We’re asking the wrong questions about mental health at university

By Rosa Tallack

At the end of last term I asked Caroline, the Head of Durham’s Counselling Service, what she would do if she were magically granted an extra pot of money to spend on the Counselling Service, and she told me that she’d add one more mental health advisor to the team.

She assured me that the service wasn’t limiting the “initial contract” to four sessions because they didn’t have the financial resources to restore it to its former six (and eight, before that), but because it was the right thing to do. She explained to me that she believes that university isn’t the right environment for longer-term mental health interventions, because the nature of long-term psychotherapy, a process she described as one of “unpicking and rebuilding”, is such that you have to feel worse before you can feel better. In the most recent Palatinate interview with Caroline, she argued that the Service has “the limit of up to 4 sessions as a first contract, [because] otherwise it would be really hard for students to get in”. As such, then, the waiting time for counselling at the service is fairly minimal, and, as Caroline rightly points out, where it does exist, it’s often as much about student availability as it is about staff availability.

The University argues that it is not the place for long-term mental health interventions

Surely though, when the number of sessions offered has been reduced to four, focusing on waiting times is a dangerous distraction from the issues that we should really be dedicating our energy and attention to. When you choose the question, you get the answer you want. And so, we must shift our focus: to bring to the University the questions that desperately need answering – and, even more importantly, asking.

Firstly, is four sessions of counselling enough? Earlier this year, the SU asked students to share their experiences of the Counselling Services. One student described how the limit to the appointments meant that “I felt like I was rushed into ‘getting better’”. Another shared with us how “though my four sessions were helpful support during those four weeks, once they were done I didn’t feel like I had really got anywhere”.

One student told us that she felt “rushed into ‘getting better'”

Looking to other universities across the country, four sessions certainly seems very low. I am no mental health practitioner, but thinking about what else happens in just under three and a half hours (the accumulative time of four sessions of counselling), makes me really think about how much quality time we will dedicate to a student’s mental health and wellbeing – something which, for many, will define their whole experience in this city. Paint won’t dry in 3 hours and 20 minutes, yet this is all our counselling service offers to people in distress. Has the initial counselling offer been reduced to four sessions because it’s believed to be the right number, or because it is all the University can offer students in order to keep waiting lists acceptably low? I, for one, don’t know the answer.

Do we dedicate enough time to ensuring students feel supported?

Let’s imagine, then, the University are limiting the counselling offer to four sessions because it’s the right number. If so, this begs the question: why isn’t university a place where there is any room to work through mental distress (and risk feeling worse for a period of time) if it will, in the long-term, be positively transformative? Why are mental health problems so common at university? If university isn’t the right environment for longer-term mental health support because they can’t risk things getting worse, isn’t the environment the problem, rather than the student?

54% of students do not seek support for their mental health

It’s difficult to know exactly how many students experience mental health problems, but the research tends to suggest that the figure is higher amongst students than it is amongst their non-student counterparts. What is more, a large proportion of students who report having experienced mental health problems do not seek support: a 2015 NUS survey put this figure at 54%, which would mean that more students do not seek support than those that do. This is something we cannot ignore. Counselling is merely the tip of the iceberg, and it’s been all too easy to turn a blind eye to the parts of the iceberg that are not immediately obvious to us.

Isn’t the environment the problem, and not the student?

Durham University desperately needs to take responsibility for the culture of stress that it plays a part in creating. We can no longer accept the deferral of responsibility – to the NHS, to the individual, and to our peer supporters who take on so much. Last year, Universities UK published Step Change: a new framework to help improve mental health and wellbeing at universities. It argued that mental wellbeing needs to be at the core, rather than the periphery, of all that universities are and do. To do this, we need to seriously consider how every part of our University can play its role in good mental wellbeing.

Durham can no longer defer responsibility

A patchwork quilt of disparate actions isn’t enough. Our libraries, our estates departments, support services, and every other corner of the University need to be united by a single vision: the University’s holistic commitment to promoting good mental wellbeing. Imagine, for a second, a university where education and learning is something which is actively positive for mental health and wellbeing. Imagine the possibility of education being a protective and restorative force in and of itself, rather than something we have begun to need to protect against.

Changes to mental health provisions need to be made with the student in mind

At the moment, Durham University lacks a coherent and transparent wellbeing strategy or action plan. This needs to change. Students deserve to have their University set out its commitment to taking a whole-University approach to promoting good mental wellbeing, and to supporting students. We need a strong student voice at the heart of the development of such a plan, and a strong student voice in the design, implementation and adaption of support services. Changes to our support services cannot be made based on management need. They need to be made based on what is right for students, and I remain unconvinced that four sessions of counselling is best. If instead, it is the case that counselling sessions have been limited to four because the University doesn’t have the resources to offer more – or, rather, more accurately, the University have not prioritised student mental health – then let us come together to demand such necessary changes.

Photograph: Zoë Boothby 

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