“I think that the transition in becoming an adult is becoming all the more intense” Amy Wells says to me, the Welfare Officer at Leeds University Union (LUU), as we discuss over the phone about what she sees as the various issues behind the rise in student mental health issues across the UK.
We talk at length for just under an hour about the services provided for students at the University of Leeds struggling with their mental health issues, trends we are seeing both close to home and on a national scale, as well as a discussion of her assessment of the political scene on the issue.
For students in particular, Wells describes the situation as they come to University as a “perfect storm” with pressures from social media, cyberbullying, finding employment, education achievements, relationships and drug use all contributing to the figures that show more and more students are struggling with mental health issues.
Moving to a new city can be an intimidating time too for many students who will be leaving home for the first time, finding a completely new circle of friends while also adjusting to new styles of teaching that differ vastly from what many Freshers experienced in school or college.
Student mental health cases have risen over the past decade, in part Wells stressed thanks to a positive erosion in stigma around mental health issues. We have seen national discussions taking place around mental health issues more broadly, a new post of a minister for Mental Health was created and £1 million was pledged by the government to go towards supporting students who are struggling.
At the University of Leeds, demand has seen a significant increase of 115% since 2010 of the number of students requesting help from the University’s counselling services. While student populations in Leeds have undoubtedly grown during this time, proportionally this is still a significant increase with one in ten students seeking help in 2019 compared to one in twenty in 2010. Counselling services in particular have seen an increase of 4.4% among University of Leeds students.
Funding for the service increased in the academic year 2018-19 by £300,000 in 2019 though that same year there was a 23% in the number of requests for both the University’s counselling service as well as the Mental Health team.
Funding has been unable to keep up with demand that has continued to increase year-on-year. With coronavirus putting Universities under more financial pressure than ever before with little hope of a government bailout, what avenues are left for Universities to tackle the problem?
In order to get to the bottom of the situation at the University of Leeds, I spoke to Welfare Officer Amy Wells, Assistant Head of Student Support: Student Counselling & Wellbeing Jane Harris, and interviewed over 170 students through a survey as well as information obtained from the University through Freedom of Information requests.
What is behind the rise in student mental health issues?
In a survey of 172 students conducted by The Gryphon, 84.2% of students who struggled with their mental health issues said that one of the main reasons was pressures they placed on themselves. Over 50% of those surveyed also pointed to isolation, workload and pre-existing mental health conditions as reasons.
Statistics show that the number of students struggling with mental health issues has increased over the past ten years. On a national scale, 1 in 4 students said they had a mental health problem and 6 in 10 said they experienced mental health issues according to a YouGov survey conducted in 2016.
In January 2018, 94% of Universities across the UK reported an increase in counselling demand according to statistics revealed in a Freedom of Information request.
Looking closer to home at the University of Leeds, there has been a dramatic rise over the past decade in the number of counselling and mental health requests. In 2010-11, a total of 1764 students requested help from the Counselling, wellbeing and mental health services. This rose by 115% over the next ten years to 3797 requests with the largest increase being the latest figures for 2018-19 with a rise of 23%. That year saw an increase of 26% in counselling requests alone.
The most recent academic year was also highly disruptive with two periods of strike action by UCU and the coronavirus epidemic. I asked Harris whether she had seen an increase this year. She told me “we have not seen an increase this year, but the previous two years saw 30% increases annually”.
The number of students has certainly increased since 2010 with the student population going from 31,811 to 36810 in 2018-19 and will account for some increase in the number of requests to student counselling.
However with more than 2000 additional students requesting help from the counselling services in 2018-19, the proportion of students requesting the service has increased too. 10.31% of the student population requested help from counselling services in 2019, almost double the figure for 2010 where 5.6% of the student population requested help.
While this rise in numbers will undoubtedly be in part due to the removal of social stigma around mental health discussion allowing more people to come forward, Wells also argues there has been an increase in distress earlier in life, in part due to the rise of social media and the pressures it creates for students when it comes to adolescent success.
I also asked Jane Harris, Assistant Head of Student Support, at the University of Leeds, as someone with extensive experience in the area to hear her thoughts on the issues at hand. Harris pointed to national statistics that show rises in the number of cases of mental health related issues across people of all ages though she also added “we still don’t know if there are a greater number of people experiencing mental health difficulties”.
She pointed to statistics that showed rises across the UK across all age-groups though rises in the number of students seeking help at Leeds was still vastly higher during this period. The number of 16-24 year-olds who have suffered from any common mental health disorder (i.e. anxiety, depression, panic attacks or phobias) only increased by 1.4% between 2007 and 2014.
However Harris says “more people are feeling able to speak about this and seek support” and therefore while actual increases in mental health issues could be small, services are witnessing significantly a higher increase in demand as a result of more people coming forward.
As for why students are coming forward, Harris believes “socio-political-economic factors are key”. Similar to Wells, she points to a competitive employment market, insecure employment contracts, and escalating living costs as contributors to students’ reasons to feel anxious or depressed. Both pointed to student debt and living on subsistence income to cover basic living costs as contributors too.
Harris says that this is further exacerbated by the “public arena” caused by social media that leads to students feeling like “they are constantly being evaluated”.
“I’ve been working as a therapist in HE for well over ten years and I’ve seen a shift in the last few years of students saying they’re not able to tell friends/housemates how they are feeling. It seems there is a massive pressure to be excellent in everything with little room to get anything wrong or make mistakes”
Jane Harris, Assistant Head of Student Support
Who is trying to access these services?
Studies have also shown that particular groups of students are more likely to suffer from mental health issues at Universities. The YouGov poll showed that twice as many LGBTQ+ students said they suffered from a mental health problem compared to heterosexual students. An Office for Students report stated that Black students with mental health conditions in particular were being failed by the University system due to large gaps in grade awarding and non-continuation.
This could potentially be linked to higher drop-out rates for these same groups. Statistics published earlier this year showed that BAME (Black, Asian and Minority Ethnic), LGBTQ+, and disabled students were more likely to drop out at the University of Leeds.
The statistics showed non-continuation rates for Black and Asian students were 9.6% and 10.4% compared to 5.4% of White students in the same period. LGBTQ+ and disabled students also showed higher non-continuation rates than their non-LGBT and non-disabled peers. In 2018/19, 7.6% of LGBTQ+ students beginning their courses in September 2017 dropped out, compared to 6.2% of their non-LGBTQ+ peers. The University does not have figures for those who identify as transgender specifically.
Disabled students also experienced non-continuation rates of 8.2% during the same period, compared to 5.9% of students who did not declare a disability.
A University of Leeds spokesperson said:
“Like with many other universities, we are working hard to improve our student non-continuation rates, and are using a strategic and evidence-based approach. It is a complex picture affected by many different factors. Enabling all students to succeed at Leeds is something that everyone who works here is committed to, and our Access and Participation Plan, approved by the Office for Students, sets out our strategic approach.”
Speaking to Harris, she said “I feel we’re living in both more progressive times in many ways, yet prejudice and discrimination continue” and for those who are LGBT+, BAME or members of other liberation groups, this appears to have a direct link with increased mental health issues in these groups.
Mental health also seems to be related to class issues. Harris pointed towards a Guardian article that showed young women from financially poorer grounds in particular are five times more likely to self-harm. Harris said there were parallels between the University of Oxford, where she previously worked, and Leeds. She said that students from privileged backgrounds face pressure from “strong family traditions of attending University and entering certain professions”. This contributes, she argues, to “a tremendous pressure to excel academically” and feeling that “only a 1st class degree is a success”.
On the other end of the scale, Harris points to social isolation due to class as a contributor to mental health issues amongst students from working class or less privileged backgrounds. Harris argues these students may feel “very out of place and judged by others”
A report by UUK also found that the number of students dropping out of their courses for mental health reasons has trebled in recent years. The University of Leeds does not have data on the proportion of students who dropped out of university due to mental health reasons. Instead, this would likely fall under the very broad categories of either ‘Health Reasons’ or ‘Other Personal Reasons’.
It is worth noting that, while it is very important to understand the factors that influence non-continuation, the University of Leeds must be mindful of the privacy of students. Some students may not wish to declare more detailed personal information if they drop out of University. Students who choose not to continue after their first year can self-declare the reason, but it might not be appropriate for the University to insist on obtaining this information.
However this still raises the question that without more specific data – how can the University address the key issues that lead to students struggling with mental health issues dropping out?
Statistics released by the Higher Education Statistics Agency in 2017 revealed that, between the 2009-10 and 2014-15 academic periods, there was a 210% increase in students leaving their course early due to poor mental health.
Statistics from the University of Leeds show that certain groups of students are being seen by the service far more than others. First and second years made up a majority of clients with a total of 65.4% with first year students making up 36.3% of all clients.
This was supported by findings in the survey where 60.7% said that they had struggled earlier in their degree. Many people cited the adjustment of moving into halls of residence, finding new friends, and adjusting to life in Leeds as reasons for this. One student said “I felt isolated without the support system I had at home”.
Undergraduates made up 77.8% of clients with those who had just left school making up 70.3%. However compared to the University student population where 89% of students are classified as School leavers (17-20 years old), it appears that older students are in fact attending the service at a higher rate compared to the makeup of the student population.
4 out of 5 clients were from the UK and women and men made up 70% and 28% respectively. For minority groups, BAME students attended the service at a slightly higher rate than White students. 72% of students at the University of Leeds are White but only 70.4% of students who attended sessions with a known ethnicity were classified as White.
One positive statistic that could be extrapolated from the data was that 78.7% of those who used the service had never received mental health support previously and were able to receive support for the first time through the University. More recently this figure for those who used the University’s online referral form, 88% this year had not approached any other professional support service about their difficulty.
What services are provided in Leeds?
A variety of services are provided to students by the University of Leeds. There is pastoral support offered by personal tutors, support and wellbeing posts in schools as well as peer mentor schemes set up in faculties such as the Faculty of Medicine and Health.
There is the Counselling and Wellbeing service with both drop-in and scheduled appointments. There are also group sessions provided through the service run in partnership with LUU. The University also has a mental health team of advisors. This service is for students who have been diagnosed with a serious mental health condition by an NHS Secondary Care Psychiatrist. This service is also accessed through self-referral. Funding for the mental health team has significantly increased in recent years from £38,378.84 in 2011 to £183,794.15 in 2018. The latest figures are integrated with the Counselling service as budgets became fully aligned.
Due to coronavirus, all sessions are now currently held online through Zoom or telephone for students who do not have access to reliable internet in a private place.
The University also provides support through the Plus Programme and Lifelong Learning Centre.
Students studying in Leeds are also allowed to access support services through the NHS and local mental health charities. In 2017-18, the University began a new partnership with Big White Wall, an “online service providing access to millions with anxiety, depression and other common mental health issues”. The service provides 24/7 online peer and professional support, with trained counsellors totally anonymous. According to the University website, more than three quarters of members feel better as a result of using the service and nearly 90% use Big White Wall outside of 9-5pm.
Figures for 2018-19 show that there were 1742 new registrations to Big White Wall.
Harris, Assistant Head of Student Support, believes that there are protective factors in place in Leeds from the “excellent source of support” provided by the LUU drop-in as well as a single campus that ensures students are less spread out than at other Universities in the country.
I ask Harris about how the service is organised and how the service has managed to handle the huge increase in demand. She tells me
“There are two key principles to how we organise the service. The first is that every student who contacts us for support will be seen at least once for an individual face to face appointment of 30 minutes or more.
The second is that we assess all requests daily and prioritise accordingly – what many students are not aware of is that any student who is flagged as being at risk in any way (risk of self-injury or suicide, risk of deteriorating mental health, risk of leaving University) or who has experienced a recent trauma (such as being a victim of crime or assault) will be offered a priority appointment within 72 hours.”
This service can be counselling, wellbeing or with a mental health advisor.
She goes on to tell me that at peak times “up to 50% of our appointments are ‘same day’ or ‘priority access’” and says “this ensures that where a student has a priority need they will be seen. However she acknowledges that this additional service “does contribute to longer waiting times for other students”.
Once students accessed the counselling support available, many said that they had had positive experiences with the service. One student told us their experience was “excellent” and added that they are “still in contact with my counsellor now during COVID via fortnightly Zoom calls” and the quality of the counselling was brilliant”.
Are students able to access the support system if they need it?
A study conducted by NUS found that 8 in 10 students had experienced mental health issues in 2017 with over half of these students not seeking support. NUS cited that most of these students gave “lack of knowledge about where to go and nervousness about the support they would receive” as reasons for this.
Many students in a survey conducted by The Gryphon talked about issues they’ve found accessing the University’s mental health support services. 41.8% of students said a barrier to them accessing the service was not wanting to put more pressure on services and 61.4% said that they felt their issues weren’t severe enough, and 42.2% felt they wouldn’t be seen fast enough to help. 35.5% said that they felt support wasn’t for people like them.
Harris believes that there has been a substantial increase in anxiety and panic as main presenting issues to counselling and wellbeing services and worries that narratives of a “student mental health crisis” in national media contribute to students not wanting to access support.
However Wells believes that media coverage can often be helpful in reminding students they are not alone and showing that “things aren’t great” with the way services are provided. She did acknowledge though that coverage of student suicides can lead to clusters (subsequent similar cases) if details were included in reporting that would trigger vulnerable students.
For many students, their first contact if they were struggling with their studies is their personal tutor. However in many of the responses we had from students, many said they found approaching their personal tutor “intimidating” as they hadn’t built up a relationship with them even if the help they received after contacting their personal tutor was beneficial.
One student in the survey told us that they “found it stressful as we were never introduced to our pastoral support officer”. However once she was able to approach the support officer, she said that they were “helpful”.
Some students heavily praised the support that they received. One student said the Business School had done an excellent job with supporting them and “signposted all the services available across campus”. Others said that they were offered time at home and away from studies. Others said they were offered help with applying for mitigating circumstances and counselling services offered to make tutors aware of the student’s issues in future academic years. One student pointed out how her “course supervisors helped [them] get [their] workload under control”.
Others also said personal tutors had been helpful in getting deadlines extended.
However overall students gave a mixed response in their experience with the personal tutor/supervisor support system. Some students highlighted that the support they received was limited. Whilst some said that some tutors’ level of understanding “showed that they cared”, they felt the support didn’t tend to go any further than that.
Many students appear to not access the support provided by personal tutors at all. 47.4% of students surveyed said that they had never sought help from their personal tutor and many of those who had told of negative experiences with the service. Figures obtained through Freedom of Information requests showed that only 8% of students were referred to counselling services by a supervisor or academic tutor.
A University of Leeds spokesperson said:
“We recognise the value of academic support for students and a review of personal tutoring is underway. All academic staff, including personal tutors, are trained to signpost students to support services. We have a robust procedure if students are dissatisfied with any aspect of their experience.”
The University of Leeds did not respond to whether they will formally review the personal tutor system.
Access to support seems to be an issue wider than just the personal tutor system. One mature student, a single mother and in her mid-50s, who spoke to me said that she doesn’t “feel part of the student community”.
From her experience she found “there is nobody to turn to in my experience as I can’t get to the University to access any help” and that she sometimes doesn’t receive any “replies to emails”. The student wasn’t based on or near campus and until recently, the University’s counselling services and personal tutor support were based on campus until moving online due to coronavirus.
The student said that the experience had left her “feeling frustrated and isolated” and she “can’t find out how to access”. She cited one incident where a relative had been diagnosed with cancer and alleged that proof of the relative’s diagnosis had been asked as a requirement for any extension to be granted.
When asked about whether she felt the University was there to support her, she replied no.
Other students also cited negative experiences with the system. One student claimed their tutor told her “medicine is a demanding course and if I was anxious, I just was not cut out for it.
Another student said they were unable to access counselling support due to incompatibility with her University timetable.
Another student said that she was first passed onto the support officer in her school and then directed onto the University’s counselling services. She described the experience as “almost like just constantly being redirected to someone else and didn’t have anyone checking in with me”. She went to say that even after she told the support officer she wanted to drop out and had been absent from her studies for a month, no tutor checked that she was alright.
The student also cited one instance where the tutor asked her about her mental health issues “in front of my seminar group” and as a result, she was “too embarrassed to go back”.
The student said that ever “since then I’ve been worried that a tutor would do the same” and therefore had not accessed the service.
Wells said access was an issue for many students, She believes the website should be clearer with information more clearly displayed about “what each service provides so people know where to go”. Wells argued that as a result of less clear signposting, “students feel like they’re being passed around between services”. 27.7% of students surveyed said that they didn’t know how to apply or what support services were available
However Harris argued that 91% of students who accessed the counselling service strongly agreed or agreed that online registration was easy to use according to their data. When I asked her about the differences in responses between the survey conducted by The Gryphon and the University’s own data, Harris acknowledged that was an “issue of maintaining high visibility for the service relates” and that students are often overloaded with information. Therefore students might not remember where to access services as it wasn’t important information at the time of reading the email.
Harris added that they promote the service in all University promotional/marketing materials and arrival guides. It is also included in all student inductions (UG/PGT/PGR) including specialist inductions such as Feeling at Home in Leeds (International Student Office) and Doctoral College.
One issue Harris points out is that students might not remember where to access services if it is not relevant to them at the time and said “it would be interesting to hear from students how they would like the information to be available – in case we are missing something here”.
One solution Wells suggested would help improve access to services is “improving peer support between schools” and allowing students to get information about services from fellow students rather than the University. Some Faculties already have strong peer support systems in place. For example students in the School of Medicine have “families” where students are supported by older students on the same course who are called “parents” with “siblings” who are students in the same academic year. One student told us friends of theirs had found this system helped them.
Wells also believes more should be done by the University to emphasise diversity within its mental health support teams. A slight majority of students from LGBT+, BAME, working class and disabled backgrounds said that they would benefit from a more diversified counselling team in the survey conducted by the Gryphon.
Wells pointed to work done at other Universities to appoint specialised roles to support minority group students, for example at York, and argues that matching between students and staff with similar experiences should be done as much as possible. Wells said negative experiences students have had with counselling to back this up. For example, she mentioned an incident where a student struggled to disclose their struggles as it related to a different religious and ethnic background to that of the counselor.
I asked Harris about what steps she was taking to address this issue. She said that she has worked with HR to ensure “our job adverts encourage as diverse an applicant pool as possible” and pointed to a recruitment evening held in January this year to encourage applications from across Leeds. Over 70 mental health professionals attended this event, many of whom Harris said that “they would not have considered working at the University, but having been on campus and met our team they would now”.
She acknowledged that diversity within her team was “something I’m acutely aware of and am seeking to address”.
How has the University responded financially and was it enough?
In 2018, in response to an article published by The Gryphon, the University of Leeds said in a statement:
“Working with LUU, we have increased investment in the student counselling and wellbeing service in 2017-18, adding new roles, such as wellbeing practitioners, and new services, such as the Big White Wall, which can be accessed at any time”.
However statistics show that funding for that year had only increased by £2193 in real terms compared to the academic year 2009-10.
While significant funding was put into the service in 2018-19 with an increase from £677,737.81 the previous year to £978,900, this is only an increase of 35.3% in real terms compared to 2010. At the same time, requests for services have increased by 115%.
The University of Leeds did not respond to why funding has not kept up with demand.
A worrying number of students don’t seem to be accessing services too. Between 2014-15 and 2017-18, the increase in the total number of students attending services from individual counselling, drop-ins and workshops was 470. However in that same time, requests for counselling services were three times that.
In 2014/15, 2090 students requested help from counselling services and 2070 students attended the service. Just three years later though, 2797 students requested help from counselling services but only 2540 were seen. This was before the increase of 26% the following year where requests rose to 3525.
Data for 2018-19 was not provided in a Freedom of Information request earlier this year but counselling funding that year did increase by just over £300,000.
The University of Leeds did not comment on whether it ensured every student who made Counselling and Wellbeing requests were seen.
The number of requests for the mental health team, for more severe cases, has largely stayed the same with 242 requests in 2011 compared to 272 in 2019 though there were significant increases in 2012 and 2014.
In 2017, an NUS report showed that only 23% of students with a pre-existing condition said they trusted their University to provide support needed and this could potentially explain how the number of mental health team requests has largely stayed the same while counselling requests have increased by 2000 over the same period if large numbers of students with pre-existing conditions are not accessing that support.
Wells also believes that the University’s policy of providing only four counselling sessions is not enough for many students. She tells me “I think the whole reducing waiting lists – it’s such a big issue at Leeds” and point to the issue’s recurrence in Welfare officer manifesto campaigns. Wells said that this was evidence that it is “clearly a longstanding issue at the University” though went on to say that the waitlist in Leeds is indeed far lower than at many Universities.
The University of Leeds currently provides four sessions to students. This is lower than the Higher Education sector average which is six. Other Universities such as Southampton, Newcastle and East Anglia offer 6. Wells believes that this does need to be addressed as “we see a lot of students signing back up for another four sessions because six just isn’t enough” and that some students may feel even worse after they struggle to open up in such a short time frame.
However Wells did acknowledge that the University is currently dealing with a “huge increase in demand”.
A University of Leeds spokesperson said:
“We offer a standard of four rather than six sessions so that more students can be seen. Two further appointments can be booked if both parties agree it would be useful.”
However as consensus from students shows from those surveyed, many of those who want an additional two sessions don’t seem to be receiving that support.
Asking Harris where she thinks services have been able to improve in recent years, she argued the University of Leeds “have invested considerably in Counselling, Wellbeing and Mental Health services in recent years and diversified and increased our support offer considerably”. She pointed to the introduction of Wellbeing Practitioners, increased counselling and mental health advisor numbers, increased our groups and workshops provision, commissioned Big White Wall, and movement to online provision on Zoom last summer as examples of this.
Harris also said that the SCW@LUU Daily Drop-in introduced this year as a really positive step as it provided students with same day sessions in an accessible and well-known location and said that they’ve “received very positive feedback about this from students and staff”.
Several Universities in recent years have taken steps to better support students and tackle the issues surrounding student mental health. One mature student said that she felt the support provided at other Universities, where her children attended, was far superior to her own personal experience in Leeds. She praised the support provided by both the University of Huddersfield and the University of East Anglia (UEA). She was particularly positive about Bradford saying:
“Bradford is just wonderful and I know they help my son and again I don’t need to know the details but feel like a burden has been lifted from me, knowing they are always there for him. I am glad he is graduating but in a way wish he didn’t have to leave their care and support”
One University mentioned above, the University of East Anglia, has taken significant steps over the past year to change how it supports students.
The University of East Anglia has introduced an opt-in policy for the University to contact a parent or guardian if they were concerned for a students’ wellbeing. A survey done by Higher Education Policy said that 81% of students said they wouldn’t mind if a parent or guardian was contacted.
The University of Leeds has no formalised opt-in policy on informing parents or guardians though the topic is brought up to students receiving help.
The University of East Anglia has also promised to spend £1.4 million on mental health support for students from August 2019 and launched a formal review of the role of academic advisers as well as an external peer review of UEA student support services. The Vice-Chancellor David Richardson also brought in a mental health task force in March 2019 after there were three student deaths at UEA in ten months.
The promised £1.4 million roughly equates to 0.4% of UEA expenditure according to their latest annual report. The latest figures for the money directed to mental health services at the University of Leeds, £978,900, was 0.12%.
The promised spending at UEA is the equivalent to £82.98 per student. At the University of Leeds, this figure is £26.59.
The University of Leeds did not respond to whether it will invest more money in counselling services in the future.
The changes brought about at the University of East Anglia was in part due to a campaign led by Concrete, the student newspaper there. The campaign began in September and received the support of several MPs, comedian Stephen Fry, Gina Miller, the University’s vice-chancellor and the mother of a student who died by suicide.
Is a growing funding crisis in the NHS leading to students falling through the cracks?
Wells tells me she believes that the University does have a basic duty of care to students that includes issues such as mental health though she added Higher Education institutions are not required to provide specialist or clinical care. Wells says that that responsibility is up to the NHS.
Harris echoes similar viewpoints in my conversation with her. Harris says that she disagrees with positions taken up by government ministers that the expectation should be for Universities to provide the care. She tells me:
“I would be interested in discussing this further and would like to see some push back on the position taken by recent Ministers who have stated repeatedly that Universities ‘should be doing more’ in relation to student mental health – I’m confused by what is meant by this as I can’t believe Universities are expected to become treatment providers in relation to mental illness – our primary tasks are education and research, not healthcare!”
Students also echoed this saying Universities should provide education services rather than healthcare for students.
However, both Wells and Harris’ comments hint at a larger issue at play that exacerbates the situation for many University mental health services up and down the country – an issue of NHS funding.
With trends in data showing cases of mental health conditions rising across the country, more pressure has been placed on NHS services and local services that provide support in that area.
According to analysis by the Health Foundation and IFS, if the NHS in England increased the proportion of people with mental health conditions it treats from around 40%—which is roughly what it treats at present—to 70% by 2033/34 then spending would need to more than double to around £27 billion. Funding has only increased for mental health provision 3.4% each year annually.
Services across the country have seen spending cuts and this has had a knock-on effect, particular for young adults who have seen the money provided for early intervention allocation drop by 55%. This was reported by the Institute for Public Policy Research:
“Mental ill-health accounts for 23% of NHS activity, but spending on secondary mental health services is equivalent to just half that proportion (NHS England 2016).”
“Significant cuts to community-based services over recent years have reduced opportunities for early intervention, which could have resulted in more young adults’ experiencing deteriorating mental health. For example, the value of the early intervention allocation to local authorities fell by 55% between 2010/11 and 2015/16, from around £3.2 billion to £1.4 billion per year.”
According to Amy Wells, mental health accounts for one third of all appointments at Leeds Student Medical Practice. Other local services are also seeing huge strains. This pressure on services is the top challenge to providing students with good mental health support from her perspective.
Leeds NHS IAPT that provides a psychological therapy service now has a 5-8 month wait for Step 3 CBT/Counselling and 2 months wait for Step 2 CBT. CBT stands for Cognitive Behavioural Therapy. Market Place that provides counselling for young people is open to referrals but there is up to three months wait for individual counselling.
Four other services in Leeds are closed to any new referrals until further notice: Leeds Women’s Counselling and Therapy Service, Leeds Mind, and Leeds Personality Disorder service programme ‘Journey’, and Support after Rape and Sexuality Violence.
Leeds Mind when referrals are open have an average waiting time of three months when open. Journey is due to reopen referrals this year after it closed in February 2019. Support after Rape and Sexuality Violence has a waiting time of over a year when it is open
With many services “NHS, third sector, voluntary services on their knees” as Amy puts it, Universities across the country, unable to provide a clinical service themselves, are bearing the brunt as they signpost students to services with months long waiting lists.
This presents a problem for the University of Leeds. If they can only provide four sessions for a student per semester and waiting list times extend far beyond that, this leaves some students unable to access support while they wait.
Speaking to Harris about this issue, she tells me “in relation to students or PGRs waiting to access specialist mental health treatments (such as eating disorder services, psychological therapies) then our service offers considerable support while waiting, through our Mental Health Advisor team.
However she acknowledges that the service isn’t “able to offer treatment, which can be frustrating”. She then went on to argue “there’s a direct parallel with students who may have to wait months to see a hospital consultant for a physical health problem” and that the University’s response to this situation is “to consider and offer reasonable adjustments for long term conditions, offer support to study, and if necessary consider a period of temporary leave if necessary”.
Nevertheless the responses from some students illustrates how not every student is supported as they wait for clinical support. One student told us “I needed a lot more help, I was on a waiting list with the NHS for a year, in that time I had the four sessions of counselling but that was it when I really needed help”. Another student said “NHS waiting lists are huge, often pushing students to go private if they can afford it or not be seen at all
Looking towards the future, Harris feels “the most important next step is ongoing coordination with NHS services to improve access and waiting times for students where at all possible”.
Is there a lack of political will to help students?
I asked both Wells and Harris about the position the University of Leeds is in when it comes to its contacts at Westminster and how it could use these to lobby local and national government to support Universities more in tackling increases in demand.
Two of its alumni, Alex Sobel MP and Jess Phillips MP, serve in the Shadow Cabinet and another, Keir Starmer MP, is now Leader of the Opposition and Labour Party.
When students were surveyed on the issue, they were very clear on what direction they wanted the University to take. Just under 94% of those surveyed said they thought Universities should lobby the government and Parliamentary groups to tackle student mental health issues.
Amy Wells tells me too that she thinks the University should do more to campaign on the issue, particularly when it is unable to provide support for periods longer than four sessions, and make NHS services more accessible to students.
Then the topic of conversation shifts to local MPs and Wells’ thoughts on their response to the issue of student mental health issues. Fabian Hamilton, Alex Sobel, Hilary Benn, and Rachel Reeves all have large student populations in their constituencies representing Leeds North East, North West, Central and West. As someone who works on the frontlines of student politics, I wanted to hear why Wells had to say.
Asking her whether she thought local representatives are engaging enough with the issue, her immediate reply was blunt.
“No”.
Wells then followed up to say that she thinks “I absolutely don’t think they are doing enough”. She said she was disappointed when she met both Sobel and Benn at Westminster earlier this year and challenged them on their record. She said that they gave “very vague responses” and that “they didn’t even admit that the issue was bigger than them”.
She goes onto say:
“You’re a member of Parliament. You need to be raising the issue at every opportunity. You need to be writing to the All-party Parliamentary group on Mental Health, you need to be drawing it to the attention of Commissioners and the relevant Cabinet positions. In my eyes, you’re not doing enough if you’re not using your position to highlight those disgusting stats about waiting times because it is literally killing people. I’ve been very disappointed in our political representatives this year”.
I don’t know what the breaking point is going to be”
Amy Wells, Welfare Officer at Leeds University Union
MP for Leeds North East, Fabian Hamilton, tabled a motion in Parliament in April 2019 after a constituent approached the MP and demanded that “mental health services can be given the priority and the resources they need in order to ensure a healthier and better society for us all”. Hamilton also said at the time that he had “requested this debate with some reluctance” due to the fact he “did not want to believe that mental health services in my city—a city that I have lived in for 40 years and which I have been privileged to represent for the past 22 years—were so appalling”
Hamilton has since raised the issue with members of the Labour frontbench and is intending to ask questions to relevant government ministers on these issues at a later date.
Another student mental health campaigner Catherine Reader cited a positive experience discussing the issue with Hilary Benn. In December at Leeds Student Radio and Television’s elections debate, Reader posed a question to the candidates for Leeds Central constituency citing the ways that she had struggled to access services.
She told me “what really struck me was that the only candidate to look me in the eye, apologise for my experiences and talk to me was Hilary Benn”. Afterwards, she said she approached him and “asked if I could talk to him about my experiences and he was so friendly”.
She told me that “he patiently listened and asked me at the end if there was any practical way he could help”. She added:
“I think it is so important politicians listen to individuals. He sent me an email a few days later saying what a pleasure it was to meet me and expressing his support for the campaign work I was doing.”
Reader also posed a similar question later on in the year to Sir Keir Starmer as he campaigned in the Labour leadership contest. Reader told me she was impressed with his response that included a “thorough understanding of how mental health impacts so many different aspects of society which I liked”.
However Catherine’s experience has been less positive with other national politicians. Earlier this year she met Health Secretary Matt Hancock and told him she felt mental health care in the NHS was really inadequate. She said that throughout the conversation “he was trying to get away from me”. When she did eventually meet Hancock, she said that
“He didn’t seem to want to hear what I was telling him. It felt like he didn’t care about the experiences of myself and others in the mental healthcare system”
When I asked Wells what she thought local representatives should do to better campaign on the issue, she told me several things.
She told me she thinks that they should “pass the concerns raised by the elected representatives (the Leeds University Union Executive) of nearly 40,000 students onto the right people in Parliament”.
She said they should be writing to the Minister for Mental Health, Nadine Dorries to raise the issue and they should be calling for an emergency meeting for the all-party group on mental health and students. She said they should be taking to commissioners in local areas to put more funding into mental health.
Looking to the future, what can the University of Leeds do to improve services?
In my discussion with Harris, I ask her about what action the University should take when it comes to campaigning on the issue of student mental health.
Harris said she certainly believes “Universities should create and facilitate positive, supportive learning communities and environments that foster and encourage personal, intellectual and professional development. She says she prefers to “speak about ‘whole locality’ or ‘whole city’ approaches to mental health, a position that recognises support and treatment for poor mental health crosses domains, and cannot be expected to sit solely with educational institutions.”
As for what work the University is currently doing in the city to work with the City Council and local NHS trusts to better provide services for students, Harris tells me that she currently sits on the Leeds Mental Health Partnership Board and chairs the Leeds Student Health and Wellbeing Partnership Board. Harris recently succeeded in establishing a sub-group to work on mental health provision for students in the city due to resume this summer after it was delayed due to coronavirus.
Wells believes that nevertheless the University should work more with councils, local authorities and clinical commissioning groups so that they can address the issues seen in data where students are receiving bad care, dropping out of the system, or unable to access support. She also thinks that the University needs to do more within Universities UK (UUK) in order to galvanise support.
She believes that by working more with local politicians and authoritative groups, Leeds will be able to help more students as they access services outside of those provided by the University itself.
Wells also believes the University should sign up to the Student Minds Mental Health Charter. She recently submitted a Union forum policy proposal to advocate the University sign up to the charter that passed.
With regards to what needs to be done to improve the personal tutor system, Wells said in a statement earlier this year:
Amy Wells, LUU Welfare Officer
I ask Harris whether she has seen positive signs over the past few years and what this suggests for the future of mental health provision at the University of Leeds. Harris says that the Student Minds University Mental Health Charter is a really positive step and she believes there is “a clear commitment to student support in the area of mental health” from University leadership.
She also adds that the continued good relationship between the Counselling services and the Student Exec has allowed to see some positive changes including new drop-in services and training “over 500 staff as First Responders in relation to disclosures of sexual assault”.
At the end of the day, what do students want to see happen on the ground?
For Wells, she believes that one of the biggest barriers is physical rather than logistical. Services on campus are currently based at different locations rather than one centralised building. Wells goes on to talk about how the University has been really receptive on this issue and showed that it is willing to put plans into place. However as a result of a potential coronavirus-related loss in income, any potential plans might be put on hold.
As for the students surveyed by The Gryphon, here were some of the comments that students provided as ways to improve the service.
One student called for the erosion of stigma around drug use. They told us “it’s not all abuse!!! This is not relevant nor is it a problem unless someone seeks specific help for it!”.
Another student asked for services to be better advertised and welcoming. They asked the University “make drop-in services a bit better advertised and more welcoming. They added “I was recommended to go by a friend, but I think otherwise I might not have been brave enough as it did not feel particularly welcoming at first”. Some students also think online resources can be improved.
Communication seemed to be a key issue. Some students felt there should be more communication between Counselling services and students about how to transfer the help they receive into completing “your studies whilst dealing with our issues”. Other students felt there should be better communication between schools and counselling services – both to ensure Schools understand the issues a student is currently facing but also to prevent students “slipping through the cracks”.
Some students felt better communication between NHS services and the University services was vital with one student even suggesting that they “would have felt better supported if there was someone at the university who could have helped me during the application process for NHS counselling”.
Other students said that some students should not be forced to attend counselling citing instances where counselling attendance was a requirement to continue their degree and that the service should only accept referrals from students themselves as tutors can muddy the waters. The University however argues that at all stages engagement with the service is voluntary. Other students also said that academic staff should be educated more on “what not to say”.
Throughout the answers given, many students said they saw more staff, more funding, and reduced waiting times as key ways to improve the service. These issues came up in dozens of the responses provided. Other students, from minority backgrounds to those suffering from more complex issues such as eating disorders, felt that more specialized care should be given.
A spokesperson from the University of Leeds said:
“The mental health and wellbeing of students is extremely important to us and we actively promote positive wellbeing through the many opportunities for students across campus, including the student-led clubs and societies in LUU. Our support for students is embedded across the University – including through schools and faculties, Leeds University Union, the Lifelong Learning Centre, the Plus Programme and Residential Services – as well as in the city, including the Student Medical Practice.“
“Like every university, we know there is always more to do, and against a backdrop of a national increase in demand for university counselling services, we have increased investment and staff numbers and diversified our support to ensure students can access help whenever they need it. This includes online support and, during lockdown, a range of appointments via telephone and Zoom. When on campus, evening appointments are available for those who can’t attend in the day.”
The road ahead will be tough as Universities face restricted funding in the wake of reduced income due to coronavirus. Serious action needs to be taken to address the issues caused by increased demand, a lack of funding, and ensuring students can access the services that are available. Support provided by personal tutors is in need of review. Nevertheless, there are positive signs when it comes to the provision of mental health services for students at the University of Leeds with increased cooperation with councils and local NHS, in addition to a broadening of the services.
However the message from students is clear. They want to see change.
If you or anyone you know has been affected by the issues addressed in this article, counselling and wellbeing support from the University of Leeds can be found here and the Help and Support team is available at Leeds University Union.
An earlier version of this article suggested that MP for Leeds North East Fabian Hamilton had not adequately raised the issue of student mental health in Parliament. This has since been updated.