CYPE(6)-23-22 – Paper to note 8   

Responses from the Centre for Mental Health to the unasked questions at the meeting on 19 October

4. Interactions between healthcare and education providers

4.1 We have heard concerns that students do not understand the different roles that education and health providers have with regard to student mental health. How useful and realistic would it be to have a consistent threshold or guidelines on where the responsibility of healthcare providers begins with regard to mental health conditions?

This is a challenging issue: our mental health is on a spectrum which means for many people a period of poor mental health or low wellbeing precedes diagnosable mental ill health. Students should be able to access help before they reach that point. Creating thresholds risks limiting access to earlier support and adding more barriers to services. Ideally health care providers and universities would have arrangements in place to meet needs at each level and for all types of need without having to fall back on diagnostic or severity thresholds.

Some groups of young people face higher risks of mental health difficulties and poorer access to effective support. These include those with neurodiverse characteristics, these with learning disabilities, those with physical health conditions and those with caring responsibilities. Coordination between education, heath and other service providers to ensure seamless and integrated help is available is essential to meet their needs holistically.

4.2 What are the barriers to effective information sharing between education and health providers in terms of student mental health, and how could these be addressed?

4.3 What is your view of the suggestion to pilot an NHS student passport, to overcome difficulties with data sharing? Is this realistic? To what extent could such a pilot mitigate difficulties in continuity of care, particularly for students who frequently move between university and home addresses?

4.4 How could initiatives such as the Mental Health University Liaison Service (MHULS) in Cardiff provide a model for improved working between healthcare and education providers? Are there any limitations to that model, particularly with regard to non-campus-based and distance learners?

5. Challenges in accessing mental health services

5.1 [To Health Board representatives] How confident are you that primary and secondary care services in Wales are meeting the needs of the higher education student population? What more, if anything, could you be doing to deliver a comprehensive service to this population?

5.2 What is your view on the potential benefits of a transition service for young people aged 16 to 25, to serve as a bridge between CAMHS and adult mental health services? How could such a service be implemented, and are there other solutions that you would propose to support young people moving from CAMHS to adult mental health services?

There is evidence that the needs and preferences of young adults are distinctive enough to justify an age-specific service response. Rather than the oft-cited ‘0-25 CAMHS’ offer, a bespoke service for young adults would have the potential to meet their needs more effectively and acceptably than existing child or adult services are able to do. We do not yet have a fully-fledged system-level model to draw on but we know that elements of the YIACS (‘early support hub’) model would be important to that, combined with age-appropriate clinical services to meet more complex needs. Some NHS mental health trusts are now developing a distinctive service for 14-25 year-olds who require more specialist support, for example the Tavistock and Portman in London https://tavistockandportman.nhs.uk/care-and-treatment/our-clinical-services/adolescent-and-young-adult-service-ayas/.

5.3 What is your view on evidence from the NUS that the next iteration of the Welsh Government’s Together for Mental Health Delivery Plan should “have more of a focus on supporting students in higher education”? How do you think this could most usefully be incorporated?

5.4 Are there any other recommendations that you would make to Welsh Government to improve mental health support for students in higher education?