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Section 6. Promoting student mental health: a proactive approach

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6.1. Introduction
6.2. Pre-entry
       6.2.1. Prospectus, promotional literature and events
       6.2.2. At application
6.3. Enrolment and induction
       6.3.1. Completion of forms
       6.3.2. Mentoring or 'buddy' schemes
       6.3.3. Welcome week/Introductory week activities
       6.3.4. Induction literature
       6.3.5. Identification of vulnerable groups
6.4. Mentoring and peer support
       6.4.1. Mentoring schemes for first year students
       6.4.2. Extension of mentoring schemes
       6.4.3. Mentor training
       6.4.4. Peer support
6.5. Study advice
       6.5.1. Initial study advice
       6.5.2. Ongoing study advice
       6.5.3. Further resources
6.6. Teaching and assessment methods
       6.6.1. Assessment
       6.6.2. Peer support
       6.6.3. Tutoring
       6.6.4. Course information
       6.6.5. Suspending study
6.7. Accommodation
6.7.1. Institutionally managed residences
       6.7.2. Community living
       6.7.3. Private sector housing
       6.7.4. Special needs
6.8. Financial support
       6.8.1. Advisory services
       6.8.2. Hardship funds
       6.8.3. Information and resources

6.1 Introduction

  • In other sections of this manual the emphasis has been on provision for students already experiencing mental health difficulties. However, in recognition of the universal nature of mental health issues, consideration is given in this section to a more holistic approach to student mental health, dedicated to developing provision for all students in different aspects of the student experience in order to:
    [a] Improve the general climate of mental well-being in the student community.
    [b] Reduce the risk factors which exacerbate or trigger mental health difficulties.
  • There can be aspects of the student experience which may unintentionally detract from general mental health, exacerbate existing mental health difficulties and increase vulnerability to mental health difficulties.

  • The approach described below moves away from mere crisis management to a more positive approach to mental well-being throughout the institution. It also recognises that participation in higher education can enhance mental well-being. A proactive approach to student mental health also encourages the identification of unnecessary barriers to learning. This approach anticipates needs, rather than simply reacts to them (this anticipatory approach is an inherent feature of disability legislation under the Special Educational Needs and Disabilities Act, 2001 (see section 1.5)

  • The suggestions in this section regarding proactive or holistic measures will obviously need to be considered in the light of each individual institution's particular mission and level of resources.
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6.2 Pre-entry

There will obviously need to be clear operational guidelines for supporting students with identified mental health difficulties starting at the pre-entry stage (Reference: AMOSSHE 'Duty of Care' document, www.amosshe.org.uk/news.asp). However, general measures can be taken prior to application or admission which may encourage a more positive approach to mental health in general:

6.2.1 Prospectus, promotional literature and events: the prospectus, open day literature and other promotional material may contain a positive statement concerning mental health both in terms of the institutional commitment to a non-stigmatising and well-informed community and the commitment to work in partnership with students experiencing mental health difficulties to define and address needs. (Any statement concerning a commitment to deliver support services etc should be considered in terms of the legal implications of the institution's 'Duty of Care').

6.2.2 At application: guidance notes accompanying all application forms can contain positive statements with regard to students with any special needs, specifically including reference to mental health difficulties. Encouragement to declare needs and clarity with regard to how such information will be used is essential to inspire confidence in applicants. A service available to all applicants to discuss any concerns could have an inclusive approach, respecting and recognising that issues relating to mental well-being will be relevant to anyone considering entry into higher education. Staff offering such an advisory service would need to be fully aware of appropriate referral, codes of conduct etc.

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6.3 Enrolment and Induction

In addition to students whose needs are already known, for whom arrangements may be made to offer support during enrolment, the whole process of enrolment and induction of all new students might be reviewed to identify unnecessary barriers and stress factors. There might be imaginative ways to make these early critical stages of the student experience less stressful, perhaps by considering what any person in a new environment might expect and value to aid transition. Proactive measures might be applied to:

6.3.1 Completion of forms: could the number of these be reduced or rationalised by co-ordination between departments or the use of IT? Could there be some degree of privacy given to students when completing forms which require discussion of needs or personal information?

6.3.2 Mentoring or 'buddy' schemes: could all new students be helped through the enrolment process by existing students, so that there is an assumption that everyone may need this? (see also section 6.4)

6.3.3 Welcome week/Introductory week activities: could these be discussed with a view to lessen social pressures? Mental well-being can be fragile during a major life transition and therefore too much pressure on having a 'good time' may be detrimental to many students. Certain groups of students may be especially uncomfortable with typical welcome week activities, due to cultural difference etc. Practical and structured activities during these early days, such as exercises in local orientation, accessing information systems, small groups working on a pre-course project etc might help to lessen the experience of loneliness and disorientation.

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6.3.4 Induction literature: all literature for new students, not just under the heading of welfare or student support but from academic departments, residences, students' union etc, could acknowledge the normality of some level of mental distress among new students and hence encourage a climate of openness and honesty about how people feel at times of transition.

6.3.5 Identification of vulnerable groups: it may be worth analysing which students might fall into this category and be proactive in establishing appropriate support and facilities. These are groups who may experience additional stress in entering higher education due, for instance, to the culture shock and isolation from arriving from another country. Culturally sensitive literature, activities arranged outside term time or at weekends and other such measures might all help in such cases.

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6.4 Mentoring and peer support

Mentoring and peer support schemes may be effective ways of reducing some of the major sources of stress which are reported by students: a sense of isolation, disorientation and anxiety about what is expected of them. Such schemes can be popular with institutions in view of the limited resource implications involved.

6.4.1 Mentoring schemes for first year students: these have been introduced by some institutions to make the process of adapting to student life less daunting. These schemes may vary from the voluntary opt-in scheme where all students are offered the service if they wish, to more formal schemes where all new first year students may be allocated a mentor (usually a second year student). The emphasis may be on academic support, by matching students within subject groups, or it may be more general, concerned with the overall settling in process. If a mentoring scheme is available with no reference to specific needs, it may help to create a climate where students have more realistic expectations, acknowledging that there is need for support and there is nothing wrong with asking questions. People generally (this applies to the workplace equally) feel more comfortable asking general questions about a new environment of peers than of people who may be judging them at a later date (e.g. tutors).

6.4.2 Extension of mentoring schemes: different groups of students, other than first year undergraduates, may all benefit from some type of mentoring scheme, including those embarking on a new phase of their studies e.g. postgraduates.

6.4.3 Mentor training: if any such a scheme is run, it is essential that proper training is given to mentors with clear boundaries and access to referral as well as somewhere where mentors can discuss issues that have arisen from their role.

6.4.4 Peer support: whereas mentors may be assumed to be those who have additional experience to those they are mentoring, peer support may be given by students at the same stage and level. Peer support groups may be formed from new students to work together on projects, orientation etc as a means to create informal support networks.

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6.5 Study advice

Students commonly report serious anxiety around managing their studies and knowing what is expected of them academically. Study advice given to all, on the assumption that all may need it, may be a pro-active way of reducing a principal stress factor.

6.5.1 Initial study advice: basic study advice can be offered as an introductory part of all academic courses, including subject specific matters. Consideration could be given to creating a formal module from such material. There may be a need to offer such advice also outside academic courses to enable students to access it confidentially.

6.5.2 Ongoing study advice: study advice sessions and self-help materials will be needed, especially at critical times on a course e.g. before examinations. Well advertised drop-in sessions, alleviating the need to register, can be very successful. Presentations could include 'coping with exam stress', 'effective time management' etc. Again with the ongoing support and advice, rather than assuming that it will be needed by certain groups or only those who identify themselves as having difficulties, it will be most effective if offered at regular intervals on the assumption that it is relevant to everyone.

6.5.3 Further resources: study advice can also be provided by individual support, handouts, well publicised short courses, web based materials etc.

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6.6 Teaching and assessment methods

Teaching and assessment methods which may help students with mental health difficulties are often good practice in relation to all students and may reduce the general incidence of mental distress. Flexibility, wherever possible, benefits a diverse student population and may make teaching and learning more effective and rewarding for staff as well as students.

6.6.1 Assessment: variation in methods of assessment may be fairer on those for whom one particular method is particularly difficult. Exploring new and imaginative ways of testing the grasp of a subject without total reliance on traditional examination, for instance, may reduce the need to set up special provision for those for whom traditional methods are problematical.

6.6.2 Peer support: as an informal, voluntary support system, peer support, perhaps as part of a subject based student mentoring scheme, may help students to gain confidence academically without extensive resource implications. This type of arrangement needs to be carefully monitored as it may not necessarily suit all students and would only possibly have minimal resource implications if not directly connected with the formal curriculum, assessment etc. (see also section 6.4)

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6.6.3 Tutoring: research has shown that, second to friends and family, the personal or academic tutor is the most common first point of contact for students seeking help in matters affecting their mental well-being. Particularly in large institutions, where students may suffer a sense of anonymity, a tutor may have a critical role in addressing individual concerns about academic progress and student life. Tutors are better placed to fulfil this role with appropriate training and support through staff development, senior tutor schemes etc.

6.6.4 Course information: there is often considerable anxiety around defining what is expected from different components of a course. Clear course information which clarifies expectations of content and student input can alleviate some of this anxiety.

6.6.5 Suspending study: for those who need to take time out of a course for domestic, personal or health reasons, this experience can be made less detrimental if there is sufficient flexibility in teaching and assessment to avoid, for instance, unnecessary repeat periods of study. Academic continuity through some maintenance of contact during times away from the institution may also lessen the difficulties of transition.

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6.7 Accommodation

In surveys identifying sources of stress for students, inadequate accommodation and housing problems are cited as major causes of distress.

6.7.1 Institutionally managed residences: institutions can look at their own student housing in terms of the general living conditions, safety, affordability and whether it is designed to allow for community and social interaction. Communal areas which are not just bars or places dominated by certain recreational activities give students a chance to talk to others on neutral territory. Being in a small room on a long corridor with nowhere to go to encounter others is a stressful experience for anyone.

6.7.2 Community living: this can create its own stress, particularly where one (or more) member's behaviour becomes disruptive. Systems need to be in place for students in residential accommodation to have access to trained and experienced personnel should support or intervention be needed.

6.7.3 Private sector housing: where housing is outside institutional control, accommodation officers will want to vet anything advertised through their offices to ensure its safety and suitability for students and to offer support and advice which lessens the strain of housing difficulties.

6.7.4 Special needs: consideration will need to be given to groups of students who might find some standard student housing arrangements conflict with their cultural, personal or physical needs.

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6.8 Financial support

Financial anxieties are numbered among the major stress factors for students. Debt and increased pressure to juggle the demands of full-time study with paid employment have been highlighted in recent studies concerning student mental health. While recognising that overall funding issues may be outside their immediate control, institutions may take measures to alleviate some of the effects of these financial pressures.

6.8.1 Advisory services: availability of professional, confidential financial advice at all stages, including pre-entry, helps to engender realistic expectations and to plan ways to cope.

6.8.2 Hardship funds: those funds allocated by the institution can be targeted to the potentially most vulnerable groups. 'Vulnerable groups' as defined by DfES (reference: www.dfes.gov.uk/studentsupport) would include single parents, mature age students, disabled students, care leavers, those with high travel costs etc.

6.8.3 Information and resources: well publicised money advice sessions and debt counselling services, together with widely distributed information leaflets etc, may help to reduce the sense of isolation felt by many in financial difficulty.

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