Policy Brief

Ensuring Adequate Provision of Mental Health Services for Students in Universities

A policy brief advocating for prospective measures to ensure that the counsellor to student ratio in universities in England and Wales more closely aligns with student demand and need.           

To be presented as the following question: What measures can be taken by the Department of Education to ensure there is sufficient access to adequately resourced mental health services by students in universities in the event of an electoral victory for the Labour Party in the next United Kingdom (UK) general election?

For the attention of Angela Rayner, Shadow Secretary of State for Education

Word Count: 1,060

I.              Executive Summary

Universities in England and Wales are widely falling short of the mark in the provision of sufficient mental health services to students in higher education under the jurisdiction of the current government. Currently, counselling services at universities are stretched and understaffed and are thus failing to provide adequate support to students in higher education who are increasingly reporting mental health problems; research from YouGov found that one in four students suffer from mental health problems. (YouGov, 2016) Furthermore, students in higher education are less likely than a member of the general population to seek help, and thus a revision of the current system to ensure the provision of effective mental health services in universities is essential to ensure that support is available when sought.

Upon election, the Department of Education is recommended to:

·      Ensure mental health services at universities are adequately staffed and resourced

·      Ensure students are made aware of and are able to access such services

·      Adjust funding for counselling services when required by changes in student population or demand for services

II.            Situation Brief

Research conducted by the Institute of Employment Studies and Researching Equity, Access and Participation for the current government found that among studied institutions there was ‘an overwhelming consensus that demand for mental health provision was rising’ with increasing numbers of students disclosing an increasingly varied array of conditions before arrival. (IES, REAP, 2015) Furthermore, research by the Institute for Public Policy Research found that a record number of students died as a result of suicide in 2015, reporting a 79% increase in such deaths from 2007 to 2015, as well as a 210% increase in drop-outs attributed to mental health problems from the 2009/10 academic year to 2014/15. (IPPR, 2017)

Coinciding with these drastic deteriorations in student suicides and dropout rates is a chronic understaffing of mental health support services within universities. Research by Brown for the Higher Education Policy Institute (HEPI) found that a counsellor to student ratio of around 1:1,358 would be required on average to meet the requirements of students for a 26-week year; the ratio that exists in actuality being 1:5,000, three to four times lower than the estimated requirement. (Brown, 2016)

The widespread understaffing of university counselling services in the face of such concerning statistics is evidence of the current government’s failure to effectively address this issue. Tackling this issue directly would help to fulfil the Labour Party’s 2017 manifesto promise of ‘increasing the proportion of mental health budgets spent on support for children and young people.’ (The Labour Party Manifesto, 2017, p.73)

III.          Policy Options

Policy Option A – direct funding of a sufficient counsellor to student ratio

The vitality of sufficiently funded counselling services to improve mental health outcomes in students in universities is highlighted in MacAskill’s research on student mental health in the UK, where she explains with regards to that ‘lecturers may not be sufficiently sensitized to these issues…counselling services may have an additional role to play in developing awareness of the mental health needs of students.’ (MacAskill, 2012, p.16)

An article for Times Higher Education highlights that ‘government funding cuts could force universities to make “increasingly tough decisions about who and what they can support”’, echoing the sentiments of the Vice President for Welfare of the National Union of Students that support services were ‘creaking at the seams.’ (Havergal, 2016) The creation of a budget to proportionally allocate funds to universities exclusively for the purposes of ensuring that a sufficient number of counsellors are employed to meet the needs of the student population would directly address this issue of understaffing and prevent its recurrence if maintained.  

Policy Option B – incorporation of mental health support quality into the Teaching Excellence and Student Outcomes Framework (TEF)

An alternative option to improve the counsellor to student ratio in universities in England and Wales would be to incentivise universities to allocate existing funds by incorporating the quality of a university’s counselling services into their evaluation on the TEF. The aforementioned research from the Institute for Public Policy Research details that when universities ‘do not respond to the challenge of student mental health effectively, they risk incurring reputational damage.’ (IPPR, ibid., p.37)

Brown’s research describes how academics have been incentivised to increase their research output and improve the quality of their teaching by the establishment of the TEF. Thus, establishing a distinct category which evaluates the extent of provision of counselling services as part of this framework could incentivise universities to improve in this regard.

IV.          Recommendation

This policy brief has outlined the significant discrepancy between counsellor to student ratios in UK universities and the needs of students at modern day universities who are increasingly disclosing mental health conditions. Furthermore, the sharp increase in suicides and dropouts among students due to mental health in recent years outlines the need to take action to ensure that there is a sufficient number of counsellors at every university to deal with and mitigate this crisis.

It is recommended that in the event of the Labour Party’s election to government, the Department of Education pursues Policy Option A, to allocate a proportional budget which directly funds a counsellor to student ratio which matches student need. The political feasibility of this option is highlighted in the aforementioned manifesto promise of the Labour Party to increase the funds allocated to mental health services for young people. The technical feasibility of this option stems from the cost-effectiveness of directly assuring effective mental health support in universities by preventing dropouts and increasing returns on public investment. (West, 2015) Furthermore, the Head of Counselling at Brunel University London estimated that the service saved the university £2.5 million (Brown, ibid., p.12) and an in-depth study the impact of counselling on academic outcomes found that ‘81 percent of students considered counselling to have helped them stay at university.’ (Wallace, 2012)

The need for direct and immediate action to ensure counselling services are adequately staffed is clear. The rapid increase in students reporting mental health conditions in recent years coupled with deteriorations in dropout rates and suicides means that reputational incentives are insufficiently reliable when the educational prospects, day-to-day emotional wellbeing and most crucially lives of students are being compromised by a lack of funding. Thus, it is recommended that the Department of Education directly provides universities with the necessary funds to achieve equitable counsellor to student ratios in universities in England and Wales.

V.            Key Sources

Aronin, S. and Smith, M. (2016) One in four students suffer from mental health problems. YouGov. Available: https://d25d2506sfb94s.cloudfront.net/cumulus_uploads/document/obtomdatp4/Survey_Results.pdf.

Establishes the salience of the policy problem and informed the executive summary by:

·       Providing quantitative data highlighting the prevalence of mental health conditions among students in UK universities

Brown, P. (2016) The invisible problem? Improving students' mental health. 88. Oxford: Available: https://www.hepi.ac.uk/wp-content/uploads/2016/09/STRICTLY-EMBARGOED-UNTIL-22-SEPT-Hepi-Report-88-FINAL.pdf.

Informed both prospective policy options, the recommendation and the situation brief by:

·      Highlighting the link between lack of funding for counselling services and reduced student wellbeing

·      Presenting research which makes clear the extent of understaffing of university counselling services

·      Detailing the reputational incentive structure that currently exists for academic and teaching quality in universities in England and Wales

MacAskill, A. (2012) The mental health of university students in the United Kingdom. British Journal of Guidance and Counselling, 41 (4) Available: http://shura.shu.ac.uk/6449/1/Macaskill_University_students.pdf.
Informed Policy Option A and the situation brief by:

·       Providing an in-depth quantitative study detailing the prevalence of mental health problems across academic years

·       Detailing the need for a well-funded, adequately staffed counselling service at universities in the UK due to the inability of other figures at university such as lecturers to fulfil this role

·       Highlighting the comparative reluctance of students to seek help for mental health problems, demonstrating the necessity of an effective counselling service to reach out to this vulnerable group

Thorley, C. (2017) Not by Degrees: Improving Student Mental Health in the UK's Universities. London: Institute for Public Policy Research. Available: https://www.ippr.org/files/2017-09/1504645674_not-by-degrees-170905.pdf.
Informed both policy options, the situation brief and the recommendation by:

·       Providing long-term, detailed studies which document the sharp increases in student suicides and dropout rates

·       Detailing the damage to reputation that universities can incur when they fail to effectively address student mental health

Williams, M., Coare, P., Marvell, R., Pollard, E., Houghton, D.A. and Anderson, J. (2015) Understanding provision for students with mental health problems and intensive support needs. Brighton: Institute for Employment Studies; Researching Equity, Access and Participation. Available: http://webarchive.nationalarchives.gov.uk/20180319114953/http://www.hefce.ac.uk/pubs/rereports/year/2015/mh/.

Informed the situation brief by:

·       Providing an in-depth, multi-university study which highlights a universal acknowledgement of increased demand for effective mental health services

·       Highlighting the increasing number of students reporting a wider array of mental health conditions

VI.          Additional Sources

BBC (2018) Student mental health support must improve, universities told. Available: https://www.bbc.co.uk/news/education-44635474.
Burnett, K. (2017) By creating a market for universities, the government has snookered itself. The Guardian, . Available: https://www.theguardian.com/science/political-science/2017/sep/07/by-creating-a-market-for-universities-the-government-has-snookered-itself.

Dandridge, N. (2015) Student mental wellbeing in higher education: good practice guide. London: Universities UK. Available: https://www.universitiesuk.ac.uk/policy-and-analysis/reports/Documents/2015/student-mental-wellbeing-in-he.pdf.

Havergal, C. (2016) Student mental health: fresh spike in problems reported. Times Higher Education, . Available: https://www.timeshighereducation.com/news/student-mental-health-fresh-spike-problems-reported

The Labour Party (2017) The Labour Party Manifesto 2017. London: Potts Print. Available: https://labour.org.uk/wp-content/uploads/2017/10/labour-manifesto-2017.pdf.
Wallace, P. (2012) The impact of counselling on academic outcomes: the student perspective. University and College Counselling, Available: https://www.bacp.co.uk/bacp-journals/university-and-college-counselling/november-2012/the-impact-of-counselling-on-academic-outcomes/.

West, S. (2015) Support Student Mental Wellbeing: Policy, Practice and Future Directions. Bristol: Universities UK. Available: http://www2.uwe.ac.uk/services/Marketing/about-us/pdf/VC-speeches/Supporting-Student-Mental-Wellbeing-Policy-Practice-and-Future-Directions.pdf.