Mental health has been described as a defining challenge for our time and as a crisis for UK universities. Those with mental health problems may lack the resilience to cope with change and pressure to the extent that it compromises their ability to enjoy life, be productive and maintain a sense of self-worth. The number of students dropping-out of their courses due to mental health problems has trebled in recent years. Legal claims and, in the most serious cases suicide, have generated national media attention and triggered change in both institutional practices and government policy.
The reasons behind the mental health crisis are not difficult to identify. Young people are recognised to be naturally predisposed to stress and anxiety and most experience these to some extent at some stage as they become adults. For those who go to university, even those who suffered no problems at school, this can present particular challenges of its own. Relocation and the consequent disruption to existing social networks may have a destabilising effect, which can impact on identity and self-esteem. Increased independence and autonomy are appealing for most, but can also bring isolation and loneliness.
In addition, there can be financial concerns and pressure to ‘succeed’. For international students the burden can be greater still, exacerbated by linguistic and cultural barriers and, in many cases, high levels of expectation from the family at home.
Acknowledgement of the importance of mental health within UK higher education is not new. In 2003, the Universities UK (UUK) and Guild HE Mental Wellbeing in Higher Education Group was created in response to concern about mental health issues. The Group’s most recent Good Practice Guide for Student Well-being in Higher Education (2015) recognises that there have been significant developments since then in the way mental health difficulties are understood and supported, and in the legal framework around student wellbeing.
In particular, there has been a move away from the ‘deficit’ approach where support is only offered to those students already at crisis point. Instead there is a focus on pre-emptive action by embedding mental health strategy not only into institutional operation but also strategic planning. Effective policies and procedures addressing, amongst other things, fitness to study, sit and practise as well as mitigating circumstances are needed for all students, whether they are studying on- or off-campus, domestically or overseas, with or without placements. Providing (and being seen to provide) effective support systems is now understood to be an integral part of delivering a high-quality student experience. It is also recognised that to be most effective, university services must be co-ordinated with local public resources including GP practices and NHS mental health trusts.
Despite these developments, there is always more that could be done. In September this year, the profile of student mental health was raised again with the launch of UUK’s #stepchange campaign, which is designed to show why mental health should be a strategic priority within higher education. It is the latest development in UUK’s mental health programme, which was created in 2016 to support senior teams to adopt a whole-university approach to mental health and wellbeing by engaging with students and staff.
#stepchange identifies four key reasons why mental health should be a strategic priority for universities:
Regarding risk, if the headline statistics are to be believed around 500,000 students are now affected by mental health problems in the UK HE sector alone at any given time. This is reflected in the clear increase in demand for student support services such as counselling and the consequent pressure that this places on limited financial resources. This should be a key risk factor on all universities’ risk registers and one which Members of Governing Bodies should satisfy themselves is being appropriately addressed and monitored.
From a regulation perspective, universities have a duty of care to their students (and staff) and must safeguard and promote their welfare. As the precise extent of this duty is unclear, and circumstance dependent, individual institutions have to strike their own balance between meeting their pastoral responsibilities and providing an appropriate level of intervention into adult life. The situation is even more complicated for those students with mental health conditions or illnesses, whether or not they constitute a disability for the purposes of the Equality Act 2010. Discrimination claims against universities from students claiming that academics failed to make adjustments for their mental health issues are becoming more common and reflect the need to provide support proactively, as an integral part of course delivery.
The success that can result from tackling mental health issues is clear. Mental health is believed to be the biggest single predictor of life satisfaction. Within higher education, student satisfaction leads to higher levels of engagement and retention, which, in turn, improve overall student performance. Indeed, some sector commentators see this crisis as an opportunity to develop student services and improve mental health strategies already in place. Holistic wellbeing programmes with an emphasis on self-help and peer-to-peer support to assist students, identify early signs of problems and increase their resilience in coping with issues such as anxiety, stress and depression are evident. A new focus on the transition between school and university is also discernible, through recognition of the need to support students who were already known to be vulnerable children into adulthood. Now that policies and procedures are subject to external scrutiny by bodies such as the Competition and Markets Authority, there is more incentive than ever to ensure that students (and their parents) are provided with greater transparency, regarding the services available and how and when these may be accessed.
Mental health is also now a key priority in government policy, having been a feature of all party general election manifestos last year. In January, the Prime Minister announced ambitious plans to reform mental health services. Removing the stigma associated with mental health problems and redressing the relative neglect of mental illness compared with physical illness are core objectives. A Green Paper on the subject of child and young people’s mental health, which sets out plans to transform services in universities (as well as in schools and for families), will be published before the end of the year.
Universities have long recognised the potential vulnerability of students and the duty of care and statutory obligations that they have towards them. Reactive approaches to mental health and mental illness are not sufficient and the necessity of preventative and holistic approaches to student well-being at both strategic and operational level are now being built into standard practice. The benefits of addressing the mental health crisis are numerous and increased awareness via sector campaigns and government initiatives is to be welcomed. Avoiding legal claims is important but the possibility of enabling all students to fulfil their potential in higher education and beyond is a far more uplifting goal.
Kris Robbetts is a senior associate at leading education law firm VWV. Kris can be contacted on 0117 314 5427 or at firstname.lastname@example.org. To be kept up to date on legal, regulatory and governance issues please register for the dedicated HE portal OnStream: www.vwv.co.uk/he-onstream/login