrados em periódicos da área da saúde, estudos empíricos, quantitativos, realizados na grande maioria em instituições públicas de ensino, preferencialmente com docentes, com predominância na região sudeste do país. Há lacunas por região, tema e categoria profissional, o que requer maiores esforços de pesquisas na área para melhor compreender o tema.

Palavras-chave:
saúde mental; servidores públicos; ensino superior

Resumen

Para comprender el fenómeno de la salud mental en el contexto laboral de las Instituciones de Educación Superior, esta revisión sistemática de literatura analizó publicaciones nacionales en el periodo comprendido entre 2011 y 2021. El levantamiento de la producción académica se realizó en las revistas CAPES, SciELO, Portal Regional de la Biblioteca Virtual en Salud (BVS) y Pepsic. Sólo 35 artículos cumplieron los criterios de inclusión. Los temas más abordados en relación con la salud mental de los funcionarios en el ámbito académico son: productividad y trastornos mentales comunes, angustia/enfermedad mental, otros trastornos mentales, síndrome de burnout, contexto laboral y salud mental. Los resultados apuntan a un mayor número de publicaciones en 2020, concentradas en revistas de salud, estudios empíricos, cuantitativos, realizados en su mayoría en instituciones educativas públicas, preferentemente con profesores, con predominio en la región sureste del país. Existen lagunas por regiones, temas y categorías profesionales, lo que requiere mayores esfuerzos de investigación en el área para comprender mejor el tema.

Palavras clave:
salud mental; funcionarios públicos; la educación superior

1 Introduction

The academic environment, especially that of Higher Education Institutions (HEIs), contributes to the progress of civilization through its activities in the multiple fields of science, art, culture, and other diversified knowledge. However, while it collaborates with a relevant and varied performance for society, behind the scenes it is often characterized by an intense demand for productivity that affects both faculty members and administrative staff, in addition to other multiple situations that can be experienced in this context as risk factors for the integrity of the mental health of these individuals: work overload, comparisons with others peers, uncertainty of public and private investments, difficulties with interpersonal relationships, among other factors (ROBAZZI, 2019).

Perez, Brun and Rodrigues (2019) point out that although this is a problem that has significant implications for the academic community, studies of psychological distress in this setting have only recently been conducted, justifying research efforts in this direction. The literature has shown that college employees are frequently affected by mental disorders that impair their ability to cope with events related to their work development.

A study conducted by Batista, Carlotto and Oliveira et al. (2015) analyzed the reasons for teachers' absences from an HEI located in João Pessoa/PB and concluded that depression was the most common cause of absence from work, corresponding to 53%, followed by schizophrenia (12%), bipolar disorder (10%), acute stress reactions (8%), anxiety (7%), delusional disorders (4%) and others (8%). Specifically in the professional context, burnout syndrome was highlighted among teachers. As described in the study by Leite et al. (2019), conducted with 100 college professors from four public and private institutions in Rio Grande do Norte, 61.6% were at risk of developing burnout; 35.3% were at the beginning of the condition; 2.1%, possibly already had the ongoing syndrome; and only 1% had no signs of mental illness.

The administrative technicians are another vulnerable working class in education. With their specific skills, this group plays a strategic role in the functioning of institutions, as they work in different areas to meet administrative, financial, human resources, and laboratory needs, among other necessary activities. The study by Mota, Silva and Amorim (2020) found a 37% prevalence of common mental disorders (CMD) in these workers. Barbosa, Aquino and Asmus (2022) reiterated the vulnerability of this group in the work environment in their study when they conducted an assessment of absences due to mental disorders in public servants (administrative technicians and professors) at a state college and found that technical-administrative public servants were more likely to be absent than professors in 2018, 2019, and 2020, with 61%, 60.1%, and 66.7%, respectively.

The above data reflects this issue's urgency and relevance and justifies the need for it to be widely discussed in the college work environment. Understanding the reality of the mental health of these workers in Brazil is a prerequisite for the implementation of policies to promote the mental health of state employees (professors and administrative technicians), which can lead to beneficial effects for them, including improved quality of life, increased job satisfaction, reduced absenteeism and evasion, prevention of illness and deterioration of mental health status (MACAMBIRA; TEIXEIRA, 2017).

By studying the national production on the subject of mental health in higher education, one obtains the possibility to understand the phenomenon and, based on this estimation of the reality, propose interventions that can promote well-being in the academy. Therefore, the objective of this study was to carry out a systematic review of the Brazilian scientific literature in order to compile information on the perspective of the national research on the subject in the last decade.

It is hoped that the findings of this investigation can contribute to the understanding of what has been prioritized, what gaps exist, what is the trend and nature of the studies, and what should be included in the future research agenda to obtain a reliable picture of this field of investigation. In this sense, this systematic review was concerned with analyzing, selecting, integrating, and summarizing the evidence on mental health in higher education based on a clear and well defined methodological approach.

2 Method

A systematic review is a method that allows original research to be examined in an organized manner and ensures access to a greater number of relevant studies. It starts with the formulation of well-defined questions, the selection of an appropriate database, the use of search descriptors, and validation strategies for the evidence collected (DONATO; DONATO, 2019). This method follows specific protocols with a theoretical-methodological basis (state of the art) on a research topic, resulting from the gathering of information from multiple studies that can refute or confirm results and identify possible gaps in the literature, i.e., create an important consultation document with a high level of evidence that can support the decision-making process on a determined subject (GALVÃO; RICARTE, 2019).

It is, therefore, an appropriate tool to consider the objective of this study. This systematic review was conducted in 2021 and was intended to bring together articles published in national journals between 2011 and 2021, using as a criterion only publications in scientific journals reviewed by more than one reviewer and following the double-blind method, as recommended by the good practices in science. The bibliographic survey included national output published in the following databases: Journals CAPES, SciELO, Virtual Health Library (BVS) Regional Portal, and Pepsic, all indexers and search engines of academic credibility.

The review included both the main open access Latin American index in the area of social sciences and humanities – SciELO as well as those with restricted access available on the CAPES platform, a complete search engine that integrates the main scientific publishing platforms.

For article recruitment, combinations of the main descriptors were performed: mental health, employee, and college, with the aim of identifying the target population and the environment of interest in the databases analyzed. Although the literature suggests that searching using standardized descriptors is sufficient, the search also used their synonyms in the selection of material as an additional precaution. For the descriptor college, the following synonyms: Institute, Institution, and Faculty were used. To identify an employee, the following words were applied: Worker, Servant, Professor, Educator, Administrative Technician, Academic Community.

Combinations of descriptors were by the Boolean operators “and”," “or,” and “and not”," resulting in the following search key: (mental health) and (servant or worker or employee or professor or educator or “technician administration" or “academic community”) and (college or institute or institution or faculty) and not (students or undergraduates). All publications that contained the search terms in the title, abstract, or keywords were selected. The next step was to select the original recruited material, using the following criteria for the inclusion and exclusion of articles:

Inclusion Criteria:

• a) Articles reviewed by more than one reviewer and double-blinded;

• b) Terms of interest included in the title, keywords and/or/ abstract;

• c) Journals published in scientific indexes;

• d) Nationals Articles;

• e) Articles focusing on higher education institutions only;

• f) Publications occurred between 2011 e 2021.

Exclusion Criteria:

• a) Repeated publications in more than one database (duplicates were counted only once);

• b) Publications out of the scope of interest, which did not address the issue of mental health at the university level.

The data collection resulted in a total sample of 528 studies. After adopting the exclusion criteria, 35 publications remained for the final analysis. The initial number recruited was quite large, covering topics that span a wide range of scientific research, such as the case of mental health. Even when Boolean criteria were applied, the systems often delivered material that did not fall within the desired scope. The resulting articles were tabulated by: Professional category (professor, technicians, and mixed), temporal distribution-year of publication, region of the country, type of HEI, method and nature of research, thematic focus, and journal focus area.

Figure 1 provides a detailed overview of the process of recruitment and the final selection of articles.

Figure 1
Procedure for selecting articles for this systematic review

3 Results and Discussion

The analyzed publications were tabulated in graphs and tables for better visualization of the data.

This review revealed a greater number of articles that dealt exclusively with professors (n 23), followed by mixed studies (n 7), i.e., studies that addressed professors and administrative technicians, and finally studies that addressed only administrative technicians (n 5), as described in Table 1. These results reflect a greater interest among researchers in investigating the specific demands of professors, who have greater professional visibility due to the development of the college's core activities (research, teaching, extension) and are also subject to daily performance, deadlines, and productivity pressures (LEITE, 2017).

Table 1
Publications by professionals category

Category	Nº of Publications	%
Professors	23	65,71
Mixed (professors and technicians)	7	20,00
Administrative technicians	5	14,29
Total	35	100,00

• Source: authors, based on the researched data.

The survey also revealed that there are few studies (14.29%) that specifically address the mental health of administrative technicians, although this is a target group that is also prone to illness and faces difficult problems inherent to their daily work routine. Thus, the findings indicate a lack and consequently a need for investment in research with this target group.

The technical-administrative servers, although they do not perform any core activity, are essential for the functioning of the various facilities of the College Campus. They are subjected to a work organization that does not always provide the conditions for optimal performance of their duties, a scenario that can generate aversive experiences, and produce anxiety, insecurity, and fear, which may manifest themselves in mental illness. A study by Leles and Amaral (2018) conducted with a similar group of servants showed that suffering is the result of inadequate working conditions, work overload, authoritarian management, lack of recognition, and routine without challenges. In addition, the “behind the scenes” work, although essential to the university, is often invisible and goes unnoticed because it is not presented as the ultimate goal of the institution (teaching). The subjective impact of a possible experience of devaluation of the work activity generates dissatisfaction and illness due to the symbolic content of the work, its hidden aspects, and the relationship of the professional with his activity (FARIA; LEITE; SILVA, 2017).

As for the analysis period, there was evidence of the distribution of at least one study per year investigated (2011 to 2021). The year 2020 was characterized by greater productivity and accounted for 20% of the publications in this period (n 7). Of the total, only 1 study examined the mental health of college professors exposed to unhealthy working conditions in the context of the COVID-19 pandemic (MONTEIRO; SOUZA, 2020), an event that changed the topography of college work, making it remote and producing new challenges for which the workers were not prepared. It is still too early to tell whether the number of investigations into the mental health of the public can be expanded with a possible renewed interest in this topic due to this event. Future studies could report on the impact of the pandemic on the relationship between health and work, particularly the impact on professional relationships and the mental health of workers over the long term. Overall, only 35 publications were identified in just over a decade (distributed across different audiences and samples), as shown in Table 2.

Table 2
Distribution of publications over the period from 2011 to 2021

Year	Nº of Publications	% Publications
2011	3	8,57
2012	1	2,86
2013	1	2,86
2014	3	8,57
2015	3	8,57
2016	2	5,71
2017	4	11,43
2018	4	11,43
2019	3	8,57
2020	7	20,00
2021	4	11,43
Total	35	100,00

• Source: authors, based on the researched data.

Table 3
Methodological Characteristics of the analyzed studies

Type of Research	Method	Nº Publications	% Method	% Type
Empirical	Qualitative	8	22,85	74,29
	Quantitative	16	45,71
	Quanti/Qualitative	2	5,71
Theoretical	Bibliographic	6	17,14	25,71
	Integrative Review	1	2,86
	Systematic Review	1	2,86
	Documentary	1	2,86
	Total	35	100	100,00

• Source: authors, based on the researched data.

The analysis of methodological characteristics showed that 74.29% of the studies were empirical (n 26) and distributed as follows: 22.85% qualitative methods (n 8), 45.71% quantitative (n 16), and only 5.71% with mixed methods (quali/quanti) (n 2). The predominance of the quantitative approach in the selected empirical studies resulted from the nature of the objective outlined in most of the studies, which focused on the use of measurement instruments for more than one variable affecting the health and disease process in the work context, as well as from the interest in larger samples and with greater possibilities for generalization. Silva, Russo and Oliveira (2018) point out that in the quantitative method, the researcher uses discrete, numerical data whose frequencies and statistical relationships are systematically analyzed, which allows a more objective exploration of the phenomenon under study. The theoretical research was not as expressive, with 25.71% (n 9) distributed among different methods.

Table 4
Empirical studies distributed by region from 2011 to 2021

Region	Nº de HEI	Nº de Publications	% Publications
North	198	2	7,69
Northeast	600	7	26,92
Midwest	285	0	0,00
Southwest	1100	11	42,31
South	391	6	23,08
Total	2574	26	100,00

• Source: authors, based on the researched data.

When reviewing the distribution by region of the country, the results show that despite the relevance of the topic and the presence of higher education institutions throughout the national territory, the studies indicate that there is not an even distribution of empirical studies (n 26) by region. In the Midwest, there were no results of empirical works published in this area, although according to the last census (year 2017), there were 285 HEIs in the region, accredited to the Ministry of Education, conducted by the National Institute for Educational Studies and Research Anísio Teixeira (INEP, 2023) by geographical area. It is known that Brazilian regions do not have identical conditions in terms of quality of life, access to goods and services, educational attainment, public investment and culture (MACEDO; PORTO, 2018). In this sense, a regional trend cannot always be generalized to other regions of the country. Because there are different contexts, research on mental health in higher education should be expanded regionally, especially in the North and Midwest where it is sparse or nonexistent, to ensure that specific mental health realities are addressed. With the exception of the Southeast, all regions had less than one study per year during the period studied, justifying research efforts in this area.

Figure 2
Publications between public and private institutions

Only 1 study brought together both public and private institutions to examine the prevalence of burnout syndrome among college professors (COSTA; GIL-MONTE; POSSOBON et al. 2013). It is noteworthy that 88.46% (n 23) of the empirical studies were conducted in public educational institutions. This result could be related to the fact that the public university has research as part of its tripod (teaching, research, and extension activities), so that, when investigating the phenomenon of mental health in the academy, professors, students, and technicians end up using the institution itself as the environment to be studied.

With a share of only 7.69% in the surveys (n 2), the private institutions are dealing with a complex reality, since they usually focus on capital accumulation and concrete and market results, to the detriment of the work and teaching process. In this context, professionals seem to be exposed to low wages, devaluation of the profession, increased working hours, job instability, and precarious employment, among other elements (FRIZZO; BOPSIN, 2017; GEMELLI; CLOSS, 2023; CUTRIM; LEDA, 2020; BIELSCHOWSKY, 2020), making the private network different from public institutions and requiring additional analyzes related to issues involving workers' health. Thus, there are gaps in scientific research on this specific reality.

In quantitative analysis research, in addition to sociodemographic questionnaires used to characterize the samples, several instruments have been used that have proven valid to measure aspects related to mental health in the university setting. Among the most frequently used instruments, the following stand out: the Self-Reporting Questionnaire (SRQ-20) with a frequency of 26.66% (n 4) and the WHOQOL-bref with 13.33% (n 2).

The Self-Reporting Questionnaire (SRQ-20) was developed by the World Health Organization and aims to assess the presence or absence of mental disorders. It is a self-administered instrument with a dichotomous scale (yes or no) for each question, which has been widely used in Brazilian studies, especially among groups of workers (SANTOS et al., 2010).

The WHOQOL-bref is the shortened version of the World Health Organization Quality of Life Questionnaire (WHOQOL-100) and consists of 26 questions. Two refer to the quality of life in general and the other 24 questions refer to four domains: physical, psychological, social relations, and environment (FLECK; LOUZADA; XAVIER et al., 2000). Responses are given on a Likert scale of 1 to 5, with a higher score reflecting a higher quality of life index.

The thematic focus of the selected articles was also a point explored in this systematic review. Thematic axes were tabulated and analyzed according to the frequency in which they occurred in the 35 publications (see Table 5). A word cloud was also created, generated by the Word It Out platform and illustrated in Figure 3.

Table 5
Article themes after categorization in the period of 2011 to 2021

Themes	Nº de Publications	% Publications
Productivity	05	14,29
Common mental health disorders	05	14,29
Mental suffering / Mental illness	04	11,43
Severe Mental Disorders	03	8,57
Burnout Syndrome	03	8,57
Work context (precariousness, occupational hazards, critical factors) and mental health	03	8,57
Moral harassment and mental health	02	5,71
Mental health in the covid 19 pandemic	02	5,71
Remote Work and mental health in the Covid-19 pandemic	02	5,71
Subjectivity and Work	01	2,86
RSI\ WMSD and mental health	01	2,86
Mental health intervention	01	2,86
Worker mood	01	2,86
Sleep and quality of life	01	2,86
Work ability by lifestyle and worker profile	01	2,86
Total	35	100,00

• Source: authors, based on the researched data.

Figure 3
Word Cloud with Discussed Subjects (software Word It Out, 2021)

The word cloud is a visual tool that allows you to identify and highlight how many times a word occurs in the analyzed text. The more often it is cited, the larger and stronger its spelling will be in the graphical representation resulting from the software analysis (DEMO; COSTA; COURA et al., 2020). Regarding the selected articles, it can be noted that the most frequently discussed topics were productivity and common mental disorders, with a frequency of 14.29% of publications each, followed by: Other Mental Disorders, Burnout Syndrome, Work Context, and Mental Health, both with a frequency of 8.57%. The other terms were cited at least once.

The word cloud suggests that mental health research related to HEI work has emphasized issues related to the diagnosing of mental illness to the detriment of approaches focused on promoting worker well-being and mental health. This finding is relevant because it indicates a lack of research that offers recommendations for individual clinical interventions as well as suggestions for mental health programs and interventions for public servants with a preventive and/or interventional focus at the institutional level.

In the Federal Civil Service, for example, Decree No. 1.261 of the Department of Human Resources (SRH), dated May 4, 2010, establishes a series of parameters and guidelines for the development of mental health projects, providing tools for professionals in the field and of human resources management units (BRASIL, 2010). However, in the last decade, this review found only one study that targeted a mental health project for workers in higher education institutions (TELLES; KLEIN; RIBEIRO et al., 2019). This scenario indicates that greater efforts need to be made to promote and publicize research conducted by teaching institutions and/or independent researchers to promote the health of higher education employees. This includes policies, projects, or programs aimed at improving working conditions and relationships, training qualified professionals, and developing professional skills to address situations that may pose health risks.

The most discussed topics in the analyzed publications, as shown in Table 5 and in the word cloud, are briefly discussed below. Among the topics studied, productivity stands out. This term, widely used in the goods transformation industry, is considered a measure of production efficiency and has been adapted as an organizational tool to achieve results, often without evaluating the impact of this production model on the quality and type of service or goods produced. This phenomenon has also been adopted in the academic environment as a measure of evaluating the performance of the worker based on the subjects offered, the number of processes forwarded, the number of publications, etc., ignoring the nature of academic service (MATTOS; SCHLINDWEIN, 2015), which has as its central feature the learning and acquisition of a technical, critical and reflective field that requires its own rhythm and time.

Publications dealing with productivity in the academic setting have taken different paths to demonstrate that work organization impacts the mental health of servers. This is not only related to the division of tasks, but is also a social division that organizes surveillance, control, commands, and hierarchies (DEJOURS, 2012). Mattos and Schlindwein (2015) identified that the introduction of new technologies and the establishment of outcome-based goals, as well as assessment tools that evaluate only academic productivity, exert levels of pressure that can pose a risk to the health of professionals (CASSANDRE, 2011). Given the nature of work in an educational institution, which requires a good deal of cognitive effort, this form of organization also leads to greater wear and tear in carrying out activities and maintaining a high level of performance, a reality that generates psychological suffering and illness in the working class (BERNARDO, 2014; LEITE, 2017).

Dejours (2012) argues that work organization has changed over the years with the introduction of new tools in the management model, such as performance evaluation and flexible hiring. In the public sector, these changes have been influenced by reformist movements such as the management philosophy known as New Public Management, which guided the adoption of management practices from the private sector to achieve better efficiency and effectiveness by reducing differences between the public and private sectors(LAPUENTE; VAN DE WALLE, 2020), which has not always had a positive impact on the organization or the workers. In the case of HEIs, for example, over the years, political movements and management processes have produced uncertainties about the future of Universities, ranging from the adoption of policies such as privatization, and financial divestment, to the downsizing of the workforce, flexibilization, outsourcing, labor deregulation and reduction of the State’s duty.

Another relevant theme in the analyzed material was that of Common Mental Disorders (CMD), which refers to the health situation of the individual, who does not fulfill sufficient formal criteria for diagnosing depressive disorders and/or anxiety disorders, according to the classifications of the Diagnostic and Statistical Manual of Mental Disorders - 5th edition - DSM 5 and the International Classification of Diseases - 11th revision - ICD-11 (SANTOS; ALVES; GOLDBAUM et al., 2019).

CMD is characterized by depressive/anxious states, somatic symptoms, fatigue, sleep problems, irritability, and difficulty in memorizing and concentrating, manifesting itself as a mixture of anxious, depressive and somatic symptoms (MOTA; SILVA; AMORIM, 2020). The research of the authors carried out with academic workers, was concerned with the analysis of the relationship between psychological illness and work activity, the prevalence of common mental disorders and absences from work due to psychological illness, having identified that 37 % of these disorders were present among technical-administrative workers. Another study (FERREIRA; SILVEIRA; SÁ et al., 2015) evaluated the association between CMD and stressors at work among professors in the health area, signaling the presence of problems of this nature in 19.5% of the participants. In the investigation conducted by Campos, Véras and Araújo (2020), a prevalence of 29.9% of mental disorders was estimated among professors at a public HEI.

A portion of the studies identified in this review aimed to investigate the prevalence of these disorders in academic workers. Therefore, considering that the results found point to a worrying general situation concerning the health of college workers, there are good reasons for the conduction of new studies that contemplates possible specificities of the positions held in universities and the different regions of the country, as well as particularities of public and private institutions. Targeted information favors more efficient and focused interventions in each reality.

Of the various conditions that can affect an individual's mental health, one, in particular, is known to describe the illness generated specifically in relation to the work context - Burnout Syndrome (SB). The SB is understood as a pathological response to chronic work-related stress (PRADO; BASTIANINI; CAVALLERI et al., 2017), consisting of three factors: emotional exhaustion, depersonalization and low professional achievement. Emotional exhaustion involves a lack of enthusiasm and a feeling of burnout; in depersonalization, the worker starts to distance himself from his function, colleagues and the organization; while in low achievement, the person feels dissatisfied with their performance and career development (MENEZES; ALVES; ARAÚJO NETO et al., 2017)

Work as a determining factor of health condition was the object of investigation in some of the selected studies in this review. Costa, Gil-Monte e Possodon et al. (2013) analyzed the prevalence of burnout syndrome in college professors and the results showed that 11.2% of the investigated professors had a profile compatible with the diagnosis of BS. Menezes, Alves and Araújo Neto et al. (2017) evaluated risk factors for the syndrome in university professors and the findings showed that 54% of professors were at the intermediate level of risk (41 to 60 points), which determines the initial phase of burnout. One integrative review by Ferreira and Pezuc (2021) investigated the approach to physical and emotional exhaustion that characterizes the burnout syndrome in university professors and showed some precursor factors of the illness, such as a high-pressure environment, organizational culture and politics, low wages, perspective doubtful regarding professional growth, excessive workload, subject instability and student disinterest.

It is observed that the articles that investigated burnout syndrome, were conducted exclusively with the professors, which makes evident the lack of studies that investigate this phenomenon among administrative technicians, professionals who are also inserted in the academic environment, with their own challenges, and are exposed to conditions that may endanger their health.

Another theme highlighted in this review was related to other mental disorders, of greater severity, characterized by clinically significant disturbances in cognition, emotional regulation, or behavior of individuals, often being associated with substantial suffering or disability that affects activities of life in general, including those carried out in the professional scope (APA, 2014).

Bastos, Silva Júnior and Domingos et al. (2018) described staff absences at a federal institute due to serious mental disorders and found that 3% of the employees were removed from their activities due to difficulties of this nature. Aiming to verify people's understanding of this issue, Cândido, Oliveira and Monteiro et al. (2012) investigated the stigma manifested in the speeches of a group of employees of a higher education institution about mental disorders and found that there was no clear definition of the issue, although it is a socially constructed relationship between prejudice and psychological distress. The study by Batista, Carlotto and Oliveira et al. (2015) sought to identify the mental disorders that most caused leave of absence of professors at an HEI, showing that depression was responsible for 53% of professors’ leave, schizophrenia (12%), bipolar disorder (10%), acute reaction to stress (8%), anxiety (7%), delusional disorders (4%) and others (8%). There is a need for further research to investigate the prevalence of mental disorders in university employees, which risk factors associated with this particular type of work can contribute to its development and which prevention and treatment strategies can be developed for this public.

Although these are meaningful data that show the mental health problems of civil servants, it is possible that they still do not reflect reality, since illnesses of this type are not always the cause of removal from work activities. In addition, professors and technicians who leave their jobs or continue in their profession despite a mental illness often overburden other colleagues who have to take on more responsibilities and, as a cascading effect, affect the quality of administrative processes, teaching, research, and consulting, in addition to the impact on their mental health. This scenario can negatively impact students' academic experiences and even affect their retention in higher education until the end of their studies, making it impossible in many cases to maintain the quality of the core activity of HEI (DHINGRA; KLONSKY; TAPOLA, 2019; LOPES et al., 2019).

Other topics listed based on access to the selected material are specific and scattered over the years, although they deal with relevant issues like the health and disease process in the work setting, such as sleep and quality of life, state of worker mood, mental health in the Covid-19 pandemic, work ability by lifestyle and worker profile. The scarcity of findings on these topics reveals the need for investments in a research agenda in this field, in order to establish a more robust scientific knowledge about these subjects that favors actions and minimizes the risk of mental illness at university institutions.

To take a comparative look at mental health in academic contexts in other countries, the international literature was reviewed, but no systematic studies on this topic with the same scope and time period as the present study were found. However, an important contribution to this topic is made by Kezar, DePaola and Scott (2019), who provide a comprehensive debate on the mental illness of higher education employees in neoliberal times and in the restructuring of the world of work on a global scale, focusing not exclusively but predominantly on teaching. The authors report on the insecurity of wages and the replacement of effective teachers with a massive contingent of substitute teachers who are paid less and lack the necessary qualifications and discuss the impact on workers' mental health (insecurities, isolation, burnout, feelings of worthlessness). They point out the problems of this period, in which there seems to be an increasing distance between college officials and managers, the latter being more interested in profitability than in the quality of education.

Based on this systematic review, it was found that publications on the subject of mental health of servers in the context of higher education institutions were disseminated by specialized journals in different knowledge areas, with at least one paper published in each journal per mentioned focus area, as shown in Table 6. The highest concentration of publications was found in journals with a broad scope of interest, such as the area of human and social sciences (32%), health sciences (26%) and multidisciplinary (17%), which includes a diverse profile of readers and researchers. Although the aforementioned journals are probably accessible to scholars in education, it may be interesting to reinforce the submission of articles on the subject in specialized journals in this area, in order to address the problem as a challenge for higher education, acknowledging the consequences that the damage on mental health can generate for the HEI (leaves, overload of the remaining staff, damage to the teaching-learning process) and for the servers, causing suffering, health expenses and work, personal, social and family difficulties (BARBOSA; AQUINO; ASMUS, 2022).

Table 6
Articles categorized by the focus of the journal

Area of focus	Nº periodicals	% Publications
Health Sciences	11	31,43%
Nursing	3	8,57%
Occupational Medicine	1	2,86%
Mental health, alcohol and drugs	1	2,86%
Humans and social sciences	10	28,57%
Psychology	3	8,57%
Education and Psychology	1	2,86%
Multidisciplinary	5	14,29%
Total	35	100%

• Source: authors, based on the researched data.

4 Conclusion

The university expansion process implemented in recent years has had an impact not only on the inclusion and expansion of access to higher education for students but also on the ingress of new workers to expand the offer of educational services (ANDRIOLA; ARAÚJO, 2021). However, the expansion of the academic community has not been accompanied by better management models focused on the experiences of these workers, that’s because how the academic environment has been organized also affects the work schedule, producing consequences for mental health, as discussed above.

For a better understanding of the issue of mental health at the university, this systematic review reunited publications from both open access and restricted use indexes, taking into account the corresponding period between the years 2011 to 2021. The result of this research identified only 35 publications with a thematic focus of interest in quality scientific journals. We chose to analyze publications that were evaluated by other reviewers, in the double-blind modality, to ensure the reliability of the material. Naturally, there are other ways of producing knowledge, available in books, theses and dissertations, making it also possible to expand the scope of analysis in future reviews.

After the tabulation of the data, it was found that the most discussed issues that affect HEI servers in their mental health conditions are related to productivity, common and severe mental disorders, in addition to Burnout Syndrome. These are relevant themes that negatively disturb the lives of these workers, justifying the interest of researchers. However, mental health is a broad topic, making it necessary that other approaches and content related to the issue be investigated, mainly those aimed at promoting the well-being and quality of life of these professionals.

Ultimately, it was noted that most studies were conducted with professors, leaving little room for studies with administrative technicians. Additionally, other important findings were made, focusing on 2020, which had greater productivity in relation to the topic studied. Publications were concentrated in health science journals. The Southeast region had a greater concentration of empirical studies conducted almost exclusively at public institutions of higher education, with an emphasis on quantitative methods

The topic of mental health in the university is broad and relevant to the academic community. Therefore, a challenge for future research is to expand the scope of the research to address the identified gaps. In addition, a better understanding of the phenomenon will allow for the development of policies, projects, or programs that have the potential to meet the needs and demands of the workforce.

• Revisão Gramatical de Maria Paula Leitão E-mail: [e-mail]
  Tradução para o inglês de Luiz Humberto Souza Junior E-mail: [e-mail]

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Publication Dates

• Publication in this collection
  25 Sept 2023
• Date of issue
  2023

History

• Received
  24 May 2022
• Accepted
  29 June 2023
• Reviewed
  06 Aug 2023