Emerging trends in student mental health

Content note: This episode contains discussion of sensitive topics including suicide. If you need support with the topics discussed in this episode, there are organisations such as Mind (0300 123 3393), Samaritans (116 123) or Student Minds that can help you in complete confidence. 

More and more students are seeking support for their mental health, and in response, we’ve seen a whole host of new initiatives to better meet that need. The creation of a Higher Education Student Support Champion. The Higher Education Mental Health Implementation Taskforce. A suite of guidance on suicide-safer universities. An innovative scheme in which Manchester’s universities collaborate with the NHS to improve student mental health outcomes. 

But what are these initiatives, where have they come from and what do student accommodation teams need to know? We’re getting into it in this month’s episode of Accommodation Matters. 

Our expert guests aren’t just talking about the work that’s happening to support student mental health – they’re leading the work themselves. Hosted by Jenny Shaw, this month’s panel includes: 

• Professor Edward Peck, Vice Chancellor at Nottingham Trent University and the Government’s Higher Education Student Support Champion for England 
• Professor Jo Smith OBE, Emeritus Professor in Early Intervention and Psychosis at University of Worcester 
• Dr Simon Merrywest, Director for the Student Experience at University of Manchester 

You can listen to the episode, or read the transcript, below.

Disclaimer: The views and opinions expressed in this podcast are the personal views of individual guest speakers and do not necessarily reflect the views of Unite Students and/or Unite Group plc. 

Episode transcript: ‘Emerging trends in student mental health’

Jenny: Over the last 12 years, I’ve seen student mental health go from being almost invisible to being a dominant theme in student accommodation. And just over the last few years, we’ve seen the ongoing impacts of the pandemic combining with an underlying upward trend in mental ill-health among young people. So how do we ensure that higher education, including student accommodation, is fully equipped to meet these rapidly growing needs? 

Welcome to Accommodation Matters, where each month we look at important and emerging issues affecting student accommodation and the wider student experience. I’m Jenny Shaw, and today I’m asking what’s new in student mental health. And this is a question I’ve asked a lot over the years, but it’s always relevant because it is such a fast moving issue as we’ve heard. 

So today we’re going to be looking at some new and emerging work in the sector, and as always, we have an expert panel to guide us through it. Professor Edward Peck is the Vice Chancellor of Nottingham Trent University, and he’s also the government’s Higher Education Student Support Champion. Hello, Edward. 

Professor Edward Peck: Hello, Jenny. Nice to join you on this podcast. 

Jenny: And we have a second professor, Jo Smith, who is Emeritus Professor in Early Intervention and Psychosis at the University of Worcester. Hi Jo. 

Professor Jo Smith: Hi. 

Jenny: And we have Dr. Simon Merrywest, Director for the Student Experience at the University of Manchester. Hi Simon. 

Dr Simon Merrywest: Hello. 

Jenny: Well, I must say I feel distinctly underqualified in such company, but absolutely delighted to have you on the show and looking forward to the conversation. 

So Edward, if we can start with you. You’ve been the Higher Education Student Support Champion since 2022. What did the minister [Michelle Donelan MP] say when she first appointed you? 

Edward: I think she wanted a Vice Chancellor who could give a counterpoint to the focus on regulation around universities and act as a catalyst I think to start conversations, develop interventions and share good practise around student support, in particular because this is her personal interest and was very much part of the original press release around mental health and student support. So I think that was her motivation. 

Jenny: And of course we have, well, we’ve had two new ministers since then. Have the priorities changed over that time or has there been a good consensus over that period of time as to what the priorities are? 

Edward: I’ve worked with three Ministers of State since Michelle Donelan and there’s been a real consistency actually of what they asked me to do and how they asked me to do it. And it’s been a very productive and constructive working relationship I’ve had with particularly Robert Halfon who was the longest standing minister. Of course now we have Luke Hall who’s just arrived, but he again, I think is very supportive of the direction of travel that Robert established and we’re carrying on down that route. 

Jenny: So you have a background both in the NHS and in higher education now as a Vice Chancellor, how has this dual background influenced the work that you do? 

Edward: Yeah, so I got involved in mental health services when I left university. I was a graduate trainee in the NHS largely for family reasons. And I found myself running a national organisation called the Centre for Mental Health Services Development, which is about creating community mental health services and closing the old Victorian asylums. And after a while I wanted to leave that behind. So I moved on and started doing research more broadly and then joined the University of Birmingham. 

So for me, it’s returning to old territory, actually, going back into mental health. These are still the people I’ve been working with over the last 12 months on the taskforce of people I knew 30, 35 years ago in the mental health world. So it’s great to reconnect with them. Things have really moved on, particularly in psychiatry and the settings for mental health support in the last 20, 25 years. But I still know some of the people, I know some of the challenges, I know some of the concept. So it does feel like it’s home turf to some extent. 

Jenny: In what way has it changed? 

Edward: I think the way in which service users, now called Experts by Experience, are front and centre of the way in which both services and individual care packages are designed is a massive shift from when I was involved in mental health services. Although I would make a small claim to fame that we established the first ever patients’ council in an English psychiatric hospital back in 1986, now we introduced the first independent advocacy group into the same hospital of the same year. So I think even there we were breaking ground around service user voice that actually now is manifest in the Experts by Experience programme. 

Jenny: And I know that involving students in the work has been a big feature of what you do. What have you learned from talking to be bereaved parents? 

Edward: I think it’s given me a different perspective on the way in which universities are viewed by some of our key stakeholders and the way in which therefore we can improve both what we do and the way that we present what we do to a whole range of interests in society, in this case bereaved parents. And it’s really shaped my conversations with colleagues at NTU about why we’re doing what we’re doing. 

We’ve really committed significantly in NTU to the rewriting of our policies and procedures to make them more student sensitive because I just heard some of the examples were given by parents, which were very distressing and very compelling. And I think it’s always incumbent for all of us to listen to people who have experiences of what we do and to learn what we can from them and take them extremely seriously. 

Jenny: I’m always really struck by the breadth of the role and I know that one of your early pieces of work was to publish a data sharing framework for universities and private PBSA providers. What made you focus on that area? 

Edward: Because the UK had already put out one that was about trusted contacts and universities, which was very clear that you should have a trusted contact when you enrol students and that in certain circumstances you could use that trusted contact without the agreement of the student concerned. So I was very keen that we had a similar set of understandings and protocols for information sharing between universities and accommodation providers. 

Accommodation is a major part of all students’ lives, particularly perhaps in their early years with universities. And that we also got across that that information could be shared when is the student’s best interest without their explicit agreement. And I think it was really important that we created that formality of channel across universities and accommodation providers for that purpose. 

Jenny: And I remember you talking about this that I think it might’ve been the Joint Codes Conference, very much welcomed within the room. So it is great to see that going forward. And since last July you’ve been chairing the Higher Education Mental Health Implementation Task Force. So for those who maybe don’t know what this is, what is it and what does it do? 

Edward: So it’s a response to some concerns, particularly articulated by families who’ve lost a student relative to suicide about areas where they think universities could be much more responsive in the sort of support they offer. And I think many of us in the sector think that’s the case. We’ve made real progress, but there’s still a way to go. I’d pick out three areas of focus for colleagues in the housing sector. 

The first is identification of students who might be at risk and over the summer, and Jenny, you know this better than anybody, we’ll be publishing a competency framework and accommodation providers could use that to benchmark their own awareness training for their colleagues. We’re working on student commitment, which is aimed at getting universities and indeed accommodation providers to reflect on their policies, procedures, and communications to make sure they’re as compassionate to students both generically and in individual circumstances as they could be. 

And thirdly, perhaps, the NHS higher education relationship. I know that often accommodation providers are the people to whom students return. Perhaps they’re discharged from psychiatric settings. So a more formal relationship, more of a case management relationship between universities and their accommodation providers and the NHS, I think, would make a much smoother and more consultative process with a clear framework of who’s responsible for doing what. So that’s a piece of work we’re working on with NHS England at the moment. 

Jenny: Very important. And I should say that CUBO is already involved in the work that we’re doing on the competency framework, so we’ve got high hopes for that. So I know that one of the other priorities is the wider rollout of the University Mental Health Charter and I think we are expecting to see all universities across England being involved in that over the coming year. What’s that going to look like? What might that mean for accommodation? 

Edward: So it means that all universities are eligible to meet the ministerial target need to have signed up by September. And we’re pretty close to that and Student Minds are reflecting on any issues that have been fed back to them about why some institutions may not yet have signed up. But the sign-up means you enter a process of development to join some roundtables and the community practise to develop and, I think, further your understanding of what the Charter’s about and what you need to do to pass. 

And in the following probably be three or four years, all of those institutions will go into the award process, will submit a self-assessment and we’ll have a visit with Student Minds who then will give a level of award, a full award or award with some conditions or areas for improvement that the provider and their other accommodation, in this case, partners could look at. 

Bearing in mind that there are several principles of good practise for accommodation – there six, actually, in the Charter – and they covered things like safe environments, meeting students’ psychological needs, building community, offering support to students specifically in mental health challenges, making sure accommodation staff are trained to recognise the support for students’ mental illness. And also maybe offering support for students who are living with a peer who’s experienced significant mental illness. 

They’re the six areas of good practise I think accommodation providers can expect particularly to be engaged in by their universities as they prepare for that awards process. The other thing just to bear in mind if you’re an accommodation provider is the review of suicides that are taking place by the National Confidential Inquiry led by a very respected psychiatrist, a world expert in suicide called Professor Louis Appleby. And he’s going to be doing a national review of the content of all suicide reviews being undertaken by universities. 

That’ll be based on your UK guidance and of course accommodation providers in many cases – not all, but in many cases will have a key role in thinking about what happened to that individual when they’re in accommodation, what lessons can be learned, what was good practise, what went really well. And then they’ll be looked at nationally and Louis and his team, will draw some messages both of what’s going really well, but also what we need to make more progress on as a sector, including the accommodation sector in thinking about what we can learn from those previous tragic events. 

Jenny: Thank you. And of course the same goes for accommodation teams in universities as well. 

Jo and Simon, we’ve been working together on the Restricting Access to Means guidance alongside David Malpas and Theo Cernow-Cooke. So we’re going to get into the details shortly, but first I’m really keen to hear more about your background. So Jo, you spent the first part of your career as a practising clinical psychologist, and later you combined this with teaching and contributing to national initiatives on early intervention. So I’d be really interested to hear your reflections on your career to date and especially what brought you into the field of suicide prevention. 

Jo: Okay. I actually feel when you look backwards on your career, it feels quite logical and probably there’s some synergy and synthesis of what can appear two disparate lines. So I worked in the NHS for 34 years. I was a clinical psychologist, but I always worked in severe mental illness. So people with schizophrenia, bipolar disorder was my specialism. 

But I realised I needed to move upstream to where these issues had their onset in order to be maximally effective. And so over 30 years ago I moved into early intervention, lobbied government and established one of the first Early Intervention in Psychosis services in the UK, and the Early Intervention in Psychosis services targeted young people aged 14 to 35 years. So for over half of my career I was working with young people, but young people with severe mental illness and I felt I wanted to spend more time in academia. 

So I finished in the NHS after 34 years, moved into academia and within six months of moving to University of Worcester, I was invited by the Vice Chancellor to meet with two families who were connected. 

One husband was the Deputy Lieutenant of the county, the High Sheriff of Worcestershire, and his ex-wife was there, Claire Milford Haven, who set up James’ Place in Liverpool, London and I think now there’s a third place for young people. Their son James had died by suicide at Newcastle University. They obviously got into a conversation with my Vice Chancellor about what Worcester were doing. 

And I went into this room really not knowing what the conversation was going to be about, but in fact I realised there were overlaps some of the work with young people with psychosis and they’ve got a very high risk of suicide for every 10 young people that I saw. One in 10 was at risk of dying by suicide in five years and through early intervention and psychosis services, by getting in early, we were able to drive suicide rates down from 10-15% down to below 1% internationally. In a way that experience set me up for thinking about the potential for early intervention in student suicide. 

I established a project, a Suicide-safer project when I was first presenting nationally, I did get some criticism from people asking either whether Worcester had a problem with student suicide and then others say it’s such a low incidence phenomena. And that had parallels with psychosis because I remember those same comments about “Why set up specific services for early intervention in psychosis,” and “Psychosis is a low incidence phenomena.” 

So I was able to argue the same as I did for psychosis. It’s low incidence but it’s high cost, it’s high cost obviously for the young people who lose their lives, for families, for peers, for staff, for the institution, very high cost. And so in a way I was able to merge the two. Through that initial family meeting, I was invited down to the Alliance of Suicide Charities and met with seven of the families who all had lost a son or daughter by suicide at university. And I think it shifted then from an academic interest into an emotive one. 

I’ve been in this field now for 11 years, but actually for the last five years unpaid. But I’m motivated because I felt that there were the things that could be done particularly around early intervention to prevent student suicide. 

Jenny: Incredibly important and pioneering work. And you were awarded an OBE I think for the work you’ve done? 

Jo: Yes, I was. It was for the student suicide prevention work, which made me smile because I’ve actually been working for 30 years in early intervention. I’m still a National Clinical Advisor for Early Intervention in Psychosis. So I did smile that my second career interest led to an OBE. 

Jenny: And I think that the work you’ve done and the results that you have got, particularly with that group of young people with psychosis, I think gives us some hope because it was a successful intervention and the results speak for themselves. So I think it is always good to have a sense of hope. 

Jo: It’s the most successful intervention internationally, Jenny, and it’s been rolled out now, not just in first world countries, but middle and low income countries now are all following that model because of its success. 

Jenny: Simon, you’re the Director for the Student Experience, as we’ve heard, and you came to this via university administrative and operational roles in a very large university. What kind of lens does this give you on projects such as this one? 

Simon: Yeah, in fact, Jenny before that I did a PhD in Neurobiology and Neurobehaviour in University of St. Andrews quite some time ago and actually did a fair bit of teaching and started going down an academic route. So I’ve got that perspective as well as Jo will have from earlier in her career. 

As you said, I’ve worked my way through various roles at the university, but I came into this current role about seven years ago and I have a team that’s responsible for a variety of functions in the university, including our accommodation and our sport, our student support, mental health, wellbeing and various other things besides. When I came into this role, I was rather taken aback to find that actually, as a university, we had very little grasp on how many of our students were dying of any cause in any given year and the reasons for that, and we certainly didn’t have any sort of compassionate and coordinated response to that. 

We tended to almost treat the passing of a student as something to wrap in legal red tape. Engagement with families I’ve found, to my surprise and horror, to be honest, was fairly patchy. It was inconsistent. It depended on the circumstances on whether a given team had been notified or would pick it up. This was something that many colleagues found very difficult to deal with, particularly in the case of a student suicide, didn’t really know how to approach it, what to say to families, whether to engage with families or not. 

And we ended up with this default of quite a formal legally framed response as an institution. And when I came into post, this was something that just felt intuitively wrong to me. It felt that the human response to any death, particularly by suicide, was something that should have much more human element to it. 

I put in place a number of changes, particularly around putting the families much more at the front of our response, contacting them within 12 hours or so of being notified of a death under any circumstances, putting in support in place for them, supporting with travel arrangements, hotels and all these sorts of things. And also recognising that the inquest process was something actually that was really, really important for families. 

Having tackled some of those issues, I then went on to develop the university’s suicide strategy and I’m also chair of the Greater Manchester Universities Mental Health Service as well, which we’ll discuss later. And then latterly, I’ve been involved with some of the national work, particularly around student suicide. 

Jenny: Thank you, Simon. When you were talking, I was thinking just how easy it can be to hide behind process when we feel individually or institutionally uncomfortable such as suicide, sudden death, other mental health issues. 

Simon: And that can be a default to hide behind those things in the absence of thinking about or having a clear human approach to how to respond to them, then an institutional process takes over and if that’s what families hear and feel, they themselves will feel uncomfortable and their experiences will be shaped by that. 

Jenny: So let’s talk about the project itself, the Restricting Access to Means project. How did the project come about? 

Jo: I feel that this has been a series of developments. We have to put it in a context and the context was when I first became involved and established a local project, then subsequently Wolverhampton established their ‘3 minutes to save a life’ campaign. So we were pretty unique. We started getting invited to national platforms, national conferences, and through that I met Rosie Tressler from Student Minds who introduced me to the National Union of Students (NUS). 

So the first guidance that was ever produced was actually following a student suicide roundtable, and it was guidance in 2015 from NUS on mental health and suicide. That work led us to link in with John de Pury from Universities UK. And I was then invited to get involved in the development of Step Change, which was guidance on mental health for universities tackling student mental health. That led to further work with Papyrus where I was involved in a working group which established the Suicide-Safer Universities guidance. 

So that was the context. And then a couple of years ago I got a phone call from someone called David Malpas at the University of Middlesex who, following a couple of student suicides, was concerned about whether they’d had handled that suicide well, whether they’d done all that they needed to do. And John de Pury from Universities UK put him in touch with me. And that actually led to a piece of work in which we were then introduced to Simon in Manchester, which was producing postvention guidance, which was published in December 2022. 

What happened from that was that as you begin to unpack something, perhaps more needs become apparent or people realise, yes, that fills that gap, but actually there’s another gap. And gradually over the course of that time – but also following on from the guidance – quite a number of people had emailed asking about what practically they could do to prevent suicide and the best evidence, the most effective interventions are around restricting access to means. 

And Simon heard the same queries from other universities, perhaps following an internal serious incident review – issues around access to means and how they might address that, maybe in student accommodation, it might be in terms of access to lab chemicals. 

And so the three of us chatted and thought there is a gap here. There’s very little guidance around restricting access to means. It’s pretty unique. There was guidance produced by government in 2015, which is preventing suicide in public places, which does address restricting access to means, but the scope is restricted because it’s about public places. 

So what we wanted to do was create a bespoke guidance for HE on restricting access to means, because it is the most effective form of students who suicide prevention, most effective intervention. That was further supported and reinforced by the English new Suicide Prevention Strategy published in September, which once again identified restricting access to means as a key target for all sectors and all institutions. 

My understanding is that Wales and Scottish strategies, which are both at the minute under consultation, will again profile the importance of restricting access to means. That’s where this guidance came from. It’s a series, it’s a suite of materials that have been developed to try and help higher education and further education and, to some extent, schools prevent student suicide, but it’s targeting the higher education sector. 

Jenny: Thanks Jo. And yeah, restricting access to means, just in very practical terms, it is about making it more difficult for people to take their own life, isn’t it? We’ve had people from all parts of the sector, some from outside of the sector. Why has it been important, Simon, to have so many people involved in this project? 

Simon: Yeah, I mean as with the previous guidance that Jo talked about, all of this has been built from perspectives not only within universities but other organisations and, most crucially, families who have been bereaved by suicide. And those perspectives together create a much richer set of guidance that’s going to be of much more practical use and much more directly based on situations that have happened in the past or potentially could happen in the future. 

We’ve really benefited in this guidance with colleagues who’ve got experience of the sector, so be they academic researchers in this space or staff in the student support area like myself, but also organisations with less direct involvement with universities, British Transport Police as an example. Colleagues there from the relevant teams have had experience of students dying on the transport network. But it brought a wider perspective about the approach to prevention and learning from incidents that have happened in the past. 

And then of course there are organisations that are more specifically focused on particularly young people’s suicides. So Papyrus as an example, Olly’s Future, the Mary O’Gara Foundation. And each, as I say, have brought their own perspective and experience, and we’ve also focused in here to an extent on technology as well. So Simplicity, who have very graciously supported the development of this work along with Unite Students, and also R;pple, which is a very innovative solution, used to provide support and advice for anybody searching for potentially harmful terms on the internet. 

Jo: The other thing that we have done, Jenny, is drawn on organisations which perhaps have led on pieces of work which may be relevant to higher education. So City of London Corporation have done a lot of work and guidance in terms of building design and planning, and we’ve drawn on their experience to apply that to the sector. 

In terms of the guidance itself, people may be wondering what it means. It’s looking at common means or common methods. And we have research from David Gunnell specifically auditing student deaths by suicide, which highlighted jumping, hanging, poisoning, and various other methods and presented some of which are very similar to young people in the general population, some of which are just slightly higher. 

So that points to certain means or methods in terms of high buildings, restricting access from balconies or from windows or access to roof spaces. But it also involves looking at ligature points. It also involves looking at design of buildings and access to chemicals, whether it be cleaning chemicals or laboratory chemicals where people might have access to materials. But it also involves having, when you’ve got constructors on site, access to skips or to scaffolding or equipment that might be used. 

And so the guidance is very broad ranging, looking at a whole range of scenarios, but it is evidence-based. And what we’ve tried to do is to ride head and heart together. In other words, academic evidence with also the heart, which is bereaved families’ experience and findings from coroners’ inquests, but also with real case examples where universities are trying to address restricting access to means. It’s got a lot of quotes, case examples, and it’s very broad ranging. 

Simon: I’m sure there’ll be some universities who may be concerned that what we’re asking them to do here is to add a whole additional burden to the mountain of tasks that they already do to maintain their operations effectively and safely. What we’re doing with this guidance specifically is asking universities to think about looking through processes they already operate around safety, around building design, around procurement, but with an additional lens. 

So as an example, estates colleagues will already do preventative and pre-planned maintenance or routine maintenance checks on things like lift shafts or roof spaces, ensuring that they’re locked off safely. They can’t be accessed accidentally by anybody. And what we’re asking, or suggesting to colleagues to do here is to look through the lens of suicide prevention and to think, well, are we doing those rigorously and appropriately? Are there other spaces we should be checking? 

Similarly for procurement or for design of buildings, often – particularly in recent years – sustainability features very highly in procurement decisions, particularly around building design. And again, what we’re suggesting is that perhaps suicide prevention built into the design and perhaps featuring as a factor when scoring procurement bits, particularly for building design or refurbishment, is something that could also be considered in a similar way. 

So, adding very little additional burden of time or cost or effort, but just adding that additional lens to things that are already happening. 

Jo: One thing we have tried to do is provide some balance, recognising that there are limited resources, limited time, lots of competing demands, and also the majority of students do cope well. And what you don’t want to do is create an environment that’s so risk-free that it becomes almost sterile or that it limits access for the majority. 

So, we’ve tried to look at a compromised position balancing the issue of risk with also people’s freedom and quality of experience at universities. So, thinking about where, for example, one might lock off access to a balcony where a particular student is living in accommodation where they have a particular risk for a time period. 

Looking at the fact that postgraduate students may need access to laboratories and to work independently and access to chemicals for their studies. So, thinking about inventory control and also maybe a two swipe access so that someone does know that they are there working in the laboratory. 

So, we’ve tried to balance that out with taking feedback from the field, thinking about how we get that balance right and most importantly, identifying potential areas that people could do something about, but actually recognising that institutions vary in size, resource, maybe focus, and so leaving some room there for people to think about, perhaps, best bang for their buck in terms of what they do do and how they do it. So we are not telling them how they do it, although there is guidance with examples of how it can be done. 

Jenny: So Edward, you’ve been sharing the reference group for this project now you’re a very busy man, so can I ask what made you want to get involved with this project? Why did you think it was important? 

Edward: I mean, two reasons. I remember from my previous time in mental health services how important access to means is in influencing whether or not an individual in real distress commits suicide. That was the first thing. 

And second, it seemed to me that given I was chairing the Mental Health Taskforce and we hadn’t got a strand of work specifically around this form of prevention, and of course ‘means’ here is a very broadly defined and it’s a brilliant piece of work, brilliantly representative and broadly based reference group, it seemed to me it fitted nicely, therefore alongside the Taskforce work. And I could probably give it some more profile and impact when it was published if I was involved with it. 

For those two reasons, I was really pleased to be asked and it was a pleasure to do because the enthusiasm, commitment and insight of the colleagues on the group was very easy to share. 

Jenny: Thank you. So yeah, really important, very intensely practical advice which will save lives as the evidence suggests. So when does the report come out? 

Simon: We’re hopeful it’ll be out in late June, early July. 

Jenny: Simon, I’d like to go on now to talk about your partnership work that you’ve been doing across Manchester with the NHS and other Higher Education partners in the city. And it’s been going on since 2019, so quite a mature model now. Can you give us a quick summary of what you’re doing? 

Simon: Yeah, so this, it’s in its fifth year now. This is a really unique, very innovative and really successful partnership between five of the universities. So that’s the University of Manchester, Manchester Metropolitan University, University of Bolton, University of Salford, and the Royal Northern College of Music. We partner with our NHS colleagues locally, the service provided by Greater Manchester Mental Health Foundation Trust. 

Part of the uniqueness of this model is a couple of things. One is, it’s co-funded by those organisations. So the universities contribute 60% of the costs of the service and the NHS, the other 40%, but also the universities themselves can refer students into the service directly through their mental health and wellbeing teams. There’s no need to go via GP or other secondary services within the NHS. 

And this is particularly for students that we would describe as being, to use a catch-all term, at the top of the support pyramid who would otherwise have always needed NHS support. But until this service was in place, were finding their way to the NHS – if at all, indeed – via a series of uncoordinated routes and often without any direct referral. And so just to really bring that alive, an evaluation of the service after the first year of operation showed an immediate and sustained reduction in students presenting at local A&E departments at the point of mental health crisis immediately coincident with the service coming into being. 

And as the service has matured and confidence has continued to grow between the universities and the NHS in terms of the appropriate type of referrals. So for instance, somewhere north of 95% of all referrals are accepted, which demonstrates we’ve got to that place where cases are being appropriately triaged in the universities before being referred on. And it’s opened up some additional referral pathways for some of the universities into other parts of the NHS mental health ecosystem. 

One of the things we’re now developing is just trying to go a little bit further in terms of some of that partnership working and we’re looking towards a more formalised data sharing. For instance, it’d be great to be in a place where we were more routinely able to have case conferences about individual students. 

I should also say that this service is about stepping students up for a period of time to receive that support as part of a step care model and then stepping them back down into the support of the universities again. And one of the challenges actually we have found is, and this is a positive function I suppose, of the service being very successful, is that the volume of students going through has meant that stepping back down has taken longer than we perhaps would like. 

But we have countless examples of students having been stepped up for a time, stepped back to the support of the universities and continuing to then succeed and thrive in their studies. And ultimately that is what the service is there to do. 

Jenny: It sounds great. Well my ears definitely pricked up when you said that it was diverting students from having to get to that point where they present with an emergency situation. And I know that’s something that I hear about quite a lot in student accommodation that actually students are falling through the system. They come to that emergency point and at that point when you’re in student accommodation, you can’t not respond to what is in front of you. So effectively you become the backstop. 

So I think there’s a lot of student accommodation colleagues who have been put in that position where students are not getting the support they need at the right time. So, sounds to me like something that will perhaps prevent that happening so often, that it will mean that students get the help that they need earlier on. 

Simon: And we’re starting to see some similar models appearing in other parts of the UK and lots and lots of interest in it as well. People are quick often to criticise the NHS and its excessive governance, commissioning models and so on. 

But the really striking thing about this model was that even though the funding for it is coming from the mental health commissioners in Greater Manchester, they had the foresight five years ago to recognise that there would be a commensurate saving in another part of the NHS, principally in the emergency medicine field. And actually that foresight and taking a step back and looking at the population as a whole and how they were best supported is one of the things that allowed this to get off the ground in the first place. 

Jenny: I do like to hear about sensible decision making and that long-term view. I know you’ve also been doing some work around student loneliness and some work with social prescribing. Can you tell me a bit about that? 

Simon: Yeah, that’s right. Again, as part of a step care model that again, many institutions will operate, we recognise there was quite a group of students who needed some form of enhanced wellbeing support that wasn’t really the right place to be sending them off to the counselling mental health service. They didn’t need a psychotherapeutic intervention in that sense. And for some students who may, for instance, be experiencing agoraphobia or elevated anxiety about perhaps entering the library for the first time, particularly in such a huge campus as our own, just needing that additional practical support to overcome some of those first steps. 

And so we introduced a social prescribing model, which incidentally actually was initially funded by some donors who themselves had seen some of this, particularly student mental health concerns from an accommodation perspective. They were student landlords. 

And we’ve then continue that funding and we have this social prescribing model which runs a series of interventions. Some of it is one-to-one support in terms of helping a student perhaps to go to a lecture for the first time or find different parts of the campus or to meet other friends, people with alike interests. And some of it then is group classes. So we do a very successful series of afternoons at our botanical grounds, bringing students more different perspectives and backgrounds together and just socialising and experiencing a bit of time out from their studies. 

Jenny: That’s great. It’s great to hear. So very multifaceted and I know that it is being looked at around the country and is in some way forming part of the work of the Taskforce as well. I know there’s a drive to see this model rolled out more widely. It is so effective. What does the future hold for this partnership? 

Simon: I’d like to see the other universities in the city join it. We have some other smaller providers. We’re having some discussions with them. I’d also like to see it of course rolled out further around the UK. But equally of course, not just about that top of that support pyramid. 

As I’ve said, what this has also done for us is to build some of those partnerships between the universities and the NHS in this case, but between the universities in particular around thinking differently about how we support the students in the city more generally. 

And there’s been a lot of follow-up initiatives. We’ve got one we’re doing some work on at the moment across a number of those universities I’ve mentioned around a wider harm reduction approach, for instance. There’s a very nice safety app that now works across three of the university campuses. So if you press the app that you have and you require support and you happen to be on a different campus from the one that you are registered on, you’ll still get the same level of support from the campus security and support team. 

So it’s been a real catalyst for some wider conversations about supporting students and thinking about them living in the city and the region as a whole rather than just their host institution. 

Jenny: That’s great. Thank you Simon. So we’re coming to the end of the episode now, but I want to take a look to the future now. And Edward, with your helicopter view across the whole of the sector, can I ask you – what do you think are the new frontiers of student support and what changes do you expect to see over the coming years? 

Edward: I think most institutions are going to have to redesign their student support. And I don’t mean student support services, I mean all of their student support to reflect the fact that the data which is going to be available from student analytics, particularly around wellbeing, is going to get so much more sophisticated and so much more insightful. Some of that will then drive machine learning AI algorithmic support to students identified at being at risk. 

But it will certainly also, I think mean that once institutions know something about a student and their potential vulnerability or actual exhibiting of worrying behaviour, they can’t not know and therefore the responses they make have to be very well-calibrated to who’s got the information, what are they making of it, who are they going to give it to, and what do they expect them to do with it? 

And I think that will need a much more fully fundamental review. Certainly it is at NTU of what we currently do and how we’re going to do it in the future when we have those data and those more machine-based AI type tools available. But also, how do we refine our human responses to make sure we make absolute most of that data that sort of analysis is giving us? 

Jenny: I think that’s incredibly important and it’s something that’s come up a lot in student accommodation circles where it’s always really important to put together that information from where the student is living and what they’re doing in their living space with what’s happening in the academic space. And it’s not always easy to do that, particularly if it’s across organisational boundaries. 

Edward: Yeah, I couldn’t agree more. Of course, what the challenge we face there is that the analytics probably have to be using data points that span or are relevant to the whole three or four years of the students’ undergraduate – indeed, shorter postgraduate experience. And given they may move at least once, if not twice or more during their times rather accommodation, it may be more difficult to use those data points as a fundamental driver of how we think about analytics and how we look for markers of students who may be exhibiting signs of distress or vulnerability. 

Jenny: Yes. And it’ll be interesting to see how AI can support in seeing patterns and looking at predictive patterns as well. 

Edward: Yeah, in the Northumbria model – which this stuff is based on – one of the metrics they used was a student not living with their peers or students of a similar age profile, they found that suggested there may be an issue that alongside other indicators might suggest a vulnerability or some mental health challenge. 

Jenny: That’s a really interesting one. Yeah. Any other predictions for the future? 

Edward: Yes. I think sometimes people say to me, this agenda may change if and when we have a change of government. I don’t think that’s the case. 

I think Labour Party and certainly my very constructive conversations with the opposition minister for FE/HE skills, they are just as interested in making sure this agenda is taken forward and that we improve the quality of student support and we do all we can support students with mental health problems. So the way in which it’s framed may change, but the fundamental content, I think the policy and what we have to do won’t change. 

Jenny: So we’ve come to the end of the show and a very big thank you to all my guests today. You’ve been a great panel. 

Thank you to Ed Palmer, our producer, and thank you to you for listening. If you find this episode useful, please do share it with your colleagues, either as a podcast or a transcription for those who prefer to read rather than listen. Jen Steadman will be with you next month on a rather futuristic topic – one to look forward to. In the meantime, you take care. 

Read Jenny’s top tips for how accommodation teams can support universities’ University Mental Health Charter applications here.