What should we take from new figures on student mental health?

David Kernohan is an Associate Editor of Wonkhe

We should be welcoming a rise in the number of students that are declaring mental health problems.

For all the way society is slowly changing long-standing perceptions of mental health, there is still a stigma attached to sharing and to asking for help. Without the confidence that such information will be used and understood in a way that is all about support – and not about stigma – there is a risk that simple, straightforward, assistance is not offered when it is needed.

Underlying risk factors

Though it may seem like students are particularly likely to struggle with their mental health, the direct experience of higher education is unlikely to be the root cause. Looking particularly at depressive symptoms (a decent enough proxy for mental health risk) from ONS data about the general population, we know that:

  • Younger people are most likely to have depressive symptoms- data from the first quarter of 2021 shows that 34 per cent of those between 16-29 experience some form of depressive symptoms. For younger women, the figure is 43 per cent.
  • Adults not in work (or otherwise economically inactive for reasons other than retirement) are more likely to have depressive symptoms (the figure is 40 per cent in both cases)
  • And low earning adults are more likely to experience depressive symptoms than those with more income – 37 per cent of those earning less than £10,000 a year have symptoms. Spending power is also a factor – 35 per cent of adults who would be unable to afford a “necessary but unexpected” expense of £850 experienced depression.
  • Loneliness is a huge factor – 62 per cent of those who reported being lonely always, often, or some of the time, had symptoms of depression
  • Where and how you live also shows correlation. Thirty one per cent of adults who rent experienced depressive symptoms, and 28 per cent of those living in the most deprived areas of the UK (compared with 17 per cent in each of the top two quintiles) experienced depressive symptoms.
  • Finally, 23 per cent of those traditionally educated but below degree level experienced depressive symptoms, higher than any other group.

So, if you took a sample of young (largely female) humans who are not (yet) educated to degree level; and then put them in rented accommodation where they felt lonely and isolated, and then ensured they had limited earning and spending power – you would expect to find a lot of people with depressive symptoms. And you do.

I make this point at length to emphasise that higher education itself is unlikely to be the problem – the demographics and living conditions of those studying in higher education are all massive risk factors. And this is why it is essential we get students to share underlying problems (depressive symptoms are linked to a variety of diagnoses, and generally make others a lot worse) as soon as possible – ideally at the application stage.

Applying with a mental health diagnosis

New research from UCAS tells us that 3.7 per cent of all 2020 UK applicants declared a mental health condition, up from 0.7 per cent 10 years ago. Declarations skew female and LGBT+. However, it is estimated that just under half of applicants do not share an existing mental health condition with the university and college they are applying to.

If you are or know an applicant I want to be sure to get the following information across before we go any further:

  • Health information is kept confidential to everyone other than those responsible for offering support or arranging adjustments. It is never, ever, used to make academic judgements.
  • Students don’t have to have a diagnosis to declare their mental health concerns.
  • After an offer is accepted, the student support team will start arranging the required support and offer information about applying for Disabled Student Allowances or similar. They might (depending on need) put together a support agreement.
  • Before sharing support needs any further, the student support team will ask permission. Information is only shared with people who need to know about aspects of a condition to offer support or adjustments – they may ask about academic staff, personal (pastoral) tutors, the accommodation team, exams officers, and library/learning support staff.

Problem areas?

There are some particular groups of applicants that are less likely to declare a mental health concern if they have one – and this should concern everyone. Men are less likely to declare than women, Black and Asian students are less likely to declare than White students, older applicants more likely to declare than younger ones (though younger people are less likely to have a diagnosis), and those applying from Quintile 5 of POLAR4 are less likely to declare than those applying from Quintile 1.

On that latter one, it is heartening that this is close to the pattern that would be expected. Young people from deprived areas (which are likely to also be POLAR4 Q1 areas) would be expected to have a higher prevalence of mental health conditions for the reasons described above. But the reverse is true for Black and Asian men – there the lower your POLAR4 quintile the less likely you are to declare a condition.

This highlights an underlying problem with men and mental health. Men are less likely to seek help, less likely to have a diagnosis, and less likely to declare a condition if they have one – but men are far more likely to reach a mental health crisis point and take their own life. One actionable insight from this report is that universities and student unions need to ramp up the offer of “invisible support” for men, and to take steps to normalise discussion and sharing of concerns among men.

There is also a less well-known underlying issue with mental health and ethnic minority backgrounds – one that combines a greater likelihood of mental ill health and a lower likelihood of seeking health. For instance, white men from POLAR4 Q1 are among the most likely groups (3.5 per cent of all applicants from that group) to declare a mental health difficulty whereas Black and Asian men are among the least likely (0.4 and 0.7 per cent respectively). There is clearly a stigma here, but work to address it is much less established.

Why not declare?

Declaring a mental health condition is good for you. If you are a student with a mental health concern and you declare it you are more likely to:

  • Understand and research what support is available
  • Know how to access support , and access it when required
  • Report that support and advice has improved your general wellbeing

Students are becoming increasingly smart in checking out available support and resources at the application stage – 19 per cent of applicants in 2020 researched mental health support for an existing condition at their chosen provider, 29 per cent researched mental health support in general. This would feel like a good moment to make these services visible and comprehensible to applicants as well as existing students.

We get a lot of information as to why a staggering 49 per cent of applicants with a pre-existing condition choose not to declare it – and why advisers say that 83 per cent are reluctant to declare. This is presented in the form of student free text quotes and quantitative ratings of “common reasons” by advisers.

The impression is very much a perception that a declaration would affect application outcomes and see applications treated differently. To be abundantly clear, this is a false perception, but one that advisers estimate is held by 90 per cent of applicants. There is clearly a massive communications job to be done here.

There is also some evidence that applicants are feeling their condition is not relevant or important, and that only a formal diagnosis counts. Here, I return again to the findings on depressive symptoms – any pre-existing conditions are likely to become more, rather than less, apparent given the way students are expected to live their lives. Declaring means support is available quickly when needed, and is targeted to the issues faced by an individual.

Data notes

The UCAS applicant data comes from a “Freshers Experience Survey” completed by 21,000 UK students who applied successfully for an autumn 2020 start. Responses were weighted to account for differences in response rate by gender, age, and mental health status.

UCAS End of Cycle data was used to report the longer time series of accepted applicants declaring a mental health condition since 2011.

The UCAS adviser survey was completed by 257 advisers and was unweighted.

The ONS data comes from the latest iteration (Q1 2021) of the “Coronavirus and GP diagnosed depression in England” publication, drawing on the “opinions and lifestyle” ONS survey for those over 16 living in the UK.

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