Referring Back To CR166 (And A Note For Journalists)

Blind Men And The Elephant
During the past few months, there have been articles about the mental health of students in the Guardian (here, here, here, here, and here), the Independent (here and here), Times Higher Education (here, here, and here), and now the BBC (here). It’s great to see the issue being covered, even if it’s because of tragic statistics and stories.

If there’s one issue with the coverage it’s that it tends to focus a lot on problems and not much on solutions. It’s important that those covering the subject don’t ignore the work that’s already been done to provide us with answers.

The Royal College of Psychiatrists’ report doesn’t have all the answers. It doesn’t even have all the questions. (It makes it clear that more research and data is needed – some of which has since become available thanks to the work of organisations such as NUS and the Equality Challenge Unit). But the report does give us a few clear guidelines and recommendations that can be acted on immediately. More than that, it’s the most comprehensive report on student mental health we have, with input from organisations across the higher education and mental health sectors. It gets us on the same page. We should all be referring to it.

When I get phone calls from journalists looking to cover student mental health, it’s usually immediately apparent that they are full of compassion and sensitivity for the subject. I enjoy talking with them. But I don’t think I’ve had a single journalist start by asking me what needs to be done. The focus has always been on what’s wrong, and why. I suppose that’s the nature of journalism, but hopefully it can begin to shift a little.

I wrote a review of the Royal College of Psychiatrists’ report after it’s publication, summarising key points and adding a few things that were omitted. I’ve now updated this paper, adding data and developments from the past 18 months. If you’re a journalist or policymaker looking to do something around the mental health of students, take a look.

University Mental Health Policies: Better Communication = Better Mental Health

In March I was part of an online discussion about the role of mental health policies in promoting students’ mental health – a subject brought to prominence by the Royal College of Psychiatrists. The starting point for the discussion was simple: should all universities have a mental health policy?

At first there seemed to be unanimous agreement from panelists: yes, all universities should have a mental health policy. Since all of the panelists were (to some degree) involved in supporting students’ mental health, this probably wasn’t surprising. Why would anyone not want to make it easier for students to access support, right? But the discussion grew more complex, and an opposing point was raised that I hadn’t anticipated. After reflection it became clear though that the disagreement was not based on a difference of views, but on an ambiguity found in the RPsych’s recommendations – one that I hope to clear up here.

The argument put forward by one of the panellists was that, whilst all universities should have mental health policy, it should not necessarily be based in a single ‘mental health policy’ document. The wider point that they alluded to was that, since the mental health of students is interrelated with other subject areas (such as disability issues and student services), it cannot be looked at in isolation; to expect universities to be able to extricate mental health policy from related policy areas and present it in a single uniform document risks oversimplifying the issues.

In some ways, this view aligns with the principles of the Healthy Universities project (based on the World Health Organisation’s settings-based approach), which recognizes that health and wellbeing is not a standalone issue but one that necessarily involves wider environmental factors. We know that social factors have a profound influence on mental health, therefore for universities to modernize and adopt settings-based approaches they need to recognize the links between mental health and wider campus issues – even those issues traditionally considered to be academic (as alien as this idea may be to certain VCs). The panellist was surely right, then: mental health policy must be embedded into wider institutional policy. And yet, the content of policy and the presentation of policy are not necessarily the same thing.

What the Royal College of Psychiatrists’ report fails to do is recognise the dual roles of a mental health policy. If we explore the definition of ‘policy’, we’re confronted by two interpretations. Whilst on the one hand policy exists to provide standards and guidelines for policy-makers and those policing policy, on the other hand, it exists as a public statement of intent – a contract between those with the power to implement policy, and those whom the policy affects. The former, we can think of as ‘policy‘ (or a number of related policies), the latter as ‘a policy‘ – which is about communicating ‘policy’ to stakeholders through a single document.

The reason I first got involved in mental health campaigning was not to address gaps in support, but gaps in communication. The Mind Matters Society was launched to ‘bring mental health out of the shadows on campus’ – by challenging stigma around mental health issues, but also by making information about mental health more available to students so that they could make their own choices. The latter of these goals (although not as topical as the former) is just as crucial. The sharing of good information necessarily reduces discrimination, but a reduction in discrimination does not necessarily lead to useful information being shared. As long as information about a university’s mental health and support provision remains impenetrable to students, mental health will be a subject difficult to grapple with. It’s for this reason that a formal statement outlining the university’s commitment to student mental health is so important.

The task for universities,therefore, is to provide a policy document on the subject of mental health that is accessible to those it affects, whilst also ensuring that policy on mental health remains embedded within its wider system. The dozens of university mental health policies already in place suggest that this is achievable.

If universities need to provide multiple policy documents then so be it, as long as there’s one starting document that sets out the university’s commitment to the mental health of students. As Chris Brill, the ECU’s policy advisor suggested during the discussion, irrespective of the complexity of policy, universities can offer a reference document that outlines the university’s position on mental health. It’s this that I believe the RPsych’s report is referring to it when it speaks of a ‘mental health policy’, and it’s this that I am campaigning around. Whether the title of this policy document contains the term ‘mental health’ is up to them, but  when ‘mental health’ is the universally used term to capture psychological issues and treatments, why complicate matters further by calling it anything else?

How We Can All Make A Difference on University Mental Health & Wellbeing Day

Note: This article was originally published on www.huffingtonpost.co.uk, here.

It seems like almost every day is an awareness day for something or other. There are a handful of awareness days, weeks, and months that get global attention and raise funds for vital causes. But then there are more obscure awareness days, not necessarily any less vital, perhaps, yet not quite managing to gain the same attention. There is, apparently, a National Pig Day, a Potato Awareness Week, and even a National Toilet Tank Repair Month – which, coincidentally, falls in the same month as National Pickled Peppers Month.

So it was with some trepidation that the idea of a University Mental Health & Wellbeing Day was put to me. Would it get lost in a sea of awareness days? Would the creation of yet another awareness day cause eyes to roll? I was unsure. But after thinking about it, I realised that an awareness day isn’t just about trying to squeeze a date into the diaries of those who would otherwise be uninterested. It’s also about aggregating the resources of those who are already involved with a cause – to get stuff done.

There are many people with an interest in university mental health; including university support staff, student unions, charities, and a growing number of student campaigners. But it’s hard to unite everyone. The issues are complex, and we have our own narrow remits and institutional issues to deal with. This is where University Mental Health & Wellbeing Day comes in. For one day of the year we can try and take a step back from the individual problems we’re working on, focus our resources on addressing the issues that exist across institutions, and know that there are others, all around the UK, who will be doing exactly the same.

Tomorrow is the second annual University Mental Health & Wellbeing Day, led by the University Mental Health Advisors Network (UMHAN). Amidst the campus events and activities aiming to raise awareness of mental health, there will be an opportunity to work towards accomplishing specific, shared goals. Goals that are unambiguous and worthy of broad support.

The most comprehensive guidance paper for university mental health is the Royal College of Psychiatrists’2011 report, which outlines a series of recommendations for how universities can improve the mental health of their members. In its recommendations, there is one that stands out for being relatively straightforward and achievable, and it’s this in particular that, in 2013, campaigners have an opportunity to push for. The recommendation reads as follows:

It is recommended that all higher education institutions have a formal mental health policy. This should ensure that they meet statutory obligations under disability legislation. It should also cover areas such as health promotion, the provision of advice and counselling services, student support and mentoring, and special arrangements for examinations (Universities UK/GuildHE Working Group for the Promotion of Mental Well-Being in Higher Education, 2006).”

It’s a precise recommendation, and when combined with guidelines on developing a mental health policy, available for download from the website for the Working Group for Promotion of Mental Well-being in Higher Education, there seems little room for ambiguity.

At its most basic, a mental health policy represents an institution’s commitment to supporting the mental health of its members. With it, staff and students can be familiar with the rights and opportunities offered to them, they can hold the institution accountable to its policy, and they can seek improvements to it when they deem it necessary. But it’s more than this. It provides a shared starting point from which the institution and its members can collectively identify and explore broader issues that go beyond the scope of the institution, such as cultural and political factors affecting the Higher Education sector at large.

For the policy to be meaningful it needs to be actively monitored, and reviewed and updated to reflect the needs of students and staff, as well as ongoing changes that affect universities. This is why each university should be encouraged to make their mental health policy publicly available through their website.

In December I wrote an article asking, ‘whose responsibility is student mental health?’ There was no easy answer to it. But on University Mental Health & Wellbeing Day, there is something we can all do. We can give our support to the range of activities taking place. We can champion great work by students, staff, and institutions. And we can push for each institution to have in place a formal, up to date, and publicly available mental health policy. It might not fix everything, but it’s a start.

Visit here to sign a petition urging the CEO of Universities UK – the representative body for 134 institutions – to encourage and support all of its member institutions in developing a mental health policy.

Think Tank Reports Minorities Have Lower Well-being. How valid is the data?

The New Economics Foundation’s Centre for Well-being, a leading think tank for well-being research and policy, expressed concern today about apparent disparities in well-being between ethnic groups. The corresponding report says the following:

“We find that Black, Arab, Bangladeshi, Pakistani, and Indian people experience significantly lower well-being than White people in the UK, even when controlling for individual characteristics”.

The research might have controlled for individual characteristics (I don’t know, I haven’t read through it yet…), but what about cultural characteristics?

The questions that the participants in the study were asked were based on self-perception (i.e. how the participants view themselves and their lives). This raises issues. We know, for instance, that according to the latest research there is good reason to believe that those from North America are more likely to show positivity biases than those from Asia, potentially causing them to inflate their own self-rating for life satisfaction (Kim, Schimmack & Oishi, 2012). Then there are the potential language issues that arise from trying to ask subjective questions of those that don’t necessarily share the same first language (the report doesn’t mention what language(s) the participants speak).

I tweeted the Centre for Wellbeing to ask if they had controlled for cultural interpretation of well-being. They responded: “We didn’t control for cultural interpretation. Could be explanatory factor, needs investigation“.

Maybe it doesn’t matter much at this stage, but due consideration of cultural differences is surely going to be crucial as well-being research becomes increasingly influential in policy-making.

References
Kim, H.,  Schimmack, U., & Oishi, S. (2012) ‘Cultural Differences in Self- and Other-Evaluations and Well-Being: A Study of European and Asian Canadians’, Journal of Personality and Social Psychology, vol. 102, no. 4, pp. 856–873.