Over the past two decades, the student mental health narrative has dominated the higher education landscape with the prevailing discourse focused on the role of traditional student support services.
Despite emerging evidence and recommendations towards a “whole-university” approach, limited change has been implemented.
As staff and students prepare to return to campus, is now the opportunity to consider approaches beyond the counselling room?
The Covid impact
March 2020 was a monumental milestone for change in HEIs. A loss in social interaction due to lockdowns and online learning has exacerbated poor mental health amongst the university population.
The magnitude and significance of the Covid-19 pandemic cannot be underestimated. Office for National Statistics (ONS) data from June revealed 50 per cent of higher education students experienced a decline in their wellbeing and mental health this academic year.
While we are not out of the woods just yet, this “once in a generation” pandemic has provided a real opportunity and catalyst for universities to address how they deliver degrees, the university experience, and support student mental health.
UK universities advocated the need for dedicated student-facing NHS services as part of the NHS Long Term Plan which commits to better integration between GP, social care, and community-based mental health services.
Student Minds’ University Mental Health Charter brings into focus the extensive role that university management and policy has in understanding, engaging, and adapting the environment and services to support their students.
The charter recommends “the whole university” approach to student mental health and wellbeing. Universities are uniquely positioned in often being stakeholders in many of the social determinants of health through the provision of students’ education, occupation, and accommodation. Within the charter, these determinants are defined as domains of Live, Work, Learn, and Support.
Integrated approach
As people return to university campuses, there is an opportunity to holistically review and reflect on how student mental health and wellbeing is designed and integrated into the environment and culture of the university.
One integrated approach being implemented in the NHS is social prescribing, which enables frontline healthcare professionals to refer patients to a wide range of non-clinical services, by connecting patients, via a social prescribing link worker, to assets within the voluntary and community sector by encouraging self-care and facilitating healthy communities.
It is a patient-led approach which empowers them to take control and ownership of their individual needs. While social-prescribing schemes vary nationwide, fundamentally they allow for a grassroots development of holistic interventions.
University students will often be in touch with multi-service providers, from accommodation, student support services, student union advisors, and their GP.
At present, universities vary greatly in their service offer, so each university social-prescribing model would have to be created through a ground-up approach. Some universities provide additional services through multi-faith chaplains, residential hubs, or career development.
The wellbeing services could be linked to the GP and additional university services. Success could be achieved through a synergy/ collaboration between the student union, student support services, academic support, and the local NHS/GP practice.
It would require talking and listening to the students and the service providers. As part of this conversation, service providers would perhaps also need to be willing to rearrange budgets and agree on a shared goal focused on student mental health and wellbeing.
Some of the best social-prescribing services work well because the money follows the patient, with services receiving funding directly linked to attendance, adherence, and showing evaluated success.
The use of evaluation is essential in allowing the creation of a feedback system so it is known when someone stops engaging, raises a concern, or fully completes an allocated period of activity and feels better.
Beyond the boundaries
A comprehensive approach such as social prescribing would allow these existing services to connect and provide a safety net which could include positive interventions too, such as community volunteering and sport clubs.
Universities do not need to stop there – beyond their institutional boundaries are many local organisations and services which have the potential to support students and encourage positive mental health and wellbeing.
The charter recommends the use of “student voice” through participation and co-production, further endorsed by the Universities UK’s Stepchange: Mentally Healthy Universities framework. In the past, this element has been absent or lacking within the student mental health and wellbeing narrative.
It is evident that existing traditional student wellbeing services may be patient-centred but in reality they are constrained to predominantly practitioner-led approaches.
What social prescribing does offer is an alternative or supplementary approach to addressing patient needs by taking a holistic approach to health, which is co-produced, and places the patient at the centre of decision making and in control of their individual needs with the support and guidance of a social prescribing link worker (health worker or community link worker) who is a non-medical professional.
The current way of treating student mental health is not sustainable and the social-prescribing model offers an alternative approach to consider the whole picture.
We often say “it is time to stop working in silos” but now that we’ve been away from campus, it’s time to reflect on the services and opportunities available in the immediate environment as well as beyond the university boundaries.
Recently, many of us have benefitted from talking to a neighbour, helping someone in our communities, or spending time in our gardens. So how do we convert those known benefits into our university spaces?
The charter, along with social prescribing, can be a catalyst for change, to think beyond the traditional indoor therapies and out across the whole university.
Interesting ideas – but the idea that ‘service providers would perhaps also need to be willing to rearrange budgets and agree on a shared goal focused on student mental health and wellbeing.’ is a beyond the scope of the university. Organisations focussed on social prescribing also have limited time/workers/budgets and it feels a bit idealistic to be expecting them to work with ‘us’ because we want them to?
I have to agree with Kate Mawby, these are very good ideas but quite difficult to attain without additional long-term government and societal investment in external service providers. In the meantime, Universities can keep working to normalise conversations about mental health (this work isn’t finished yet, far from it!) and continue prioritising mental and physical wellbeing for both students and staff. This is well-placed effort that can build momentum for more widespread changes and increased opportunities to de-silo and join forces with social prescribing outside of HE’s current student services provisions.