Cyflwynwyd yr ymateb hwn i ymchwiliad y Pwyllgor Plant, Pobl Ifanc ac Addysg i gymorth iechyd meddwl mewn addysg uwch

This response was submitted to the Children, Young People and Education Committee inquiry into Mental Health support in Higher Education

MHHE 25

Ymateb gan: Prifysgol Cymru

Response from: Universities Wales

Nodwch eich barn mewn perthynas â chylch gorchwyl yr ymchwiliad. | Record your views against the inquiry’s terms of reference.

About Universities Wales

Universities Wales represents the interests of universities in Wales and is a National Council of Universities UK. Universities Wales’ membership encompasses the Vice Chancellors of all the universities in Wales, and the Director of the Open University in Wales.
Our mission is to support a university education system which transforms lives through the work Welsh universities do with the people and places of Wales and the wider world.

Universities Wales welcomes the opportunity to respond to the Welsh Government’s draft innovation strategy. Some questions have been grouped for responses.

Universities Wales welcomes the opportunity to respond to the CYPE Committee’s consultation on mental health support in higher education.

1. Maint yr angen | Extent of need

Please note this consultation response should be read alongside Universities Wales’ joint policy recommendations on student mental health published in May 2022: Post-16_Mental_Health_Policy (uniswales.ac.uk)

General picture
Before the pandemic, universities were seeing increasing numbers of students arriving at university with a declared mental health condition. UCAS data suggests there was a 450% increase in the number of students declaring a mental health condition on their application between 2011-2021[1].

It is also understood that this will not be an accurate record of the number of students with a mental health condition, as some will opt not to declare it upon application. Anecdotally, universities are reporting an increase in the number of students presenting to student services in crisis.

There are a variety of challenges that students can experience when needing support for their mental health, which will be set out throughout this response in more detail. These include a lack of join-up between NHS services and education providers, the impact of geographic and educational transitions and the transition from CAMHS to adult mental health services.

Individual groups

As with the wider population, there are certain groups of students that will be more likely to experience mental health conditions such as LGBTQ+ students[2], black and minority ethnic students[3], and disabled students[4]. Universities recognise the need for student support services to be culturally competent and inclusive for students from all backgrounds.

Students studying different modes and levels will also have different experiences. For example, students studying part-time may experience different challenges to those undertaking a full-time course of study. They are more likely to be balancing work and possibly caring responsibilities for family members or children alongside their studies.

Similarly, UUK recently published guidance for institutions on specific support that might be needed in supporting students on placements including ensuring they are aware that they can continue to access central university support services, creating peer support networks and embedding wellbeing in pre-placement briefings, training and resources.

Impact on services

Much like the wider population, the pandemic had an impact on the mental health of students. Student Minds found that 74% of students reported the pandemic impacted on their mental health.^{^[5]} University support services (that weren’t already providing support online) moved online during the pandemic and innovative solutions were sought to continue supporting students in need.

Example: The Connect Project

The Connect project is a partnership between Swansea University, UWTSD, HEFCW and local FE colleges and their respective students’ unions. The project moved to providing peer support via Zoom and online courses as well as safe outdoor spaces to encourage socialising within the parameters of social distancing.

Example: Cardiff Metropolitan University

Cardiff Metropolitan University moved all services online, provided appointments via phone/MS Teams and adapted policies such as Mitigating Circumstances, joining-up with academic services. The student services team created a new resource bank directing students to self-help and provided dedicated mental health support to students needing to isolate, as well as practical support such as grocery deliveries.

2. Adnabod a darpariaeth | Identification and provision

Universal good mental health

All universities in Wales are signed up to the UUK Stepchange framework which advocates for a ‘whole university approach’ to mental health.

The whole university approach recognises the effect of culture and environment, and specific inequalities, on mental health and wellbeing; seeks to transform the university into a healthy setting; and empowers students and staff to take responsibility for their own wellbeing.

Early identification

Any student that declares a mental health condition on their UCAS application will be identified to university student services in order to provide support when they arrive. Institutions may also contact students pre-enrolment to get support in place from day 1.

Attendance data can also be a useful tool to identify students potentially at risk who have stopped engaging with their learning. For example, institutions will monitor attendance and have a mechanism for reaching out to students whose engagement changes. One institution reports that when they reach out to students who have stopped engaging, around a third of those students disclose a previously undeclared mental health conidition.

To quote a director of student services at a Welsh university, ‘the more information we have, the more support we can offer.’ Students also have the opportunity to reach out to student services at any time during their university experience.

It is, however, worth bearing in mind that not all students will apply for higher education via UCAS.

Example: Cardiff University

Student Intervention is part of Cardiff University’s tiered student support model. It is loosely based on Behavioural Intervention approaches common in North American higher education. It is a multi-disciplinary professional team with a two-fold role: firstly managing and de-escalating risky or in-crisis student presentations to the University; secondly working with colleagues across the University, especially staff in academic departments, to help them understand how to respond to someone in crisis in an appropriate way and refer those cases on.

Example: Aberystwyth University

Aberystwyth University offers its students the opportunity to enhance and develop their skills in managing mental health and well-being. Students have access to 24/7 online support platforms with chat, assessments and module options, links to NHS and other evidenced based online courses and information. The university also provides practitioner-led quick video guides and more comprehensive training sessions which students can book onto to improve their own knowledge to help themselves and others.

HE and NHS collaboration

One of the most significant challenges to providing mental health support for students is caused by a lack of join-up between health and education providers. It is technically possible, for example, for a student to receive support in A&E for a mental health crisis, and be discharged without notifying the university. There is also currently no specific mechanism for identifying that a patient is a student when admitted to NHS care.

Example: South East Wales NHS Partnership – University of South Wales, Cardiff University, Cardiff Metropolitan University, NHS

The South East Wales NHS/HE partnership has piloted a successful Mental Health University Liaison Service which has served to join-up provision and encourage referral between university and health settings as appropriate.

Within the first six months of the service’s operation, over 200 mentally unwell students have been supported into appropriate NHS mental health care.

This partnership model could be translated across health boards delivering NHS mental health care online or on campus, depending on the local context. Additional funding would be required to roll-out the model across Wales.

Example: Wrexham Glyndŵr University

Social prescribing is a HEFCW-funded pilot project where students self-refer themselves into community support through a special website run by social prescribing firm, Elementals. Students can also be referred to services via chaplains, year heads, counsellors and housing, funding, and inclusion officers. The project aims to transform the way Wrexham Glyndŵr University works in partnership to promote and deliver well-being for students, based on best practice from other successful social prescribing projects.

Specific issues

Data sharing presents a challenge for providing mental health support for students. As already identified, the MHULS has served to plug the gap in data sharing between universities and health services. Without this join-up, students can struggle to access the support to which they are entitled.

Students are a largely transient population, with many living near campus during term time and travelling home during holidays. Around 50% of students in Wales are not Welsh-domiciled, and so their GP is not registered with the Welsh NHS, and those that are Welsh-domiciled may have moved to the other end of the country to study. Students are actively encouraged to register with a local GP, which ‘unlocks’ access to wider NHS services such as mental health support. However students with a pre-existing mental health condition may find themselves back at the start of a diagnostic journey, or having to re-tell their story to a new GP as data is not shared between GPs across clusters or between the English and Welsh NHS.

GP Passports could be explored as a mechanism for minimising the impact of students’ transitions from home to university for months at a time during the course of their higher education journey. The IPPR report ‘Not by Degrees’ recommended the development of a digital Student Health Passport to aid GP registration.

The transition from CAMHS to adult mental health services occurs around the same time that a ‘traditional’ student may be starting university and moving away from home for the first time. This cliff-edge in their support network can create a vacuum of support compared to a safety net that was in place a few months previously. Exploring a transitional services for 16-25 year olds could mitigate against this cliff-edge in support.

In 2009, the National Assembly for Wales’ Health, Wellbeing and Local Government Committee recommended the establishment of a mental health service for ages 17-25, which the Welsh Government at the time accepted in principle: ELL(2)-14-05(p1) (senedd.wales)

Example: University Ready

University Ready is a collaboration between Wales’ universities and partners, which has been curated by the Open University in Wales, to provide an online hub for prospective students going to university for the first time. It offers a range of resources from universities themselves to provide young people going to university with a better understanding of what they can expect, linking to mental health support resources and a range of other support services.

Example: Bangor University

In order to support students entering higher education at Bangor University, an online module ‘Be Bangor Ready’ was created to provide a full induction throughout the course of a student’s first year.

The module includes ‘find your people’, ‘know your campus’, ‘get to know your Students’ Union’ and so on to increase confidence of first years before arriving on campus. This academic year, the module has been accessed by over 1000 students.

3. Polisïau, deddfwriaeth a chyllid Llywodraeth Cymru | Welsh Government policy, legislation and funding

Dedicated in-year HEFCW funding aimed at student wellbeing has been helpful over the last few years. However, short-term funding uplifts are not a sustainable means of enhancing student mental health support within higher education longer-term, particularly when many effective mental health support measures involve some form of in-person interaction requiring contracted employees.

Universities Wales would like to see longer-term, sustainable funding used to facilitate partnership with the NHS as appropriate to different contexts across post-16 education, with sufficient flexibility for educational institutions to use funding as they see fit.

The new Commission on Tertiary Education and Research can help to define and ensure a widely held understanding across stakeholders of the roles and remits of education and health providers when it comes to mental health support across post-16 education. CTER could work to develop links between the NHS and education providers to facilitate data sharing and improving transitions.

Universities Wales would recommend Welsh Government’s refreshed Together for Mental Health Strategy refers to students as a specific group with particular needs and addresses the need for collaboration across health and education to meet those needs.

4. Argymhellion ar gyfer newid | Recommendations for change

In May 2022, Universities Wales published a set of recommendations for Welsh Government’s consideration: Post-16_Mental_Health_Policy (uniswales.ac.uk)This work was developed in partnership with NUS Wales, Colleges Wales and AMOSSHE.

The recommendations include:

- Welsh Government update and provide clear guidance on information sharing between health services and education institutions in relation to mental health issues for post-16 settings, addressing misconceptions around GDPR and data protection legislation

- Welsh Government to coordinate work bringing services together to produce guidance detailing accountability of services and where responsibility lies – health services, police, educational institutions, placement providers; this may involve modifying referral pathways or better defining the relationships between different bodies and institutions, especially where individuals present in crisis

- Welsh Government to address how best to improve the relationship between CAMHS and adult services with specific consideration given to age boundaries for people under 25 and a possible specific service for 16-25s.

- Continued funding through Renew and Reform for projects supporting transitions including University Ready and equivalents in FE, including adult learning.

- Embed longer-term funding for mental health and wellbeing across post-16 education

Further to these recommendations, Universities Wales would suggest Welsh Government consider appointing a Specialist Policy Adviser on Student Mental Health and Wellbeing to direct the important work being developed in this area.

5. Arall | Other