We’re in the middle of a crisis. Students across England and Wales are experiencing the impact of mental health problems on a devastating scale. Ninety-five students died by suicide in the year to July 2017 – one almost every four days. At the University of Bristol alone, 13 students are believed to have died by suicide in less than three years. The most recent was chemistry student Maria Stancliffe-Cook, who died last month. She was 20 years old.
Students are asking for help from their universities, but some are waiting for as long as 12 weeks to receive any. Sir Norman Lamb, the Liberal Democrat MP and former health minister who revealed those figures in mid-September, is calling for a legally binding student mental health charter to set minimum standards of support provided by universities.
After all, universities have a duty to create a safe and supportive environment. It is true that as institutions, they find themselves in a hybrid caretaker role, sometimes for people who are moving away from home for the first time. What universities cannot provide, however, is specialist medical treatment for students.
So what can they do to proactively support people with diagnosed mental health conditions, while ensuring the wellbeing of all those studying on their campuses? We spoke with student mental health experts to hear the advice they’d give to university administrators. Here’s what they suggested:
Design campuses that support positive wellbeing
“Universities need to take a campus-wide approach to mental health,” says Dr Faraz Mughal, a GP in Birmingham and Solihull and clinical fellow in mental health at the Royal College of General Practitioners. “The food available, most urgently, needs to be thought about. Students need access to low-cost, nutritious food that can help promote health. Encouraging healthy habits needs several small elements, including food and physical activity, to have a big impact.”
Dr Bridgette Bewick, a psychologist and associate professor in health research at the University of Leeds, says: “We need to support the wellbeing of all students, alongside those with diagnosed mental health problems. We need to give students the opportunity to learn life skills such as sleeping well, making sure they’re aware of good nutrition, the importance of exercise and providing opportunities for accessible exercise on campus.”
Develop mindful curriculums
“We have things in our curriculum that are historical,” says Bewick, who’s about to embark on a two-year fellowship looking at how to embed wellbeing into university curricula. “We need to look critically at our pedagogy of education and about whether or not the ways universities teach and assess are necessary and fit for purpose.
“There are places where we need exams, essays, presentations; I’m not suggesting they disappear altogether. But we need to think about how courses are structured, how students are learning and how they show us they’re learning. Then we can consider if there might be new ways to design study that is more supportive of positive health and wellbeing and that, most importantly, equips students with the life skills they need in future employment and their life outside of university.”
Tom Madders, director of campaigns at YoungMinds, adds: “There needs to be reasonable adjustments when students are unable to attend or complete work due to poor mental health, to enable them to continue their studies.”
Don’t keep libraries open 24/7
“We need to open a discussion about what library opening times would look like for a healthy university,” says Bewick. “There may be subsections of the university population that have a real need for libraries to be open outside of usual hours, because of caring responsibilities, for instance.
“Lots of us are accessing libraries virtually now so it’s not as easy as closing the doors, but we need to ensure people are thinking about how their actions are impacting their wellbeing and mental health. Choice is a positive thing but we need to arm students with the information they need to make informed decisions about how they want to structure and manage their university experience.”
Model positive behaviours
Bewick explains: “As university faculties, we can model better behaviour. For example, is there an expectation that everyone is on their emails all the time, that things need to be responded to 24 hours? Are we exhibiting an environment where students can learn and flourish, develop coping strategies and improve their wellbeing or are we creating an environment that is not allowing that to happen? We need to think holistically about what we are presenting to students.”
Improve living conditions in halls
Mughal says: “The quality of accommodation needs to be conducive to good health and sleep. Consider all details, even down to the mattresses people sleep on. Also, think about how many people are sharing a dorm or wing. If you can hear noise from the whole corridor that’s an issue in itself.”
Teach staff how to talk about mental health problems
“All lecturers, teachers and support staff, any member of staff working with students, need to have training, generally, in communication skills,” says Mughal. “Some might not have experience of talking to people who come to them with mental health problems. They need to know how to listen to students on this topic.”
Build strong relationships with local healthcare providers
“Students are a niche group of patients,” says Mughal. “They need NHS services as well as community services, which as GPs we often use, such as Mind. A good place to start would be cooperative engagement with important regional stakeholders. These would include anything from third sector organisations that have mental health resources to councils to financial organisations that deal with student debt, and drug and alcohol services. All these elements need to be linked up to the campus.”
Madders says: “It’s important that universities are able to clearly communicate to students what support is available should they begin to struggle, and provide a clear offer of early support when problems first emerge.”
Bewick says: “It’s about understanding the pathways in the local context, having processes in place so universities know where referrals can be made and being able to talk through that process with the NHS trust. Universities can also look at providers outside of the NHS’s formal structure that may be able to provide support. It’s for universities to have those conversations because if we [as staff] can’t navigate those pathways, how are we are expecting students to? A mental health advisor on campus could build collaborative relationships with local services so there is a dialogue to facilitate a more timely connection for those students who need it. Sometimes that is what is missing.”
Introduce dedicated student mental health centres on-site
“Every campus needs to have reliable, readily accessible student mental health and counselling centres,” says Mughal. “I’d recommend evening and nightline services too – some universities have those already and they’re fantastic. By making sure these are well funded, resourced and staffed and open around the clock, students will have access to crucial care if and when they need it.”
Listen to students
“Universities can ask students for feedback on how the help being offered is working for them, whether or not it did what they wanted it to do,” says Bewick. “There is something unique about the student experience so when things are brought onto campus they need to be tailored.”
University is a major transition in anyone's life. Mental health issues and/or mental illness can make this unstable time even more complicated. Elsewhere on the site, we're breaking a story about the dearth of data on student drop-outs due to mental health issues and, featuring testimonials from recent first-year students on freshers week mental health triggers and hearing the personal stories from parents left behind by a tragic spate of student suicides at the University of Bristol.
But if you or anyone you know is affected by the issues raised in this story, please use the following resources for help and support. In the UK and Ireland, the Samaritans phone lines are open 24/7, at 116 123. In the US, if you're in crisis, the National Suicide Prevention Lifeline is at 1-800-273-TALK (8255). You can also contact the Crisis Text Line by texting TALK to 741741.