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Mental Health (Higher Education Institutions)

Volume 596: debated on Thursday 11 June 2015

Motion made, and Question proposed, That this House do now adjourn.—(Margot James.)

Congratulations, Madam Deputy Speaker, on your election to your post.

I thank Mr Speaker for granting this Adjournment debate on an extremely important issue that is of growing concern—how to support our most precious young people on the thresholds of their lives. I want to set out the background to the issue, the evidence that shows that it is an area of growing concern, what is good practice, and what can be done for the future.

Hon. Members on both sides of the House may have seen the recent examples of students who are putting mental health and counselling services at the top of their agenda for change. In March, students from Goldsmiths University occupied Deptford town hall and demanded the recruitment of more counsellors. Also in March, students from the London School of Economics called for the removal of the standard six-session cap on counselling sessions. In April, students from King’s College, London included in their provisional occupation demands a call for mandatory training for their personal tutors in giving advice on mental health, and they wanted an additional cognitive behavioural therapist to be employed, to cut down on waiting times.

Members will have seen recently that two students from the same Oxford college committed suicide—one in December 2013 and the other in March 2014. Across the House Members are agreed and have accepted that the Government are going to pursue parity of esteem between mental health and physical health, which is welcome.

Why is this becoming an issue of concern? There are a number of reasons. We expect the many students who have left home for the first time to get into college, set up a household, learn how to budget, form new relationships and get involved in their academic courses, but at the same time they are separated from their usual support networks. Some may come from another country, while others, because of widening access to higher education, including vocational qualifications, may also face particular challenges. I am concerned that the Royal College of General Practitioners says that tens of thousands of 15 to 34-year-olds are suffering from depression, stress and anxiety.

Another issue is study pressure and the continuous annual examinations that young people face from the age of 13—sometimes even younger—to 18. Now their CVs have to be bulging with placements and work experience. They say that they have climbed Mount Kilimanjaro, that they play three instruments at grade 8 and that they have a string of A*s—and that is before they even get to university.

Another possible reason is financial pressure. We talk of paying down the debt, and yet we are saddling our young people with, on average, a debt of £44,000 at the start of their working lives, which they then have to carry through. That is the estimate of the House of Commons Library, based on Student Loans Company statistics for 2013-14. It is notable that Germany has abolished tuition fees: Lower Saxony was the last federal state to abolish them, and that was in October 2014. Perhaps we can learn some lessons from that.

After graduation, some find it difficult to find well-paid work, or they have to work a long-hours culture. The latest figures from the Student Loans Company showed that 30% of new graduates were working but not earning enough to be liable to pay their loans. That was the figure for 2012, so it will be interesting to see the new figures, which will be released on 18 June.

What of the evidence? A 2013 survey by the National Union of Students found that 49% of students had felt depressed during their studies; that 55% had felt anxious during their studies; and that 20% considered themselves to have a mental health problem. In 2011, 6,000 students had a diagnosed mental health condition, compared with almost 9,000 in 2013—that is a 58% increase in three years, even though the student intake actually fell by 16% during the same period.

A freedom of information request in 2014 revealed that the number of undergraduate and postgraduate students accessing counselling services at Oxford University went up by 136% and 172% respectively between 2003-04 and 2013-14. For undergraduates, there was a rise from 4% to 9%.

Happily, we are moving on to a different track, because we are now able to track the student academic experience. The Institute for Higher Education Policy Institute and the Higher Education Academy have produced two consecutive reports. The 2014 report states that students generally feel lower levels of wellbeing than the general population, which is of some concern. They may require further support from institutions, not only through dedicated support services, but through peer networks and mentoring programmes.

The 2015 report concludes that students are less happy and have less of a sense that the things they do are worth while than the general population, even compared with people in the same age group. That shows the need to improve student support services, including counselling, even in challenging financial times.

What can be done? There is good practice from the Open University, a non-campus university that supports lifelong learning. The OU contacts students about their adjustments to ensure that they are supported, giving advice about staying on track, prioritising work and having flexibility with deadlines, and about other adjustments.

Students are encouraged to apply for disabled students allowances so that they can access the support of a mental health mentor. They all have access to the guide “Studying and staying mentally healthy”, which the Open University states has lots of practical guidance. As a result, the Open University found that evidence showed that disabled students who received DSAs have higher completion rates and are more likely to progress in their studies. However, the British Association for Counselling and Psychotherapy, a professional body for counsellors and psychotherapists, is concerned that counselling is no longer viewed as an essential element of student support. It says that more generalised wellbeing support and advice offered by non-clinically trained staff is increasingly seen as the way forward.

Dr Ruth Caleb, head of counselling at Brunel University and chair of Mental Well-being in Higher Education, has written a timely article entitled “Student Mental Wellbeing: whose responsibility?” She makes many points, but the two most important ones are that ignoring student wellbeing support costs the university or higher education institution a great deal of money when student retention is very important; and that it is the responsibility of the Government and senior management to ensure that students are supported to stay until the end of their course, to help them to achieve the best they are capable of. The more compelling reason is the need to behave morally and ethically for our students.

Dr Caleb has published a guide—“Student mental wellbeing in higher education: good practice guide”—and makes important recommendations, including on guidance structures, and training and awareness raising activities to help institutions to work towards a much more collaborative model. I suggest to the Minister that that might be a good blueprint for a policy or guidance note that can be rolled out to higher education institutions.

Ben Lewis, from the Cardiff University student services organisation, has said that students are forced to rely on support from their institutions, which is finite and resource-limited, so the NHS has a collaborative role. However, BACP has said that there might be a temptation for universities to hand over responsibility to the NHS. If it is more difficult to see a counsellor, people are referred to the NHS, which has longer waiting times. That also means more pressure on the NHS.

BACP has cited data showing that, of 5,500 students from 65 universities, 81% considered that counselling helped them to stay at university; that 79% said that counselling helped them academically do better in their work; and that 78% said that counselling helped them to develop employability skills. That is all pointing in the right direction if we continue to embed those services.

I have a number of questions to ask the Minister. First, will he ensure that there is a Government-led review of higher education counselling services to formulate a policy before the situation gets worse?

Secondly, as the Institute for Higher Education Policy recommended, will the Government ensure that counselling services are funded even at challenging financial times, that students get the appropriate service of higher or lower-intensity counselling, and that those are embedded in higher education institutions’ policies?

Thirdly, will the Government stop the proposed changes to DSAs? As the Open University has found, many students benefit from support tutors to stay on the course. I was at a round-table discussion at the Royal Society of Chemistry last year. The Royal Agricultural University stressed the importance of DSA for their students, two thirds of whom are on DSAs. That helps the university to give them the support they need to stay on. If they did not have those students—they are graduating with science degrees—the university might have to close. That is why it is important to ensure that DSAs are retained.

Fourthly, will the Minister work with the Department for Health to ensure that clinical commissioning groups and university counselling services work together in areas with a high student population, and that services are complementary, not duplicated, so that students do not fall between the two and miss out on the services they need?

Fifthly, will he publish guidance so that students who interrupt their studies for mental health reasons, as two students did, are properly supported by higher education institutions during that period? A period of intermission should not simply be a means for the institution to avoid addressing a problem a student may be facing. Students should be supported back into their studies.

I hope the Minister will agree with what I believe are reasonable asks. Above all, I hope they will be embedded in any Government policy he sets out to protect our students. Students are our most precious assets and our hope for the future. We must support them so they can discover and unleash their talents, and fulfil their potential for the good of us all.

It is a pleasure to see you in the Chair, Madam Deputy Speaker, and to have the chance to debate this important topic.

Ensuring the wellbeing of students is very important for our higher education institutions. I know that they take their responsibilities in this area exceptionally seriously. As the hon. Member for Walsall South (Valerie Vaz) made clear, students have also highlighted how important this issue is for them. However, tackling mental health is a priority not just for higher education. The Government will continue to take mental health as seriously as physical health. It is estimated that funding for mental health will increase by £302 million in 2014-15. Total mental health spending is rising from just over £11.3 billion in 2013-14, to just over £11.6 billion in 2014-15. That is an increase of 0.6% in real terms. We have made it clear that spending on mental health should increase in real terms. NHS England has published planning guidance for 2015-16. This makes the expectation clear that each clinical commissioning group should see spending on mental health services increase in real terms in 2015-16.

It is right that higher education institutions, as autonomous bodies independent from the Government, have the responsibility to ensure the wellbeing of their students. This includes their mental health. They have clear legal responsibilities under the Equality Act 2010 to support their students, including those with mental health conditions. Institutions are best placed to determine what welfare and counselling services they need to provide to their students. That will vary according to the needs of each particular student body. Students who, as the hon. Member for Walsall South mentioned, are paying up to £9,000 in fees should be able to access the high quality support they need to sustain and complete their studies. Our universities are in sound financial health. We have, and will continue to have, a world class higher education system. This has been achieved and maintained during a period when higher education has been opened up both to greater numbers and an increased diversity of students.

I thank my hon. Friend and brother for giving way. On diversity of students, is it not absolutely vital to maintain this country’s high profile in those vital markets, particularly India, where we have seen a sad falling away in the number of students coming to Britain?

I thank my hon. Friend for his helpful intervention. We do, of course, encourage diversity of students. We encourage diversity in all groups that are under-represented: people from disadvantaged backgrounds and those from the most disadvantaged sections of society. We also welcome the diversity that comes from international students and hope that the numbers from the country he mentioned stop declining in the years ahead and begin to rise.

Universities are adult environments, where the expectations on students are different from those at school. As such, it is only right that students take responsibility, working with the institution, for their own welfare. However, I know that universities are very mindful of the fact that many of their students, particularly those who have moved away from home for the first time to study, will be undergoing a significant transition and may need extra help. Universities provide a wide range of support. In recent years, there has been an increasing awareness in higher education of the need to offer support services to students, and I welcome the efforts the sector has made to develop guidance and support materials, including from a range of sector and medical bodies.

The hon. Lady mentioned the Open University. We must indeed spread good practice, which is why I welcome the recent publication by Universities UK of a good practice guide on student mental wellbeing in higher education, published in February. This is a practical resource for senior higher education leaders and managers and aims to support institutions in building and improving their provision for students with mental health problems.

There are many examples of the support that universities have in place. They have induction systems to help students understand university life, and support is available to reassure students that there are people to turn to if they are experiencing difficulties.

I wish to make a point relevant to the debate. Does the Minister think that some work ought to be done in secondary schools to prepare people for higher education in terms of wellbeing and mental health?

It is important throughout the education system that proper attention be given to mental health issues, and that includes the secondary education system as much as higher education.

I was mentioning some of the examples of good practice across our higher education system, and I want to cite work by the University of Wolverhampton, close to the hon. Lady’s constituency, which has recently appointed a mental health adviser. It also offers a counselling service that runs “dealing with students in distress” workshops as part of the university’s annual staff development programme. This is available to all staff, including front-line staff.

The University of Salford works with a number of services in the community, including mental health teams and charities, such as Mind in Salford, Self Help in Greater Manchester and early intervention teams. The University of Sheffield has developed postcards on which is written, “Worried about another student?”. These are aimed at supporting mental health and wellbeing and are distributed through their residences, timed for when students return in January and at the start of first semester exams.

Those are excellent examples of university initiatives, but Bristol University saw a 64% increase in mental health diagnoses in the five years between 2009 and 2014. It recruited a new psychotherapist, and the local psychiatrist now visits twice a week, whereas he used to have to visit only once a fortnight. It needs specific funding to help them cope with the increased demand. Will the Minister speak to his colleagues in the Department of Health to secure some of that funding?

As I said, universities are in sound financial health. Students paying up to £9,000 in fees should be able to access the high-quality support they need to sustain and complete their studies.

The Government are providing extra support for disabled students on an individual basis through the disabled students allowance. This can provide support to students with mental health issues. In the academic year 2012-13, just over £127 million was paid in DSA to about 56,000 full-time students. All students applying for DSA undergo a needs assessment interview to ascertain their specific requirements with regard to their chosen course of study. Students with mental health difficulties can apply for the full range of support available through DSA, including specialist mentors, equipment and assistive technology, to help them overcome the barriers they face.

The proposed changes to DSA, which the hon. Member for Walsall South mentioned, will be subject to a public consultation. It is vital to remember that the changes are not about removing support, but about rebalancing the source of that support and ensuring that universities and other higher education institutions play a full role in delivering their legal duties under equality legislation. The aim will be to set clear guidelines on what the Government expect from institutions to ensure that students receive a consistent level of support and that the sector is clear where DSA is the most effective source of support. This is intended to improve the levels of support overall, including for students in receipt of DSA and disabled students who do not claim it. Under the proposed changes, students with mental health conditions will continue to have access to DSA-funded specialist support such as mentors.

The higher education sector has much to be proud of in its work to ensure the wellbeing and mental health of its students and to fulfil its duties under the Equality Act 2010. I expect the sector to continue to meet its obligations in this area and to build and develop the support it provides.

Question put and agreed to.

House adjourned.