Are Schools' and Universities' Mental Health Services Adequate?
“Put mental health at the heart of a good education” says a report by the
Centre for Mental Health (1)
For several years now, governments in various corners of the UK have been gradually recognising the influence on young people’s mental health of schools/ universities–for better or worse. And it is worth noting, too, that they have a duty of care in common law to their students – both educationally and pastorally, to protect their students’ health, safety and welfare.
The importance of this issue has gathered momentum, especially in the past decade, not least because numerous research papers have shown that good mental wellbeing is interwoven with good academic achievement and life opportunities.
The purpose of this article is to consider the adequacy of school/university mental health support services from a variety of perspectives. We shall focus on universities and secondary schools though not primary schools - there is not the scope here to discuss their provision as well. However, the importance of such services in primary schools needs acknowledging.
Unfortunately, we need to start from the premise that – for the foreseeable future – there’s unlikely to be adequate funding for the requisite support to correspond with growing need. We’ll explore what’s typically on offer, as well as look at simple and effective strategies that are inexpensive, if not free.
Provision and mode of delivery depends on the type of school/university and the overall needs and culture of the establishment. Whilst we often hear about under-funding, a well-funded service doesn’t necessarily equate to an adequate service. The institutions’ ethos and attitudes towards mental health comes from “the top” and can be impactful - this might take various forms but, essentially, staff need support to support students. Student mental health support services are more than therapy rooms, counselling teams, and appointment-booking systems!
So, why is mental health support so important in schools/universities? In these settings, students can address barriers to learning and receive support that can facilitate achievement in school/university and ultimately in life. They are also places where early intervention strategies can be implemented in non-stigmatizing and safe environments: the adage, “prevention is better than cure” feels apposite.
First, some definitions of Mental Health
The definition is broad, ranging from diagnosed mental health illnesses to positive mental wellbeing. Depending on how it’s defined and measured, the rates of students reporting mental unwellness vary enormously.
Mental health conditions are clinically diagnosable. They may be more or less acute, and treatment pathways depend on the condition.
Mental ill health is a broader term describing mental distress that may not necessarily be related to a diagnosable mental health condition.
Wellbeing: broader still, relating to people’s thoughts and feelings about their own quality of life. It refers to psychological, emotional, and social wellbeing. It’s subject to ebb and flow and over time and can be affected by myriad factors. The state of wellbeing affects how people manage stress, relate to others/themselves, and navigate life.
When young people are resourced to look after their mental wellbeing and develop coping skills, it can help boost self-esteem, resilience, and confidence, as well as help with self-regulation, feeling calm and engaging with their education. This can, consequently, improve academic success.
What are we dealing with?
From countless research and anecdotal evidence, we’re seeing a mental health crisis in schools/universities which might be viewed as a consequence of poor understanding on the matter. We’re also seeing a dearth of resources to mitigate it. Most school/university staff who are frequently hands-on with students, don’t have formal mental health training.
Young people’s increasing awareness of the importance of good mental health, the reduction in stigma and the year-on-year rise in students seeking support, have all added pressure on schools/universities’ services and on their staff, with counselling/allied services reporting longer waiting times.
Even students with good mental health face challenges that can affect their wellbeing, and schools/universities need to have robust enough systems and initiatives in place to support students through such times. But the startling statistics below, relating to schools, makes for disturbing reading; is this the tip of the iceberg?
In June 2021 MIND, the UK’s mental health charity, published the report “Not Making the Grade: why our approach to mental health at secondary school is failing young people” (2) which examines secondary schools’ approaches to student mental health. In it, David Stephenson, Senior Policy/Campaigns Officer says:
“The prioritisation of academic achievement cannot be at the expense of
mental wellbeing. As a young person struggling with your mental health,
learning and taking part in school life can be a significant challenge. What
you want is for someone to listen to you, try to understand what is happening
and help you get the support you need. Our inquiry has found that this isn’t happening” (2)
The study, that included a sample of 2,870 young people; caregivers of young people affected by mental health issues; associated professionals and staff, worryingly found that:
96% of young people reported that their mental health had affected their schoolwork at some point.
68% reported being absent from school due to their mental health.
62% of young people received no support from school for their mental health.
48% of young people were disciplined at school for behaviour that related to mental health issues.
25% of staff were aware of a student being excluded from school because of their mental health.
17% of young men with mental health issues had been excluded (7% of young women)
Unsurprisingly, the report calls for the reframing of schools’ responses to students’ behavioural issues. Presently, students find their mental health difficulties treated as bad behaviour, rather than being given the necessary support to address them.
The big picture: so what are schools/universities doing to mitigate?
The vastness of this topic is a given (for there are 4,000+ secondary schools and 130 public universities in the UK!) so a broad-brush approach is used here, in order to examine what multi-layered support typically looks like:
Many schools/universities collaborate with external organisations (including the NHS) to access or deliver support. These tend to offer broad support and expertise with mental health specialisms, and/or local knowledge and networks. Joining up with external organisations increases capacity, helping institutions expand services, clarify referral pathways, and increase response times. Additional there are usually policies in place for emergencies such as a student/staff death within the school/university community.
Early intervention support: Some key examples of early interventions for mental health needs (often focused on vulnerable students) include training to recognise declining mental health, making appropriate onward referrals, monitoring attendance/performance; identifying potential students at risk including key points when students could be most vulnerable; focus on suicide prevention and encouraging a culture where mental health is discussed.
Targeted support: Face-to-face or online counselling/Cognitive Behavioural Therapy (CBT) as well as signposting to well-recognised and effective online tools and apps found on platforms such as Kooth, and Togetherall.
Wellbeing: Typically, wellbeing support initiatives that can underpin student wellbeing, so perceived as preventative, might include for example: workshops on mindfulness, resilience-building, complementary therapies, anxiety, loneliness, stress-management, awareness-raising campaigns, peer support, and online self-help resources. Support focusses on helping students deal with life’s challenges, recognising unhealthy behaviours and promoting a healthy lifestyle.
As seen in this article, mental ill-health is a longstanding concern for schools/universities, and their students. Institutions seem to be working on steps to maintain wellbeing and to offer support when mental health issues emerge. Onsite counselling and wellbeing support have been features for years and some exciting initiatives are being fostered, encouraging good mental health to be the norm.
As mentioned earlier, schools/Universities are trying to link in with local NHS services aiming for better integration with primary care. In some institutions, students have campaigned to improve support for mental health and wellbeing including shorter waiting times, as well as, in the case of universities, long-established volunteer-led services like Nightline (student-run listening service)
When money’s too tight to mention:
In a report (3) commissioned by the Department of Education (DofE) the following was noted:
96% of universities reported that resources to support student mental health had increased over the past five years. Similarly, resources to support student wellbeing had increased for 86% of universities. But, despite many support services having access to increased resources, they may still struggle to fully meet the demand for support. The picture is likely to be similar in schools.
So given the reported funding shortages, could schools/universities be trying to further promote an integrated school/university approach, ensuring that the mental health of students (and staff) is embedded in their culture, attitudes, and ethos? Essentially, making schools/universities more supportive, inclusive, and kinder environments incurs little financial cost!
This feels very much like work-in-progress, and that drum needs constant beating. Above all, remembering that mental health support should never be viewed as extracurricular in these settings is paramount.
And some sobering thoughts to conclude with – whilst referring to universities, they’re equally relevant to schools:
“Higher education has the potential to change lives and set students up for the future by providing a solid foundation to build upon in terms of knowledge, skills and networks. However, there are a number of factors hindering universities to fulfil these promises and lack of support for student mental health and wellbeing is one of them. Growing pressures on students need to be taken into account and transforming the student experience needs to be a joint effort from universities, government and employers” (4)
WC 1581
References
3) https://www.employmentstudies.co.uk/system/files/resources/files/Survey_of_HE_Providers_Student_Mental_Health.pdf June 2021
(DofE)
Written by Jennifer Pitt
Jennifer Pitt is a counsellor/psychotherapist accredited by the British Association of Counselling & Psychotherapy (BACP). Until March 2020, she worked for 17 years in secondary school settings, managing a team of school counsellors as well as delivering counselling sessions to students. Now in practicing privately, 50% of her current caseload comprises school/university students from various parts of the UK, who are unable to access the requisite support from their places of learning, to fully address their mental health needs.
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