'​It’s time to change the narrative around student mental health'.

A 32,000-strong The Tab petition states “there is blatant and obvious neglect of the importance of student mental health at universities nationwide” while The Telegraph writes that “Universities must step up.”

Entering UMHAN’s 18th year in the sector, our 400-strong mental health specialists are not ignorant of the challenges faced by students studying at HEIs. However, we would argue that there are limitations and boundaries to the impact universities can have on mental health without a huge increase in focus and investment on key areas outside of their control.

Since UMHAN’s inception, we have witnessed the scaling-up of elements necessary to effectively support students within their educational context. This includes:

• more robust triaging and risk assessment processes
• collaborative working practices both internally and externally
• the professionalisation and increased numbers of staff in mental health-specialist roles
• budgets for interim support such as Specialist Mental Health Mentoring
• training
• greater recognition and initiatives/campaigns that focus on context-specific issues
• co-production with students who experience mental health difficulties.

University services have diversified to better reflect the needs and complexity of mental ill-health amongst its student population, and many now employ professionals from a range of backgrounds. UMHAN members, for example, have differing backgrounds, such as nursing, social work, counselling, occupational therapy, psychology, art therapy and others, and are all unified by their extensive training and experience in mental health.

Waiting times

Despite the fact that referrals to university services have increased year-on-year, waiting times for assessments and support recommendations for students is generally days rather than weeks. For students in crisis, many teams now have staff on a duty rota who respond on the same day, with colleagues in security and accommodation services trained to provide a proportionate response and facilitate access to statutory care providers.

Ongoing support, where waiting times vary dramatically depending on the time of the year, can be contrasted to the availability of both the general and specialist mental health care and treatment provided by statutory services. Access to local IAPT services (which provide talking therapies for anxiety and depression) can be reasonably short in some areas. For more specialist services, however, waiting times can be up to two years. The Royal College of Psychiatrists report that during this time two-fifths will require emergency or crisis services. In some regions, and particularly rural areas, there are fewer services available – for example eating disorder services. In some instances, therefore, university services have recruited a nurse or occupational therapist, or facilitated peer support groups, or invested in training and partnerships run by charities such as BEAT or First Steps ED.

Universities remain responsible for ensuring their specialists are proportionately resourced to the incidence of mental ill health in their student population, and that such staff are equipped to assess needs, resources, risks and safety.

Inequalities

However, the causes, contributors and consequences of poor mental health are complex, numerous, and closely associated with a range of inequalities.

Universities have direct impact on these inequalities and their possible cessation for people experiencing mental ill-health. We’d argue that the sector has yet to fully recognise and respond to mental health inequalities through, for example, adapting the education ecosystem to the needs of students with mental health conditions, providing mental health-inclusive education, influencing structural issues within other sectors like employment, alongside initiatives that improve access to healthcare. There is not better time to consider how Universities sustain inequalities in mental health, and work with local and national partners to address these.

3 recommendations for the sector

Some relatively small developments could make a huge difference in improving student mental health support.

Common terminology

To be able to understand exactly what we’re dealing with and what works we need to start using the same words and phrases to describe and collect data on the same interventions. We need to stop conflating wellbeing and normal reactions to difficult situations with clinically diagnosable mental health conditions.

• To ensure senior leaders, the sector, NHS commissioners and the government have a proper understanding of the quantity of support,  its complexity, and degrees of risk being held by MH practitioners working with university students, we need a common data set which is used across the full range of MH practitioners.

Communication

This needs improvement - both within student services and with external providers.

Until we have improved how services communicate internally and with external support providers, we cannot be sure that we have provided the best support to those most at risk.

Range of support

We need to improve understanding about the range of support that can be accessed by students. The narrative focuses on a one-size-fits all model of counselling/therapy or risk, whereas a more holistic and developmental approach should be consistently offered and promoted. Taking a rights-based approach to mental health can open up dialogue about this, challenge unfair processes, and lead to better outcomes. Taking proactive inclusive measures, as well as individual reasonable adjustments, can help students thrive, with/without periods of mental ill-health.

Conclusion

By focusing on what we can control, we believe that the sector can fully embrace the recurring mental health experiences and inequalities that feature in many students’ lives, preventing or reducing their replication in education and into the workplace.  To do so effectively and efficiently necessitates changing systemic practices and joined-up effort. How many University leaders have risen to this challenge and have used their power and influence within their institution and beyond the sector to achieve a more mentally-healthy Higher Education?

Dan Doran (UMHAN Trustee), Sam Gamblin (Charity Manager),  Anna Matthews (Chair of UMHAN)

To find out more about Mental Health Equality, please join us on Thursday 13th May, for our Lunch & Learn session on this topic.

Lunch& Learn