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?
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.