Concern about what has been described as an “epidemic” of poor mental health has been growing across higher education, as across society generally.
More young people are reporting anxiety, stress and loneliness: the numbers of students declaring mental health problems has increased and the expectations on universities to be aware of, understand and cater for the attendant needs of students experiencing difficulties is growing.
In the Office for Student’s new access and participation risk register, mental health among students can be considered a risk to equality of opportunity. It can also impact universities’ continuation, completion, and progression rates that are being measured as part of the B3 conditions of registration.
Research shows that some student groups are more likely to report a mental health condition, and that having such a condition affects the outcomes of specific student groups differently.
How best to respond when students are in crisis is also a concern, following tragic and high profile cases of student suicide. The extent to which universities’ have a duty of care is being tested in the courts and some institutions are asking students, via opt-in systems, to give prior consent to enable institutions to notify families about mental health concerns.
More generally, money worries, cost of living pressures, workload and anxiety about the future can impact staff wellbeing, as well as that of students.
For all these reasons, governors need to be assured that mental health and wellbeing provision is robust and responsive.
At a new university in the north of England, one of the main sources of information for the board is an annual student mental health and wellbeing report, which comes up from committee level. It includes figures on levels of referrals to services, suicide prevention strategies and, more recently, data on loneliness as a risk factor.
“In recent years, Covid makes some of the data trends a bit more tricky to assess but at the moment, things looks relatively steady,” said a governor at the institution. “The difficulty with mental health support is that in some ways, it’s not really the people who are managing to get through to the referrals process that you need to be concerned about, it is those that are not accessing services. But how you identify those people is very difficult.”
For this reason, the student governor on the board is another crucial source of information about student wellbeing due to being able to share current lived experiences of students.
“They have the opportunity to feed in about things that are going on and they take that opportunity,” said one governor. “On the whole they understand the reality of the balance between what university mental health support can do and how much it can fill the gap between NHS levels of mental health support.” The SU is also well placed to help identify issues around loneliness or exam stress.
At some institutions there is also monitoring of how quickly a student is seen if they are seeking a counselling referral.
If it was taking too long for people to be seen “that would lead to a conversation about upping resources” said a governor of a post-1992 university.
According to this governor, the board wants to know that there is good mental health provision in place and good signposting to university services and what is available locally, and to have a high level of confidence that the university can deal with issues that could lead to reputational damage.
Trying to create a student experience that promotes wellbeing is also a focus. In particular, levels of engagement are monitored, whether that be data around attendance, work submissions or SU activities.
“If we are seeing a drop off, we will be asking if this is a wellbeing issue or whether something else is happening,” she said.
A student governor at a new university in Scotland highlighted the importance of understanding patterns of engagement and how they impact on student wellbeing.
“At the strategic governance level, the conversation on mental health and wellbeing is not really there,” he said. “I’m not sure if that’s because they don’t see the action and impact as operational or if the feeling is that provision is at the right level because they are not hearing otherwise.”
According to this governor, students generally are experiencing anxiety and stress to a much higher level and are less engaged in university life than in previous cohorts, both as a consequence of the pandemic and pressures such as the cost of living crisis, which is forcing them to prioritise other responsibilities.
He feels that there needs to be a wider recognition of this at governance levels.
“These issues were not faced by cohorts before the pandemic but there is still a lot of complacency and the assumption that we can still apply the same models of engaging with students despite these changes,” he said. “There has been little work in trying to understand what those changes are or recognising this at court level.”
For the first time, the university is drawing up a student experience strategy, which he hopes will grapple with some of these concerns.
“I hate to refer to students as consumers but if this was any other business trying to understand the demands and needs of their consumer base, it would recognise that if those needs change, your strategy has to change,” he says. “If you continue to approach those people in the way you have done in the past, you’d risk going under.”
Feeding into this discussion will be a student union survey on the student experience, covering different aspects of student life, from their social life and housing, to feelings of loneliness. The findings will be presented to the court but early indications are that the themes of isolation and confusion are emerging.
“From the 1,000 students who responded, 7 per cent felt that they did not have any friends and of course this isolation can be linked to mental health issues,” said the student governor. “We need to do everything possible so that students know what services are available and how to access them.”
This kind of survey data helps to establish needs and prioritise resources, according to the student governor.
“Universities across the board are facing financial challenges and making cuts and we have to ensure that mental health and wellbeing is an area where cuts are minimised,” he adds.
Concern over mental health issues can also be used to lobby governments. Universities and colleges north of the border were recently successful in securing an extra year of Scottish Government funding for councillor support which was set to end in 2022/23.
Keeping track of student wellbeing at smaller, specialist institutions is arguably easier. At a specialist performing arts university in London, students are on site and have contact time every day, creating strong relationships with staff.
“Everybody knows everyone else and students are very engaged at all levels,” says one member of the governing board. “Supporting students’ mental health and wellbeing is a different prospect here than at an institution with thousands of students, where they might go weeks without really speaking to staff. That said, we can’t be complacent about it. Mental wellbeing does come up, it is on the horizon.”
According to the governor, the issue has been discussed more in the last three years than ever before at board level because “everyone was very clear that it was necessary”. Despite high levels of engagement, there has been “a lot more demand” for pastoral care services since the pandemic and the university has increased access to counselling for instance.
One issue of heightened importance at this type of institution, which is related to wellbeing and duty of care, is safeguarding.
“Across the sector, historically it has issue that has been very problematic and we are fortunate that we have never had anything like that,” said the governor. “The leadership team are very hot on it and they have to be. We, as governors, have to be assured that reporting of concerns and grievances, for instance, is watertight.”
Efforts by the university, fully backed by governors, to diversify the intake have been successful and have led to an increase in the number of neurodiverse students and students with disabilities. While something to be celebrated across the sector, inclusion has resources implications.
As the OfS risk register highlights, different groups of students may have different mental health and wellbeing needs. Universities with high proportions of disadvantaged undergraduates, international or mature students may need more flexibility and a focus on creating a sense of belonging, for instance.
All governors interviewed emphasised the importance of staff mental health and wellbeing. One said that the subject was mentioned much more now than when she first became a governor, partly as a result of the pandemic.
“We have carried out staff surveys in the last few years and there are wellbeing questions as part of that,” she said. “Happily, levels of satisfaction are very high and staff turnover is very low.”
Some governors felt staff mental health was not discussed enough.
“As student needs increase, it has an impact on academics,” one commented. “Staff have to engage with the cohort they have in front of them and that has implications for things like greater workloads and the setting of expectations that they might not be able to manage or meet.”
One new university in the north has taken steps to address the issue by setting up a confidential, 24/7 mental health phone and email counselling service for staff.
“Support is available for both personal and work-related matters, so things like legal, financial, housing and family related issues,” said one of the board members.
For further guidance and support on issues raised in this article, governors may wish to refer to our Education for Mental Health Toolkit. Developed as a partnership between the University of Derby, King’s College London, Aston University, Student Minds and Advance HE, and funded by the Office for Students via a Challenge Competition, this toolkit has been created to provide evidence informed guidance on the ways in which curriculum can support both wellbeing and learning.
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