The Office for Students has recently released two pilot versions of the new National Student Survey question set, to apply from January 2023 onwards.
In both “scenarios”, the question “I feel part of a community of staff and students” has been axed. Yet amongst other new additions, both scenarios include two sparkling new questions about “services which support mental wellbeing” – which are likely to be interpreted as questions about treatment-based services like counselling.
Is that a problem? At first glance, this doesn’t look like such a big deal – you might even be pleased to see an explicit mention of mental health services featured on the NSS. But this decision looks symptomatic of the more general mistake the sector makes in its approach to student mental health.
First, it represents a misunderstanding of the duty of care that higher education institutions have towards their students. Second, it ignores a growing bank of evidence that shows we should see student mental health through a more preventative, public health-style lens. And the danger is that a mistaken approach like this will lead to the creation of missguided and inefficient policy.
What exactly is the duty of care that an HE institution has towards its students? It’s a controversial topic, where students’ expectations often don’t align with those of the institution.
The crucial thing to remember is that, on average, students have worse mental health than the general population. This is a significant problem for undergraduates, and becomes particularly pronounced at the PGR level. Why is it that 2.46 million students in the UK just happen to have worse mental health than their non-student counterparts? Maybe there is something about being a student – something about studying at a HE institution – that causes students’ mental health to suffer.
This is where the “duty of care” of a university ought to be uncontroversial. To the extent that an institution causes, contributes to or perpetuates the poor mental health of its students, it has a duty to alter and improve itself. As such, universities ought to be prioritising identifying the causes of this mental health gap between students and non-students – and taking active steps to close it.
The second and related issue is that there is a growing bank of evidence that suggests we should not be understanding mental health purely as a set of idiosyncratic problems confined to separate individuals. Instead, all the evidence suggests that we should also be looking at aspects of the environment we live in, and asking how these affect the mental health of whole groups of people.
One reason to take this approach is the research that shows that students have worse mental health than their counterparts. But evidence in favour of a culture-wide understanding of mental health comes from a wider range of sources – including the finding that people in marginalised communities (e.g. ethnic minorties and queer people) suffer worse mental health than the general population, and research showing that population mental health fluctautes with wide-scale economic changes and policy changes.
It’s becoming increasingly obvious that it doesn’t make sense to dismiss every person suffering from mental health problems as simply having a biological deficit of some kind, whilst ignoring a myriad of environmental factors that affect people’s mental health.
This wider, public health approach to mental health has important policy implications, both for universities and elsewhere. Pushing for more mental health support services whilst ignoring environmental factors is like handing out inhalers to people standing in a cloud of smog – yes the inhalers help (in fact some people will probably always need inhalers), but surely the priority should be removing the pollution so everyone can breathe more easily.
When we understand mental health as a public health issue, the duty of care of universities becomes even more clear. We would not ordinarily expect a university to hand out inhalers on site when this is the responsibility of an effective health system – but we would expect them to have a campus with air quality good enough that their students could breathe.
In the same way, whilst some may question whether counselling services are really the responsibility of the university (rather than a properly funded NHS), it seems blindingly obvious that universities do have a responsibility to create a mentally safe and healthy environment for their students.
Clearing the air
Once we accept the tenets above, the next important question is what we might regard as the equivalent of good air quality when it comes to student mental health.
Much more research is needed in this area, but one factor that has been shown to be vastly beneficial for students’ mental health is feeling connected to other students and staff. What would be sensible then, is if universities were to focus on increasing the extent to which students felt part of their university community, with initiatives to help those students who may find it harder to feel connected.
This sense of community is something that students’ unions already play a huge part in fostering, and universities would do well to collaborate with SUs in order to expand this community even further. By focusing on preventative policies like this, universities could work towards decreasing the number of students who need to use support services like counselling.
And that brings us back to NSS questions. Universities’ priority regarding student mental health should be using a wide, public health approach to closing the mental health gap between students and non-students. Given that feeling part of a connected community is one of the key factors that contribute towards good mental health across all students, it becomes obvious that we ought to be supporting and incentivising universities to improve this sense of community.
One of the benefits of the NSS is supposed to be that it incentivises improvements in the areas it monitors, both within universities and across the sector. If so, we should harness this by retaining the community question in the NSS – and paying much closer attention to the results than we have in the past.