Mental health of students in higher education

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Higher education contexton higher education. This chapter has provided only an outline of the mainissues.There has been a general increase in liaison between higher educationcounselling services, primary care health services and locality mentalhealth teams, although the extent and success of such partnerships hasbeen widely variable. There is a continued need to build bridges betweenhigher education and mental health services, at a locality level but alsowith commissioning bodies, primarily the primary care trusts in Englandand Wales and NHS boards in Scotland. Difficulties that preclude effectivepartnership working include different planning cycles, bureaucracy andthe relative size of the organisations involved. Plans for the creation ofspecialised student community mental health teams (CMHTs), optimisticallysuggested in the early part of this century, seem out of reach in the presenteconomic climate.Counselling in higher educationHistoryThe first university counselling service was established some 60 yearsago at the University of Leicester. Others followed and many services(and the Association for University and College Counselling (AUCC), www.aucc.uk.com) have now been in existence for more than 40 years. Nowalmost all universities have counselling services as do the vast majority ofhigher education colleges. The 2003 Royal College of Psychiatrists reportconcluded that university counselling services are, in effect, the primarymental healthcare option for many students and recommended that theyshould be resourced accordingly. Since the publication of that report, thoseservices have continued to be major providers of mental health servicesfor students in higher education. A recent HUCS survey (P. Hunt, personalcommunication, 2010) indicated that across the UK approximately 4% ofuniversity students are seen by counsellors each year for a wide range ofemotional and psychological difficulties.Since the mid-1990s, counsellors have been noticing an increase in theseverity of the difficulties students are presenting with. Their concerns ledto the publication of Degrees of Disturbance: The New Agenda (Rana et al,1999) and the hosting of a national conference, ‘Beautiful Minds? Students,Mental Health and the University’ in 2002 (www.beautifulminds.info). Afterthe success of this conference, HUCS (www.hucs.org) was responsible fortaking the lead in bringing together the different professional, governmentand student groups concerned with mental health in higher education; thisled to the establishment of the MWBHE in 2003.Work of university counselling servicesCounsellors working in higher education are distinguished by theirunderstanding of the connections between psychological and academicdifficulties, their knowledge of the educational context and their integrationwith the wider institution. They strive to be accessible and inclusive. It isusual for them to offer:consultation, risk assessment and referral when appropriatea range of therapeutic work to students and to staffRoyal College of Psychiatrists41
College Report CR166consultation to staff concerned about studentstraining (including suicide awareness) for students and staffworkshops for students and staffwritten materials to guide students and staff in their response tostudents in distressonline information about how to help with study and mental healthdifficultiescollaboration with others with responsibility for mental well-beingwithin their own organisationscontributions to institutional policy-making on mental health mattersliaison with local NHS providers.Many make considerable use of the opportunities afforded bye-technology by, for example, establishing online discussion boards orproviding online multimedia programmes such as CALM (Campaign AgainstLiving Miserably, www.thecalmzone.net). Services routinely evaluate theeffectiveness of their counselling; many use the Clinical Outcome in RoutineEvaluation (CORE) scale to track changes in clients during the course ofcounselling.Clinical workMost counselling is of individuals, although many services offer groupcounselling as well. Many services see staff as well as students. The mostcommon issues students bring to counsellors are depression, anxiety,problems in relationships, loss and worries about their academic progress(data from AUCC annual surveys, see www.aucc.uk.com/survey.php).Many of these concerns are similar to those of the general population;what is different is the way these difficulties can be triggered by academicrequirements and can interfere with the ability to study. Counsellors attendto the pressures on their clients caused by the demands of the student roleand the impact of the educational cycle. They are aware of the therapeuticpossibilities of harnessing work on the issues thrown up by the educationalcontext in order to promote development and maturation.A range of interventions are offered. An initial consultation will usuallyinclude risk assessment. Short-term work, perhaps in the form of brieffocal therapy, can help to deal with a personal crisis, adverse life event orcurrent conflict. Longer-term therapeutic work can focus on exploration ofmore complex developmental issues, and deeper-seated and long-standingemotional, psychological and mental health problems. Whereas a numberof services have staff appropriately trained and experienced to offerlonger-term, specialised help, few have the resources to offer open-endedpsychotherapy to all students who might benefit.The model of counselling offered by higher education services followsthe paradigm described by the Department of Health.‘Counselling is a systematic process which gives individuals theopportunity to explore, discover and clarify ways of living moreresourcefully, with a greater sense of well being. [It] may be concernedwith addressing and resolving specific problems, making decisions,coping with crises, working through conflict, or improving relationshipswith others.’ (Department of Health, 2001, p. 9)42 http://www.rcpsych.ac.uk
Page 1 and 2: Mental healthof studentsin higher e
Page 3 and 4: DisclaimerThis guidance (as updated
Page 5 and 6: Working groupPrincipal contributors
Page 7 and 8: AcronymsAMOSSHE, Association of Man
Page 9 and 10: College Report CR166Epidemiological
Page 11 and 12: College Report CR166Care pathwayThe
Page 13 and 14: College Report CR166Psychiatrists w
Page 15 and 16: College Report CR166Promotion of Me
Page 17 and 18: IntroductionThe purpose of this doc
Page 19 and 20: College Report CR166managing mental
Page 21 and 22: College Report CR166Students who ex
Page 23 and 24: College Report CR166Students must a
Page 25 and 26: College Report CR166of postgraduate
Page 27 and 28: College Report CR166alcohol use. Fo
Page 29 and 30: College Report CR166driving, unsafe
Page 31 and 32: College Report CR166the first, the
Page 33 and 34: College Report CR166ConclusionsWhen
Page 35 and 36: College Report CR166undergraduates
Page 37 and 38: College Report CR166and the Institu
Page 39 and 40: College Report CR166body. The EHRC
Page 41: College Report CR166and provision o
Page 46 and 47: Higher education contextConclusions
Page 48 and 49: Higher education contextMental heal
Page 50 and 51: Higher education contextHealthy Uni
Page 52 and 53: Higher education contextImproving h
Page 54 and 55: Pathways to psychiatric careIn coun
Page 56 and 57: Pathways to psychiatric careand is
Page 58 and 59: What to do if a psychiatric patient
Page 60 and 61: What to do if a psychiatric patient
Page 62 and 63: Mental health issues facedby intern
Page 64 and 65: Mental health issues faced by inter
Page 66 and 67: Medical and other healthcare studen
Page 68 and 69: ReferencesAdams, T. & Moore, M. (20
Page 70 and 71: ReferencesJumaian, A. (2001) Preval
Page 72 and 73: ReferencesSocial Exclusion Unit (20
Page 74 and 75: Appendix 1understanding of, student
Page 76 and 77: Appendix 2Internal liaison within h
Page 78 and 79: Appendix 3Different models of psych
Page 80 and 81: Appendix 3see this as a step forwar
Page 82 and 83: Appendix 4I have also been involved
Page 84 and 85: Appendix 5University general practi
Page 86 and 87: Appendix 6Initiatives from counsell
Page 88 and 89: Appendix 6The Westminster mentoring
Page 90 and 91: Appendix 6to the volunteer and then
Page 92 and 93:
Northampton Assessment CentreUniver
Page 94 and 95:
Appendix 8AimsThe aims of the MWBHE
Page 96 and 97:
Appendix 8Current projectsThe group
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