Student mental health action plan

Appendix One: Case studies

Examples of good practice within colleges and universities and collaboration with external organisations

Universities in the City of Edinburgh

With approximately 70,000 students in Edinburgh, there is added pressure on local primary care, mental health services, and third-sector organisations. The demand for these services is rising, driven by a range of factors including increased awareness of mental health issues, the continuing impact of the Covid-19 pandemic on young people’s mental health and wellbeing, and a growing student population.

Evidence showed that students in the city underwent repeated mental health assessments, often receiving fragmented care across different organizations, with a disproportionately high use of crisis and in-patient services.

To address these challenges, a partnership comprising universities across Edinburgh (the University of Edinburgh, Edinburgh Napier University, Queen Margaret University and Heriot Watt University) and local Health and Social Care Services (Public Health, Strategic Planning and Commissioning, Community Mental Health, Primary Care) has been established to close gaps in mental health service provision and enhance service quality.

The participating institutions are actively implementing strategies to promote positive mental health and wellbeing, offering support for students with mental health issues through a range of initiatives which make use of online resources and brief counselling sessions.

Their work is informed by Universities UK’s Mentally Healthy Universities research which emphasizes a ‘whole-university’ approach that integrates mental health considerations into all aspects of university life. In addition, the Universities UK Minding our Future document and the Royal College of Psychiatrists’ Mental Health of Higher Education Students report each highlight the benefits of collaboration between universities and Health and Social Care services in delivering improved and more integrated mental health support for students.

This collaborative effort has resulted in several successful initiatives aimed at improving student access to care services, such as developing information sharing protocols and providing senior university staff with secure access to healthcare records so that patient/student information can be shared securely. Additionally, efforts are underway to raise awareness among healthcare professionals of university mental health services, and to improve opportunities for students to access third-sector services and other supported self-management initiatives.

Moving forward, the partnership aims to establish collaborative care pathways across institutions and NHS mental health services; standardise data collection methods for students accessing primary care and specialist mental health services; develop transition of care guidelines; and create a dedicated student mental health pathway and service in Edinburgh. These actions are expected to lay a strong foundation for further service improvement and better support for students' mental health needs.

Ayrshire College

The Mental Health Liaison Officer (MHLO) at Ayrshire College is an equally funded partnership between Ayrshire College and the three Health and Social Care Partnerships that make up NHS Ayrshire and Arran Health Board.

The MHLO is a Band 6 registered Mental Health Nurse employed by the Health Board, who has the skills and knowledge to manage the unpredictability of mental health risks and crises that students may present with, and can effectively liaise with local mental health services.

The role promotes an early intervention model of support for the students. The MHLO provides students with education and resources to keep them mentally healthy which reduces the vulnerability to a mental health crisis such as suicidal ideation or self-harm.

Whilst the role does not operate on a caseload basis, the MHLO provides opportunities for students to access 1:1 advisory and signposting support through a referral-only system managed by the Student Services Advisors at each of the colleges’ campuses. There, students are provided recommendations of supports and resources to address their concerns and follow-ups are often offered to evaluate the effectiveness and progress. This approach promotes patient autonomy and self-management.

Since the introduction of the Board’s Mental Health Practitioners’ Service in 2018, there is less need for the MHLO to liaise with a range of different mental health services as GP surgery-based mental health nurses are best placed to help students.

The MHLO identifies when a student requires further clinical input and will liaise with the Mental Health Practitioners’ Service at the student’s surgery and arrange an appointment or referral on their behalf. Student feedback highlighted the efficacy of this approach. Students are less anxious and feel more in control at their surgery appointments because discussions have already taken place in advance.

The MHLO works with academic teams to provide 30 – 60 minute psycho-education sessions across the curriculum on topics such as improving emotional health; how to manage stress; anxiety coping techniques; and suicide prevention.

The success of the role is maintained by promoting its advisory support and psycho-educations functions.

Dumfries and Galloway College

Dumfries and Galloway College and its Student Association have worked collaboratively to develop a Student Mental Health Agreement (SMHA) which has enabled the development of approaches to support student mental health and wellbeing and student attainment. These are:

Here For You campaigns – The Student Association with the College’s Equality and Diversity Forum planned and implemented a series of ‘Here for You’ events. These included providing necessities for students such as access to local food banks, Christmas appeals and facilitating a number of events which brought key partners on site to connect students with regional and local services supporting personal finance, accommodation and wellbeing.

Digital wellbeing and safeguarding – The College developed digital, including self-service, referrals for students who may be remote or lack confidence to seek help via staff. This allowed students to refer directly into adviser and counselling services. College students co designed and developed the digital wellbeing pod which offers a range of wellbeing advice. This has been enhanced by the College partnering with Spectrum Life which offers students 24/7 mental health support and guidance but also important out of hours safeguarding.

Basic needs – The College continues to provide free breakfast and lunch for students and additional food vouchers for students the College identifies as extremely vulnerable. The College has purchased water bottles for students to ensure they access water and stay hydrated and has developed self-service areas on campus so students can bring their own food.

Staff training and capacity – The College has invested in staff training, including counselling. It has refined its approach to students who have advised, on application, they have a mental health condition but have declined support, by putting in place mechanisms to reach out to them and support them, through the College’s Advisory Team, throughout the year.

Partnership working – The College continues to work with partners, such as Citizens Advice and has partnered with University of the West of Scotland to offer additional training and support for staff through the University’s medical academics. The College seeks to develop shared activities and events for students including sport and physical activity. The College, in recognition that many students need lower-level interventions to support daily mental health, resilience and managing daily life, is exploring with Dumfries and Galloway Council Youth Work Service how it can better utilise this local authority service to help students.

West Lothian College

West Lothian College worked with West Lothian College Student Association, supported by NUS Think Positive, to develop a Student Mental Health Agreement (SMHA). This has enabled the development of shared strategic objectives and evaluation frameworks to improve student mental health and wellbeing and support wider learning outcomes.

The SMHA was developed by the SMHA Lead Group which consisted of lead staff, student association officers, and students. Their work was informed by consultation with students, staff expertise, external research including Think Positive’s report Improving mental health and wellbeing support for Scotland, and good practice from other institutions.

The starting point was a student consultation to establish their perception of a mentally healthy college, what support students could currently access and their ideas of how to improve health and wellbeing. This highlighted that factors, external to the College, impacted student mental health and wellbeing. These included poverty (cost of living, food, money, housing), relationships, poor nutrition/diet, lack of physical exercise, smoking, alcohol and drugs and stigma.

This provided an opportunity to work with external organisations, which led to the College being part of the Fast Online Referral Tracking (FORT) system, developed by the West Lothian Advice Shop to enable partners to refer students for external help. This enabled students to access additional support for food, clothing, benefit advice and domestic abuse issues. Integration with FORT also allowed the College to review its core health and wellbeing support for students.

Allied with this SMHA work, the Colleges’ award-winning Trust project, developed to support students who are not ready to proceed to mainstream qualifications due to trauma, created a space to partner with more external organisations. These organisations visit the college to support all students, providing specialist support and advice.

These services, integrating with those already provided in the wider community, have played a key role in supporting students and building resilience. It means that the College can better support its students, maximising all the local resource and support available. The SMHA process has enabled this to happen.