Not all in the mind

Exam stress and mounting debts are leading to depression among students, writes Jennifer Currie.

Depression is one of the most misunderstood medical conditions, despite the fact that it affects one in four people and is thought to be the reason for more than 70 per cent of the 6,000 suicides that take place in the UK every year.

According to the Depression Alliance, the UK charity for people with depression, young people - including students - now account for a large proportion of this national total because of heavier financial and emotional burdens.

Its survey of 1,069 people aged between 15-34 reveals that one in three think they have already suffered from depression, while nearly half admit to knowing someone who has either contemplated or committed suicide.

Antony Tiernan, campaigns manager for the Depression Alliance, believes that a growing number of students turn to suicide or decide to harm themselves to escape worries caused principally by exams or mounting debts. "Depression is seen as a sign of weakness by many people, including those suffering from it, so they won't talk about it. It has to be understood as being much more than a phase that we all go through," he said. "Lecturers and teachers need to be able to identify the symptoms during the early stages."

"A stigma surrounds depression because people can't see it," Mr Tiernan explained. "Unlike a broken leg, you don't know how long it is going to take to heal, and what people don't know about, they tend to fear."

What concerns organisations such as the Depression Alliance is that information on student mental health is vague and subject to misinterpretation.

In order to fill in this information gap, Gill Kester, head of health studies at University College Chichester, has been commissioned to lead the first UK-wide study into the incidence of student death and self-harm, by the Committee of Vice-Chancellors and Principals and the Standing Conference of Principals. "Some institutions have compiled their own reports, but nobody knows what the overall number of suicides in higher education is. Part of the problem is that suicide is not a diagnosis, it is a legal decision made by a coroner," Dr Kester said.

"In a year, we hope to have a baseline database providing incidence rates from institutions all over the country, together with details of the support services that are currently offered by universities. I don't yet know how easy or difficult this will be, but I hope people will see the logic behind this initiative. We can't devise the strategies we need without this kind of information and it simply doesn't exist at the moment."

The CVCP has timed the launch of this study to coincide with the publication of its student mental health guidelines. Designed to help universities and colleges care and provide for students with mental health problems, the guidelines also come as a response to the perception that the number of student suicides is on the increase.

A CVCP spokesperson said: "There is no firm evidence yet that this is a growing problem in universities. We are working on the basis that going to university does not make students commit suicide."

The guidelines encourage universities to promote higher education as a means for students to ward off stress and depression.

"There is a challenge to institutions to help students capitalise on the positive mental health benefits of higher education, while identifying and providing appropriate support to those who are vulnerable to its stresses," the guidelines state. A sense of personal achievement, creativity and increased self-esteem are all put forward as fringe benefits of an undergraduate degree programme. And the guidelines stress that staff training programmes relating to mental health problems should be made mainstream requirements. The CVCP also recommends that internal task groups should be set up to tailor the guidelines to fit individual institutions.

Although student leaders have welcomed the CVCP's moves to improve support structures, the National Union of Students is concerned that greater openness may make students with mental health problems more vulnerable, because of the long-standing taboos associated with the condition.

An NUS spokesperson said: "The admissions criteria for certain professional bodies can be used to prevent well-qualified students from gaining a place. Nursing students have been excluded from their clinical placements as a result of personal appearance, for being too fat, for example, while social work placements have been ejected as a result of once being found drunk and disorderly in a bar. Given that this is how some professional bodies act, the NUS does not want to see undue weight given to a students' mental health history. Each case should be judged on its merits and no blanket exclusions on the grounds of disability are acceptable."

Yet Annie Grant, director of Leicester University's educational development and support centre, who contributed to the CVCP's guidelines, thinks this scenario is highly unlikely.

"Of course a student is entirely at liberty not to reveal their problems. We are trying to promote positive attitudes and an understanding so that students will find help when they require it. I hope and think that these initiatives will find that there is a lot less stigmatism in a higher education context than there is anywhere else."