Mental Health Services survey results summary

Visual data are presented for the results of a mental health services survey sent out to all students of the University of York in March/April 2015. The comments from the open comment section were excluded in this version of the report for confidentiality reasons, but were summarised where appropriate.

General overviewIn total, 665 responses were received from Undergraduate, Taught Masters and Research students; both Home and International students are represented in the responses.

Considering the differences in number of responses by degree and nationality, all data has been rescaled so that each group totals 100% (i.e. if there were twice as many home as international, we adjusted it so that the column for Home looks at Home only so reflects 100% and International the same).Question 1 Have you ever experienced mental health difficulties (e.g. depression, anxiety, stress, trouble sleeping, panic, suicidal thoughts, thoughts of self-harming, etc.) while studying at the University of York?The graphs show that between 71% and 84% percent of all participants have experienced mental health difficulties while studying at York. Home student reported to experience such difficulties slightly more often (14%), although it would be interesting to note that 5.7% international participants preferred not to say as opposed to 2.3% home participants. Mental Health Difficulty by Degree type Mental Health Difficulty by Home/International status

Question 2 Have you ever been diagnosed with a mental illness (e.g. depression, social anxiety, bipolar disorder, etc.)?Between 30% and 41% of participants stated that they have been diagnosed with a mental illness. The highest figure for diagnosed mental illness can be observed with undergraduate participants (41.1%). There is a significant drop to 19.4% in international students diagnosed with mental illness as compared to 43.6% diagnosed home students. Although this survey was not able to tease apart the reasons for that drop, it would be interesting to explore whether cultural differences and stigma affect whether international students seeks help and get diagnosed as often as home students. Mental health diagnosis by Degree type Mental health diagnosis by Home/International status

Open Door Team (ODT)Question 3Are you aware of any of the below organisations/services offering advice and support on mental health difficulties? A high 71% of participants were aware of the ODT. PGTs appear to be significantly less aware of the service with only 54% compared to 83.3% of UGs. Similarly, international students appear to be significantly less aware of the ODT only 53% of international participants were aware of the ODT, compared to a high 81.1% of home students.

Awareness of The Open Door Team by Degree type Awareness of The Open Door Team by Home/International status

Question 4Have you ever used any of the following advice and support services in relation to any mental health difficulties?Despite the fact that the participants seem well aware of the ODT, only 35% of them have actually used the service. Once again, PGTS access the service the least while UGs access it the most. Only 21.7% of international participants answered that they have used ODT, compared to 43.1% of home participants.

Use of The Open Door Team by Degree Type Use of The Open Door Team by Home/International Status

Question 5If you have accessed any of the support services, how easy was it for you to find information about these services?

Question 6If you have accessed any of the support services, what was the length of time between booking the appointment and being seen for the first time?

Question 7If you have accessed any of the support services, overall, how satisfied were you with all aspects of the service?

Overall, 48% of all participants who have used ODT have said that they were satisfied with the service, while 39% of participants were dissatisfied with the service.

Unity Health Centre (UHC)Question 3Are you aware of any of the below organisations/services offering advice and support on mental health difficulties? 80% of our participants were aware that UHC provides support for mental health difficulties and the awareness is almost evenly distributed across the three degree types (with awareness of PGRs slightly lower). Also, 71% of international compared to 85.3% home participants were aware of UHC. Overall, awareness that UHC can provide support regarding mental health difficulties appears to be higher than the awareness of ODT, especially among international students.

Awareness of University Health Centre by Degree Type Awareness of University Health Centre by Home/International Status

Question 4Have you ever used any of the following advice and support services in relation to any mental health difficulties?Interestingly, although participants seem to be well aware of UHC, they don't appear to be accessing it for support regarding mental health difficulties (only 24% answered that they did). Once again, the figures are the lowest for PGTs and highest for UGs, while PGRs fall in between. Only 16.1% of international participants were ware of UHC compared to almost the double figure (28.9%) of home participants.

Use of the University Health Centre by Degree Type Use of the University Health Centre by Home/International Status

Question 5If you have accessed any of the support services, how easy was it for you to find information about these services?

Question 6If you have accessed any of the support services, what was the length of time between booking the appointment and being seen for the first time?

Question 7If you have accessed any of the support services, overall, how satisfied were you with all aspects of the service?

55% of all participants that have accessed UHC in regards to mental health issues were satisfied with the service, while 30% were not.

Summary of results for other services

Research studentsIn the open comment section of the survey, research students often pointed out the isolation and pressure they feel, stating that the departments should be more involved in providing information and signposting research students to appropriate services. Moreover, several research students have mentioned the issues of stigma and inability to talk to their supervisor and colleagues about mental health issues. College Welfare TeamsStudents that had used the college welfare teams for mental health advice and support, pointed out in the open comment section that although the welfare team members are usually very nice and helpful they cannot provide professional help that is sometimes needed. The students complained about instances where a welfare tutor (and the students) are left to deal with suicidal housemates, or are told by the Open Door Team to talk to their tutors when the student feels they should be talking to a professional. Comparison with other Russell Group UniversitiesWe have compared mental health services and resources at the University of York and 4 other Russell Group Universities Leeds, Durham, Oxford and Cambridge. The following is an independently produced summary of what services and resources each of the universities offer for their students experiencing mental health difficulties. As you can see there are some gaps in our provision, especially compared to the University of Leeds whose counselling services are more diverse and tailored to students needs than they appear to be at York. The summary of all provisions at all five universities is provided as an appendix.CambridgeDurhamLeedsOxfordYork

Counselling Services-

One to One

Group

Emergency/Crisis support

Drop in info/signposting

Mental Health Advisers

Workshops

OtherX

X

X

X

XX

XX

X

X

X

XX

X

XX

X

*the service exists but is not publicly advertised

X

External Agency Resource ListXXXXX

Self-Help Resources

Self-help leaflets/cards

Self-help workbooks

Self-help book list

Self-help website list

Podcasts/AppsX

X

X

X

X

X

XX

XX

X

X

XX

X

Peer-Support GroupXXX

Night-time Talking ServiceXXXXX

Student Advice ServiceXXXX

Students Union SocietiesX

DetailsFocused group counselling and longer-term group counselling availableDrop in to calm sessions Student Minds & Mind Your Head Campaign

RecommendationsOpen Door TeamFrom the results, especially the open comment section, it appears that students have a different perception of what the ODT provides and who it is for than the ODT does. Therefore, it would be highly beneficial if ODT sent out a clearer message to inform students why and when to access the ODT. The ODT has made it clear on a number of occasions that it is not for long term therapy but neither is it for minor distress. It doesnt seem that students are aware of the fine differences that separate a low and medium intensity crisis (nor can they really be expected to), and are more prone to experience their issues as intense and requiring immediate attention. Furthermore, the open comment section of this survey shows a trend of students urgently seeking ODT help only to be booked onto an appointment 4 weeks later. By that time the problem is gone and the student does not need help any more (probably does not cancel the appointment). The student believes the ODT has failed them and has not provided support when they most needed it, while the ODT faces the problem of too many students not showing up for their appointments. There are different groups of students with mental health difficulties at the University those less resilient but otherwise healthy, students who suffer from mental health difficulties that can be managed by a service like the ODT, and students with mental illness and they do not seem to perceive the support they receive as enough. We recommend the following:1) More diverse services - we believe that diversification of services would go a long way to ease some of the current issues, such as long waiting times and students then not turning up. We are aware that the ODT already offers workshops and group therapy but more frequent and diverse workshops targeted to particular groups of students and at particular times of the year would be better. Also some form of short drop in sessions to deal with minor crisis would be advisable (similar model exists at the University of Leeds), or perhaps group sessions in form of a caf. 2) More diverse lengths of appointments - we recommend that the length of appointments be carefully considered. 45 to 60 minutes might be too long for someone who is not in a crisis, while 60 minutes may not be enough for someone severely distressed. Considering that students come with a wide variety of needs and distress level, we recommend that the lengths of sessions reflect that. 3) Online evaluation we recommend that an online evaluation system be put in place (similar or the same as the one that is already given to students when they come to ODT) in order to speed up the process and give students a sense that they are being taken seriously. Then, those students that are not in a crisis situation should be signposted to different options group therapy, workshop, drop in sessions and online resources. If after a week (the length is up to professionals to decide) the symptoms are still the same they will be given an appointment (similar to how you dont immediately give someone antibiotics but rather wait to see if the symptoms persist). 4) More information, especially for international students - the data clearly show that international students are less aware and use the services less than home students. Clearer publicity would be beneficial. Although the ODT website provides ample of useful links, what is actually needed is the information to be more summarised and explained to help students make sense of all of the information and choose the most appropriate source for themselves. This is especially crucial when it comes to international students who may have language barriers and come for cultures where mental health issues are dealt with in different ways to the UK.

Unity Health Centre

Unity Health has put a lot of effort into diversifying its services and listening to student feedback, and the results of this survey clearly reflect this as the overall satisfaction rate with the services is quite high. However, when it comes to mental health the open comment section of the survey indicates that some GPs seem to be more sensitive to patients with mental health difficulties than others (or at least that is how students perceive them). Therefore, it should be the overall aim for all GPs to ensure that their patients (with mental health difficulties) are clearly informed on what the GP can do for them and how the course of treatment they are recommending would help their condition.

Moreover, it is not always clear to students (especially international students) how a GP surgery can help them with mental health. We recommend that a section of the website be dedicated to information about that, clearly outlining what to expect and what support can be received. Also, students that are given medication should receive more information. We fully understand that UHC GPs work very hard and do not have a lot of time, but it should be a basic requirement that patients are properly and fully informed of all benefits but also side effects of medication they are about to be given. There is a large number of anecdotal evidence that if this is not done, students who experience side effects will simply stop taking medication causing their symptoms to even worsen and they will develop a negative attitude towards medication.

Finally, we recommend that the referral system to external services be made clearer and consistently available to all GPs in the practice. At the moment, the open comment section of this survey suggests that there is inconsistency between GPs in their knowledge of external services available to students with mental health difficulties. General RecommendationsOverall, there is a great need for better communication between all services on and off campus. When ODT and UHC are not enough and students need to be referred to other services, there seem to be many discrepancies as some ODT and UHC members are more aware than others of what to advise students and what services are out there. Therefore, there is a strong need for better overall signposting and coordination. Also, we have a recommendation for the University. Considering the increase in diagnosis of clinical depression in the last two years, the increase in eating disorders, and the strain on the ODT, it is highly advised that the University considers mental health difficulties more seriously. It is true that the University is an academic institution and dealing with mental health is not its primary focus, nevertheless, good mental health is a prerequisite for productive and successful young minds and the rise of mental health difficulties among student population cannot be ignored. Services, such as the ODT and UHC, should be expanded to meet the greater demand. Furthermore, there is a need for diversification of all services in order to meet the diverse students needs. One avenue of achieving this is also establishing stronger partnerships and collaborations between the colleges, relevant services and the students unions (YUSU and GSA).

May 2015Jelena Horvatic (GSA President)Fran Griffin (Mind Your Head intern)Ken Leach (GSA General Manager)

APPENDIXRussell Group Universities support for student Mental Health

Mental health issues in students- facts and figuresIn research conducted by the national union of students (NUS) they found that 20% of students in higher education considered themselves to have a mental health problem, with 13% having suicidal thoughts. In addition, 92% of respondents identified as having had feeling of mental distress, including feeling down, stressed and demotivated. The main causes for these feelings include coursework (65%), exams (54%) and financial difficulties (47%)1.With approximately 50% of young people entering higher education, and the median age of higher education students overlapping the peak age of onset for mental health difficulties, we should expect to find high levels of first onset mental distress in universities2.Universities focused on:Research has been conducted on four universities within the Russell Group, in order to understand the mental health support services provided for students at each establishment. The information available on each universitys support services are collated below and compared to that provided by the University of York. Cambridge Durham Leeds Oxford York

References:1. http://www.nus.org.uk/en/news/20-per-cent-of-students-consider-themselves-to-have-a-mental-health-problem/ 2. http://www.studentminds.org.uk/uploads/3/7/8/4/3784584/peer_support_for_student_mental_health.pdf

The University of CambridgeA collegiate university, with pastoral care from college staff. 6 main resources offered to students.1. Counselling Service Counselling appointments- up to six sessions at 50mins each. If a longer period of counselling is required then group sessions can be offered. Mental Health Advisors- work in the counselling service and provide support to students in crisis or those who experience moderate to severe mental health difficulties. Workshops- generally one-off events and do not require any ongoing commitment. Examples include exam preparation, self-help with CBT, understanding and managing panic attacks. Focused groups- for people who want help with a particular issue- longer course. Examples include dealing with the loss of a parent, managing your mood and healthy-self-esteem. Longer counselling groups- offer support over a period of several weeks. Sharing of life issues in a group, for 10 weeks (undergraduate) or 14 weeks (postgraduate).2. External Agency resources List of external agencies contact details- split into sub-sections by location, from the University, in local community and national organisations.3. Self-help resources Mindfulness program- aimed at encouraging better mental health through mindfulness practice. Pilot study to see if mindfulness builds the resilience of students. Self-help leaflets- information and resources for anxiety, depression, eating disorder, insomnia and others. Links to externally produced self-help leaflets. Self-help book lists- split into sub-sections by type of problem. Self-help website list- split into sub-sections by type of problem. 4. Student Advice Service Advice service on student matters- Mental health and eating disorders sections with links to external resources and university counselling service.5. Link-line Student led talking service- by phone, skype or email for any information about student life/campus or for issues and mental health problems. Available every night of term.6. Peer-support Peer2Peer campaign- student led support services within colleges. Can contact via college or email. Primary Reference:http://www.counselling.cam.ac.uk/

Durham UniversityA collegiate university, with pastoral care from college staff. Mental health policy at University level. 4 main resources for students, split between University and Student union led. 1. Counselling Service Emergency drop in appointments- for 30mins (first come first served) Counselling appointments- up to six sessions at 50mins each after initial consultation Recommendations- on what to do whilst on counselling waiting list (bibliotherapy- list of self-help books to buy, links to self-help leaflets, workbooks, relaxation podcast, body relaxation programme).2. External agency resources List of external agencies contact details- split into sub-sections by type of help that may be needed (e.g. for addictions, depression etc.)3. Self-help resources Information leaflets- University produced advice and guidance for university worries such as exam stress, homesickness, loneliness, sleep problems, understanding depression and others Student work-books- taken from the Centre for Clinical Interventions (Australian public mental health service). These include modules on different subjects such as depression, assertiveness, body image etc. Each workbook contains information on the difficulty, plus space to record feelings and behaviours relating to the difficulty. Resources are given for external support also. Flow chart on how to help peers that you are worried about- who to talk to and what help to give. Work smart campaign- Student union led campaign to provide support to students during periods of exam stress and whilst writing their dissertations. Links to external resources on stress management, how to get a job with a 2:2 and information on academic skills. Mental Health podcasts- relaxation and sleep podcasts from the mental health foundation and body mind relaxation podcast from the University of Limerick. 4. Nightline Student led talking service- by phone or online for any information about student life/campus or for issues and mental health problems. Available every night of term. Number for nightline is on Student cards.Primary Reference:https://www.dur.ac.uk/counselling.service/students/

The University of Leeds8 main services for students, including a student-led Mental Health campaign. Not a collegiate University.1. Counselling Service Drop in appointments- daily information and sign-posting service, not meant as an emergency service. Drop in to Calm sessions- two sessions every Friday of 30minute group sessions to learn 8 minutes to calm. Podcast available also. Counselling appointments- up to four sessions of 50mins each (can return for further sessions). Groups and Workshops- Some need referral through counselling service, other groups are open to all. 5 groups available including meditation, postgraduate support and feel better faster groups.2. Mental Health Team Mental health support- Team to offer support on moderate to severe and enduring diagnosed or emerging mental health difficulty. Can put together a mental health support plan (MHSP) or Crisis support plan (CSP). Offers drop in sessions.3. External agency resources A-Z guide- split into sub-sections according to type of problem.4. Self Help Self-help podcasts- On calming techniques, mindfulness and meditation. Head-start cards- 10 cards giving information and advice on matters such as stress, low moods, panic, grief.5. Student Advice Centre Drop in sessions- for getting information and advice on issues. Appointments- for more complex issues.6. Nightline Student led talking service- no advice given, just information and listening services.7. Peer Support Trained students to give support to others- available for anyone within the University for any range of issues. Trained students signpost to other services if student needs further help/counselling.8. Societies Mind matters- provides student-led support services, holds talks in local schools, hosts fundraisers for Mental Health charities and runs campaigns which change people's attitudes towards Mental Health. Psyched - society of psychiatry and psychology students- reducing stigma of mental health issues and increase awareness.

Primary Reference:http://www.leeds.ac.uk/info/20026/choosing_leeds/1901/health_welfare_and_safety

The University of Oxford A collegiate University with pastoral care from college staff. 8 main services for students, including a student-led Mental Health campaign. Mental health policy at University level.1. Counselling Service Counselling appointments- Maximum number of sessions, or length per session not given. Workshops- group sessions based on mindfulness, overcoming panic, sleep difficulties etc. Group counselling- referred on from counselling service for weekly 90 minute sessions.2. External Resources List of external agencies details- split into sections by emergency, non-emergency, local and national resources.3. Self-Help Self-help external resources- sub-sections by problem. Lists books, films, apps and websites.4. Peer support Within colleges- Trained students for talking services. Over 350 trained peers available in every year.5. Student Advice service Student Union led Advice- for students to talk over their worries in private and for information to be given.6. Nightline Student led talking service- Information and listening service by phone, skype or in person.7. Student Minds Eating Disorder support group- weekly meetings to support those with, or recovering from eating disorders. Run by trained student volunteers to encourage talking. Drop-in sessions.8. Mind Your Head Campaign Student-led campaign- aims to raise awareness and reduce the stigma of mental health issues. Website with students stories, blogs and list of resources.Primary Reference:http://www.ox.ac.uk/students/welfare/counselling

The University of YorkA collegiate University with pastoral care provided by college staff. 5 main services provided for students mental health provisions. 1. Counselling Service Open Door Team- up to 6 counselling sessions after initial consultation. Case management for those with a diagnosed mental health difficulty & CBT sessions of 50 minutes each. Workshops- Group sessions on topics such as procrastination, anxiety and mindfulness.2. External Resources List of external agencies contacts-sub-sections by emergency and non-emergency.3. Self-help Self-help pages- Information on multiple issues such as depression, body image, academic pressures and schizophrenia.4. Student Advice service Student advice and support service- provided by the students union. Student support hub- first point of contact for advice and help.5. Nightline Student led talking service- Information and listening service by phone, email or in person. External links- sub-sections by problem encountered.

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