Scholarship to North America - building the whole university population's capacity to respond to mental health

I’m visiting universities in the US and Canada on a scholarship, funded by The Churchill Fellowship, to investigate effective mental health training initiatives for students and non-clinical staff.  

From my experience as a trainer and from managing the Student Mental Health Research network and contributing to the research phase of the Student Mental Health charter, it is clear to me that mental health training in universities needs to be thought about in a more considered and strategic way.

With year-on-year increases in student mental health issues, many non-clinical staff (and students) describe responding to poor student mental health as an inevitable part of their role. Research tells us many of these groups feel under-prepared and under-supported to act effectively.

Universities have a duty to ensure staff know how to respond to presentations of poor student mental health. Ideally all staff would be able to spot the signs of someone struggling and have the confidence and knowledge to signpost them to the right place. To this end, many have made mental health training available for all staff (and often for students too).

However, the university population is complex and designing a mental health training provision that meets everyone’s needs is not straightforward. For a start, different types of staff encounter students in different contexts and relationships, from labs and libraries to halls of residence or perhaps via virtual means only.

Many staff have pastoral duties as an inevitable part of their job - such as PhD supervisors, Academic tutors, managers - but are wary of receiving extra training that is too generic and not tailored to their specific role and context.

At the other extreme, significant numbers of staff and students have taken on additional duties - such as student peer supporters, Mental Health First Aiders, Resident Advisors or wardens - that require both a more advanced mental health literacy training and an ongoing emotional commitment. Ideally these non-clinical staff responding to mental health issues would have consistent emotional support and space to develop and navigate challenges and boundaries through reflection with others. Research suggests this is an area the UK could improve upon.

Quite simply, mental health training can’t be a one size fits all.

I want to learn from experts in North America. How do the leading universities plan mental health training at scale, which caters for the idiosyncrasies of the university community? How do they support the ‘supporters’ – the non-clinical staff and students who are responding to student and staff mental health issues. And how do they measure their impact?

I want to return with a suite of evidence-based practices to share with my UK network, so that together we can make mental health training in UK universities more impactful. Mental Health training can lead to lives being saved; the more effective and suitable we can make it, the better we can protect the people in our university communities.

Should UK Universities teach Mental Health as part of curriculum? - what can North America teach us..

On Monday I depart for the USA and Canada for 7 weeks. Funded by Winston Churchill Memorial Trust, I’m learning how North American Universities have successfully put Mental Health on the curriculum, so we can follow suit in the UK.  

I’m an Associate Trainer for Mental Health First Aid England. In workplaces and Universities across London, I’ve trained hundreds of people to be Mental Health First Aiders. They leave confident in approaching and talking to someone in distress – perhaps depressed or anxious – and equipped to respond in critical cases like panic attacks, psychotic episodes and suicidal ideation. In a nutshell, the training encourages people to ask others, genuinely, how they’re feeling – without fearing the response or fretting about saying the wrong thing.

Inevitably, during these two training days, participants think, talk and learn a lot about their own lives too. Such as how they’ve handled setbacks. How setbacks then helped them build self-understanding. How they cope with life’s stresses. How often they’ve resorted to drinking ten pints rather than sharing their troubles. How one mistake at work led them to spend a week branding themselves a failure / expecting an imminent sacking.

We call it mental health. Perhaps it’s better called the inevitability of being human.

There is always more we could learn. Understanding ourselves and our psyche is a lifelong pursuit. I think Universities should encourage their students to talk and be curious about it, to thereby be better equipped for life’s ups and downs. It’s this conviction that’s driving my scholarship to North America.

I’m also privileged to manage a national student mental health research network, Smarten, based out of King’s College London. There’s been a furore in University Student Mental Health in recent years. Suicides are increasing. Students are reporting worse mental health than ever before – some reports suggest a five-fold increase over the last ten years. But we lack data to understand why. UKRI, the Government’s research arm, set up SMaRteN to ask: what is the true prevalence, what are the reasons behind it and, critically; what works (or isn’t working) to help students feel better. Comprised of 1,000 researchers, University staff and students across the UK, we’ll spend the next 3 years trying to crack this.  

One hotly discussed topic amongst our network is whether Universities should make Mental Health a compulsory part of curriculum. How effective would this be, and how could we do it well? Several Universities are giving it a go, yet this is relatively unchartered territory in the UK.

Universities in the USA and Canada pioneered in-curricular mental health teaching long before us. Over the next 7 weeks I’ll visit and learn from the continent’s most longstanding and successful models. My itinerary is listed below. During my visits I’ll probe with curiosity; how exactly are you encouraging student (and staff) conversation about Mental Health? What kind of things are you teaching about? How did you implement it? What challenges did it bring? What do students think about it? How do you measure impact?

I want to return with a suite of options, empirically evidenced and adaptable for the UK climate. But most importantly I’ll bring back practical information, real stories and behind-the-scenes insights that couldn’t be gleaned from data and desktop research alone. I’ll bring together SMaRteN network members and interested parties to benefit from my learning. How can we use it to bolster a culture of compassion, self-enquiry and authentic conversation in our own Universities and workplaces?

As I go, I’ll build connections between the UK, Canada and the US. I’ll create an international eco-system of Universities that value well-being as much as academic success.  

If you’d like to connect on my return to the UK in early May, please get in touch; Laura.Beswick@kcl.ac.uk – or follow my activity on Twitter @laurabeswick1

Itinerary

At Harvard University I’ll meet with the Office of the Provost about their Student psychological well-being task force ,  Jeanne Mahon, Director of the Center for Wellness and Health Promotion and the staff who developed a Science of Stress module .

Also in Boston I’ll meet with Abigail Lipson from the steering committee of the Academic Resilience Consortium.

In Philadelphia I’ll meet with staff from University of Pennsylvania’s Counselling and Psychological Services, responsible for the I CARE programme , a training for students, faculty and staff that builds a caring community with the skills and resources to intervene with student stress, distress, and crisis. So far 4,000 members of the University have gone through the training.

At Georgetown University I’ll spend time with Joselyn Lewis, Senior Associate Director for Inclusive Teaching and Learning and her team responsible for the Engelhard project; . Running since 2005, and one of the most well-established models of collaborations between Academic Schools and Student Services, it integrates well-being issues into academic contexts.  

At George Mason University, Virginia, I’ll meet with Nance Lucas, Chief Well-Being Officer and Executive Director of the Center for Advancement of Well-being and Melissa Schreibstein, Director of Well-being programs at the Center. Established in 2009, the Center develops well-being programs and resources for the George Mason community and beyond. Being ‘a model well-being University’ is a goal of the University’s strategic plan.  

At University of Guelph, Canada, I’ll meet with Associate Professor and Director of Clinical Training, Margaret Lumley, who delivers a Mental Health and well-being module exclusively for students experiencing Mental Health difficulties , together with her colleagues from Accessibility Services.

In Toronto I’ll meet with the Director and team at the Centre for Innovation in Campus Mental Health. They work collaboratively across colleges, Universities and health services in the province of Ontario on Student Mental Health initiatives.  

At University of Washington in Seattle, I’ll meet the Directors of the Resilience lab - a cross-campus collaboration between students, academics, and Student Services staff. Their focus is on designing research-led well-being programmes. They also collect Mental Health-specific longitudinal data about their student cohort - in 2017 they began tracking baseline data for every undergraduate student at entry, after the first quarter and at the end of the first year.

At University of California Santa Cruz, I’ll meet with Gwynn Benner, Assistant Director of Student Services and Managing Director of the Student Success Equity Research Center. She is spearheading a whole-campus approach to improving Student Mental Health.

Putting Mental Health on University curriculum

Student Mental Health is woeful. Suicides have soared 79% in ten years[1]. Dropouts by 210% in 5 years[2]. Campus counselling services are at saturation point and, to boot, stigma prevents over half of students seeking help. The stakes are high. Add to this a new Government mental health charter and ultimatums to Vice-Chancellors to make it priority number one.

It’s a zeitgeist moment. Universities are acutely aware we need a radical approach. We’re scratching our heads. ‘How do we fix the Student mental health crisis’ conferences are announced more frequently than 90’s pop band come-back tours. Universities UK tell us the solution is a ‘whole University, whole population approach to Mental Health’[3]. In other words, Mental Health must extend beyond the counselling service. It must permeate our policies, culture and everyday conversations.

Fantastic idea. Now where do we start? This is uncharted territory. Mental Health is still taboo. 50% of students dare not disclose it[4]. How do you trigger a culture change? How do you make it everyday dialogue?

Putting Mental Health on the curriculum is the answer. We need to find ways to bring it to every student’s study plan, as a complement to their academic studies, whether they have a diagnosed Mental illness or not.

I’m off to North America on this very mission. Funded by the Winston Churchill Memorial Trust, I’ll spend 6 weeks learning from the world experts; the several American and Canadian Universities that have pioneered in-curricular Mental Health courses, with very positive results. Their rationale is compelling; how can a student flourish academically if they are not emotionally robust?

UK Universities would do well to follow suit. It’s time we recognised the intrinsic link between well-being and learning. We’re making a mistake by focusing on the subject discipline alone. 

True, new students spare thoughts on Shakespeare, Pythagoras and test tubes. Overriding these, however, are frets about identity, belonging and culture shock. Later come battles with anxiety, motivation and self-esteem. Disturbingly, some will endure trauma like sexual assault. As important as their academic prowess is their resilience to manage stress, overcome hard times and have optimism for the future.

It’s a tough gig. In fact, it’s the most unstable part of the life span. More students than not have clinical levels of distress in the first 6 weeks[5]. Prevalence of Mental illness is higher during second and third years than first[6], suggesting the University experience is causal. 18-25 is the age bracket most vulnerable to stress, drug and alcohol dependence, personality trait change and schizophrenia. Unsurprisingly, 75% of Mental illnesses develop before age 24.[7]

Why are we not teaching them how to manage their emotional health?  

Imagine the benefits. Putting Mental Health on the timetable would normalise it. Students would learn vital lessons in emotional self-care and available supports. They’d learn positive psychology techniques to re-frame their thinking. Sounds scientific, but it’s really about adopting regular habits to focus on their strengths, motivations and the positives in their lives. Evidence has proven this offsets depression and increases happiness. They’d have skills to spot poor Mental Health in their peers, begin a conversation and signpost them to help. They’d be equipped for crisis moments like panic attacks, psychotic episodes and conversations about suicide.   

Teaching Mental Health would create empathy, reduce stigma and build solidarity. When half the lecture theatre nods that they too suffer anxiety symptoms, you’d suddenly feel less alone. Strategically, it puts Mental Health in a place where all students must confront it. Unlike any other University well-being intervention so far. It also answers academics’ concerns. They’re overburdened in their pastoral roles. Responding to student mental ill health is simultaneously hampering their well-being[8].

It’s the perfect whole University, whole population Mental Health intervention the Government is crying out for. In fact, a number of UK Universities are keen to give it a go. What we lack is the expertise to make the transition.

This is where North America comes in. My research scholarship will probe deep into the continent’s in-curricular Mental Health successes. I’ll find answers to key practical questions; what consultation and planning were undertaken; how is well-being content made academically rigorous; how is impact measured over time. (Particularly because the UK lacks frameworks to measure the latter).

I’ll talk to students. I’m curious to see what resonates. Why, for example, was Yale’s Science of Happiness course the most popular module in its history?  

I’ll find the secret to successful teaching collaborations between Student support Services and academic schools. This is certainly a gulf to bridge in many UK Universities.  

I’ll return with a suite of options, longitudinally evidenced and adaptable for the UK climate. I’ll embed the most successful ones at my institution, Queen Mary University. I’ll collaborate with my partners at Universities UK and Student Minds to share the learning across the country. Over time, we’ll build an ecosystem of Universities that value well-being as much as academic performance. We have a chance to change lives here. I can’t wait to get going.

I will share my journey via this blog. Please follow it, or get in touch if you’d like to be part of it.

[1] Institute for Public Policy Research, Not By Degrees: Improving Student Mental Health in the UK’s Universities

[2] Institute for Public Policy Research, Not By Degrees: Improving Student Mental Health in the UK’s Universities

[3] Universities UK, Stepchange: Whole University approach to well-being

[4] Institute for Public Policy Research, Not By Degrees: Improving Student Mental Health in the UK’s Universities

[5] Oliver Robison, Senior Lecturer for Psychology, University of Greenwich

[6] MaGaskill 2012, Andrews and Wilding 2004

[7] Centre for Mental Health

[8] Student Minds, Student Mental Health: The Role and Experience of Academics