CW: suicide, racial violence
“The funding and structure of the services failed me.” These are the words of ‘Hannah’, a current second-year student, who, in winter 2019, contacted university support services for help after her mental health significantly deteriorated. She was experiencing severe suicidal ideation as a culmination of previous complex mental health issues, the stresses of life as a fresher, and a lack of support. Knowing that GP appointments only designate 10 minutes to each problem, and feeling desperately scared of what she might do if left alone, she visited the Advice Place, which she felt had been presented by the university as a stable bastion of support.
She was desperate, and made it clear to the staff that she was seriously, and imminently, considering suicide. The first member of staff she spoke to seemed new or untrained, and implied that she might have to wait several days for any kind of appointment. She again explained that the situation was more than urgent, and that there was a genuine risk to her life, so another member of staff spoke to her for five minutes, gave her some pamphlets, and told her to apply to the counselling service. When Hannah called them, she was told that she would be put on the urgent list, but, without cancellations, she would have to wait for another week.
A student who had clearly admitted she was on the brink of suicide was told she could have to wait an entire week to receive university help. This is unacceptable, and, to Hannah, a sign that no one cared for her when she was telling them she wanted to take her own life. That night, she put a knife to her wrist and was saved at the last moment by her brave decision to call the Edinburgh Crisis Centre, who allowed her to stay overnight and de-escalated her situation.
Despite the constant bombardment of university rhetoric claiming to care about student wellbeing, and the vast sums spent on a shiny new building, the university was callous not just with Hannah’s wellbeing, but her life. Her story is not unique. As Hannah is keen to emphasise, the university wellbeing staff were “working hard to provide the best care”, but were constrained by “very limited resources”. Is this good enough? Our generation is in the midst of a student mental health crisis. What Hannah experienced was pre-2020, and the subsequent coronavirus crisis and lockdown fiascos have decimated student mental health even further. Is the university doing enough to support its students?
Alex, another student I spoke to, felt similarly let down. She contacted the university in October 2019, after feeling very depressed. After two weeks, she had an assessment, in which she explicitly explained that she did not want CBT (cognitive behavioural theory), as she had tried it before and had not found it helpful for the problems she was experiencing. The response was to suggest online CBT, or join a two-month long waiting list for other support. After querying this, and emailing again, the university acquiesced, and she was finally offered counselling a week later – over three weeks after first contacting the university, a lengthy period of time for someone struggling with mental health. She was only offered four sessions, nowhere near enough to have a positive impact on her mental health.
These accounts may be from last academic year, but they are not isolated. If this is how the university let students down pre-coronavirus, how are we supposed to trust them with our wellbeing at a time when, according to Mind UK, 73% of 18-24 year-olds have seen their mental health deteriorate?
In a small anonymous survey I sent to university students, about recent experiences with student support, similar criticisms arose as those experienced by Hannah and Alex. Some lauded the support provided, and were clearly helped, a good sign, but there were many more who felt that they had slipped through the cracks of a flawed system. Waiting times between first contacting the university, and receiving help, ranged from one day, to a month, to six weeks.
It is understandable that some students will be designated a priority, but from student experiences, it seems that front-facing staff are not being trained to spot those in urgent need of help. It also seems dangerous to leave any vulnerable student for a longer time, as mental health deteriorates rapidly. Grading mental health concerns is a slippery slope, and this triage should only be undertaken by psychologically trained staff.
So, is the university holding itself accountable for the clear gaps in their support? I contacted EUSA, who had a mixed message. EUSA reports that from September 2020 there was an increased demand for mental health services compared to the previous year, straining an already precarious system, and demonstrating that the pandemic has indeed devastated student mental health. In response to this rise in demand, the Student Counselling service increased working hours, recruited additional posts, and introduced digital sessions, as well as creating a new check-in service for isolating students. The university has also committed funds for an additional 5.51 full-time equivalent posts, which will include two BME counsellors – a long-overdue decision.
The counselling service is running at full capacity, facilitating 300 appointments per week, seemingly impressive. However, referral time is a significant issue that does not seem to have improved. 64% of assessments are completed within a week, and 94% within two weeks, with all students then being offered counselling sessions within two weeks of their assessment. So-called ‘urgent’ cases, including students experiencing suicidal ideation, or victims of sexual assault, are apparently seen in a more rapid timeframe. However, as student experience has proved, that is not always the case. Due to this, the university has promised to invest more in the provision of same-day appointments.
At first glance, these statistics may seem laudable, but, after a closer look, and following my research with students, I am not convinced that this is good enough. A major issue seems to be how university staff define ‘urgent’ cases, and whether staff are sufficiently trained to recognise warning signs. Examining the statistics shows that some students may have to wait for up to a month for a session – if it takes two weeks to be assessed, and then a further two weeks to get appointments- which is easily long enough for a mental health to seriously deteriorate. Those struggling with mental health often only reach out for help as a last resort, and the university support services need to prove with rapid action, rather than words, that they can actually help.
Another major issue – perhaps the biggest – that was mentioned by every student I spoke to was that once you reach the counselling service, the maximum amount of sessions offered is six, simply not a sufficient time frame to tackle even minor mental health blips, let alone longer-term issues. This takes us back to Hannah’s story. After a near suicide attempt, she took up university-provided sessions, and found that the staff were trying their hardest, but the structure was limiting effective provision. In Hannah’s words, six sessions only “scratch the surface” of many people’s complex mental health contexts. Many of the students I spoke to also complained that after the sessions ended, there was no follow up contact, putting pressure on ‘solving’ someone’s entire mental health in six short sessions.
A representative of EUSA also provided the following statement: “The Students’ Association believes that now more than ever, the University and the Government must invest in student mental health services. Whilst this year has seen an increased demand in wellbeing services, we have successfully lobbied the University to commit to further resources to keep up with demand.
“We believe the University should invest in more specialised mental health support, and we have seen a positive commitment to increase BME counsellors, provide multilingual wellbeing support, proactive student check-ins, and support groups for survivors of sexual violence. We will work with the University to achieve this change.”
It is positive that EUSA are pushing for these changes, but to fully convince the university to invest in wellbeing, we as students must advocate. These services were not enough before the pandemic, and have only been slightly expanded since. In a time when the ONS has reported that 57% of students experienced worse mental health since the pandemic, and that 53% were dissatisfied with their social life during the autumn term, radical change is needed. We pay nine thousand pounds a year (and even more for international students); the very least we can ask for is support when times are tough.
So, what else can the university actually do? As well as taking in student feedback, I spoke to Dr Ruth Caleb MBE, who was Head of Counselling at Brunel University for 17 years, and chaired the Mental Wellbeing in Higher Education Working Group. When I asked Dr Caleb whether student wellbeing was the responsibility of their university, she answered “a resounding yes”. Of course she clarified that it is also their own responsibility, and that of their friends and family, but that universities must hold themselves accountable for how they support their students, and must themselves pressure the government for better resources if that is the reason for shortages in provision.
According to Dr Caleb, all universities, as a bare minimum, should have a professional counselling service, and, crucially in the case of Edinburgh, the advisors who first make contact with struggling students should be professionally trained to spot warning signs of severe mental ill-health. She also suggests that universities find a way to have some sort of 24-hour availability, even if through having partner organisations or online providers, and that the university should perhaps provide a long-term student mentoring service for those who have had previous problems or who are now struggling with mental health difficulties. Finally, there should be a member of staff regularly checking in on each student each term, and all staff, including those in a purely academic position, should receive full mental health and wellbeing training each year.
This is a suggestion that I found particularly fascinating and think that Edinburgh could really benefit from, especially when Dr Caleb also suggested that this training in mental health should also be provided to all students when they start university. This would radically improve student wellbeing. If every member of the university community received basic training on mental health, if someone is vulnerable, a flatmate, or coursemate, or tutor or lecturer would recognise this, and help them to access the appropriate support. As Dr Caleb argues, “a university should be a community, and that community needs to be trained into understanding how to support each other”.
However, this should not be used to take the responsibility away from the university structure, which is the centre of the community. Dr Caleb emphasised that a major cause of poor student mental health was overwhelming “pressure to always succeed”, and the university culture of perfectionism. As I’m sure we all know, this can take away much of the joy of university life. As The Student has previously argued, it is imperative that the university reinstate the no-detriment policy for final years, and I would argue, introduce more relaxed marking for all, to reduce the stress on students in what is already a very difficult situation. As Dr Caleb is keen to assert, we must resist the weaponised language that tells us that young people nowadays have no resilience, and tackle the fact that we are living through an incredibly challenging time.
Of course, the university faces challenges too, in their version, a lack of financial resources. However, as Dr Caleb explains, universities often feel they have to look for expensive solutions, when in reality, it doesn’t take vast amounts of money to check-in, or arrange online training. The university should also remember, in Dr Caleb’s words, that the best way to come up with policies for students is to actually ask students. Our generation is the most aware ever of mental health, and I’m sure students would be willing to give their honest opinions on how they should be supported.
Finally, the university pay attention to the structural inequalities that make certain students more vulnerable to mental health issues, and that may make them feel ostracised when asking for help. This includes LGBTQ+ students, BAME students in a predominantly white university, neurodiverse students, and more. The university must have specialist support for marginalised groups, especially during recent spikes in racist and transphobic crimes.
Tumi Akeke, director at antiracist group BlackED, gave the following statement when I asked for her view. “EUSA is working on getting a BAME counsellor, however, this is EUSA and not the university.
“I stand on my grounds that the counselling service at the uni, and the advice place at EUSA, need a BAME counsellor. I genuinely feel like the university is not equipped to deal with racial abuse.
“When an Asian student was attacked outside the library in December, what were the resources available to help that student mentally? Special circumstances? The Advice place, where no staff can understand what he went through? We need a BAME counsellor at this university, and until the university starts with that, they will not be able to efficiently support their BAME students mentally.”
This investigation has proved that the university is not living up to their false promises of supporting mental wellbeing, and has a long way to go. It is high time for the University of Edinburgh to call a commission on student wellbeing, taking feedback from students, as well as experts and staff. The university must recognise what they are doing wrong, and implement meaningful change before more lives and futures are put at risk. From my research, with both students and Dr Caleb, these are my suggestions of topics to be discussed: more counselling sessions offered; long term checking in on students who have previously struggled; better contact between mental health services and academic departments; more signposting to where help can be found; more specialised personnel; stronger links with a 24-hour crisis centre; training for all staff and students; and regular check-ins for all.
This is a wide range of suggestions I found from researching just one article. The university, which has more power to assess the situation, could easily investigate much more. The question is, will they? Will they invest in the wellbeing of their students, or continue to ignore us in favour of making money, and promoting their Russell Group status? I am calling on the university governing body to answer these questions and decide their priorities – the longer they wait, the more dire the consequences.
Illustration: Hannah Robinson