Why should students be enrolled at a university that doesn’t take mental health seriously?

Back in July 2018, Students Minds announced the development of their University Mental Health Charter, and it has now launched.

It’s basically a well researched quality improvement model. You know the sort of thing – domains, principles and examples of actions, and next year there will be an assessment and award programme for excellent practice. It’s an impressive result of an extensive programme of involvement and consultation from actors across the sector, and skillfully straddles many of the big debates in this area on things like information sharing, the role of academics and the interface with the NHS. Best of all, it’s an open goal for SUs lobbying for improvements to their university’s mental health strategy and/or services.

For SUs subscribers, we’ve put a couple of briefings online that go through the 100 odd pages with a fine toothcomb:

The essential guide to the Student Minds University Mental Health Charter (Part 1)

The essential guide to the Student Minds University Mental Health Charter (Part 2)

A framework

There’s a couple of components here. First, there’s an evidence-informed “Charter” that provides a “reference point” for universities to adopt a “whole-university approach” to mental health, and “inform ongoing enquiry and debate”. The framework is composed of 18 themes, mapped against the 4 domains and enabling themes of the Universities UK “Mentally Healthy Universities” model – a “revised” version of StepChange that we’ve not seen yet.

Within each of the themes, the charter document sets out what the theme covers, evidence supporting why it is important and what matters within this theme, and principles of good practice.

As well as the charter itself, there will be (from early next year) a Charter Award Scheme, which will assess universities against the document and recognise “those providers who demonstrate excellent practice”, providing “further structure” and building an “evidence base which can inform ongoing improvement”. It’s the principles that really matter – they will form the basis of the scheme and universities that apply to it will be asked to demonstrate their progress towards the principles to achieve the award.

Participation games

It is hard to imagine that any university in the country is going to respond to this by not adopting the charter and taking part in the assessment scheme – it wouldn’t look on open days, and Student Minds has been very careful to ensure that it could be applied flexibly across the diversity of the sector – the “needs and responses of small scale, online only universities”, for instance, “are not the same as those of large scale, campus universities”. Participation will partly depend on the design of that award scheme (“Oh god no, better to have no award than a mental health Bronze”) and the cost – but universities daring to dismiss it will likely find red flags in league tables and angry student officers in meetings.

That does raise the question of why Student Minds have positioned participation as voluntary. Although the “principles” aren’t framed as “standards”, they certainly read like standards to me. If it’s true that the charter’s principles are flexible enough to apply to all providers, why would a provider have the institutional autonomy and freedom to not take student and staff mental health seriously? Some of the sector response to the Lib Dem manifesto commitment to adopt a “mandatory” charter seemed worried about regulation – but don’t students and staff need to know if a provider would “fail” at this stuff? And oddly, the scheme will only be open to “degree awarding bodies” – quite why students and staff in institutions without TDAPs or RDAPs should suffer is unclear – and there’s nothing to suggest that validation or franchise partner colleges will be covered by the scheme.

SUs

One of the more frustrating aspects of the charter is the way in which SUs are framed. Students’ Unions are likely seen as suppliers of student voice – fair enough – and the role in supporting clubs and societies is discussed in passing.

But in most universities SUs are in fact major delivery partners in this space. SUs are employers whose staff and full time officers need dedicated mental health and wellbeing strategies. Many SUs are running significant wellbeing programmes and innovative social programmes designed to combat loneliness. Some SUs are leading the way on PG mental health. And SU officers, staff, reps and crucially advisors are often meeting students in considerable distress. The danger is that lots of that gets lost in discussions about the charter, particularly important given that that work should be properly resourced.

It’s academic

The section on the academic experience is interesting for all sorts of reasons. On the one hand in all the mental health strategies we’ve seen, it’s teaching and learning and the role of academics that arguably receives the least attention – but on the other hand because learning is an inherently mental process – and both the way in which students are taught and assessed can obviously have an impact – it would have been very strange for Student Minds to leave it out. The danger is that student minds ends up writing a pamphlet on effective teaching, which would not be its role – but in truth this section treads a fine line quite effectively.

What it does notice is considerable academic resistance to having to take student mental health seriously. Some of that comes from inevitable and understandable concern about workload, and a desire to avoid blame if they do the wrong thing, and those doing supervision or personal tutoring often don’t want to become counsellors. That said, if you’re in a supervision role most would accept that you ought to have a basic understanding of student mental health, even if you’re only intending to refer students to other services – and there’s now solid research on supervision in the PGR experience and the potential impact on mental health.

The charter notes that many resist being sent on additional training courses, particularly if they have a long established career in teaching – but given our understanding around student mental health is developing all the time, there is a good argument to be had here for for training on these issues and for student mental health to become a core facet of what is believed to be good teaching. This will probably be one of the hardest parts of the charter for a university to get right.

Services

On many campuses the big debate is about services – and specifically, counselling wait times. It was certainly the subject of Norman Lamb’s ire. The charter does discuss wait times and identifies resourcing as a factor, arguing that universities should ensure they are providing sufficient budget, recruiting the right staff and managing services effectively and efficiently.

But there’s no mention of consumer rights issues. Effective mental health services are sold to students as part of the university “package”, and both students and their parents have legitimate questions about the standard that is being promised, and whether the reality meets that standard.

Student suicide has also attacted considerable interest fron the press, and whilst stats show that the rates are lower thasn in general society and for comparable groups of non-student young people, the counterargumernt rtuns that university is supposed to be a more supportive and safer environment.

The narrative notes that that universities are not entirely responsible for the safety of seriously ill students or for treating or keeping safe those who require urgent psychiatric intervention – much of this clearly lies with the NHS and Social Care. But one area not explicitly covered in the document is how universities might learn from suicide cases. The need to protect the university from legal challenge often means that lessons learned are not effectively and publically interrogated – and it remains the case that if there’s a suicide “cluster”, there doesn’t appear to be any statutory or regulatoy body that can roll its sleeves up and investigate properly. Few of us would regard that as acceptable in any other industry.

There are loads of other little issues but to be fair, Student Minds has made clear that the charter will get reviewed and developed. It’s that original question that’s getting to me – another voluntary quality model? If these sorts of issues are to be discussed by academic boards and senates, why isn’t this agenda a central part of the UK Quality Code? Why is the UK Professional Standards Framework (the thing that recognises academics and teaching) still largely silent on the issues? Why would we let a provider onto the OfS register and give it access to public funding – let alone give it Teaching or Research Degree Awarding powers – without taking part in this? And are we really trying to credibly suggest that the only circumstances in which we’ll do something good for students (and staff) is when universities aren’t told to?

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