This is the first of four pieces exploring how university mental health, wellbeing, and counselling services operate, from various perspectives. Firstly, the student’s view.
For many onlookers, mental health care at British universities is currently in crisis. Too many students are seeking care from university wellbeing or counselling services, that those services are finding themselves overwhelmed.
There has been a fivefold increase in declarations of mental health issues via UCAS since 2006. Suicides are up, from 75 in 2007, to 134 in 2015. Average applications to university wellbeing and counselling services have seen grown rapidly, with 20-40% yearly growth not uncommon.
All of that reflects the institutional perspective. It is not what the average university student sees.
Many students, many situations
Students are far from a homogeneous group, and approach university services in different ways. Multiple cultures, levels of capability, and income all affect how a student might interact with a wellbeing or student support service.
Let’s take freshers – first year students. To most intents and purposes, they are essentially children. The vast majority will have little to no experience of navigating any bureaucracy, let alone a care system. Their ability to identify problems within themselves may also be weaker, through no fault of themselves. These two factors, plus other disruptive factors that come with attending a university, make them particularly vulnerable.
Instead of reporting issues to their personal tutor, they might speak to a trusted lecturer or residential assistant. They may not be aware that the student support office even exists, let alone a counselling service. Their route to that service may be long and winding, especially if their mental health issues are giving them difficulty when accessing a service. Anxiety may make picking up the phone particularly troublesome, so that recommended appointment isn’t booked until two months later, when the student has been struggling for some time.
Older students, familiar with navigating university systems, and with friends who may have gone through similar experiences, are likely to find it much easier to access those services. They know they are there, they know a student support office exists, and they may know their personal tutor well enough to confide in them, to subsequently be signposted to the correct service.
Different situations impact experiences
These two broad groups of students, even without discussing their respective issues, interact with university services in fundamentally different ways. Their reactions to the university services offered may be different as a result.
A younger student may view being waitlisted for two months as the equivalent to being told: “Your issues aren’t as important as everyone else being seen before you.” An older student may think that they are being asked to wait until after they leave, so the university doesn’t have to look after them at all, despite it actually just being a result of he university having to prioritise more urgent cases.
A student may view being offered four sessions of counselling as only four sessions: “Why, I need more than four hours to sort out all my issues”, despite those fours hours likely being enough.
A waitlist might seem to say 'your issues aren't as important as everyone else being seen before you'
A student may view being offered a self-help digital course as: “Your issues aren’t that bad. Help yourself get over yourself”, despite the support and tools a course might provide.
Communication is key
Clear communication and signposting to the student support services across all areas and departments of the university is not an advantage, it is required. Once in the system, it is just as important to make sure that an uncertain and unwell student knows exactly where he or she stands, in addition to explaining the process of care itself.
All of the above perceptions increase the likelihood that a student will simply not turn up to an appointment and fall out of the system all together. Redressing these perceived slights is not hard – most UK students are familiar with the NHS and having to wait while those most in need get the help required.
Clear communication is not an advantage, it is required
That said, communication is particularly important for those students who aren’t familiar with UK healthcare. They may be used to standards of private care, regardless of their ability to pay for it in the UK. Services should explain the process to all students who seek to access them, and foreign students deserve the additional attention. Away from home and vulnerable, they are higher risk.
Student journalists see the waitlist and proclaim a crisis. University officials sigh and explain the higher demand, the prioritisation system, and how proclaiming a crisis could harm more students than it helps.
Beyond actionable solutions like more money and staff for the services, better communication remains the cheapest and easiest way to improve care, reduce non-attendances, and establish trust with the student community.