Fighting the student mental health crisis using technology

Cathy Parnham examines the role social media and digital channels play in tackling student mental health

The stark truth

50.3% of students have thoughts of self-harm – twice as many as reported in 2017

44.7% use alcohol or drugs to cope with problems

One in three needs professional help

Nine out of 10 students struggle with feelings of anxiety – up 18.7% on 2017

33% feel lonely often or all the time

21.5% have a current mental health diagnosis

75.6% conceal their symptoms from friends for fear of stigma

Source: University Student Mental Health Survey 2018, conducted by The Insight Network and Dig-In

The data is alarming: nine out of 10 students struggle with anxiety and a third feel lonely often and over half have thoughts of self-harm.

One of the challenges universities face is identifying students who may be struggling and getting appropriate help to them, in time and in a way in which they can engage with complete confidence and trust.

While there has been a lot of research highlighting the negative effects of social media upon young people from body image to anxiety and poor concentration, with such heavy reliance by generation Z on social media, is there a way to tap into this to create positive tools to aid students suffering from poor mental health?

Mental health crisis: Digital developments

Bespoke student websites such as Student Minds offer an array of supportive information, while offers online support such as guided breathing exercises, links to universities offering mindfulness courses, and a Facebook page with links to various additional resources.

But there have also been some interesting developments in the wider digital sphere.

Take the hashtag #itsoknottobeok on Instagram – with over 128K positive messages, images and videos posted, this provides a positive way to tackle the stigma associated with mental health and opens up a common dialogue through a peer-to-peer support network.

Blog site Tumblr has partnered with National Alliance on Mental Health (NAMH) and set up OktoTalk, with the tagline ‘It’s time we talked about mental health. Share what’s on your mind.’ The site offers an open, safe place for users to blog about their feelings., with the hashtag #365daysofselfcare, is dedicated to those suffering with depression.

Its aim is to increase awareness and understanding and to develop a supportive peer network.

Interactive websites such as Big White Wall, go a step further offering “optimised self-management of healthcare through personalisation, driven by algorithms that generate support and recovery pathways tailored to the individual” 

Many universities have, or are developing, their own digital support tools. The University of Sussex, for example, offers free online self-help for students and staff via its online Silver Cloud service, offering four therapeutic programmes focusing on anxiety, depression, stress and eating issues.

There was a 161% increase in the number of students accessing Kooth Student in March 2019 compared to March 2018

How screen-to-screen can benefit mental health

The use of social media and digital channels to target student mental health has many benefits: there is no waiting time, so help and advice can be immediately available; it is always on, 24/7 – so in a moment of need, there is always somewhere to go; it can be anonymous; and some students may find it difficult to pick up a phone to seek face-to-face help. Perhaps, one of the most important benefits is the community feeling these channels offer and the peer-to-peer support they can give, reducing isolation and normalising mental health.

Above all, as Steve West, vice-chancellor of the University of the West of England, Bristol, comments, screen-to-screen tools give students choice: “They increase choice for our diverse student population and support students who may not feel able to engage with traditional models of support.”

Case study: The Open University

Catherine Coldbeck, business change project manager, talks to UB about the OU’s primary support channel for students with mental health issues

In the past few years the pressures on student mental health and wellbeing have been documented within the conventional sector, in the media, in government initiatives and in sponsored research.

At the OU, there is evidence that one in three students declaring a disability to the university indicate mental health support needs and, from staff in contact with students, that there is a growing need for support in the areas of mental distress and wellbeing.

A student mental health working group founded in February considered what kind of first step the OU could take to provide better mental health and wellbeing support for students. As a distance-learning institution with students across the UK and beyond, it was obvious that a conventional student wellbeing service could not meet our needs. It was important that the service was available to our students wherever they were and whenever they were likely to need it – outside office hours and term times.

We explored the possibility of an online mental health and wellbeing support service from a commercial provider and of the options available we established that Big White Wall (BWW) is the current sector leader with a considerable number of clients already in the HE environment, and a level of accessibility and functionality greater than those of all competing systems we considered. The advantages of

BWW include:

Support is available 24-hours a day, all through the year

OU students can tap into a large supportive community with a range
of experiences

Students are able to interact through art as well as words

There is a range of tried-and-tested guided support courses that students can access

Students can be signposted towards the service by non-mental-health support staff.

BWW offers an efficient and effective means of offering mental health and wellbeing support to all OU students and, through its use of evaluation, of how much need for this kind of service exists amongst our students and the benefits of offering it.

Since joining BWW in October 2018, over 1,700 students have registered for the service; as at April, around 250 students were using BWW regularly, posting on the message boards, signing up for guided support courses and taking self-assessment tests. The most popular guided support courses are ‘manage stress and anxiety’ and ‘manage your depression’.

Instant help in a time of need

Texting also offers a vital, familiar and instant tool to help support students. The Students’ Union at UWE, for example, has partnered with Crisis Text Line to offer a 24/7 crisis support text line. West explains:

“If in distress, the students can text ‘UWE’ to 85258. All texts are answered by trained volunteers, with support from experienced clinical supervisors.”

In the wider arena, and helping to raise awareness globally, is the mental health textline ‘Shout’ just launched by the Duke and Duchess of Cambridge and the Duke and Duchess of Sussex, with a £3m donation from their Royal Foundation.

Texting gives instant support – and a vital lifeline – to those in a moment of need, no matter where they are.

So, what’s next for student mental health support?

While one of the major disadvantages of social media and digital mental health channels is the lack of face-to-face interaction, this can also be a deterrent for those seeking help due to the fear of stigma and wanting anonymity. But this is where chatbot technology can bridge the gap – with the potential to offer users a two-way dialogue via ‘human-like’ engagement 24/7 and with complete anonymity. Plus, the potential is there to give feedback and advise on coping strategies.

With men three times more likely than women to kill themselves, according to the Samaritans, listening chatbots such as HARR-e are vital. In fact, HARR-e’s creator Harry’s conducted ‘The Masculinity Report’ and identified that men are “three times more likely to talk through technology about their intimate, personal issues than [through] humans”.

A further pull for using this tech is that it is completely anonymous as no personal data is stored.

One successful therapy bot is the app Wysa, “your 4am friend”, a virtual coach you can talk to for free and completely anonymously. Available in 30 countries, with 1.2 million users and 80 million+ conversations, and an app rating of 4.5 out of 5, this is testament to the importance of AI tech as part of a student wellbeing strategy.

Or there is the Stanford University-created Woebot, built around cognitive behavioural therapy techniques, which is able to recognise negative thoughts and encourage users to change them. And the University of Ulster has just secured £1m investment to explore how AI chatbot technology can support those suffering from mental health issues.

Such resources, however, are designed to complement existing therapies – as says, “People should not solely rely on therapy bots, or use them for more serious or long-term issues… however, people can use these services in real moments of need.”

Positive feedback on mental health tools

While currently we may not be able to completely assess the effectiveness of digital tools in terms of prevention, we can see the importance of existing – and future – social media and digital channels by the rising number of users.

Take the free, anonymous online platform Kooth Student service, first launched at UWE in 2017. West tells UB: “There was a 161% increase in the number of students accessing Kooth Student in March 2019 compared to March 2018,” validating the need for such services.

West adds that while it is currently difficult to assess the effectiveness of social media and digital tools until more information becomes available, at UWE “anonymous feedback from students who have used the services has been very positive in terms of their experiences and how useful they have been”.

Continued investment in digital platforms and social media, together with funding innovative approaches to tackling student mental health such as chatbot tech, show just how important digital channels are in the fight against poor student mental health. While we may not have all the answers yet, such investments are key to reaching those in need via the social media channels they use daily.

Case study: Big White Wall

Henry Jones, CEO of Big White Wall, shares how the unique Big White Wall online service platform can help students needing mental health support

Online platforms have a pivotal role in supporting students with their mental health. Big White Wall was founded to provide a safe online community. There is a proactive and robust clinical risk management structure in place to support our members to ensure that safety and anonymity are maintained within peer engagements. It is this anonymity within the online community that helps our members to share more about their distress, often for the first time, and removes the element of stigma from such disclosures.

BWW has two fundamental offerings available to students: a peer-to-peer support network and online one-on-one therapy sessions, known as live therapy. Our online and anonymous peer-to-peer support network is available for students to log on to and seek support 24-hours a day, while being professionally monitored. The community allows students to share their experiences and get help from people in all walks of life, who may be going through similar circumstances. Our live therapy service complements existing university counselling teams by providing online one-on-one therapy sessions via text, audio and secure video.

We now offer support to over half a million students throughout 50 universities across the country. Ninety per cent of our student members log in outside the working hours, highlighting their need for easily accessible, out-of-hours support.

We also know that the anonymity of our service is a key driver in helping students to overcome the stigma attached to mental ill health and open up about how they’re feeling: 67% of our student members use the wall to share an issue or feeling for the first time; and 90% of our student members cited anonymity as the main reason for choosing to share on the wall.

Our main goal is to ensure that we help our members on their journey towards feeling better using technology for good. Our survey data shows that we are successful in doing so: 77% of our student users felt better after using BWW and 67% claimed it improved their overall student experience.

Identifying those in crisis

We have a highly skilled and experienced clinical team sitting behind, and working with, the technology of our service. They implement risk management processes, if required, be it a student or otherwise. Our wall guides work 24-hours a day to moderate our online community and are on hand for extra support if any student needs it. They are trained clinicians whose primary responsibility is to ensure the safety of our members, whether that is making sure isolated members know they’re not alone, or being proactive in helping those in crisis seek further specialised or local support, such as Samaritans or their GP. In cases of imminent risk, the clinical team may contact emergency services.

BWW is there to complement university wellbeing services for students when other services may not be available to them, so they feel less alone with their struggles. Equally, online therapy may not be for everyone and sometimes the difficulties an individual might encounter are better treated face to face.

In these instances, university support services and NHS services should remain the first port of call. One of the biggest shortcomings of mental health services throughout the UK is access. In 2017, the Institute for Public Policy Research found that in some UK higher education institutions, one in four students were using or waiting to use support services. In such circumstances, online support can offer immediate access to resources, shared support and a sense of community for those suffering with poor mental health.

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