Mental health and mental illness are extremely sensitive issues that present enormous challenges at every level of society. One of the most extreme manifestations of the problem has been the growing trend of suicides. A World Health Organisation (WHO) publication ‘Preventing Suicide – A Global Imperative’ (2014) provides what it considers an underestimate of world suicides in 2012 of c 804,000. WHO Director-General Dr Tedros Adhanom Ghebreyesus stated that “Despite progress, one person still dies every 40 seconds from suicide.”
It is no surprise that this distressing phenomenon is reflected in the population of students in higher education. In the US, the Center for Collegiate Mental Health (CCMH) reports that 150,483 college students from 139 HEI’s sought mental health treatment in the 2015/16 academic year. This was a 50% increase on the previous year and generated over one million individual appointments. That same year a survey 621 HEIs by the Association for University and College Counseling Center Directors (AUCCCD) found that “… counselling centre staff spent an average of 65% providing direct clinical services, an increase over the 61% reported last year”. Active Minds, a non-profit organisation supporting mental health awareness and education for students, highlights on its website that “39% of students in college experience a significant mental health issue”.
The American Psychiatric Association (APA) looked at Mental Health service utilisation amongst US College students between 2007 and 2017 and found that the “… rate of treatment increased from 19% in 2007 to 34% by 2017, while the percentage of students with lifetime diagnoses increased from 22% to 36%.” It concluded that the “… the high rate of multiple stress exposures among the U.S. college population and the high impacts of stress on MH and suicidality point to an urgent need for service utilization strategies …”.
Similarly in the UK, student mental health issues and, in particular, student suicides, have had much greater prominence in recent years. Headlines such as “At least 95 students took their own lives in 2016-17” quoted in Suicide Safer Universities highlights the nature of the challenge facing HEIs. When considered alongside the five-fold increase in students disclosing a mental health condition between 2006/07 and 2015/16, we have an indication of the real scale of the challenge.
Much work has been done across the sector to address mental illness and mental health issues within the student population; with a particular focus on student (and staff) ‘wellbeing’. In its ‘Student mental wellbeing in higher education’ good practice guide, Universities UK (UUK) states that “Transition points in life can be particularly challenging: at the start of their courses, many students are likely to be adapting to significant changes in their lifestyle at a time when they are themselves adjusting to study.” The sector has approached the growing concerns around student mental health from both pastoral support and academic perspectives.
The Higher Education Academy (HEA – now Advance HE) provided helpful guidance in ‘Embedding mental wellbeing in the curriculum: maximising success in higher education’ that addressed embedding mental wellbeing in the curriculum and maximising student success. Whilst acknowledging the enormous challenges, the report looks at both curriculum content and curriculum processes. It provides helpful links to a wide range of resources, including discipline-specific resources and examples of innovative approaches adopted by some HEIs.
Unsurprisingly, student organisations have been very active in engaging with these sensitive issues too. ‘Look after your mate’ is an initiative by Student Minds which provides tips for students to enable them to respond to friends who may be displaying signs of distress or an inability to cope. It also provides guidance on how students can look after their own needs; especially when helping friends.
Traditionally, student support services have taken the lead in dealing with student mental health and wellbeing. In line with many sector-wide recommendations such as those in ‘Mental Health of Students in Higher Education’ by the Royal College of Psychiatrists, HEIs have strengthened their support services’ links with appropriate health professionals in the NHS; especially where students have presented with a history of mental illness at the point of registration.
However, one of the major difficulties facing HEIs is knowing when to act or intervene in such a sensitive area. In the UUK good practice guide, there is a heart-rending quote from James Murray, the father of a student who took his own life in May 2018, “We learned that mental distress can be very difficult to detect. Spotting outward signs of vulnerability that point to inner distress, is a challenge for staff, parents and the whole community.”.
The UUK/PAPYRUS publication ‘Suicide Safer Universities’ encourages HEIs, as part of their intervention strategy, to recognise signs and vulnerabilities through the use of “… alert systems to detect patterns of difficulty, such as not engaging with academic work, running into academic difficulties or dropping off the academic radar, not paying rent, fees or fines; disciplinary issues, not engaging with other students or staff”.
HEI intervention strategies can be developed to underpin student wellness or wellbeing by removing student data silos. This would help HEIs to cope with, not only the growth in the number of students disclosing a mental health condition but also with those students who have not disclosed such a condition and may be distressed. We can all see that there is a critical need for ‘joined-up’ thinking here and that, in turn, means a joined-up approach to data. This is where the SEAtS Student Success platform comes into its own. HEIs that have implemented the SEAtS Student Success solutions have, at their fingertips, real-time access to information on student engagement that is customised to meet their own specific requirements.
SEAtS enable HEIs to identify situations where there is a critical need for intervention based on their knowledge and understanding of their particular students. The fully integrated nature of the SEAtS solution’s powerful case management tool means that HEIs can share this critical information in real-time to enable the appropriate action to be taken. This could be via student services (such as Student Wellness/Wellbeing Centres), personal tutors or any other pastoral or academic support mechanism depending on the HEI’s preference. SEAtS is developing a student wellness/wellbeing scorecard that will enable HEIs to customise their intervention approach to meet the needs of their specific student population.
SEAtS Student Mobile App includes a single ‘button’ that students can use to indicate that they are in immediate need of help. The key point here is that critical conversations can be initiated by both staff and students at the earliest possible moment to maximise the likelihood of a successful outcome.
Philip Henry is a former U.K. University Registrar and Secretary with almost 40 years’ experience in higher education in the UK and overseas. He was an active member of the UK’s AHUA, ARC and AUA (a founding Executive Committee member) and AACRAO and ARUCC in North America. He is still engaged in the sector as a passionate advocate of initiatives to support student success and has submitted articles to AACRAO’s College and University quarterly journal on this subject.