Student diversity in higher education continues to increase, potentially resulting from ongoing advocacy for inclusion and improved outcomes for students during their secondary education (Moriña, 2017). This diversity is to be valued and celebrated, with research recognising the many ways this enhances the higher educational experiences of all (Denson & Bowman, 2013). However, enrolment at university is only an initial step in the process towards true inclusion for all (Locke & Shirley, 2022). It is internationally recognised that educational institutions must continue working towards being effectively responsive to the strengths and needs of the students they enrol to ensure that all are being provided with fair and equitable opportunities to reach their academic potential (see Moriña, 2017; Pavone et al., 2019). Many universities have established student support services in an attempt to address the barriers which students may encounter at university (Pavone et al., 2019), yet research indicates that these services may not be adequately supporting all who require them (e.g., Australia: Pech, 2017; Brazil and Portugal: Martins et al., 2021; United Kingdom (UK): Beck, 2022; United States of America (USA): Abreu et al., 2016). Furthermore, these services are constrained by the funding made available to universities, generating a bio-medical approach to accommodation provision, and often only those students with documented diagnoses are eligible for support (Fovet, 2024). As demand increases and resources limited, student services may be placed under increasing strain, and it is noted that a less personalised provider-consumer relationship now exists (Roberts et al., 2018) where students are customers within the ‘neoliberal reality of higher education’ (Martin-Sardesai et al., 2021, p. 3). There is currently limited research investigating students’ experiences with these services and there is a call for gathering students’ perspectives to gain insight into ways to strengthen the available support and understand how services may provide a more student-centred approach which is considered to be lacking (e.g., Roberts et al., 2018; Thompson et al., 2019).

This study adds to the limited body of literature by foregrounding the voices of students who have or are utilising university student support services by examining their beliefs regarding the accommodation of their needs. This is crucial considering that there is little research exploring students’ experiences in this area from the students’ perspective, limiting the guidance available for support service and teaching staff when accommodating students’ diverse needs (Anderson et al., 2018). This study included students’ anonymous views on the ways in which the support may not have been effective for their particular needs, and how it could be further strengthened and improved. This study then considered possible solutions which emerged from students’ suggestions. It is believed to be the first to employ Senge’s (1990) theory of leverage to student support services and did so with the intent of providing universities and support services with deeper insight into ways to cater to the growing diversity of students’ needs within a context of finite resources (e.g., Australia: Cathcart, 2016; Stallman, 2012; UK: Friedman et al., 2020; USA: Lederer et al., 2021).

University students: a diverse population

Influenced by global advocacy for inclusion, such as the Convention on the Rights of Persons with Disabilities (United Nations, 2006), universities have been working to improve their educational environments and learning experiences to cater to their students in more equitable ways (Moriña, 2017). This, along with greater numbers of students with accessibility requirements and/or disabilities (ARD)Footnote 1 completing secondary school, has seen an increase in the diversity of the university student population internationally, and the need for greater inclusivity to remain a focus (see Moriña, 2017). This growing diversity is to be valued and celebrated, with research showing that quality interactions with a diverse student cohort can benefit students’ development with the attributes required to function well within a global society (Denson & Bowman, 2013).

During their higher education studies, many students encounter challenges which can impact their academic performance and wellbeing. However, for students with ARD, there may be additional challenges to them participating in learning activities or performing at the level they are capable of within the structures and timeframes in place at their university (Osborne, 2019). For example, some students may experience substantial fatigue, pain, illness, challenges concentrating or retaining information, or circumstances which impinge upon their time to complete academic tasks (Hughes et al., 2016; Osborne, 2019). To manage this experience at university, some students report the need to expend substantial effort and sacrifice other aspects of their lives to achieve their academic goals (Couzens et al., 2015). The additional challenges or stressors these students face can negatively affect their wellbeing, with them experiencing higher stress than their peers (Hitches et al., 2023) which can further impact their learning and achievement, as well as their health (Pascoe et al., 2020). The impacts of the COVID-19 pandemic have only increased the stressors students must manage (Cooley Fruehwirth et al., 2021), and in Australia, students may be less able to cope than before (headspace National Youth Mental Health Foundation, 2020).

Despite improvements, universities are suggested to have ‘a long way to go’ to be inclusive of all (Moriña, 2017, p. 4). Although we have growing diversity, the following points suggest we may not yet have equity in students’ academic outcomes. University students with ARD are underrepresented and have lower retention rates (Kilpatrick et al., 2017). Furthermore, they may achieve lower rates of success than their peers (e.g., Department of Education, Skills, and Employment (DESE), 2020). Thus, barriers to these students’ success still exist. This has long-term implications, as obtaining a university degree can provide individuals with improved employment prospects (Ma et al., 2016), not to mention broader benefits to society and the economy (Chan, 2016).

Support services

To cater to student diversity, all students need to be provided with equitable access to learning and educational resources, equitable opportunities to fully participate in the learning environment, and have their capabilities for success and degree completion supported (Moriña, 2017). In Australia, these principles are underpinned at universities by the Disability Discrimination Act 1992, Disability Services Act 1993, and Disability Standards for Education 2005 (DESE, 2005). To meet the legal requirement of providing reasonable adjustments to eligible students, universities have established services which aim to improve accessibility and support students’ wellbeing (Roberts et al., 2018). These services are considered to fall under the university’s duty of care (see Fichten et al., 2014), and may be the main source from which students access support, possibly being seen as more capable of supporting students’ diverse needs at university than external services (Martin, 2010). Although disability classifications and policies at Australian universities are in place and operating, there are said to be ‘inconsistencies, emerging from the complexity of bureaucracy, processes and the exercises of power’ (Yerbury et al., 2021, para. 4).

Support seeking: the process and outcomes

To receive assistance from university support services, students must undertake complex (Strimel et al., 2022), and at times emotionally challenging processes (Reed & Kennett, 2017). Students must prove they meet the criteria to be eligible for support, which often includes self-disclosing a diagnosis and providing evidence; a stipulation which unfortunately can rule out those whose needs are still undergoing medical or psychiatric diagnosis, or form a barrier to those whose financial circumstances make it costly to obtain the evidence required (Karimshah et al., 2013; Martin, 2010). For others, barriers to seeking and obtaining support can include uncertainty or a lack of awareness regarding the processes required and services available, fear of stigmatisation, or believing the services were not designed to cater to their particular needs (Couzens et al., 2015). In fact, many students only seek university assistance when experiencing severe distress (Vivekananda et al., 2011), and the process of accessing support can be further impeded when services have limited resources (Stallman, 2012), availability (Roberts et al., 2015) and are in high demand (Cathcart, 2016; Pech, 2017).

There are a number of benefits to receiving support from university support services. When students are experiencing challenges, these services may enable students to progress with their studies and succeed academically (Drury & Charles, 2016), and assist their wellbeing (Couzens et al., 2015). Furthermore, for students experiencing mental health challenges, the feeling of being supported by service staff can mean that students’ disclosure of their needs becomes empowering (Martin, 2010). Unfortunately, this is not the experience of all students (e.g., Kilpatrick et al., 2017).

Research indicates that whilst many students are benefiting from the assistance these services provide, others are receiving support which is not sufficiently catering to their needs. For some students there is a ‘mismatch’ between what is required and what is received (Kilpatrick et al., 2017, p. 12), or a lack of appropriately targeted support (Hughes et al., 2016; Spencer et al., 2018). There are also suggestions that university support services only partially understand their students’ needs (Serry et al., 2018). It is also not clear what impact academic accommodations are having in reducing the academic stressors students encounter (Hitches et al., 2023). Several studies have called for a more student-centred approach (see Heagney & Benson, 2017; Roberts et al., 2015, 2018; Serry et al., 2018; Thompson et al., 2019), which service staff and students have reported are lacking (Roberts & Dunworth, 2012). It is argued that as the available support has become more generic, support services and students have entered the relationship of provider and consumer, respectively (Roberts et al., 2018), and this less-personalised approach may be inadequate for students’ individual and diverse needs in the higher education environment (Roberts et al., 2015).

How then do we improve upon the current system to better cater to student diversity, enabling fair and equitable opportunities for all in higher education, whilst also acknowledging that support services are facing pressures with limited resources? As stated by Heagney and Benson (2017, p. 231) and echoed by others (Anderson et al., 2018; Serry et al., 2018), ‘asking students what they believe would assist them to succeed is an important first step in the process of moving to an effective student-centred model of support’. Furthermore, to assist in identifying an efficient and resource-conscious way forward, Senge’s (1990) and Senge et al. (2011) theory of the learning organisation and leverage offers a useful lens.

Theoretical framework

For organisations to strengthen their ability to produce desired outcomes, Senge (1990) and Senge et al. (2011) argue they need to be learning organisations, learning with the intention of adapting and improving. To do this well, Senge (1990) and Senge et al. (2011) argue organisations need to identify potential actions that could be taken and focus their efforts upon those which will require minimal effort but produce the most substantial positive results. These are known as high leverage actions. Woodcock and Woolfson (2019) explain that if we consider how a stationary car might be moved, a high leverage action would be turning on the engine and using the accelerator. This contrasts with low leverage actions which require great effort but achieve comparatively little, such as if a stationary car was instead moved by being manually pushed (Woodcock & Woolfson, 2019). Whilst Senge’s (1990) and Senge et al. (2011) theory was originally applied within business organisations, it has now become a useful lens to consider how educational institutions may learn and improve in a rapidly changing world, and without laying blame (Pensieri, 2019).

Leveraging points of potential action

Organisations best achieve the level of learning necessary to identify and leverage points of action when they are learning directly from experience. However, this can be challenging when those deciding upon the organisation’s actions do not directly experience the outcomes or consequences of the actions taken (Senge, 1990). This challenge is present in organisations such as university support services, where those deciding and implementing the procedures of these services are not those in direct receipt of the support the services offer. As such there is a need to leverage the insider’s perspective, that of students in receipt of support, as when the insider’s beliefs and attitudes are examined, there is greater opportunity to identify potential high leverage actions (see Many & Sparks-Many, 2014).

Leveraging students’ insights

As both the literature and Senge’s principle of leverage suggest, identifying high leverage actions which require the least effort and resourcing to produce positive change may be achieved by listening to the voices of students. As such, this current study sought to understand and explore students’ beliefs about whether the support they received was insufficiently effective and in what ways they believe it can be improved. An exploratory qualitative research design was considered appropriate in enabling students’ voices, the insider’s perspective, to be valued and deeply understood, whilst simultaneously allowing novel and unanticipated insights to emerge (Lapan et al., 2011). These insights were then examined in relation to Senge’s (1990) and Senge et al. (2011) types of leverage to identify potential actions which may be most efficient in improving students’ experiences of support.

Methodology

Participants

Participants were undergraduate students (n = 60) who had received or are receiving support from university support services at one metropolitan university in Sydney, Australia. These participants attend a university which, like many others in the Sydney metropolitan, has tended to see increasing numbers of students with ARD enrolling each year (DESE, 2019). Like many others, it offers accessibility and wellbeing support to students who provide evidence of their eligibility, such as medical documentation.

Participants did not need to be currently receiving support to be included in this study, and they were not convenience sampled directly from the university support services. Instead, participants were purposively sampled (see Johnson & Christensen, 2017) by inviting any undergraduate student who had experienced difficulties whilst at university and sought support from university support services, to anonymously and voluntarily participate in the study by completing a paper–pencil questionnaire. This was an intentional broadening of the typical sampling criteria and recruitment pathways for studies involving students with ARD (see Kutscher & Tuckwiller, 2019; Osborne, 2019), and is considered a strength of this study as it enabled often unheard voices to be heard: those of students who were previously, but not currently, receiving support, such as students who were provided with temporary support or who had withdrawn themselves from the service. Students were not provided with incentives for participation and the response rate was 39.8% of those who were invited.

Regarding sample demographics, 50 students identified as female, 9 identified as male, and 1 student identified as of another gender. This ratio reflected that of the courses students were sampled from. The majority of the sample comprised students aged 20 to 29 (n = 47), and in addition, 6 students were under 20, 3 were aged 30 to 39, 3 aged 40 to 49, and 1 student was aged 50 or above. Students were either in their first (n = 13), second (n = 5), third (n = 17), fourth (n = 14), or other year of study (n = 11). Students identified as experiencing disability or impairment (n = 12), learning difficulty, such as dyslexia (n = 10), illness (n = 22), chronic illness (n = 17), or difficult personal circumstances (n = 46), and over half of the students experienced 2 (n = 21) or 3 (n = 13) of these broad categories of ARD.

Institutional context

As with many universities across New South Wales, the site of this study has tended to see a yearly increase in the number of enrolled students reporting to the university that they experience ‘disability, impairment or an ongoing health condition’ (DESE, 2020). This university provides a designated service offering both accessibility and wellbeing support, provided students meet eligibility criteria to access these.

Participants in this study had disclosed their needs to this support service and sought assistance. Where these needs related to accessibility, students were required to provide supporting documentation from a health professional which communicated their formal diagnosis and the impact on their studies; a legal requirement for the service to abide by government reporting requirements. If accepted by the service along with a completed registration form, an individual education access plan was created for the student during a disability assessment appointment. In considering reasonable adjustments to enable equitable access to learning at the university, the service considers the students’ requirements, the cost and benefits, and interests of staff and other students. Where students’ needs instead related to wellbeing and mental health support, should students require more than three appointments, students were required to follow a similar process to that above. Such processes reflect those seen at many institutions internationally where accommodations rely on available funding, and often only for students with a diagnosis (see Fovet, 2024).

At the site of this study, when students experience an acute onset of their condition or intensification of their needs which results in unavoidable disruption to their attendance or ability to complete assessments in a given time, students must undergo an alternative process of accessing support which is open to all students at the university, even though registered with the service. The special consideration process sits outside of the service and thus students must provide evidence for the period of unavoidable disruption each time this occurs and have this assessed by a central body in order for extensions, an alternative assessment, or permission to withdraw from a course without penalty to be granted. Contextual information is provided here to shed light on students’ discussion of both the service and special consideration processes, noting that how these two processes are implemented and integrated differs across universities within and between countries.

Procedure

Ethical approval was sought and obtained from the relevant university human research ethics committee. Students were recruited from core classes within one academic field of study and invited to participate voluntarily and anonymously by completing a self-administered paper–pencil questionnaire. It was considered necessary to enable anonymous participation in the interests of gathering deep, honest responses, particularly when students with ARD may already feel uncomfortable disclosing their ARD-status and experiences to their university (see Osborne, 2019). Enabling students to complete a questionnaire in their own time was considered appropriate as students with ARD may feel they are less able to expend the time and energy necessary to participate in research when already managing additional demands (see Dryer et al., 2016). To ensure the anonymity of those who had and had not participated, students returned both complete and incomplete questionnaires the following week to a locked post-box in their classes. Course instructors (i.e., subject coordinators or convenors) were not involved in the research or data collection in any way, and students were made aware that their participation in the research had no influence on their studies or relationship with the university.

Instrument

A questionnaire was developed which asked students closed-questions to obtain demographical data (i.e., age category, gender, year of study, and whether students experienced accessibility requirements and/or disabilities), and open-ended questions related to the research questions. This research is part of a larger study which sought to understand the beliefs of students with ARD about the extent to which student support services catered to their needs, including the ways in which the support was considered effective, ineffective, and could be improved. This paper reports on the portion of findings investigating students’ experiences of ineffective support and their suggestions for improving the support that they receive(d), obtained from the following four open-ended questions from the larger survey: (1) please explain how effective the support was in accommodating your needs; (2) what were the negatives of the support service for you?; (3) do you feel that there was any support that was not offered, that would have been beneficial to you?; and (4) were there any areas of the support service that could be improved upon?. Questions were worded in this way to avoid leading participants’ responses and were closely aligned with the objectives of the research, as is considered best practice (see Johnson & Christensen, 2017).

The length of responses to each question ranged from one sentence up to 90-word paragraphs, however, even where shorter responses were provided, these often offered very clear, direct, and emotive insights on students’ support experiences, possibly aided by the ability for the participant to remain anonymous through this mode of data collection.

As the questionnaire was completed outside of the classroom setting, students were informed of what they should do if they experienced discomfort and were provided with the researchers’, university support services’, and Lifeline’s (Australian 24-h crisis support line) contact information.

Data analysis stages

Stage 1

To foreground the voices of students who had received support, it was necessary for insights to inductively arise from the data, and therefore, in the first stage of data analysis, participants’ responses to the open-ended questions were initially inductively coded via open-coding. These codes were low inference, descriptive codes closely aligned to participants’ voices (see Creswell & Poth, 2018). A constant comparative analytical approach meant codes were defined and redefined, compared with each other and the data, maintaining consistency across the coding and ensuring codes captured the nuance and meaning of participants’ responses (see Strauss & Corbin, 1997). Axial coding then enabled relationships between codes and the development of broader themes to occur (see Creswell & Poth, 2018). For example, initial codes such as ‘lacking a feeling of care ‘, ‘generalised ‘, and ‘fit into predefined boxes’, indicated that students felt support was ineffective and required improvement when it was deemed not to be personalised and student-centred, leading these to sit as subthemes under the theme ‘personalised and student-centred’ support. Once themes were clearly defined, word frequency analysis and text searches in NVivo 12 allowed participants’ language choices to be explored, and differences in the presence of themes across students’ responses were examined. This enabled a deep level of analysis as suggested by Glaser (1965), and theoretical saturation was then reached (see Johnson & Christensen, 2017).

Stage 2

Following this exploratory stage, each subtheme identified in Stage 1 was viewed through Senge’s (1990) and Senge et al. (2011) theory of leverage and classified through a priori coding as either a: (i) high leverage point of action (an area for improvement which, with minimal effort applied, may produce significant results); or, (ii) low leverage point of action (an area for improvement which, with great effort applied, may produce minimal results; Senge, 1990). For example, the subtheme ‘lacking a feeling of care’ presented as an area which with little effort may be improved, and appeared to affect students greatly in their consideration of whether the support was effective for them, and therefore it could be coded as high leverage. This classification was informed by literature which illustrated that staff training and policy documents may be low leverage actions (see Woodcock & Woolfson, 2019), whereas exam provisions and notetaking accommodations may be effective and simple to put in place (see Anderson et al., 2018). Where a subtheme instead presented an area which with great effort may produce substantial results (i.e., the subtheme ‘timely access’), it was coded and discussed as an outlier to the theory.

Results

It should be noted that of the 60 students in this study, 19 reported experiencing purely effective support, 8 reported purely ineffective support, and over half of the students reported a mix of both effective and ineffective accommodation of their needs, often qualifying the support received as ‘effective, but…’ (SarahFootnote 2). What this illustrates is that although the support systems currently in place are benefiting a number of students in various ways, there are areas which can be strengthened and enhanced. Leveraging students’ voices provides insight into ways in which universities and support services may potentially achieve this. This paper reports on what students considered did not effectively accommodate their needs, and their suggested improvements.

When students considered in what ways the support received was ineffective in accommodating their particular needs, three themes were pertinent: that there was a lack of personalised or student-centred support (n = 15), challenges in the accessibility of support (n = 29), and limited facilitation of student agency and empowerment (n = 6). Mirroring this, students’ suggestions for how the support may better cater to their individual needs highlighted a need for more personalised and student-centred support (n = 19), and improvements to the accessibility of support (n = 22). Students also suggested (n = 2) and implied (n = 8) that support may be strengthened by facilitating student agency and empowerment. Whilst these themes were discussed by a range of students with ARD, some additional subthemes were reported specifically by students with chronic illness.

Personalised and student-centred

The theme of personalised and student-centred support captured students’ perceptions of whether their particular needs were understood and responded to in an individualised way, and whether students felt personally cared for. This theme also captured students’ suggestions of improving these aspects of the support to accommodate their needs.

Students reported that support ineffectively accommodated their needs when it was generalised, rather than individualised. For example, one student stated whilst support was offered, it was ‘quite generalised…didn't actually suit what [they were] struggling with’ (Nadia). For another, ‘there wasn't accommodation for different strategies…assumption that all illness of one type is the same’ (Justin). Related to this, yet only reported by three students experiencing chronic illness, were perceptions that in order to receive support, the service required them to ‘fit’ predefined boxes. As one explained:

There was a category which I didn't meet of being able to get lecture or tutorial notes because the condition I had didn't involve not being able to write. This was not fair because even though I can write my condition meant I couldn't even get out of bed in order to make the notes I needed’ (Naiyer).

Furthermore, it was reported that beyond exam provisions, accommodations were not responsive to the needs of four students with chronic illness. One of these students noted that although they received effective exam provisions, ‘once [they] tried getting support for being sick in an exam—it wasn't effective… consequences in lower marks’ (Sarah). Experiencing generalised support was ineffective for a number of students with ARD. In addition, why some students with chronic illness appear to ‘fit’ the available support and others do not was beyond the scope of this study, however, warrants investigation.

Students suggested that support needed to be more personalised through gaining a deeper understanding of students’ particular needs. As one student suggested, ‘look into the categories people fall in more closely (not at superficial level…), have meeting with students to make sure their needs are being catered for’ (Naiyer). Suggested only by students with chronic illness was that support around notetaking and attendance was necessary, especially when managing their studies during an exacerbation of symptoms. For example, one suggested the ‘need to be able to do make up work or access notes…an option for flexibility on tutorial attendance. One time I fainted before class and lay on the floor all class just so I didn't fail’ (Sarah). Ensuring that students’ unique needs are understood may be a high impact strategy requiring low effort (see Senge, 1990). Furthermore, if teaching staff may be supported to provide students waivers to attendance requirements and access to class notes or recordings as required for students registered with the service, this too may provide a high leverage point of action (see Senge, 1990).

Support was also perceived as ineffective when students felt a lack of care from the service. This was described as the service being ‘all very impersonal’ (Kathy), or experiences such as staff being ‘very clinical and offer[ing] no sympathy in a difficult situation. [They] came off quite cold’ (Jo). For two students this negative affective experience stemmed from having their disclosure of their personal circumstances and needs being met with scepticism. One remarked that they were ‘treated as if [they were] lying’ (Claire), whilst another was ‘dismissed as exaggerating…met with placations’ (Laura). Students suggested that when disclosing their needs and seeking support, a positive affective experience when interacting with the service would contribute to the effective accommodation of their needs. As one student stated, ‘more understanding from first contact (reception people) as…because I am sick, I am already stressed’ (Sameena). Providing a feeling of care for students requires minimal effort and resourcing, making this a high leverage point of action (see Senge, 1990).

Linked to the perceptions of care were students’ suggestions for personal communication and follow up from the service to evaluate and refine accommodations, or to check in with students who had disclosed challenging circumstances. One suggested ‘a follow-up of people who access the service, to check on their progress and to provide additional support if needed’ (Belinda). For four others, it was ‘someone [to] catch up with [them] later on to make sure [they were] ok’ (Sean). Concerningly, two students requested that students contemplating harm to themselves or to others receive increased communication, implying this had been lacking in their experiences. One student stated the importance of ‘a call back especially for [people] who might be suicidal and don't turn up to a session’ (Angus), whilst another highlighted increased personal communication was necessary ‘for those who had severe issues and might be on the verge of harm to themselves or others after sitting and hashing out their issues’ (Georgia). These students position the service as a factor which may intervene during crucial times and imply that this level of care may not be consistently present for all students who experience acute mental health challenges at university. Communication with students may require low effort, yet in cases such as these, have a significant impact; a high leverage point of action (see Senge, 1990).

Accessibility

The theme of accessibility captures students’ beliefs about the accessibility of support and the service’s approachability and included students’ suggestions for their improvement.

Challenges related to the accessibility of support impeded its effectiveness for around half of the students in this sample. The waiting time for responses from the service and for appointments contributed to this, and as a few students stated, appeared to result from a service already in great demand and with little available time. As one student stated, ‘they showed that they cared, but responded so late that it was hardly useful…they were clearly really busy and didn't have a lot of time to help’ (Jeryn). For some, this was ‘2 plus weeks’ (Liz), whilst for two students, the wait was indefinite. For example, one stated ‘I didn't receive any responses from [staff]’ (Amanda), and for this to occur after disclosing their personal circumstances and asking for assistance, the student felt it was ‘extremely disappointing’ not to have this acknowledged. Students requested improvements to the ‘speed of the process’ (Nadia) and suggested providing more ‘time to help’ (Kim). The crux of this challenge was astutely pointed out by one student who simply suggested ‘more staff’ (Ginny). Students appear cognisant of the finite resources of university support services and the demands they are facing. Increasing staff numbers and the associated resourcing would constitute a high effort strategy, despite the improvements to more timely accommodation of students’ needs that it may provide, situating this as an outlier to Senge’s (1990) levers.

Students noted that receiving support involved difficult processes to navigate. For example, a majority of them found it was a challenge to complete special consideration processes. At the university the students were sampled from, when acute/short-term disruption to their studies was experienced (e.g., circumstances which require an extension of an assessment or waived penalties for non-attendance at classes) students were required to apply to a department beyond the remit of the support service for special consideration. Students had to undertake this process even if they had already provided sufficient evidence to receive ongoing support from accessibility and wellbeing services. This application for special consideration requires evidence from a medical or other professional each time the disruption is experienced and must be submitted within a short timeframe. For students undergoing this process frequently, there was frustration that although registered with the service, they had to provide to a different university department ‘constant medical certificates for the same condition when [they] needed extensions for assignments’ (Chloe). Another struggled to complete this while in hospital but argued ‘if you submit evidence late…you can’t [get support]’ (Arianna). The paperwork was considered ‘difficult to lodge’ (Kathy), ‘very time consuming’ (Bronwyn), and students reported being unsupported by the service in navigating this process: the service ‘did not help with locating/filling out documentation’ (Helen), nor help ‘contact the services to get extensions’ (Jeryn). For four students, teaching staff recognised this challenge and provided them with ‘a low-key [unofficial] arrangement’ (Dilshara) which avoided the special consideration channels. Students suggested the need for a more streamlined process. Reducing the number of times students need to be assessed for academic accommodations, particularly when this is for the same condition or diagnosis, may decrease the time and effort required by both students and the university; a potential high leverage point of action (see Senge, 1990).

Students perceived there was limited communication between the support service, teaching, and other university staff. For these students, it implied their disclosure to the support service was expected to have reduced the number of times they felt they must disclose to others at university. For example, a student explained requesting support ‘feels like a waste of time and energy because there is no communication to convenors [course/subject coordinators] or tutors’ (Laura). Students suggested improved ‘communication’ (Elena), ‘coordination’ (Jeryn), ‘links’ (Helen), or ‘connections’ (Katie; Ashwin), or ‘communication within the university so you don't have to explain yourself every other day’ (Laura). Ensuring students are made aware of the communication occurring, and what is being communicated to whom, may be a high leverage action (see Senge, 1990).

For a few students, support appeared accessible in the short-term, but others believed ongoing support with the service was not available to them. As one stated, ‘[support] concluded and had no follow up or intent of ongoing support’ (Tegan). In addition, one student with chronic illness suggested ‘long term assistance’ (Stephanie) for their ongoing needs. Developing a plan with the service as a means of providing awareness of the ongoing support available, may be a high leverage point of action (see Senge, 1990).

For three students, accessibility was hindered by perceiving the service as intimidating or unapproachable. This included feeling ‘uncomfortable, sometimes’ (Ashwin) or ‘judgement’ (Ginny) and noting the service environment was ‘quite professional/ sterile…make[s] it intimidating to go into to ask questions/make appointments’ (Sean). Providing students with information about various methods through which they can interact with the service and make appointments may prove a high leverage action (see Senge, 1990).

Student agency and empowerment

Students felt that support was ineffectively accommodating their needs when it was unable to facilitate student agency and empowerment. The single reported cause of this was receiving limited information or guidance from which to make informed decisions or take action. One student remarked that the service had ‘no extensive knowledge of how to fix [the student’s] problems at uni. They seemed as in the dark as [the student]’ (Anne). Another reported that ‘support was there but I was still left confused as to what to do’ (Jo). Students suggested that the information provided to them needed to be improved, such as being ‘told the correct information from the outset’. The provision of information should be a high leverage point of action (see Senge, 1990).

Eight of the 60 students, all but one of whom were in the final year of their degree, implied the need for services to better facilitate students’ agency and empowerment in their responses of being ‘unsure’ when responding to the question ‘is there any support you did not receive which would have been beneficial to you?’. This is best conveyed by one student who said ‘yes. A lot. But can't think of specific…. It just simply is not offered…for someone who doesn't know…it's not explained’ (Ginny). Their limited understanding of what support is available (even at this late stage of their degree) and what this would entail, rendered then unable to advocate for their needs and suggest improvements. The provision of information which clearly advises of the accommodations available, the way in which they are applied and for what outcomes, may be a high leverage point of action (Senge, 1990).

Discussion

This study has actively foregrounded the voices of students who have received or are currently receiving student support at university. In so doing, it has gained deep insights into specific aspects of support which did not effectively cater to students’ particular needs, and through the lens of Senge’s (1990) learning organisation, identified high leverage (low effort, yet high impact) solutions put forth by students themselves. Seeking support at university, which requires students to disclose their needs and diagnoses, can be a complex and emotionally challenging process (Martin, 2010; Reed & Kennett, 2017). For those who undergo this process, when their needs are effectively accommodated, it can enable students to reach their academic potential (Drury & Charles, 2016). However, for half of the students in the current study, the support they received only partially catered to their needs, and a few students reported experiencing only ineffective accommodation. Students’ suggestions for how this could be improved demonstrated thoughtful consideration, illustrating an awareness of not only what they themselves needed from support services, but what was perceived as possible in a context of high demand and limited resources. Overall, students are calling for support to be personalised and student-centred, to be accessible and approachable, and to facilitate their agency and empowerment.

Personalised and student-centred support

Support did not effectively cater to students’ needs when it was perceived as lacking a personalised and student-centred approach. For example, students reported that more generalised support did not always suit their specific requirements, echoing concerns in the literature that sufficiently targeted support can be inconsistent (Hughes et al., 2016) or limited (Serry et al., 2018; Spencer et al., 2018). Furthermore, such reports align with perceptions that accommodations have become more generic as the locus of student support has moved further from teaching staff and to centralised support services (Roberts et al., 2015). This was further emphasised by a portion of students with chronic illness who perceived that they needed to fit the predefined boxes of the service to access support, and that beyond exam provisions, accommodations were not effectively responsive to their particular needs. When students’ needs require more frequent or ongoing accommodation, these are considered to be more challenging and complex to accommodate effectively (Anderson et al., 2018), and current university processes may not be adequately supporting those with chronic health conditions (Spencer et al., 2018). Students suggested that their unique needs be more deeply understood, perhaps through deeper consultation with students, and for those with chronic illness, that accommodations related to notetaking and attendance waivers would assist, particularly when students are managing their studies whilst experiencing an exacerbation of symptoms. Taking a Universal Design for Learning approach (see CAST, 2018) to courses, which includes proactively reducing barriers to access, engagement, and performance for students, may assist with catering to students’ diverse needs from the outset. For example, enabling all students to have multiple means of access to class resources and recordings, regardless of their mode of attendance, would provide equitable access for students who are absent, reducing the need for students to request this to be accommodated. Overall, students’ reports align with Thompson and colleagues’ (2019) who have also stressed the need for more individualised support where the nuances of students’ strengths and needs are more deeply understood, and offers a high leverage point of action (Senge, 1990).

In addition, support was considered less effective when students were lacking a feeling of care from the service, and strongly linked to this were students’ suggestions of increased personal communication and follow-up. As many students only seek support when experiencing severe distress (Vivekananda et al., 2011) and the process can be emotionally challenging (Reed & Kennett, 2017), students are noting the importance of a positive affective experience when disclosing needs or difficult circumstances and requesting assistance. Following up with students was suggested in order to refine the accommodations put in place and ensure they were meeting the outcomes intended by the service and students, echoing advocacy for a student-centred approach (Roberts et al., 2018; Thompson et al., 2019). Follow-up was also requested by students to check on the wellbeing of those disclosing challenging circumstances. Of concern, two students argued that this was required for those contemplating harm to themselves or others, implying they did not receive this at crucial times. Personal connection, feeling understood and interacting with empathetic staff align with the expectations of first-time help seekers (see Moore et al., 2016). Furthermore, it suggests that effective support relies on more than tangible accommodations, highlighting the importance of students’ affective experience when interacting with support services. A feeling of care, further facilitated through personal communication, may require minimal effort in relation to the positive impact it may have, offering a point of high leverage (see Senge, 1990). When service staff are catering to large volumes of students, ways for this form of support not to be compromised should be further explored.

Accessible support

The accessibility of support was hindered by limited available appointments, delays in gaining responses from the service or not receiving a response to a request for support. Students themselves recognised that the services were under great pressure, in high demand attending to a number of students, and with little time available to support them personally. These delays were inconsistently experienced across the sample, which may be explained by different volumes of demand on services throughout the year, with peak times during assessment periods (see Cathcart, 2016). A high ratio of students to staff can impede a support service’s best efforts to effectively cater to students and widen the gap between students’ needs and what support is available (Stallman, 2012). Students suggested improvements to delays they experienced but recognised that this may require additional staffing. This places this as a high impact, yet high effort strategy; an outlier to Senge’s (1990) framework, and potentially unfeasible in a climate of scarce resources (see Stallman, 2012). Ways to streamline processes to aid in timely access to support and timely communication may benefit from further exploration.

In addition, when students perceived that there was limited communication between the service, teaching staff, and other areas of the university, they felt that registering with the service had been a ‘waste of time and energy’. Despite disclosing their needs to the service, they felt they needed to disclose their needs or circumstances repeatedly to teaching and other staff across the university; a process which some find emotionally distressing (see Hughes et al., 2016). Making students aware of what is being communicated to whom, and when, may assist with this, perhaps reducing the feeling of needing to repeatedly disclose, constituting a high leverage point of action (see Senge, 1990).

For some, whilst support was perceived as accessible in the short-term, students felt that ongoing support was not provided or available for them. Developing a plan with the service which makes it clear that there is ongoing support available may assist students to understand the courses of action required should further or future challenges arise, which may be a high leverage point of action (see Senge, 1990).

Whilst not within the remit of the service at the university of this study, students reported challenges with accessing extensions to assessment deadlines at crucial times. Students expressed frustration that despite having sufficient evidence for ongoing support with the service, additional evidence (e.g., medical documentation) was required to be provided to a separate faction at the university each time students experienced short-term or acute unavoidable disruption to studies. This became substantially challenging for students who underwent the process repeatedly during the year, requiring them to repeatedly gather evidence and navigate the appropriate administrative processes, all whilst managing the difficulties they were currently experiencing. Perhaps recognising this challenge, some teaching staff reportedly bypassed special consideration processes to directly accommodate extension requests and attendance waivers; a ‘low-key’ solution students found effective. Finding ways to streamline this process for students and university staff, particularly for students registered with support services who undertake this process frequently, may reduce the effort required by all, suggesting a high leverage point of action (Senge, 1990). This may have additional benefits considering our healthcare systems are also facing pressure at this time, and repeatedly providing medical evidence can be a financial burden for students (see Karimshah et al., 2013; Martin, 2010).

For a portion of students in this study, discomfort and a sense of judgement were experienced, hindering how approachable and accessible support was perceived to be. In this way, not only was accessibility of the support and the support service important in its tangible sense, but in terms of students’ affective experiences too. Perceptions of being supported can lead to empowerment when disclosing needs or challenging circumstances (Martin, 2010), and the perceived helpfulness of staff can impact how useful students believe services may be (Roberts et al., 2018). Supporting positive affective experiences may be a high leverage point of action (Senge, 1990), along with ensuring students are aware of the various ways in which they can interact with the service to select modes of communication and appointment booking which best suit their needs and comfort level.

Facilitating student-agency and empowerment

Student agency and empowerment were hindered when students felt they did not receive sufficient information and advice to take appropriate steps or necessary actions. This led to confusion and students felt disappointed, perhaps as support services are experts in catering to students’ diverse needs in the higher education context and thus perceived as well positioned to provide the support they need. This aligns with students’ expectations when approaching services for the first time (Moore et al., 2016). Furthermore, there was an implied need for services to find ways to support student agency and empowerment, as a number of students in their final year of study were unable to advocate for the support which they felt would best cater to their needs due to limited understanding of what was available or possible in this space. This was summarised by one student who stated, ‘for someone who doesn’t know…it’s not explained’. Providing information from which students can make informed decisions and be empowered in their learning journey may form a high leverage point of action (Senge, 1990). In Australia, work in this space is already occurring, such as Students Thriving, a co-designed project which aims to explore ‘the most important things students need to know’, and ‘the ways to give this knowledge to students’ (see Australian Disability Clearinghouse on Education and Training (ADCET), 2022).

Implications

Overall, students’ insights have provided a number of avenues for exploration in considering how student support may be enhanced and improved. These students had undergone the potentially emotionally challenging and complex process (Reed & Kennett, 2017) of seeking support at university, yet half were either only partially accommodated, or reported receiving support which did not cater to their particular needs. Effective accommodations are seen to support students to reach their academic potential (Drury & Charles, 2016), suggesting partial accommodation may create barriers for students’ achievement. In addition, insufficient accommodation can result in stress (Osborne, 2019), which itself can negatively impact students’ learning capacity and achievement (Pascoe et al., 2020) in addition to the challenges students may already be experiencing (Osborne, 2019). This may shed light on why students who receive academic accommodations may experience similar levels of academic stress to those who forgo support (see Hitches et al., 2023). Furthermore, academic stress can impact students’ health and wellbeing (Pascoe et al., 2020), and is inversely related to their academic confidence (Hitches et al., 2023). As such, effectively accommodating students’ diverse strengths and needs at university is essential in enabling students to thrive in learning and in life.

In need of more comprehensive investigation is that feeling they needed to ‘fit into the boxes’ of the support available at university was reported only by those students experiencing chronic illness, but not by all students experiencing chronic illness in this sample. It is not known why the support was effective for some students with chronic illness and not others, but understanding differences across specific diagnoses and the nature of impairment effects may provide insight into this.

It should be noted that the current higher education climate, internationally, is one of finite resources (Abreu et al., 2016; Cathcart, 2016; Friedman et al., 2020; Lederer et al., 2021). For example, student support in the Australian higher education sector faces high student to staff ratios in support services and limited consultations available, placing strain on the ability of services to achieve their aim (see Stallman, 2012). Furthermore, support services are constrained by the available funding and often only able to support those with documented diagnoses (Fovet, 2024). Whilst drawing on Senge’s theory of the learning organisation, this study has offered a range of potentially high leverage solutions grounded in students’ voices, it is incumbent that support service staff receive the requisite support and resourcing to enable them to cater effectively to the number of students requiring their services (and to support service staff wellbeing in the process). Future studies may wish to further triangulate data by including the voices of other stakeholders in student support, such as support service staff who are facing the challenge of catering to students’ needs whilst under the pressures of substantial demand.

Furthermore, replication of this study across other higher education institutions and with students in various courses or subject areas would assist with understanding whether these insights are echoed in broader contexts and the changing higher education landscape of a pandemic/post-pandemic world. Framing this exploration through Senge’s (1990) theory of the learning organisation, with consideration of the impact of potential actions in relation to their requisite effort, may assist other institutions to determine the most appropriate actions to strengthen students’ experiences of support while mindful of the resource constraints of the current climate.

Limitations

The sample was drawn from one metropolitan university, and as such, caution should be taken in generalising beyond the context of this study. Nevertheless, students’ experiences in this Australian study are echoed in research from the UK (Beck, 2022) and USA (Abreu et al., 2016), and collectively, may offer insights into the challenges facing the provision of effective and inclusive student support internationally. Additionally, the majority of the sample identified as female, and students’ socioeconomic and cultural background were not examined. Future studies may sample in such a way as to ensure a greater representation of a diversity of genders.

Conclusion

Student support services have been established across many universities as a means of accommodating students’ diverse needs. However, as this study illustrates, there are areas to be strengthened and enhanced. This study adds to the limited literature by leveraging students’ voices to gain rich insight into what students believe was ineffective in the support they had experienced, and the ways in which this can be improved. Not only were tangible accommodations, such as access to learning resources, key to catering to students’ needs, but also the intangible aspects which impacted students’ affective experiences, such as feeling cared for. Foregrounding students’ voices unearthed a range of solutions related to increasing how personalised, student-centred, and accessible support can be, and how it can facilitate students’ agency and empowerment. Notably, students offered these suggestions whilst conveying cognisance of the great demands support services and staff are under. Considering students’ suggestions through Senge’s (1990) theory of the learning organisation enabled high leverage solutions to be identified, reflecting on the likely impact in relation to the effort or resources required. All students should be enabled to reach their full potential at university, bolstered through equitable opportunities to access learning and perform at the level they are capable of. Listening to the insider’s perspective, that of students with lived experience in this space, can provide insight into ways the higher education context may achieve this.