Barriers to students opting-in to universities notifying emergency contacts when serious mental health concerns emerge: A UK mixed methods analysis of policy preferences

• Most students opted-in to university-contact with family in mental health crises. Students currently experiencing poor were less likely opt-in. Mature, ethnically marginalised, and international opposition worried about the outcome appropriateness of policy. In highest-risk situations contact was viewed as understandable. : When experience serious difficulties, universities face dilemma deciding whether notify trusted others such parents. This study investigates key factors underpinning students’ decisions not opt-in ‘consent contact’, which would allow their university an emergency choice event difficulties. An online survey administered a UK institution active consent self-reported: (1) they had or opted-out policy, (2) socio-demographics, (3) outcomes including depression (PHQ-9) anxiety (GAD-7). who recalled opting-in invited explain decision via qualitatively analysed free-text responses. 2637 responded, 648 (24.57%) opting-in, 463 (17.56%) 1432 (54.30%) unsure how opted. moderate/severe demonstrated lower rates than these The most common reasons for ‘not wanting contacts worry’ ‘preferring tell themselves’. These policy underpinned by four qualitative themes: ‘unhelpful anticipated outcomes’, ‘seriousness student difficulties experienced’, ‘quality relationship contact’ ‘situational appropriateness’. focussed on at single university. are greater risk may be resistant wider support networks being contacted. Future research is required address barriers at-risk.