Opting-in to a serious approach to mental health

As the academic year commences the wellbeing of our students is at the forefront of all our minds.

Many will take to university like ducks to water, but for others it will take a bit longer to settle in. Some will experience difficulties during their time with us such as family, relationship, financial or academic challenges, or physical or mental health issues. The one thing they can all be sure about is that they are not alone in facing such difficulties nor the first to do so.

Public health

Mental health is fast emerging as the single biggest public health issue affecting young people today, both in the UK and globally. The exact causes are difficult to determine, but there can be many contributing factors on a personal and societal level. It is refreshing there is an increased awareness of mental health among current students and a willingness to talk openly about mental health challenges – so different to my life as a student in the late 70s and early 80s.

In some situations, the natural mood swings that have always characterised the human condition (good days and bad days) and the anxiety that is a normal precursor of major events such as presentations or exams (and arguably a positive factor in terms of performance) are misinterpreted by students or misrepresented by observers as abnormal. But even allowing for these factors, there does appear to have been a very real surge in mental health challenges facing young people, including students.

The causes are unclear and will take time and research to tease out. Putative factors include increased academic pressure, concerns about employment, changing patterns of drug and alcohol use, student debt, and concerns about geopolitics and climate change. Many of us worry that the sheer volume, content and pressures of social media may also be a factor. In this cyber world, there is no longer time to daydream, to muse or to have a bad hair day without getting judged, trolled or abused.

A major challenge

The scale of the challenge is forcing us to re-evaluate every aspect of our student support systems – to challenge established practices, examine innovations elsewhere in the sector and beyond,  make major changes and significant additional investments where warranted, and monitor the impact of our interventions with a view to continual improvement.

Here in Bristol we are taking every step we can to work with our students to help them build the life skills and resilience to cope with these pressures, and to identify vulnerable students as early as possible so that we can support them. We are implementing an institution-wide approach to student (and indeed staff) wellbeing for this academic year and beyond – part of this work is focused on further strengthening support for our students during their transition into university.

Opting in to parental contact

This includes an ‘opt-in’ policy which encourages our students to allow us to include a third party, chosen by the student themselves, in discussions on their mental or physical health where we have significant concerns. Consent is granted via online registration, or in discussion with university staff. The named contact can be changed at any time and consent can be withdrawn or added during a student’s time at Bristol.

Universities have always been empowered by law to contact parents, guardians and others in life-threatening situations. Our new policy aims to agree upfront with students that we can involve a third party of their choosing at an earlier stage if we have significant worries about their physical health or wellbeing. We are definitively not in loco parentis and our students are adult learners with all the rights of privacy enjoyed by other adults. We believe, however, that where someone is experiencing difficulties they may benefit hugely from the early involvement of a parent, former teacher, friend or guardian – involvement that vitally requires the student’s unequivocal consent.

In legal terms, a young person wakes up on the day of their 18^th birthday with a dramatically different set of rights and entitlements. From a human, biologic and behavioural viewpoint, they are essentially the same person! Difficult that it may be, common sense and judgement must prevail if we are to support our young people as they navigate the tricky journey from adolescence to adulthood – a vulnerable period for even well-adjusted confident individuals and an unnerving and stressful period for many more. We are delighted that in the first week of registrations 94 per cent of our students, both those new to Bristol and those returning, have signed up to this new common-sense policy. It seems a simple step but one that could make a real difference in the coming year.

A range of measures

Other key measures to our whole-institution approach include:

• embedding personal development, wellbeing and resilience in the curriculum through our new Bristol Futures initiative;
• introducing a team of full-time professional staff in our halls of residence (Residential Life Teams) who are rostered on a 24/7/365 basis and whose full-time job is to work with our established teams of live-in student peer mentors on community building and early identification and support of vulnerable students;
• introducing a similar team of dedicated full-time professional staff into our academic schools and departments (Student Wellbeing Advisers) working alongside our personal and senior tutors;
• bolstering our triage, GP and Counselling Services so we can treat urgent cases on the same day if necessary while channelling less urgent cases to appropriate counselling, life-style, mindfulness and exercise programmes;
• strengthening partnerships with external providers such as the NHS, Public Health England and the charitable sector so students in difficulty can be referred and treated promptly;
• creating a strong focus on employability with a view to supporting our students during their second challenging transition – moving from student life to the workforce after graduation;
• reviewing our policies and communications in difficult areas such as withdrawal and fitness-to-study ensuring students are appropriately supported by the University, their parents and others during such challenging events.

As a world-leading research-intensive university we are taking an evidence-based approach to inform our practices and to monitor outcomes, investing in research to evaluate the effectiveness of new interventions where such evidence is lacking. This programme involves multiple components – many of which overlap – and must be underpinned by easily understood care pathways and communications channels. I have established a Vice-Chancellor’s Taskforce to coordinate our efforts across the university which, in turn, is supported by an expert advisory panel of national and international experts.

In our view, mental health is everybody’s business at our university. But while we take our pastoral care responsibilities very seriously, it would be remiss of me as a parent, clinician and vice chancellor if I did not state that we should not be expected to replace the NHS in the provision of mental health support. For too long, mental health has been the poor relation to other NHS services – and this must change.