Exploring Undergraduate Mental Health and Well-being.

Exploring Exploring UndergraduatUndergraduat

e Mental e Mental Health and Health and Well-beingWell-being

The term The term mental health mental health describes a sense of describes a sense of well-being. well-being.

There is still a great deal of stigma attached There is still a great deal of stigma attached to mental health to mental health

It is hoped that providing students with the It is hoped that providing students with the appropriate knowledge, guidance and appropriate knowledge, guidance and support this will relay some of their fears support this will relay some of their fears

The figuresThe figures 50% increase in the number of students seeking 50% increase in the number of students seeking

counselling over the previous 5 years (Kitzrow, 2003).counselling over the previous 5 years (Kitzrow, 2003).

92% of counselling centres endorsed a continued trend 92% of counselling centres endorsed a continued trend towards students on campus with severe psychological towards students on campus with severe psychological problems (Gallagher, 2007).problems (Gallagher, 2007).

50% of students reported having emotional or stress-50% of students reported having emotional or stress-related problems over the past year (Hyun, Quinn, Madon related problems over the past year (Hyun, Quinn, Madon and Lustig, 2006)and Lustig, 2006)

75% of students aware of on-campus counselling services. 75% of students aware of on-campus counselling services. 26% utilized this service (Hyun et al, 2006)26% utilized this service (Hyun et al, 2006)

There is a real need to understand There is a real need to understand students’ worries and the type of issues students’ worries and the type of issues they face.they face.

Issues range from financial worries, Issues range from financial worries, family issues and homesickness to low family issues and homesickness to low self-esteem which may have an effect on self-esteem which may have an effect on their well being and mental healththeir well being and mental health

Many of the issues go unnoticed or Many of the issues go unnoticed or untreated by both the student and untreated by both the student and service personnel within the service personnel within the university university

For many reasons:For many reasons: StigmaStigma Thinking they can copeThinking they can cope Not knowing where to turn Not knowing where to turn Unaware of the services available Unaware of the services available

Previous research have identified a Previous research have identified a number of issues. The majority focus on number of issues. The majority focus on academic success academic success

Data from support and counselling Data from support and counselling services which do not take into account services which do not take into account those students struggling that do not those students struggling that do not seek out counselling or support.seek out counselling or support.

Data from student questionnaires which Data from student questionnaires which address specific issues such as address specific issues such as depression, stress and anxiety depression, stress and anxiety

The fall-out from MH issues among The fall-out from MH issues among students and young people manifest students and young people manifest in a number of ways;in a number of ways;

suicidesuicideself-harmself-harmdrugs/alcohol drugs/alcohol depressiondepressiondrop-outdrop-outpoor academic performancepoor academic performance

One great concern of the current political agenda is young One great concern of the current political agenda is young people’s mental health and incidences of self harm and suicide.people’s mental health and incidences of self harm and suicide.

In Wales the at risk group is from 15-24.In Wales the at risk group is from 15-24.

The average age at Trinity is 22The average age at Trinity is 22

The number of suicide deaths occurring each year in Wales is around The number of suicide deaths occurring each year in Wales is around 300 (aged 15 and over). 300 (aged 15 and over).

Three quarters of suicides are of men: 21 per 100,000 population for Three quarters of suicides are of men: 21 per 100,000 population for men and 6 per 100,000 for women.men and 6 per 100,000 for women.

The suicide rate in Wales is higher than the UK The suicide rate in Wales is higher than the UK average.average.

At least 6,000 people are taken into hospital At least 6,000 people are taken into hospital each year because they have harmed each year because they have harmed themselves.themselves.

In reality, this number is probably much higher, In reality, this number is probably much higher, as many people who harm themselves are as many people who harm themselves are treated as outpatients or keep it hidden and do treated as outpatients or keep it hidden and do not ask for help.not ask for help.

Wales 1996-2006Wales 1996-2006

Although suicide Although suicide is rare, it still is rare, it still ranks among the ranks among the highest causes of highest causes of death among death among young people.young people.

(National(National public health service for public health service for Wales, 2008)Wales, 2008)

Age specific suicide rates, femalesWales 1996-2006Source: Annual District Death Extract (ADDE), ONS

0

1

2

3

4

5

6

7

8

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85+

Age band

rate

per

100

,000

Age specific suicide rates, malesWales 1996-2006Source: Annual District Death Extract (ADDE), ONS

0

5

10

15

20

25

30

35

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85+

Age band

rate

per

100

,000

European age standardised rates (EASRs), suicide or event of undetermined intent, males aged 15+,by Local Health Board: 1996-2006Source : Annual District Death Extract (ADDE), ONS

0

5

10

15

20

25

30

35

40

The V

ale

of

Gla

morg

an

Monm

outh

shire

Torf

aen

Card

iff

New

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Isle

of

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sey

Gw

ynedd

Pow

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ynon T

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Welsh average = 21.5

Compared to Wales Signif icantly low er Low er Higher Signif icantly higher

European age standardised rates (EASRs), suicide or event of undetermined intent, females aged 15+,by Local Health Board: 1996-2006Source: Annual District Death Extract (ADDE), ONS

0

2

4

6

8

10

12

14

16

18

New

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of

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sey

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Bridgend

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iff

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Welsh average = 5.6

Compared to Wales Signif icantly low er Low er Higher Signif icantly higher

Key initiatives in WalesKey initiatives in Wales

Mental Health first aid programme Mental Health first aid programme (Mind Cymru)(Mind Cymru)

Extension of CALL help line to a 24/7 Extension of CALL help line to a 24/7 facility facility

Strategies to reduce self harm and Strategies to reduce self harm and suicidesuicide

Strategic ObjectivesStrategic Objectives Promote mental health and well-beingPromote mental health and well-being

Improving children and young people’s MH through the healthy schools schemes and PSEImproving children and young people’s MH through the healthy schools schemes and PSE

Expansion of school counselling services Expansion of school counselling services

Develop additional approaches to providing the population with information, help and adviceDevelop additional approaches to providing the population with information, help and advice

Deliver early interventionDeliver early interventionEnsuring timely access to a range of information, counselling and support servicesEnsuring timely access to a range of information, counselling and support services

Structured counselling in primary care settings Structured counselling in primary care settings

Response to personal crisisResponse to personal crisisFull development of crisis resolution and home treatment services Full development of crisis resolution and home treatment services

MH advisors are available to each youth offending teamMH advisors are available to each youth offending team

Ensure rigorous follow up and support for care leaversEnsure rigorous follow up and support for care leavers

Manage the consequences of suicide Manage the consequences of suicide and self-harmand self-harmEnsure that support and counselling services are available for those affected by suicide and self harmEnsure that support and counselling services are available for those affected by suicide and self harm

Develop guidelines for local partners on responding to a suspected cluster of suicides Develop guidelines for local partners on responding to a suspected cluster of suicides

Promote learning and research and Promote learning and research and improve information on suicide and improve information on suicide and suicide preventionsuicide preventionEvaluation of suicide and self harm programmes Evaluation of suicide and self harm programmes

Undertake action research on outreach work to investigate MH and well being needs and encourage Undertake action research on outreach work to investigate MH and well being needs and encourage help seeking behaviour in children and young people help seeking behaviour in children and young people

Work with the media to ensure Work with the media to ensure appropriate reportingappropriate reportingWork on developing national media guidance in collaboration with other home nations and SamaritansWork on developing national media guidance in collaboration with other home nations and Samaritans

Use of social networking to raise awareness of suicide and sources of support Use of social networking to raise awareness of suicide and sources of support

However…what about HE However…what about HE students?students?

All of the prospective strategies and All of the prospective strategies and interventions concentrate on schools, interventions concentrate on schools, those in care and young people in general.those in care and young people in general.

There is no current strategy aimed at There is no current strategy aimed at helping students in higher education.helping students in higher education.

Universities and HE colleges are left to Universities and HE colleges are left to monitor and deal with these issues monitor and deal with these issues themselves.themselves.

Our StudyOur Study

Aims of the research Aims of the research

To develop a comprehensive To develop a comprehensive strategy/good practice guideline strategy/good practice guideline to support students’ mental to support students’ mental health and well-being during their health and well-being during their time at university. time at university.

To facilitate this, a collaborative To facilitate this, a collaborative group consisting of academic and group consisting of academic and support staff and student hostel support staff and student hostel wardens will work together to wardens will work together to identify the level and risk in identify the level and risk in terms of mental health and well-terms of mental health and well-being. being.

All members of the group have undertaken the All members of the group have undertaken the Mind Cymru ‘Mental Health First Aid’ course Mind Cymru ‘Mental Health First Aid’ course which teaches people how to recognise the which teaches people how to recognise the symptoms of mental distress and provide initial symptoms of mental distress and provide initial help. help.

All wardens have received training from student All wardens have received training from student support staff and the university’s counsellors.support staff and the university’s counsellors.

All members have available to them key contact All members have available to them key contact names and numbers – provided in their student names and numbers – provided in their student survival guide and warden pack.survival guide and warden pack.

Initial meetingsInitial meetings Assured that they are not there to diagnose, Assured that they are not there to diagnose,

but simply to listen and provide advice, but simply to listen and provide advice, guidance or referral to the most guidance or referral to the most appropriate person/agency.appropriate person/agency.

Confidentiality/anonimity Confidentiality/anonimity

Discussed potential issues and difficulties Discussed potential issues and difficulties they may face. they may face.

Year of Year of studystudy

Level of StudyLevel of Study Time of DayTime of Day GenderGender

0800 to0800 to12 12

middaymidday

12 12 m’day m’day

toto16001600

16001600toto

20002000

2000 to2000 tomidnightmidnight

Midnight toMidnight to08000800

11 22 33 44 UGUG PGPG MM FF

Brief note of the issue brought to your attention:Brief note of the issue brought to your attention:

Warden ActionWarden ActionNote, if applicableNote, if applicable

Reassurance, no further action Reassurance, no further action

Reassurance, further Warden contact necessaryReassurance, further Warden contact necessary

Reassurance, referral to Student ServicesReassurance, referral to Student Services

Reassurance, referral to Counselling ServicesReassurance, referral to Counselling Services

Emergency action necessary – contact duty Personnel in Emergency action necessary – contact duty Personnel in CollegeCollege

Emergency action necessary – external services contacted Emergency action necessary – external services contacted (please indicate which)(please indicate which)

Name of Warden

Name of Block/House

DateDateNumber of requests to Warden during the Number of requests to Warden during the

week -week -

Issue related to…..Issue related to….. Brief detail, with action taken (please continue overleaf if necessary)Brief detail, with action taken (please continue overleaf if necessary)

General, non General, non specificspecific

MaintenanceMaintenance

CateringCatering

SafetySafety

Student Student DisturbanceDisturbance

Personal issuePersonal issue

Data Gathering Form Weekly Sheet

Monthly focus group meetings

Discuss and collate information on well being and mental health issues that arise in the student population

Discuss courses of action taken to support individuals and to identify any ‘gaps’ in provision

It is anticipated that this evaluation will aid early identification of MH issues and the development of early intervention strategies to support student wellbeing

Issues discovered so Issues discovered so far…far…

Family issuesFamily issuesTransition from school/college to university Transition from school/college to university

Leaving home for the first timeLeaving home for the first time

Alcohol inducedAlcohol inducedDepressive episodes Depressive episodes

Academic worries Academic worries

Suicide/self harmSuicide/self harmSelf harmingSelf harmingSuicidal thoughts Suicidal thoughts

What do we hope to gainWhat do we hope to gain Information from students about Information from students about

students.students.

Provide the students with a mental Provide the students with a mental health and well being guidehealth and well being guide

A set of mental health and well-being A set of mental health and well-being issues that can be used to develop issues that can be used to develop further studyfurther study

Where will the research go Where will the research go in the futurein the future

A set of mental health and well-being A set of mental health and well-being indicatorsindicators

Encourage other Universities/colleges to Encourage other Universities/colleges to undertake a similar programmeundertake a similar programme

Provide a guide book for student well being Provide a guide book for student well being and mental health for all Universities/HE and mental health for all Universities/HE colleges.colleges.

Gallagher, R. P. (2007). Gallagher, R. P. (2007). National survey of counseling center National survey of counseling center directors. directors. International Association of Counseling Services, Inc.International Association of Counseling Services, Inc.

Hyun, J. Quinn, B. Madon, T and Lustig, S. (2006) Graduate Hyun, J. Quinn, B. Madon, T and Lustig, S. (2006) Graduate Student Mental Health: Needs Assessment and Utilization of Student Mental Health: Needs Assessment and Utilization of Counseling Services. Counseling Services. J.Coll. Stud. Dev. J.Coll. Stud. Dev. 47(3):247-266.47(3):247-266.

Kitzrow, M. A. (2003). The mental health needs of today's Kitzrow, M. A. (2003). The mental health needs of today's college students: Challenges and recommendations. college students: Challenges and recommendations. NASPA NASPA Journal, 41 (1), Journal, 41 (1), 165-179 165-179

National public health service for Wales. Suicide in Wales National public health service for Wales. Suicide in Wales Briefing document to Bridgend Local Health Board January 2008 Briefing document to Bridgend Local Health Board January 2008

Price S (2007) Price S (2007) Suicide Prevention: Summary of the EvidenceSuicide Prevention: Summary of the Evidence. . National Public Health Service for Wales. National Public Health Service for Wales.

Welsh Assembly Government. A National Action Plan to Reduce. Suicide and Self Harm in Wales 2008-2013

ReferencesReferences