Universities and student mental health: how are universities coping with soaring demand?

Blog posts

9 Oct 2015

Matthew Williams and Emma Pollard

October 10^th is World Mental Health Day, and while there have been many research studies into mental health at work, the mental health of students in higher education (HE) has perhaps received less attention outside of the HE sector. In a recent project for the Higher Education Funding Council for England (HEFCE), with our partners at Lancaster University’s Researching Equity Access and Participation, IES investigated how 12 HE institutions provided support for students with mental health problems.

Although the largest groups of students with support needs that universities and colleges’  cater for are those with dyslexia, research has shown that the group least likely to feel their needs have been met sufficiently are students with mental health problems The number of students declaring a mental health problem has more than doubled in the last five years, much faster than the increase in the numbers declaring other disabilities. The most recent data from HEFCE show that 1.4 per cent of all students have declared a mental health problem, up from 0.6 per cent in 2008/09. However, institutions recognised that only a small proportion of students experiencing mental health problems disclose it to their institution. NUS research in 2013 with over 1,200 students found that 20 per cent in fact considered themselves to have a mental health problem, and more than 90 per cent had experienced some form of mental distress during the time they’d spent at their current place of study.

Demand for support is therefore growing in the sector whilst institutions and wider health organisations are facing increasing pressures on resources. At the same time universities and colleges are also tackling proposed changes to the ways in which funding is delivered to support disabled students. Indeed, the consultation on the Disabled Students’ Allowance (DSA) (one of the major funding sources) closed last month and the Department for Business Innovation and Skills are now reviewing the responses before making their announcement on the future of the fund.

Our research showed how HE institutions are facing these challenges (and others) and working hard to improve provision and reduce barriers to accessing support, although support is most effective when institutions are aware of problems. Students experiencing mental distress may choose not to disclose for a number of reasons: they may not identify as having a mental health problem; they may not see themselves as ‘disabled’; and they may be fearful of stigma or it acting against them in admissions or their studies. The institutions we visited made a lot of effort to encourage disclosure of problems by students, and particularly early disclosure (even prior to making a full application or at least before starting the course), so that they can plan support effectively; late disclosure could result in students not having support put in place and thus affect their academic performance and retention. Their activities to encourage disclosure included awareness-raising campaigns at open days and Freshers’ Week, and peer mentoring/support, and there were numerous ways for students to disclose before and during their studies.

The universities we spoke to were positive about the amount of support on offer and the quality of support for students who were known to have a mental health problem, and there was a commonality of approaches across the institutions visited. There was generally a disability support team located within student services, with a number of disability advisers who supported students. In some institutions there were specialist mental health advisers while in others, advisers dealt with students across the range of impairments that may lead to a support need.

Where students were in receipt of DSA in relation to mental health problems, DSA generally paid for one-to-one specialist mentor support, provided either by in-house mentors or those from an external agency.

In addition to specific and individual support provided through the disability support team, there was also wider, more general support provision. All the institutions in our study had a counselling service available to all students. This offered  time-limited counselling support with onward referral to appropriate statutory services if necessary. We found that counselling services were seeing more students with severe and enduring mental health problems, whereas in the past counselling had been more about responding to difficulties students faced with transition, homesickness and relationship issues. Some universities and colleges had introduced programmes aimed at preventing issues arising in the first place, through improving general health and wellbeing among students and building resilience.

The case study institutions recognised the important role of tutors, and tended to feel that support for students was a whole institution responsibility. Academic staff are often the first point of contact for students with mental health problems. The 2013 NUS survey found that students were more likely to tell academic staff about their feelings of mental distress than they were to tell counselling or disability services. Academics have important roles around communication, education and guidance, as well as involvement in pre-entry activities and attendance monitoring to help spot any emerging problems. However, there was often a disparity between the understanding and knowledge around disability issues of academics compared with staff from the disability support teams. Some institutions had specific staff in post to improve the links between academics and support staff, either academic staff with additional support responsibilities, or disability advisers assigned to and located in particular departments or faculties.

While universities put considerable effort into support around managing the impact that a student’s condition has on their studies, they were clear that they are not a medical service and cannot provide medical support to students, although they are often left providing ‘holding’ support to students (those waiting for support from health services to ‘kick in’). All the institutions we visited were working with external agencies including GP practices, NHS mental health services and voluntary organisations, and this was felt to be an important part of the support picture. Some institutions were more strategic in their relationship with external agencies, for example having services come onto campus or being involved in wider steering groups, while others relied on more ad-hoc individual level relationships.

Developing more systematic relationships with external agencies could bring benefits through facilitating access to more specialist and expert support for students, and allowing both parties to gain a better understanding of each other; some institutions felt that statutory services could lack awareness of student life. This last point echoes concerns that Student Minds has been raising through the Transitions Campaign regarding health inequality experienced by students.

With a rising number of students accessing support services, there were clearly challenges in meeting demand, but most institutions focused on understanding and meeting needs appropriately. Many institutions had recently restructured their provision of support, often as part of a wider drive towards taking a more student-centred approach, in order to: take a holistic approach to provide support across the whole of the student journey; centralise the physical location of the support and provide a ‘one-stop-shop’ for ease of student access and visibility; and improve communication and dialogue within support services. They were also looking to continue to improve provision by placing particular attention on the transition period helping students prepare for and adjust to university life; and working to make their services accessible and reduce the stigma attached to seeking help.