Student experiences of Co-production in the Liverpool Partnership

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By Alex Hives (Year in Industry placement student) and Siobhan Sutherland (Project Administrator) at University of Liverpool.

The Office for Students (OfS) issued a Mental Health Challenge Competition in 2019 focussing on student mental health in Higher Education Institutions. The University of Liverpool was successful in securing funding for two new projects; one as the leading partner on a Liverpool project and the other as a regional hub within a national collaborative project led by UWE Bristol. Working with our partners: Liverpool John Moores University, Mersey Care NHS Foundation Trust, Brownlow Health, The Innovation Agency and the Guild of Students, the aim of the project(s) is to improve student pathways into NHS mental health services and develop new services to support student mental health.

I first got involved with the project through the ‘Year in Industry’ placements, offered by the University of Liverpool. I was looking for a very personal placement on a smaller team where I could be a valuable part of a team effort. I was drawn to the role of Student Engagement Assistant due to the unique nature of the position and the chance to perform impactful work. Going into the placement, I had vastly different expectations as to what it turned out to be. It was intended to be a purely student engagement role with some opportunities to shadow various departments. However, the role ended up providing a myriad of opportunities to expand my skillset from back-end website development to being involved in hosting mental health forums. By being in a position as a paid, full time Student/Employee of the Project, I offered a unique perspective on student life, student mental health awareness and student mental health provision.

To support student mental health awareness, the Improving Student Mental Health through Partnerships Project (SMHP) began a series of ‘Mental Health Awareness’ workshops focusing on a prominent mental health topic every month. For example, Anxiety, Motivation, Stress etc. These workshops have grown throughout the year and it has been a privilege to work alongside our partners at Mersey Care in developing these sessions. The purpose of the workshops was to allow students with lived experience of mental health conditions a place to hear from practitioners and ask questions. It also provided information to those students who wanted to find out more about living as a student whilst managing various mental health conditions.

I have been involved with this element of the project from the start. From setting up the events, to further monitoring and evolving the workshops through encouraging student feedback. From student suggestions, specialist teams from across Mersey Care were invited as guest speakers to discuss topics such as Bipolar Disorder and Psychosis, and links to recommended tools, apps and products to aid with the mental health conditions discussed were shared. I am really proud of the workshops’ success and as the programme developed the project was approached by other HEIs in Liverpool to widen participation to include their students. Liverpool Institute of Performing Arts (LIPA) students now regularly attend workshops and attendance from HEIs across Liverpool has steadily increased throughout the series, with 39% of all students attending our previous workshop on Depression and Bipolar Disorder coming from LIPA or Liverpool John Moores University.

I have also been involved with focus groups run by SPEQS (Student Services Partnerships Evaluation and Quality Standards) Toolkit project team, as part of the Student Mental Health Partnerships project, led by UWE Bristol. The toolkit is being developed for institutions across the country, with recommendations on how to develop effective partnerships between services. The Liverpool Hub contributed to focus groups led by Student Officers on student experience and opinion. The aim was to host discussions between students to explore experiences and recommendations on partnerships between University and local NHS services, mental health perspectives and experience of mental health services. Some of the topic areas in these focus groups centred on:
• Which Student Mental Health Services have you accessed?
• How would you describe your experience of these services?
• What was your experience navigating university and NHS support services?
• What did you like most about the support you received?
• How can we improve these services in the future?

To facilitate the sessions, the Student Officers underwent training on impartial moderation, facilitating tough conversations, and ensuring that the discussion remained on track. This training was led by the SPEQS Toolkit research lead and research co-ordinator. During the session, the skills learned proved key as discussions were concise, provided vital information and received positive feedback from students involved. This role allowed me to develop key skills for my future career at University and beyond. It developed my aptitude with hosting group sessions and my ability to work on a larger project, as I co-operated with other student fellows involved in the project in developing question sets and promotional material.

I have had time to reflect on our successes as a team throughout the year. Being able to have real autonomy on my work has been the most rewarding part by far, and this has shown in being able to work independently from the local project during my work on the National Project, as well as helping the University to promote external wellbeing sessions and presenting to NHS England about student engagement, an experience I won’t soon forget. Being able to dedicate a year to aiding the project in student co-production was a wonderful experience, and I hope that my perspective and work was useful to all stakeholders of the project.

If you’d like to hear more about our work please contact us at StuMHfeedback@liverpool.ac.uk

Liverpool Partnership Approaches to Student Pathways into Mental Health Services

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The University of Liverpool, along with our partners; Liverpool John Moores University, Mersey Care NHS Foundation Trust, Brownlow Health, The Innovation Agency and the Guild of Students have been working to improve student pathways into NHS mental health services and developing new services to increase the support available to students. We are involved in two Office for Students (OfS) Mental Health Challenge Competition projects; a local and a national project, which have run concurrently. The University of Liverpool leads the local Liverpool project and as part of the national project, we form 1 of 5 regional NHS-HEI partnership hubs. Through partnership working, the projects have delivered ‘The Liverpool Model’, consisting of the U-COPE therapy service and the Student Liaison Service.

Following strategic review of local need; linking with Mersey Care Trust, Primary Care representatives and University Support Services, an area of focus was recognised to be Self-Harm.  Nationally, half of all students report thoughts of self-harm (Community Mental Health Survey 2020) and the risk of suicide in the first year following self-harm is 49 times greater, than the general population (Hawton et al., 2015). It is therefore key to support these students with early intervention.

The project has implemented a new on-campus service, delivered by Mersey Care Foundation Trust clinicians and lead by the project’s Innovation Lead. Named ‘U-COPE’ (University Community Outpatient Psychotherapy Engagement) this six-session therapy encompasses a blended model of Psychodynamic Interpersonal Therapy (PIT) and Cognitive Analytical Therapy (CAT). PIT provides an interpersonal approach throughout the U-COPE intervention, with CAT included in the collaborative effort of the ‘Staying Well’ plan, completed during the final session. The service is designed for those who have recently self-harmed, or those currently exhibiting self-harm behaviours. Currently delivered at both The University of Liverpool and Liverpool John Moores University, students can access this service via referral from a University Wellbeing Advisor, Mental Health Advisor or Counsellor or through their GP. Students can also access the service through referral from the Student Liaison Service. Since its inception in September 2020, to date (October 2021) 168 students have been referred into the U-COPE service; 74 from UoL, 51 from LJMU, 33 from GPs and 10 from NHS services.

The original aim of the project was to produce well-defined seamless referral pathways for students into NHS services.  Early pathway mapping confirmed the complexity of entry pathways; this was further complicated by frequent service redesign.  It became clear that a pathways approach would quickly become outdated and that a more person-focused approach was required and from this, the Student Liaison Service was developed. Currently operating as a pilot, this service is delivered by the project clinicians, who act as the interface between NHS and HEI professionals. The service is informed of a student in distress, or requiring follow-up, by urgent care services and then contacts the student to offer a brief intervention and to signpost or refer to relevant services.  This has led to NHS services improving their identification of student users, and those students receiving follow-up in a timely manner, offering an extra level of support to this high-risk population. As part of the liaison service, the clinicians also attend multi-disciplinary team (MDT) meetings at each University, providing the opportunity to discuss students with complex needs and where students are presenting to multiple services, the most appropriate care pathway is agreed. Originally offered to The University of Liverpool and Liverpool John Moores University, the service has now expanded to include Liverpool Hope University, Liverpool Institute of Performing Arts and Liverpool School of Tropical Medicine. Since the liaison service began in October 2020 348 individual students have been contacted to date (October 2021), resulting in over 459 liaison actions.

The project clinicians have also delivered a ‘Living with and Understanding…’ series of workshops on a range of topics identified by student focus groups including; anxiety, depression, eating disorder, etc. and the U-CAN Psycho-Social Education Skills Group. This was designed for the student population, following a co-production process with students, and facilitates an additional early intervention offer for 30 students, to address low-level concerns and support self-management skills for long term mental health and wellbeing. 

The development and testing of The Liverpool Model, has provided a solution to the challenges the project aimed to address.  Although there are still multiple referral routes in to NHS and University services, the Liaison Service enables students to navigate these services more effectively.  The addition to the Mersey Care Record keeping system of a field to record student status will provide improved data for longer term service planning.  Multidisciplinary Team meetings attended by the service ensure enhanced support for students with complex needs and effective use of University and NHS resources to support students. The development of key roles and responsibilities for the liaison service, addresses the secondary aims of the project through:

  • improved risk management of students;
  • enhanced communication between organisations;
  • joined-up care approaches where appropriate;
  • opportunities to begin to collate appropriate data sets to measure live need of the student population and evidence impact. 

Looking forward, The Liverpool Model is being considered for adoption at other healthcare providers and higher education institutions, whilst locally HEIs and NHS leaders are considering the long-term funding model to extend the service and secure its future.

If you’d like to hear more about our work please contact us at StuMHfeedback@liverpool.ac.uk

Greater Manchester Universities’ Student Mental Health Service

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Our first blog is written by Madeleine Siniscalchi, a student partner in the project from the University of Manchester.

Student coproduction and evaluation

We’re so excited to be part of the Student Mental Health Partnerships Project funded by the Office for Students. Our project, evaluating the Greater Manchester Universities’ Student Mental Health Service (GMUSMHS), is one of the 5 NHS-higher education partnership hubs (funded by the Office for Students) that have developed across the country in efforts to meet the rising demand for student mental health support. We aim to evaluate and help develop the Greater Manchester Mental Health Service and its relationships with the five Greater Manchester higher education institutions and third sector mental health organizations. We are exploring the experiences of GMUSMHS users hoping to raise their voices and highlight why this service is so important to students’ health, wellbeing, and university outcomes.

Partnerships do not stop at the institutional level though. Our student co-production project team is made from a group of students representing all five Greater Manchester higher education institutes: University of Manchester, University of Salford, University of Bolton, the Royal Northern College of Music, and Manchester Metropolitan University. In addition, our team hails from all different disciplines. Among us, we cover degrees in psychology, social policy, political science, music, medicine, health and social care, and biomedical science. This wide-ranging set of skills and experiences allows us to bring many perspectives to our work and better connect with the students we work with.

The obvious link to a project like this is with our psychology student partners, many of whom are well versed in the clinical language of the GMMHS, psychological research practices, and have a solid foundational knowledge of the various mental health issues students are living. This is vital in our evaluation design, data analysis, and navigation through partnerships with various mental health services. In many instances, they’ve been able to act as translators between the technical language of the service staff, and the student experience.

Of course, no student lives in a service-student vacuum. Our lives, opportunities, and access to support are a direct result of our social and public health policies, and our partners in political science, governance, public and social policy know well how the intersection of these policies can affect the lives and experiences of the students we work with. These partners scrutinize everything from child poverty to gender inequality and unfortunately many service users are deeply familiar with the flaws in our systems. If we fail to take into account the context of students’ lives, we only paint half a picture. Our partners also have experience in social research skills, data protection, and presenting this information in engaging and accessible ways.

Our partners in medicine and biomedical science understand that mental health is not just mental. Many of our service users come with complex trauma or generational mental health problems which are stored in the body. On a wider scale, they believe that many public health issues are a result of poor mental health.

The student partners studying music are perhaps a less obvious choice. However, these partners have experience building and working with student communities, whether through the Students’ Union, education and community projects, or working with young people with special emotional and educational needs. They’ve been able to help our team connect with service users and empower them to authentically share their stories.

Our diverse range of skills has helped us to design and deliver several workshops for service users of the GMUSMHS to share their experiences with the service. We’ve written a report for the board of the GMUSMHS and fed back to the Clinical Reference and Operations Groups, and used this initial work to inform our next steps. We are currently designing and delivering the second set of workshops to collect a more in-depth view of the student service user experience.

Under our project coordinator, our team has a unique way of working that allows us to bring the skills learned through our courses and other positions into this role. Some of our partners have co-hosted training sessions for the team on areas specific to their expertise and course material (such as facilitation or data protection) so the team can learn from each other more formally.

Our ability to carry out this project while also being full time students is in large part because we focus heavily on teamwork, and since the beginning have been building lines of communication and trust within the team. As the role has progressed, we’ve taken more initiative and been encouraged to take on more responsibility for the direction of our evaluation. This trust and empowerment within the team is a result of the co-production ethos that has existed as a part of this project even before our hiring.

Co-production (when students and institutions make joint decisions on process and outcomes) is essential to our project because the student mental health landscape is constantly changing. Co-production respects the student service users as well as our student partners as having valuable insight and expertise into the student experience and student mental health services. We believe this respect and communication between institutions, staff, and students is essential to healthy dialogue and partnerships about student mental health.

If you’d like to hear more about our work please feel free to contact us at Madeleine.Siniscalchi@manchester.ac.uk.

Welcome to the Student Mental Health Partnerships Project blog

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UWE Bristol is leading a partnership across the Higher Education sector to improve care for students in need of mental health support through the development and evaluation of local partnerships between universities, the NHS and Students’ Unions, connected via a National Learning Collaborative. The Student Mental Health Partnerships Project is one of ten projects funded through the Office for Students (OfS) Mental Health Challenge Competition to find innovative approaches to improving mental health outcomes for students. The project runs until December 2021.

The project has developed five regional partnerships between universities and local NHS services in Bristol, Liverpool, Manchester, North London and Sheffield. Over the next few months, we will publish a series of blogs from the five regional hubs, reflecting on the experience of people involved in the project and what they have learned.

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