Understanding how students manage their mental health while at university is more important than ever, given the increasing number of undergraduate students experiencing poor mental health and seeking support from their universities. This paper reports on an exploratory qualitative study and discusses how students with mental-health conditions use literacy (reading, writing, and the use of texts) to manage their mental health, focusing on reading for pleasure, creative writing, and bullet journaling. Through in-depth qualitative interviews across the academic year of 2018–2019, 11 students’ reflective accounts of their practices in managing their mental health were collected and then thematically analysed. This paper focusses on the experiences of three students as case studies of how students use literacy to manage times of mental health distress and promote wellbeing through relaxation, the expression of emotions, and the recording of their mental health. These practices enabled the processing of emotions, engagement in supportive relationships, development of a sense of self, and reflection of mental health progress. These findings demonstrate that supporting students to engage in self-directed creative literacy practices could help students to manage their mental health and develop on-going positive strategies while helping universities manage the increased demand for help from students.