CYPE(6)-20-22 - Paper 6

Mind Cymru Initial Response

October 2022

“During my time at university I attempted to access support but was put on multiple waiting lists or offered one session. I think due to difficulties in accessing support many students feel like there’s no point seeking help as not much will change.”

“Same as with university services, the waiting lists are very long and not enough counsellors. Considering that adult services are for those over 18s, those NHS waiting lists are far lengthier than university ones since it is not just students trying to get help.”

We welcome the Children, Young People and Education Committee’s inquiry into mental health support in higher education as one of the growing issues areas for the sector. We know the sector are making every effort to support as many students as they can and work with the relevant NHS services.

Higher education institutions need to address a particular set of issues in order to meet the needs for their students, including:

 

We are aware that demand has been increasing for support with the number of UK applicants through UCAS declaring a mental health condition having risen by 450% in the last 10 years to 3.7% of all applicants[1]. Due to the nature of much of the data in the higher education sector being held privately by universities, there is little to be gleaned beyond service user testimony, such as those quoted above. For demand to be appropriately assessed a joined-up approach to data sharing is needed from the sector. UCAS regularly produce helpful admissions data, and perhaps a top-down approach in this model would greatly assist strategy development in this area.

Whilst anyone can experience poor mental health, we know that our mental health is affected by a range of different determinants, much like our physical health. Inequalities can impact on access to appropriate mental health support, and this must be recognised in the context of this inquiry. The pandemic highlighted how these inequalities fundamentally impact on the risk of experiencing poor mental health. There is a need for higher education institutions to consider in particular how support is provided to students who experience poverty, from Black and other ethnic minority communities (including international students), those with caring responsibilities and some course specific support for those undertaking certain degrees, such as medical students.

“I would love to see short training courses on mental health first aid to give students the confidence to open up and help others if needed. There is not much information and advice on supporting others, and many people do not have the confidence to approach a friend or start a conversation about mental health because they might not know what to say.”

 

In the 2019/20 academic year, Mind worked with a series of universities in England as part of our Mentally Healthy Universities programme with outcomes of:

 

 

To achieve this the programme we developed delivered six workshops/interventions:

 

 

Just under three-fifths of students (58%) and 73% of staff had personal experience of mental health problems. A third of students (33%) and over half of staff (53%) used or had previously used mental health services. The majority of students who engaged with the programme evaluation were UK/EU students (86%) who were female (73%), white (88%), aged 16-24 (77%).

The programme identified a range of recommendations both for Mind as a provider but also for government and higher education institutions themselves:

 

“I personally experienced so many difficulties accessing services and my antidepressant medication and I was not allowed to be registered at two GPs at once. I found whenever I went home I had to get my parents to post my medication which was expensive and I often missed many doses.”

 

The relationship between university based mental health support and that available in the wider community is critical in providing students with consistent support. If a student has a more severe and enduring mental health problem it is likely that their support would be placed within the Local Health Board delivery rather than within the university. Creating a seamless support between these services is key to the overall student mental health experience.

As the quote from one of the young people we spoke to testifies to, confusion between home services and those near university can lead to issues with things such as medication, which can have enormous wellbeing implications. Joined-up thinking and clear pathways, as well as easy-to-understand guidance can make all the difference.

 

Another recent graduate we spoke to recalled sign-up forms for a transfer to a GP surgery near their halls of residence being handed out in induction week, but with little follow up and not much understanding from the staff distributing the documents as to how the healthcare system would work as a student. 

 

It is not just an issue of getting a consultation, it is the quality and nature of the consultation itself that is often the issue. For some, going to see their GP could be a daunting experience. Mental health discussions can be a nerve-wracking, vulnerable experience for many. Where possible, students need to be given clear guidance as to what this step could involve, if it is the right one for them, and what they can expect from the university support services in tandem. There needs to be a no wrong door approach, with different professions communicating effectively.

 

“At university age, the transition to AMHS from CAMHS will be ongoing for anybody. Perhaps the additional transition of starting university would put added pressure here. The main issue I can think of is keeping in touch with their therapist if they already have someone and they are moving to a university away from home, they may not offer remote treatment. Also in regard to moving their GP maybe this would cause an issue if someone wants to stick with their therapist, but they're based in a different health board and so would have to stop seeing them. Breaking away from their home, family, friends, schoolteachers and then ALSO their therapist, could be incredibly difficult.”

 

We feel it is important to highlight the specific experiences of young people arriving at university having moved from CAMHS to adult services. Mind’s Sort the Switch report, published in May 2022, spoke to young people who had experienced the move to adult services and found that:

 

Many young people will be entering university at the age of 18, and some are likely to have experienced this transition. They may be feeling vulnerable and isolated from their familiar mental health support services, which is why it is so vital that, where suitable and possible, university services can communicate effectively with the NHS.

Even if young students enter adult services as their primary means of mental health support, clear information with universities along this journey can make all the difference. The warmer the relationship students can have with university support services from the first moment of their studies, the more likely they are to feel settled during their studies, and hopefully achieve their potential.

A rarely discussed issue for students is the transition from student support services to something suitable afterwards, whether with the NHS or otherwise. Some universities are known to offer recent graduates careers a limited few advice appointments after finishing their studies to help them into their futures, but a similar provision does not exist for mental health support.

There are several clear mitigating reasons for this, such as the demand for services already being high. However, there is need to ensure that there is ongoing support for a young person who may be moving away from the support mechanisms they have developed both in terms of services as well as socially. An end of studies may be a suitable time for some to cease their current mental health support, but for others it can trigger a series of issues, as graduation can be a daunting experience.

Solutions to this will require creativity and innovation, but it is a pressing issue that must not be overlooked if the higher education sector (and this inquiry) would like to evaluate the student mental health journey in full. Ideas may include:

 

At the heart of both of these transitional issues is the necessity for students to be listened to. At these sensitive times in their lives, they must feel that their needs are being taken seriously. This needs to be recognised at a Welsh Government and an institutional level with urgency.

Mind Cymru will be submitting more substantial written evidence to the Committee in due course.



[1] https://www.ucas.com/corporate/news-and-key-documents/news/450-increase-student-mental-health-declarations-over-last-decade-progress-still-needed-address