EDUCATION MATTERS YEARBOOK 2013
Contributor’s Name: John Broderick
Article Title: Addressing the mental health needs of third level students
Abstract: What can half a million hours of counselling with nearly 100,000 students over two decades tell us about the mental health of some of Ireland’s brightest and best within our universities and institutes of technology? In this article I outline the valuable role that student counselling plays in response to the needs of this vulnerable group in our society. I also discuss recent trends and changes based on data from the Irish Association of University and College Counsellors (IAUCC) and last year’s My World Survey conducted by Headstrong. I will also review UK data from the Royal College of Psychiatrists and the Association for University for College Counsellors (AUCC).
student mental health; student counselling service; psychological distress; risk factors;
Keywords: student mental health; student counselling service; psychological distress; risk factors
Article: For a majority of young people, college life can be an enriching and rewarding experience – in terms of academic success and through the opportunities inherent in the college environment for personal, social and emotional development. But for others college life can pose several challenges and threats to mental health and well being as the cope with managing their time, their studies, their health and their finances. Transitioning from dependence to independence and greater personal responsibility can also prove to be demanding with new academic requirements, new freedoms, new relationships and new ways of relating to family and friends.
Today, there is a wide range of campus-based support services available to students including health, careers, disability, chaplaincy, students union, mature student support, sports and clubs, student financial aid and counselling services. The IAUCC is the representative body for student counsellors. It was founded in 1994 and has a membership of over 70 whole time, part-time, sessional and trainee psychologists and counsellors. 26 of Ireland’s higher education institutions, (including all 8 universities, all 14 institutes of technology and 4 other third level institutions) employ at least one if not several counsellors. With their knowledge of the educational context, their integration into the wider academic community and their deep understanding of the relationship between student mental health and academic success, counsellors in third level colleges are uniquely placed to research, address and support students’ psychological, developmental and emotional needs.
The third level student population in Ireland is expanding and is becoming increasingly diversified. Over 196,000 full time and part time students enrolled in HEA funded institutions in 2011/12. The number of mature students, international students, students with a disability and students from lower socio-economic backgrounds has also grown steadily. Yet the provision of counselling services to meet the growing numbers and diverse needs of students has not kept pace. In fact, several services have seen a reduction in staff in the past 4 years, as vacated positions remain unfilled. Student enrolments have increased by 16% since 2006/7 while the numbers attending counselling have increased by 33%. One institution in particular noted a 41% increase in students seeking counselling in the past 3 years. The result is that services are seriously overstretched and long waiting lists are now common. So while the demand for counselling has never been greater, the majority of counselling services can no longer respond in a timely and adequate manner to their distressed students.
The IAUCC began collating annual statistics in 2006. Each year approximately 5% of enrolled students attend counselling and avail of an average of 5 sessions. While short term therapy is the norm, several students require a far greater number of sessions and may require support for the duration of their stay in college. The majority of students who attend counselling are undergraduates; postgraduates make up approximately 15-20%.. Yearly figures also demonstrate that about 63-64% of those who attend for counselling are female which is over-representative for the overall student population. Most students are self referred although other college support services (especially health); academic tutors and even parents and family are frequently involved in a student’s decision to seek counselling. In the past 6 years, the numbers of students presenting with mental health concerns have steadily increased. Anxiety disorders have increased from 19% to 32%; depression from 9% to 24%; relationship problems from 11% to 24% and academic-related issues from 19% to 29%.
Several services use standardised instruments or symptom checklists of current emotional and psychological functioning as part of initial intake and assessment. Combined results for several reporting institutions reveal that over 80% of intakes score at clinically significant levels. In one institution, a study of approximately 500 students (not attending counselling) revealed a mean baseline index of psychological distress greater than one standard deviation above the test’s published norms. By comparison, the mean distress levels reported by students in the week prior to their first meeting with a counsellor were even greater, at two standard deviations above the norm (i.e. at the 96th percentile).
To highlight this growing crisis in student mental health, the IAUCC convened a conference in the Dublin Institute of Technology on December 2012 and brought together over 160 staff and students from third level colleges nationwide, representing counselling, health, psychiatry, disability, chaplaincy, accommodation, peer support, students union, health promotion and academic services. Delegates were presented the findings of Headstrong’s My World Survey (2012), the first large-scale national study of youth mental health in Ireland. Two senior UCD researchers presented data on 8,053 college students between the ages of 17 and 25, drawn from all Irish Universities, from four Institutes of Technology and from two VEC colleges.
The conference focused on risk and protective factors, help-seeking behaviours and coping strategies employed by students. With regard to mental health, the survey found that 61% of students were engaged in problem drinking (10% of them being alcohol dependent); 43% have felt at some point that life is not worth living; 40% suffer from depression; 38% suffer from anxiety; 21% have engaged in deliberate self-harm; and 7% have attempted suicide. These findings are quite shocking when one considers a typical lecture hall of 100 students – and the detailed exploration of students’ experience in a typical Irish university had a profound effect on several academic leaders present at the conference.
The research also highlighted that if young people have one good adult they can talk to they will have lower risk factors for mental health problems and higher levels of optimism, life-satisfaction and self-esteem. 62% reported that they would talk to someone if they had a problem, with males being less likely to do so than females. The study also found that suicide ideation, self-harm and suicide attempts are higher in young people who do not seek help or talk about their problems. In addition, students who identified their sexual orientation as ‘bisexual’ or ‘unsure’ reported higher levels of distress than heterosexual students and much lower levels of protective factors such as social support and self-esteem.
In the UK a similar crisis in student mental health has been highlighted by the Royal College of Psychiatrist’s report into the ‘Mental Health of Students in Higher Education’ (2011). The report argued that the student population is in some ways more vulnerable than others and that student progress can be easily disrupted by mental disorder and misuse of drugs and alcohol. Of course, underachievement or failure at this stage can have long-term effects on self-esteem and the progress of someone’s life. The report indicated that the USA, it has been estimated that mental disorders account for nearly a half of the disease burden for young adults and that most lifetime mental disorders have first onset by age 24 years. The report then made several key recommendations; including that long established systems for student support such as counselling, be maintained and, when possible, expanded. It also emphasised the importance of students be seen quickly for initial assessment in order to avoid significant disruption to academic progress.
For the past 20 years counselling services have been a vital and integral part of the support structures on campuses across the country. Despite the severe impact of reduced resources, counsellors continue offer a range of therapeutic interventions to students in the form of one to one and group counselling, and where possible, support and advice to staff who are concerned about their students. Several services offer training and workshops (including suicide awareness) for students and staff, as well as a range of written and online psycho-educational materials. Counselling services also actively contribute to institutional policy making such as anti-bullying policies and other health directives and initiatives.
Outcome measures used by counselling services in IAUCC consistently demonstrate that counselling is effective in significantly reducing levels of depression, anxiety, interpersonal sensitivity and somatic distress in those who attended for 4 to 5 sessions. Last year the AUCC (the UK’s equivalent to Ireland’s IAUCC) presented the results of a year-long sector-wide study on the impact of counselling on academic outcomes based on data from over 5,000 students in 65 universities and FE colleges. It found that over 75% of students considered counselling to have helped them stay at university or college, improved their academic achievement, their overall experience in college and helped them develop employability skills. Similar impact studies are currently being conducted by the IAUCC.