Academics need greater help in addressing the mental health problems of their students

Increasing numbers of students are seeking counselling, suffering from depression and even feeling suicidal. Jason Murugesu urges universities to put much stronger systems in place to provide essential backup for teaching staff

October 17, 2019
Illustration of students sinking
Source: Anke Gladnick

“I couldn’t risk losing another one,” says an academic we’ll call Anna, in a university courtyard on a late summer’s day. The campus is bristling with anticipation for the new academic year.

Anna is wearing a floral shirt and radiates warmth and affability. She is talking about a student who was in such a state that she decided to walk him to A&E: “What if he got lost? I mean, I would feel responsible till the end of my days.”

She also recalls another student who emailed her about suicidal thoughts on a Saturday night: “I think I spent a couple of hours on the phone with this student and her friend who was also there. I made sure that the friend would get her to A&E.”

A few years ago, Anna did lose a student to suicide. The death made her and her colleagues a lot more anxious: “The possibility of something really bad happening is very much at the forefront of our thoughts. It really weighs on you.”

More and more students are looking to academics for support with serious mental health issues. It is only natural that academics such as Anna want to do all that they can to support such students. Nevertheless, they often experience the kind of helplessness described by “Sam”, a social scientist at a university in the Midlands, when he talks about a student he recently lost to suicide.

“Even when you are helping someone,” he explains, “you’re wondering: is there something more I can do?”

What overwhelms him most, Sam goes on, is the “sheer number of students that need additional support”, noting that even “just sitting down and talking to people who’ve had a really rough time – it takes a toll”.

Students often don’t realise the lengths some academics will go to to look out for them. Niamh, for example, lost her brother (also a student) to suicide while she was in her final year of university. But she was determined she would finish the academic year and signed up to student mental health services.

On one occasion, a few weeks after her brother’s death, she was in tears talking to her mother on the phone. A few hours later, she bumped into her personal tutor outside a coffee shop. Niamh would only discover a year later that the meeting wasn’t a happy accident. Her mother had emailed the tutor about her worries. And the tutor had then spent an hour scrambling around campus looking for her.

Studies generally show that student mental health is getting worse. A report published by the Institute of Public Policy in 2017 found that, in the previous five years, most higher education institutions saw at least a 25 per cent increase in the numbers of students requesting counselling. Those disclosing a mental health condition to their university, according to the Higher Education Statistics Agency, doubled from 33,045 to 66,660 (between 2014 and 2017).

Universities UK also found a steady increase in the number of student suicides in the past decade, with 95 between July 2016 and July 2017 (the latest available statistics). Yet, significantly, two-thirds of students who die by suicide are not known to university mental health services. In such cases, the most senior adults they are in contact with are likely to be those who teach them.

On one level, this makes sense. Academics are the personal tutors, course organisers and lecturers who see their students on a regular basis and whom students are encouraged to make their first port of call at times of distress. Yet academics are not counsellors, and most have had no training in how to support such students. Many are themselves struggling with the pressure to publish, the lack of long-term contracts and failed grant proposals.

So is it fair to expect academics to shoulder this burden and are universities doing enough to support them? In Anna’s case, very little help was forthcoming.

After her student’s death, she emailed senior management several times about offering counselling sessions to those in the student’s year group. It was a relatively small cohort. The university responded by asking who in the class needed it most.

“How would I know?” Anna replied.

Group counselling sessions were offered instead, although again only at her request.

Meanwhile, Anna and her colleagues went back to work as usual. Nobody at the university asked if they were OK or offered them counselling sessions.

Since the personal tutors in her department are not trained in pastoral care or how best to look after themselves, Anna tried to organise a workshop with student mental health services. But she found they were unwilling to help, saying they didn’t have the time or personnel to spare.

Other factors exacerbate the tendency for academics to take on much of the burden of trying to aid students with mental health problems.

One is the lack of clarity about what their “pastoral” responsibilities entail. Most people would agree these include helping a student with a piece of reading or an essay, but should that extend to a student’s personal problems? In practice, it is virtually impossible to make such a clear-cut distinction, given that academic and personal problems very often overlap.

University guidelines often suggest that academics should restrict their interventions to “signposting”: telling students what their options are and explaining how to get help. Academics are not meant to provide this help themselves.

Yet the simple word “signposting” disguises how complicated such a task can be. As Anna points out, “You have to decide, ‘Is this a small thing where a couple of tissues is enough or is it serious?’ – which none of us are equipped to do.”

Hannah Murray, a teaching fellow in early American studies at the University of Liverpool, adds that signposting works only if the rest of the system is working: “Counselling services both within and outside the university have incredibly long waiting lists and students still need someone to listen to them and help navigate issues around attendance.”

Furthermore, Murray highlights the fact that the responsibility for supporting students in distress tends to fall largely on female academics. Several studies show that students are more likely to see women as caring and nurturing, and so to go to them with their problems. This adds an extra gender dimension to the general issue of academics having to step up when students suffer from anxiety or depression.

Illustration of student on a life ring

Taking all this together, we clearly have a grim situation. More students suffer from mental health problems, and yet it is often untrained and unsupported academics (particularly women), rather than professionals, who end up on the front line providing support. Neither students nor academics are best served by this system. So what needs to change?

Gareth Hughes, research lead for student well-being at the University of Derby, is one of the few academics to have studied the effects of the student mental health crisis on academics. He believes that there needs to be better communication between academics and student mental health services, noting that his university has established a phone line specifically for academics to call about students they are worried about.

Although students are becoming more open about mental health, Hughes adds, academics have not kept pace. No senior university leader, he claims, has openly discussed struggling with mental health. For academics and students alike, “universities should be a place where it’s OK to admit this stuff”.

Helen Carr, the University and College Union’s national head of equality and participation, agrees that there is a “taboo in a lot of places about [academics] disclosing issues around mental health because employers might think their mental health issues [could] affect students”. Managers need to be given the tools to talk to academics about mental health, and a culture change is required in academia too, so academics feel comfortable talking about it among themselves.

Murray would like the responsibility of supporting students shared more equally between men and women. Although she acknowledges that it may be difficult to overcome broader societal expectations, one solution would be for all first-year students to have personal tutors who also teach them. That way, the student would be more comfortable speaking to them outside the classroom, man or woman.

Perhaps the most comprehensive set of suggestions comes from “Bob”, a chemist at a university in the north of England.

In his own role as a personal tutor, Bob gets two or three students a week coming to him with personal problems. He has had 10 students talk to him about suicidal thoughts in the past three years. He even had meetings at 9am every day for a month with one student he was worried about, just so he knew that “he was safe”.

Despite the burden of all this, Bob reports on several support systems that his university has put in place – and that others could also consider. In his own department, every new personal tutor is given an academic mentor who can advise them on how to deal with difficult situations. Moreover, all tutors must take a two-day “mental first aid course”. The department designates “year tutors” who receive a higher level of mental health training and who can provide additional support to individual personal tutors.

There is also another level of support. Notwithstanding the challenges of dealing with students who come to him in distress, Bob stresses that it is the students who do not talk to academics about their issues who worry him even more. By the sixth week of the new year, therefore, he has created an electronic watchlist of students he is concerned about.

“We look at engagement,” he explains. “We look at marks. We see if students did not attend.” Bob’s students have no idea about the level of resources the university is putting in to keep an eye out for them.

All these solutions reflect the difficulties in being an academic today. In 2017, Universities UK created a framework for university mental health called StepChange. One of its suggestions was to “enhance the role of the personal tutor”, although (like other suggested solutions) this in effect implied that the key to helping overwhelmed academics is to put even more responsibility on their plates.

It is fairly uncontentious that students should feel comfortable talking to academics about their mental health, and that academics should be better trained in supporting their students. But is this enough? Anna’s solution is the most straightforward. She wants her department to have a psychotherapist on call, someone whose sole job is to support students, “even just for three hours a day”.

Although Universities UK claims that mental health is “of course” a priority for universities, Anna’s comment – “You don’t have to build another wonderful expensive building – just get a couple more people in” – makes it clear that many academics are sceptical.

According to a BBC investigation published in 2018, UCL was one of the universities that spent the most on mental health in the 2016 academic year: just over £1.3 million. Yet what was the price tag for the redevelopment scheme for its law building in the same year? £16.5 million.

Perhaps saying mental health is a priority is no longer enough. Ultimately, as many hard-pressed academics will tell you, it’s money that talks.

Jason Murugesu is a postgraduate student at Imperial College London studying science communication.

POSTSCRIPT:

Print headline: Stemming the tide of misery

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Reader's comments (6)

Or maybe, just maybe, academics are not the appropriate personnel to deal with mental health issues at all (i.e., not clinically trained)? It's like saying, we do not have enough doctors (i.e., GPs) and so we need to have more non-medically trained personnel (e.g., clerks) do their job. The solution is to have adequate mental health professionals in HE.
Academics should not be expected to deliver the support for students with mental health issues, but they do need to be able to handle a crisis or a concern appropriately and there should be clear training and guidance about what to do and how far their responsibilities should go so everyone is on the same page. But more importantly, as the article says, there should be sufficient professional support available. At my institution, we have training which is quite good (but not all academics attend - I think it should be mandatory), there are designated "mental health first aiders" in the departments (who tend to be administrators - something that I don't think should not be the case), and a clear way to identify students about whom staff may be concerned. All good. BUT there is inadequate professional support on campus and the people who are providing that support are overwhelmed. We just had another suicide this week. While staff reacted quickly to a concern raised by another student, it was too late. Perhaps if the student in question had been able to easily access support on campus quickly, it would not have happened. As the article points out, the expectations on academic staff by students and the institution is causing major stress for the academics as well. At a different institution where I worked, each department had a designated Wellness Advisor who was in the department twice a week at designated times for anyone, staff or student, to see and who could be contacted at other times, as well as having a crisis team and the usual student support teams. This type of professional support should be the norm.
A lot of front-line staff dealing with students don't receive training either, so this is not just solely an issue for academics. Having been a warden in a hall of residence, I've undertaken Mental Health First Aid training but I'm now recommending this to all of my team of immigration advisers (we prefer to call ourselves professional services staff not administrators). I would recommend this to anyone who works directly with students in a pastoral setting, regardless of their role in an institution. With student deaths being so high-profile at the moment in the media, there will be increased expectations from institutions. However, if you are required to be an academic mentor as part of your role, then unfortunately this will be part of it. The key is knowing when to refer on or to ask for help.
I have read a number of articles like this and most of them conflate a wide range of issues that affect society as well as universities and other major institutions. What is missing in universities is a strategic perspective on health. The result is that well meaning individuals can feel tempted, for whatever reasons, to take upon themselves the belief that they as individuals carry the responsibility for other people's health and well-being. Others do not for many good reasons. The strategic perspective will emerge through co designing conversations between all those involved. It is not necessarily about funding services but exploring attitudes beliefs and their consequent behaviours so that as our complex human systems develop we learn what it is to be mindful of health for all of us in society and within institutions. Time to take a step back a little.
For acute physical ill health, unis have trained first aiders. It is expected that academics signpost to health services, and not start ‘treating’ students themselves as unis are aware staff lack relevant clinical experience. Academic mentors are expected to look at how the physical ill health impacts on academic performance and advise on how the student can continue with their studies. For acute mental ill health, unis should therefore also have much more ’first aider’ staff available for ill mental health, alongside more counsellors, psychotherapists etc for relevant response and treatments in parallel to health service. This as in a similar fashion to acute physical ill health, academics are not trained/do not have clinical expertise in acute care for ill mental health. Academics are most times well-meaning and caring for their students, and they can be expected to be supportive of students with acute issues as personal mentors whether ill mental or physical health, but that mentoring role should not be expanded into requirement to act as first aider. The lack of appropriate provisions is damaging not only to the students at uni but also to uni staff that is already overworked.
This is a well researched and informative article by the university student Jason Murugesu on the large increase in HE students seeking help with mental health or psychological issues and the subsequent impact that this has on academics who wish to support the students, but usually have little or no training in the area. In some institutions academics are encouraged to 'signpost' the student of concern to the HE's Wellbeing department, which itself might well be overstretched. However, even to effectively 'signpost' it is essential that proper training for academics is provided so that they are more likely to recognise the signs requiring action. Academics who are personal tutors are not expected to act as counsellors, but are often the first person in the institution that a student in distress opens up to seeking help - even if this is not always obvious. It is essential that they have at least some training in student mental health issues, so that personal tutors are aware of the boundaries of their role and are not pulled into supporting a student beyond their professional capacity. Moreover, it is important that they are able to identify a student whom may be struggling, whilst also being confident in knowing what to say to them so as not to exacerbate an issue and offering a degree of understanding and pragmatic guidance to ensure that the student feels the staff member is responding in their best interest. Importantly, any new training offered to staff needs to come with a sustainability and good practice clause, whereby staff have to receive ongoing supervision and they continue to feel supported when confronted with the reality of mental health which can be unnerving, messy and difficult to navigate. Any training which offers tools always needs additional on-going support of the person trained to ensure that they ‘practice’ appropriately. There are organisations like mine (UMO Pro) which do offer appropriately focused training, supervision and specialist mentoring to academic staff on mental health issues. That a significant increase of staff are availing themselves of this service shows that the problems are becoming more openly recognised and HEIs are beginning to take steps to improve their support for academic staff when confronted with mental health issues. However, it is clear that this is only a start and much more needs to be done including research. While there is a body of research into student mental health there is little or no research into academic mental health issues or how academics interact with students as personal tutors when confronted with a student displaying signs of psychological distress.

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