Norman Lamb’s well-meaning intervention on student mental health doesn’t reflect reality

Sir Norman Lamb, Liberal Democrat MP for North Norfolk, has called for a mental health charter “to make sure students have an equal access to care.” This follows data obtained by his office via Freedom of Information (FOI) requests to 133 UK universities.

I have absolutely no disagreement with the above statement and have no doubt that this research and its subsequent release is well intentioned.

I do, however, flinch when I see claims that universities are not doing enough on student mental health. While there may well be institutions in the UK who are actively ignoring the problem – which I find hard to believe – and there is inevitably more that can be done, sweeping assumptions based on limited data can be misleading. When turned into headlines that state we are “subjecting students to long waits” and “failing” them I fear they actually become dangerous.

Asking the right questions

The data obtained by Sir Norman that led to this call is based on two main measures: counselling waiting times and spend on mental health. The problem with using these measures to reach conclusions is that neither is an exact science.

Counselling appointments are not given on a first come first served basis – a process of triage will take place in most if not all services to identify those at most risk of harming themselves or others, and to identify the most appropriate support to be offered. Counsellors themselves are not a homogenous group – they have different specialisms for the wide variety of conditions that exist under the banner of “mental health difficulties” that may be presented. Students may present with a long term diagnosis and be seeking ongoing therapy that they have accessed at home via the NHS. They may be experiencing an episode which has come out of the blue and need help to understand. They may be dealing with addiction, bereavement, stress, anxiety, depression or any number of conditions too numerous and complex to list here. Offering appropriate support is more important than offering quick support.

Often students have been directed to counselling by well-meaning staff but the appropriate support for that student may be something completely different. Stressed because of an upcoming assessment? Perhaps a study skills session is more appropriate than therapy. Anxious about your financial situation? Let’s set you up with a Student Money Advisor before seeing a counsellor. If you are given an appointment with a counsellor eight weeks from now it doesn’t mean you are ignored for eight weeks. You will have access to a range of other support in the meantime – other mental health services, drop in sessions, workshops, online support, conversations with trained staff to name a few. If you genuinely need an appointment quickly then you will likely be seen quickly.

I doubt many, if any, universities would say that they don’t want to reduce waiting times in support services, but there are many reasons for those times and they fluctuate across the year so much that the ‘average’ really isn’t an indicator of appropriate service delivery. Of far more use would be a true measurement of the impact of the various initiatives listed above, and an assessment of how they are promoted and accessed. I fear that there is a risk that the more universities are criticised for “not doing enough”, the more panic could be fostered among students. Surely what we want is students to feel confident in asking for help? No student is currently “denied” access to support but in reality some are not finding the support they need, either because of stigma, fear, lack of awareness or – god forbid – because they have seen headlines saying they will have to wait twelve weeks to be seen. Identifying and removing barriers to support should be our number one priority, but waiting time for an appointment is only one possible factor.

The wide range of support available is also a reason why it can be hard to cost the exact spend on mental health. It may seem simple to look at a specific budget and share the figure in response to an FOI, but given the way spend on support is often allocated to different departments, and support given by staff with various responsibilities, it isn’t necessarily a true reflection of resource allocation. Some interventions don’t have a simple cost – reasonable adjustments made to assessments for example – or are covered by Disabled Students Allowances. At the University of Greenwich we are working closely with local NHS Trusts to create pathways for our students into NHS psychological services – a hugely positive intervention without a price tag to the institution. How should that be costed in response to an FOI?

Recognising progress

Universities seem to be getting a bad reputation for our mental health support at a time when waiting lists for counselling are significantly shorter than in the NHS, and when ONS data published last year demonstrated that students in higher education are less likely to die by suicide than those in the same age bracket who aren’t in higher education. But that doesn’t change the fact that we are striving to do more, and yes, more resource may need to be spent in order to improve what we do. But to suggest we are in the dark about the issue ignores the efforts already being made.

Sir Norman Lamb has called for a charter, but the sector is already awaiting the launch of the University Mental Health Charter led by Student Minds, expected later this year. We will see what that charter recommends and respond accordingly. My hope is we can use it as an opportunity to recognise the good in the sector and strive for better, rather than being accused of failing the very people we are working so hard to support.

2 responses to “Norman Lamb’s well-meaning intervention on student mental health doesn’t reflect reality

  1. Glad to see you mention disabled students allowances in your article. These play such a vital role in supporting students with long term MH conditions, yet the government reforms are making it harder and harder to recruit and retain staff to support them (specifically specialist mentors because of ott qualification criteria for new entrants combined with a race to the bottom on price). That’s the real tragedy. We had a model that worked and we’ve watched it steadily decline over the last 4 years when it should be being strengthened to meet increased demand.

  2. I think one of the challenges in all this is leaving a lot of the duty of care to academic and teaching staff to spot signs of distress or below par mental health. They may not be the best people to do that, owing in part to the high levels of stress and mental health distress they face themselves with teaching and research loads.

    Within this article it is also suggested that directing students to counselling services may not be the best route and staff should consider other options. I would be very careful with that approach as students and individuals with mental health issues and distress may see that as a ‘fob off’ or an undermining of their situation/experience. I would not play fast and loose on academic and teaching staff ‘triaging’ the situation themselves.

    Having worked within a University as a staff member with depression I found the experience varied greatly between employers, with one University have face-to-face option for staff through their in-house counselling service, and another simply providing an EAP service. I suspect it is a similar experience for students and not all universities will be onboard with what needs to happen. It would be helpful if the NHS backup was there, but unfortunately it can be challenging to find help that route.

    All in all, I think more investment into counselling services is required by Universities, more training for key staff, more resilience training for students and an acknowledgement that you can’t get it right all the time, but you can always aim for continuence improvement and compassion.

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