During the evening of Wednesday 13 March, the Student Officer Committee met to talk about what we can do next for our community who are going through a difficult time following the announcement of Theo Brennan Hulme’s death.
We want to let you know that there’s no right or wrong way to feel right now. Some students are feeling upset or worried about themselves or friends, we’d encourage you to speak to each other and those in Student Support Services who will do all they can to help. Some students are feeling angry and calling for more to be done, [https://www.change.org/p/david-richardson-directly-address-the-mental-health-crisis-at-uea], we share your view that things need to get better here and we want to work with you to amplify your voice.
It is important in the coming days, that students feel like they can seek support from wherever they need that so we’ll be clear in saying that students should feel able to access Student Support Services.
Last night, we communicated directly to the Vice Chancellor immediate actions that students had suggested he should take in the coming days. We know these actions won’t be the answer and we want to be clear that whilst mental wellbeing is clearly linked to mental health, activity to support positive mental wellbeing is no alternative for mental health support.
On Friday (15th March), we will be organising a gathering of students in the square called ‘We Will Be Heard’ https://www.facebook.com/events/407913353115100/. From 1pm, students will be able to collect an item from the Hive, add their name to it, and bring it to the square to be with other students and show solidarity.
In the coming weeks we’ll release more details as to what we’re calling on from the university. This includes better training for advisors, more counsellors, mental health first aid training as well as issues raised in the growing change.org petition.
In the meantime, please contact Student Support Services if you need support. Now more than ever, we need to be there for one another, so look out for your housemates, your coursemates, your friends.
With love,
Your student officers x
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Below is a plain text version of our we will be heard piece of work which aims to suggest the next steps of the discussion surrounding student mental health at UEA.
We'd welcome your thoughts and comments.
Our community at UEA is going through difficult times and we wouldn’t be doing our job as your students’ union if we weren’t talking about the range of feelings that are being expressed at this point in time.
Some people are upset, some people are scared, some people are angry and some people are just concentrating on looking after themselves and the people they love. All of these feelings are valid.
We felt it was important to be measured in how we started the next part of the conversation on campus on what should happen next. We wanted to give people space and time whilst not losing the very real sense that something should be said by students about our collective feeling.
We hope that we will be heard has the desired affect – that the conversation on student mental health here at UEA involves student voice right at its centre and that we get that conversation moving soon.
With love,
Your uea(su) Student Officers
What this document is
This document is intended to be a positioning paper – something which sets out what uea(su) thinks, something to start the conversation
This document is collaborative – we’ve tried to capture as many of the voices that are being shared on campus and the feeling of “what should happen next?”
This document is carefully written – we know that our community has been rocked recently and so every attempt has been made to be respectful and caring in our approach to the language we’ve used
What this document isn’t
This document is not a strategic plan – it doesn’t take into account everything currently in place in UK higher education, the NHS or a wide range of policy decisions which we know affect the subject
This document is not “costed” – we want to present a first attempt, a discussion starter and a true reflection of our feelings not a balanced budget approach to the subject
This document isn’t finished – we want to be clear that we’re always learning and that this document will and should grow, change and develop as we learn more
Where next?
We believe that there some areas which require focus from those at UEA. They are presented below in no particular order and set out a direction of travel which we believe UEA and other stakeholders should explore. UEA needs a coordinated, planned and well thought out focus with oversight from senior staff members – without this we risk a number of sporadic “good” actions being carried out in isolation which ultimately may not lead to the changes people wish to see.
Transitioning to and from UEA and settling in
We know that the first few weeks at UEA are a hugely important time in terms of students establishing support and developing new friendships which can be crucial later in the their experience. For many this period is particularly high risk in terms of ill mental health and particularly important in setting up a good environment for them to achieve.
We believe that:
- UEA should establish a genuine “week zero” offer which equips students with the information they need about support services and is referenced at various points in the academic year
- An institution wide focus should be placed upon tackling loneliness and establishing social connections in the early part of each academic year including actions delivered in schools and uea(su)
- Particular attention should be paid to those students at UEA who are estranged from their carers or parents with UEA utilising best practise from Stand Alone, the charity which supports estranged people
- A focussed series of training opportunities on resilience and understanding mental health should be provided to students at the outset of their university experience with an aim of removing stigma about disclosure
- All students should be given information about support services and where to turn for help early on – UEA should commit to ensuring that all students are personally handed this information
- UEA should support students in developing their understanding of how to be a supportive friend, how to support friends who may be struggling and how to look after themselves as a person “looking after a mate”
- UEA Outreach teams should work with local schools and colleges to improve mental health literacy
- Perspective students should be sent detailed information about support services at UEA and in Norfolk as well as information to be provided to parents and carers
- Students should be supported in their “exit” from UEA not only in terms of practical advice about careers but in preparing for and adapting too another new environment
Academic advisor and the first point of contact
The first person you speak to regarding any concerns you might have is often the most important person. We recognise that for many students their Academic Advisor will be one of the first professionals they are most likely to turn to but that they are also likely to be ill-equipped or supported themselves. Whilst we recognise that Academic Advisors have been seen in the past as having a purely academic role it is clearly the case now that students identify this role as one which they can turn to and as such we either continue to deny this or equip those in these roles to be able to meet this demand.
We believe that:
- A full review of the workload on Academic Advisors is taken at an institutional level and resource identified to ensure that there is enough time and space for these relationships to be meaningful
- Oversight of the Academic Advisor system should be reviewed ensuring that those with responsibility for oversight are equipped to properly support Academic Advisors in completing their role
- All front-line staff and Academic Advisors should undertake Mental Health First Aid training to equip them to be able to spot the sights of mental ill health, have access to the correct language and signpost to the correct services for support
- A system whereby Academic Advisors can refer students to Student Support Services without simply pointing students in its direction should be established and implemented
How we communicate at UEA
We understand the power of language and at UEA we like to talk about how we are a community of people who cares about those around us. This is so often the case however there are times where we should explore the ways in which we communicate with one another to ensure that we approach all situations with kindness, respect and care.
We believe that:
- UEA should undertake an audit of all template letters and information which is routinely communicated to students to ensure that it is presented in a tone befitting a community who cares about its members and offers them options on where to turn next for support
- Those who are required to give feedback to students are enabled to do this in a challenging and supportive manner with specific training on the impact of SpLDs and how this affects the way in with feedback may be received
- It should be clear when students disclose information to UEA what it be used for and why they are asked to disclose information at various points to different parties
The pressure of student debt
Simply by attending university the vast majority of students are saddled with debts which 15 years ago seemed unimaginable to many. Not only are tuition fees causing students to feel that they have only one opportunity to “get university right” there are also spiralling costs associated with being a student beyond directly funding your education.
We believe that:
- UEA should approach decisions with financial implications for students with a “student first” approach, recognising the mental strain that debt places on students
- UEA should move quickly to understand the whole cost of student life and take active steps to reduce costs which unequally negatively affect students from non-traditional backgrounds
- UEA should ensure its systems of financial support interact with all areas of the University to ensure that those seeking support from one area of the institution are not being pursued for outstanding payments by another area of the institution
The design and delivery of assessments
Assessing student achievement and progress is a key component of university education and one which students are expecting to take place. We know from our members that assessments are stressful time for many and whilst it is normal for assessments to be mental taxing they should not be mentally damaging. The manner in which an assessment is constructed can help to limit the likelihood of assessments causing students undue harm.
We believe that:
- UEA should review it’s practises and guidance surrounding the development of assessment including the development of a process by which impact on mental wellbeing is considered at the inception of an assessment
- UEA should audit the number and types of assessments across programmes at a course level to understand the assessment load on students
- Those who develop assessments should be supported to explore alternative and innovative practise
- An audit of current regulations which could interact with mental ill health should be undertaken including but not limited to withdrawals, extenuating circumstances and Senate Student Disciplinary Committees
Understanding mental wellbeing activity and mental health support
We understand that there is link between mental wellbeing and mental health and that taking actions to support positive wellbeing can be important for many students. We also understand that whilst positive wellbeing activity is hugely valuable it is in no way a replacement or substitute for mental health support for those in need. Too often in the recent past at UEA wellbeing activity has been wrongly labelled and spoken about in terms of mental health support and we want to see a greater degree or understanding as to why this may be problematic.
We believe that:
- An audit of current activity should take place defining where actions are wellbeing activity and where they are mental health support – from this a decision should be taken as to whether this balance is correct
- A review of the current UEA Mental Health and Wellbeing Strategy should take place to ensure that it is fittingly balanced and reflects learning since its inception.
- Training and clarity should be provided to those in decision making roles as to the key differences between positive wellbeing activities and actions to support mental health
- UEA should further support the work on the NUS Alcohol Impact initiative to better understand the link between alcohol/substance abuse and mental health
- UEA should spearhead work at a national level to bring sector good practise in and should look to involve UUK and NUS
Those waiting for support from UEA services
We’ve heard loud and clear from our members that the waiting times for accessing UEA services though Student Support Services (SSS) are too long and that too often students can be left waiting for a number of weeks to access the support they need. We also know that the times between initial interactions between students and SSS can be long meaning that for some an initial meeting is quick to access but there is a long “pause” before the service which is recommended for them is accessible. It’s been reported to us that students can initially access SSS with a service in mind following a “referral” from elsewhere and can be confused and disappointed when an alternative service is presented as the correct service for them – this again highlights the need for correct use of technical language by front line staff.
We believe that:
- UEA should improve waiting times for initial meetings for students and when that initial meeting happens it should be person centred, supportive and enabling not transactional
- A fit-for-purpose online presence should be developed. This should include a personalised wellbeing dashboard for all students displayed in a simple, easy to understand format which allows self-reporting of information and presents support materials in an accessible and understandable way
- UEA should improve the time spent “on pause” between an initial assessment and access to the support that students need
- That communication needs to be improved between SSS and students following initial meetings which set out not just the “what” of the next steps but the “why” of what next steps will be
- Communication to students should be of a good quality and appropriately regular. This should be in advance of initial meetings, between meetings and following the meeting taking place. Students who miss appointments should be reached out to and not allowed to drift away
Those with complex needs
Our members have let us know that there are acute difficulties for those identified by UEA as having more complex needs which they are not best placed to support. Currently UEA offer services on campus at tiers 1 and 2 of support and refer students elsewhere for all other services. We recognise the need for UEA services to “know their limits” and not attempt to cover areas of support where they aren’t equipped to do so however we want to ensure students are properly supported to transition to the services who can help them.
We believe that:
- UEA should develop a referral system which is person centred, multi-agency and ensures that students who are referred to NHS services are handed to services and supported to use them rather than just pointed towards them
- UEA should develop good practise with the University Medical Centre to ensure that this is the most seamless of transitions including the exploration of data sharing so that student only need to “tell their story” once
- UEA should challenge current practise which does not allow practitioners in university settings to make direct referrals to NHS mental health services without the need of a GP
- UEA should invest in tier 3 level practitioners in situ on campus
Those moving to UEA with existing conditions
We know that many students arrive at UEA with existing, diagnosed and previously supported mental health conditions. We know that a number of students are likely to have transitioned from Child and Adolescent Mental Health Services (CAMHS) to adult mental health services very recently. We also know that care plans and existing support does not travel well when a person moves to a new area and that the quality of service a person may interact with when they move might be vastly different to the one they had access to before they moved. As universities are responsible for the movement of millions of people in and out of Clinical Commission Group (CCG) areas each year they should be a voice calling for this system of transferring service users to be better than it is now.
We believe that:
- UEA should actively support students who are transferring from other areas with existing conditions in linking up with new services in Norfolk
- UEA senior leaders should lobby for improvements in how those with existing conditions are supported in there transferring in and out of CCG areas
- UEA should explore an opt-in system of providing contact details for parents or carers who should be alerted in times of difficulty
Suicide prevention
Universities should have robust plans which work to reduce the likelihood of students in their care completing suicide. They should reflect the complexity of this subject, be far reaching and reviewed regularly to ensure that they are working. Developing and delivering a robust suicide prevention plan should never take place after tragedies have already taken place but important lessons should be learnt.
We believe that:
- UEA should create a multi-agency working group to develop and regularly review their provision for and support for those at high risk
- UEA should increase provision for those who we know are more at risk of completing suicide due to actions which UEA control such as those who are interrupting study or struggling academically
- UEA should better understand the materials that students are accessing on campus via the internet and develop a system where “flags” are followed up
- UEA should ensure that it adequately captures when disclosure of suicidal thoughts take place, wherever this happen, so that they are able to best support students who may be in need
- The role of Wardens should be reviewed as well as the development of a Halls Rep system to support education in UEA residence
- UEA should develop an offer of on-site support that is required by private provides with whom UEA have agreements
Male mental health
We know that men and particularly young men are some of the most at risk for sever mental health conditions for a wide variety of reasons. We also know that suicide is the largest cause of death for men under 45. It’s clear that the current system is not working for young men and action must be taken to address this as a matter of urgency.
We believe that:
- UEA should develop specific interventions for men to provide education and understanding about mental health
- UEA should fund research to better understand young male mental health and what interventions would best support young men
- Work must be undertaken to move the access point of professional service to where men are and not wait for them to come to the services
- Provision should be put in place to explore data such as attendance, engagement and extra-curricular activity to see if we can identify “flags” that point to those who may be at risk of developing mental ill health
BAME mental health
Similarly to men, we know that members of the BAME community are less likely to access mental health support when they need it, are a group of people who are more at risk in terms of developing mental ill health and are more likely to have a negative experience of support when they do seek support. We know that racism and micro-aggressions can have a profound effect on mental health and that reported rates of hate crime are rising. The environment in which BAME people are operating is compounding existing mental health conditions as well as causing new conditions to develop.
We believe that:
- UEA should develop specific interventions for BAME people to provide education and understanding about mental health
- UEA should undertake a workforce analysis in support services to understand if the workforce is representative in its diversity when compared to its service users
- UEA should support the acceleration of the Decolonising the Curriculum project to provide a better learning environment for BAME students
Norfolk and Suffolk NHS Foundation Trust
We are deeply concerned about the state of NHS provision for mental health support in Norfolk. Norfolk and Suffolk Foundation Trust (NSFT) are currently rated as inadequate by inspectors who noted that “We were very concerned about access to services and the management of the many patients who are on waiting lists” in their most recent inspection report from November 2018. The report also noted that “The trust had not ensured a clear overarching strategy and development plan for children’s, family and young people’s services” – we should help them shape this. It’s clear to us that NSFT needs to be better and this should be clear to UEA too.
We believe that:
- UEA senior leaders should publicly call for better public reporting on funding for Trusts and for more funding to be put in place for NHS medical services
- UEA senior leaders and UEA Council members should actively lobby for improvements in NSFT provision
- UEA senior leaders should support action to lobby Matt Hancock, Secretary of State for Health and Social Care and MP for West Suffolk, to address the abject failures of the mental health services in his and other local constituencies
- A regular stakeholder meeting with senior leaders from Norwich’s educational institutions, their student representative bodies and NSFT should be established
- UEA should invest time and energy into establishing relationships with Norfolk based mental health and wellbeing charities to ensure our work on mental health is well informed
Where we’ve got information from and what’s informed this document:
Samaritans [www.samaritans.org]
CALM [www.thecalmzone.net]
Movember [uk.movember.com]
Student Minds [www.studentminds.org.uk]
Andys Man Club [www.andysmanclub.co.uk]
Standalone [www.standalone.org.uk]
UUK Guidance for universities on preventing student suicides [www.universitiesuk.ac.uk/news/Pages/guidance-for-universities-on-preventing-student-suicides.aspx]
Adam Harvey’s petition [www.change.org/p/david-richardson-directly-address-the-mental-health-crisis-at-uea]
University of Bristol suicide prevention response plan [www.bristol.ac.uk/university/media/strategies/suicide-prevention-response-plan.pdf]
Norfolk and Suffolk NHS Foundation Trust CQC Inspection ratings [www.cqc.org.uk/provider/RMY?referer=widget3]
The Five Year Forward View for Mental Health [www.england.nhs.uk/wp-content/uploads/2016/02/Mental-Health-Taskforce-FYFV-final.pdf]
False economy, The Health Foundation [www.health.org.uk/sites/default/files/False-economy-NHS-funding-pressures-May-2018.pdf]
Conversations and meetings with:
Aaron Hood
Ayeshah Lalloo
Colleagues in UEA Student Support Services
And stories shared with us over the past few weeks