Every higher education institution clearly strives to be a place where people can flourish. More than 2.2 million students and over 400,000 staff are engaged in higher education in the UK. However on mental health universities are clearly facing an increasing challenge. Nationally we know around 1 in 4 people in the UK will experience a mental health problem each year and the average age of the first onset of major mental disorders is between 17 to 25 years, the age of many undergraduate students.
Universities have been reporting a greater increase in students declaring a mental health issue and a threefold increase in the demand for counselling services since 2007.
More concerning is a high level of student suicide – with the Office of National Statistics stating the number of student suicides increased from 100 in 2013 to 130 in 2014, the highest since 2007. And the problem that many of these students aren’t known to the student services departments beforehand.
So what can we do about this?
This week I report on the interim findings of the work we have been doing at UniversitiesUK in relation to the development of a Mental Health Framework. The research is due for release later this summer. It builds on UUK’s 2015 Student Mental Wellbeing in HE: Good Practice Guide, as well as a variety of other reports and research that are available.
The case for investment by universities in this area is compelling. The most important reason is of course valuing people – ensuring we support our students, help them thrive, help them manage any potential stigma attached to mental health and most importantly of all ensuring we don’t leave any gaps or leave people behind in the shadows by them not accessing the services often readily available to them.
So what are our interim recommendations?
Time has come for clear leadership. To me this is an obvious area where a Vice-chancellor can pull together areas in the University, and the external bodies we work with. It also calls for leadership at all levels with regards to the evaluation, prioritisation, partnership and resourcing to embed mental health across organisations. Mental health needs to be included in strategy development in planning rounds – set shared and ambitious goals. There are universities like UCLan and York who have done this. The strategy should align policies, procedures and coordinate resources and increase communication across departments.
We need to use more evidence and robust evaluation to find and address gaps in provision. This means monitoring year on year mental health of the population. It means improving current practices by seeking feedback and measuring the quality of services. It means identifying, evaluating, and disseminating promising mental health initiatives and strategies.
We need to change the culture. Engage every department and team of the university in a conversation that reduces stigma and encourages disclosure and appropriate help seeking. Make sure we provide a broad array of information and training for students and staff to increase awareness and compassion. We can create messages to promote ways people can support their own mental health or the health of those they care about, thus, increase the mental health literacy and disclosure.
We need to recognise we all have mental health and engage with determinants of mental health across all aspects of university life. We should give students and staff tools for self-care and stress recovery. Most importantly we should Invest in prevention and early intervention. Ensure that we gain early awareness in the student journey and take up.The narrative we use needs to be much less dominated by mental “illness” and “risk” which, in turn, tends to fuel service-led provision and deficit models, in which only those students who present with difficulty receive support – this is not the right solution to deal with the demand we are facing and the needs of our students and staff. It also serves to reinforce the stigma that we must reduce.
Instead, we all need to drive forward a narrative built around mental “health” in which the HE sector properly recognises mental strength, resilience and confidence as key graduate attributes. After all how many of us has woken up in the middle of the night thinking of something that they have do that might be difficult the next day. An institution’s mainstream curriculum and co-curriculum activity can have apart to play here. For example, through assessment strategies and classroom pedagogy that enhances a sense of engagement and belonging, with strong attendance, which is fundamental to combating isolation, stress and distress.
In terms of supporting the unwell our student services play a vital role and we can take whole population approaches to mental health promotion and self-care with clear messages on distress and support. We can align work on reducing stigma and disclosure with clear signposting, appropriate staff training and peer-to-peer initiatives and support service configuration. There will be a need to configure services for different types of interventions – technology, drop-in, triage systems, telephone, after hours, peer-to-peer. As well as how we reduce the risk of crisis/ suicide situations.
Finally, working partnerships will be key not just between departments, and areas like the student union and sports, but the broader HE sector, the NHS, 3rd sector & charities, schools and graduate employers as well as the town or city, communities and families.
At UWE Bristol, we’ve recognised how important these partnerships and the ‘whole journey approach’ are, linking up with Avon and Wiltshire Mental Health Partnership NHS Trust at an academic and practitioner level, the city councils and charities. We have recognised how important it is that the guidelines and provision we develop for the co-commissioning of services and approaches, should be integrated with feeder schools and colleges, to enhance the preparedness as well as fuel the aspiration of prospective entrants to higher education. Universities are part of a much broader eco-system. To really do the best by our students it is critical that we are as joined up as possible in the approach we take, in order to really maximise the impact we can have for our students.
The note I would like to end on is an important one. Here I believe is the real opportunity to look at this not as a problem of the few but something that impacts many. Where we can look to prevent rather than react to a crisis. And most significantly of all see this as an opportunity to set young people up well for later life. Good mental health should be a strong graduate attribute. This is about shaping a resilient and healthy society for the future – the significance across our public services and the way we live cannot therefore be overstated.