History of mental health support in Higher Education Changes to DSA announced UMHAN response to New Horizone Royal College of Psychiatrists report, UMHAN response to social exclusion unit Counselling services in place from 1950s onwards Changes to DSA fully in place UMHAN Policy Position on Exams Royal College of Psychiatrists report, UMHAN rep on DSSG HEFCE Project Counselling provision. “Degrees of Disturbance”. Introduction of Mental Health Advisers. Development of UMHAN. Expansion of mental health-specific services. 1950s 1995 1997 2001 2003 2007 2008 2009 2010 2011 2012 2014 2016 UMHAN Formed, 5 members 9420 students declare mental health, 81% of HEIs have specialist MH post University Mental Health and Wellbeing Day launched DDA Equality Act, UMHAN guidance for developing HEI MH service 24,630 students declare MH, 153 members of UMHAN, 65% increase of DSA on previous year in September 5095 students declare MH, 53% of HEIs have specialist MH post

Mental health support as a specialism Quality assurance for institutions and students. They need to know… …support needs are being assessed appropriately by a specialist. …support will be delivered with a full understanding of what their diagnosis means on many levels/in different contexts. …appropriate resources are mobilised to meet needs. …and practitioners in education need to be able to challenge mental health stigma.

Mental health support as a specialism The course of all mental health difficulties is unpredictable. Diagnosis, severity, longevity and causes (or lack of these) can be misleading about the impact on a student in higher education. Mental health difficulties may be context-specific and very individualized. The implications for study therefore vary between people. Expertise and assessment must take these factors into account.

Mental health and wellbeing “The emotional resilience that enables us to enjoy life and survive pain, disappointment and sadness. It is a positive sense of well-being and an underlying belief in our own and others’ dignity and worth.” Health Development Agency (1997). Mental Health Promotion: A Quality Framework. Continual effort with the normal “disturbance” of life. e.g. Age/stage of life, social change, life events, etc. Adolescence is a key age range, and Higher Education is a context with transitions (to, from, within), where “identity-work” takes place. Each period of change may result in positive health, self-awareness, or social positioning (or a decline).

Mental health and wellbeing A context that can sustain our mental wellbeing: Confidence, self-esteem. Purpose and direction. Feeling in control; some consistency. Positive peer and cultural contact; identity. Achievement, employment and further opportunity. National Institute of Adult Continuing Education (2000). Learning and Health.

Mental health and wellbeing Academic pressures; levels of competition. Financial issues. Friends/relationships. Living skills; transient living. Emerging health conditions; lack of/emerging self-awareness. …which may result in fluctuations in mental wellbeing (stress, alcohol/drug use, isolation) and longer-term mental health difficulties or illness. Royal College of Psychiatrists (2011). Mental Health of Students in Higher Education.

Distress and illness Associated with childhood physical, emotional, and sexual abuse; age and degree of exposure. Significant mental health problems emerge during adolescence and early adulthood where identity changes quickly. Traumatic life events (rape, assault, natural disaster, life-threatening accidents). Adverse social and material conditions are often also identified as causes of distress for common and severe mental health difficulties.

Distress and illness Decline or change in many aspects of daily functioning (e.g. Loss of confidence, low self-esteem, low motivation, high anxiety, paranoia, distraction, sleep problems). Feeling unable to meet the demands of achieving goals in life/role. Loss of self, a loss of power, a loss of meaning and a loss of hope. Changing interactions and a re-organising of interpersonal and occupational activities around this. A “lost future”. Changing interactions with social structures, in many cases the impact being of the latter on the former.

Distress and illness Illness disrupts taken-for-granted assumptions and behaviours (subjectivity). Illness disrupts explanatory systems normally to the extent that a person fundamentally re-thinks their biography and self-concept (coping actions and strategies for managing everyday life). …And there is a response to this disruption involving the mobilisation of resources to face an altered situation (material consequences and social structure). Bury, M. (1982). Chronic illness as biographical disruption, Sociology of Health and Illness, 4, 167–82.

Some statistics 50% of life-time mental health difficulties are present by the age of 14 Mental Health Foundation (2005). Childhood and Adolescent Mental Health: Understanding The Lifetime Impacts. In any given week, 1 in 6 people experience a mental health difficulty Department of Health (2010). New Horizons. During the ages of 16-25, mental health difficulties likely to be at their most acute. Rutter & Smith (1995). Psycho-social Disorders in Young People.

Implications for students Mental health difficulties will already affect a proportion of prospective and enrolled students. Students can and will develop mental health problems (like anyone else) – they can minimise the chances but there is no guarantee. Mental health difficulties affect a lot of students; mental health difficulties are the leading cause of disability amongst young people.

Mental health and equality Four of the ten leading causes of disability in industrialised countries are mental health difficulties: depression, bipolar disorder, schizophrenia and obsessive compulsive disorder. Mental health difficulties are the leading cause of disability amongst young people. Combined with date of onset, HE is an environment where mental health difficulties will occur, and be disabling.

Mental health and equality Legally, a disability is defined as: A physical or mental impairment that has a substantial and long-term effect on a person’s ability to carry out normal day-to-day activities. Long-term means that it has lasted for, or is likely to last for, at least 12 months. Equality law applies to all people at all times in all situations.

Mental health and equality Institutions should prepare for students with mental health difficulties – inclusive design, services, and operation. A key concept is “access” (equal opportunities)… Access to education. Access to placement/employment. Access to social and non-academic facilities. Access to healthcare (e.g. timing, communication between services).

Mental health and equality: Recovery  Inclusion  Equality Mental health recovery does not always refer to complete recovery in the way that we may recover from a physical health problem. The guiding principle of recovery is hope – the belief that it is possible for someone to regain a meaningful life. “Meaningful life” will require the support of a HE environment that permits integration to help people maintain/regain their place in the communities where they live.

Moving beyond equality law The Act forms the basis for minimal, legal provision; equality issues. Adverse life events (e.g. bereavement, divorce, rape, physical illness) may have serious short-term consequences or result in a recognisable (not necessarily diagnosable) mental health difficulty, but individuals may not be protected by law. Instead, arrangements to maintain academic progress mean going beyond equality law... …and fall under the responsibilities associated with our duty of care.

Service and whole-institution approaches A focus on symptoms and functions, to the exclusion of broader social and well-being factors, is incomplete. “Sick role”. Contemporary practice recognises the need to promote independence and coping. Such needs include a meaningful life, to feel valued, equality, positive identity, identities beyond illness. “Flourishing” (or opportunities to). Context-specific approaches need both discrete services and whole- institution means of permitting people with “ill” identities to thrive.

Service and whole-institution approaches - service Subjectivity Social structure Coping strategies Experience: Student Self-management: Specialist Mentor Inclusion: Mental Health Adviser Resources: Service Manager Healthy setting: Community

About UMHAN A national network of Higher Education Mental Health Advisers Over 200 members across over 90 institutions Focused on helping our members provide practical support to students with mental health difficulties Mental health advisers are not counsellors, but rather provide practical information and guidance for students facing mental health difficulties, and help them access support they are entitled to.

The UMHAN Committee The UMHAN Committee is made up of Mental Health Advisers from across the UK, and supported by a full-time Development and Operations Worker. Chair Strategic planning, organisation and leadership. Secretary Ensuring the smooth functioning of the Committee & Network Treasurer Responsible for managing the charity’s accounts. Development and Operations Coordinator Sustaining committee efforts & maintaining organisation Supervisor Supervising, managing and supporting the Development and Operations Coordinator Working Groups Mental Health Equality Creating an all-inclusive environment in Higher Education Publicity and PR Responding to media enquiries DSA Develop and review best practice guidelines to facilitate student access to the DSA Mental Health Promotion Representing UMHAN in mental health promotion working groups Member Applications Reviewing and accepting applications

UMHAN’s Aims Ensure HE and FE mental health support staff are equipped with the tools, support, and empowerment to best support students, and ensure national representation to influence the sector for good. Influence policy development in the fields of Education, Mental Health, Disability, and beyond, to proportionately and accurately  represent the needs and interests of people with mental health difficulties. Remove the barriers to the full participation of people with mental health difficulties in higher education and beyond, encouraging the development of a culture in which people with mental health difficulties studying in higher education is a mainstream notion.

Member’s Benefits PEER SUPPORT AND CONSULTATION ​As a member, you become part of a supportive community, which gives you the opportunity  to share your experiences, knowledge and advice through exclusive discussion forums, and connect with other professionals throughout the UK and keep on top of what’s going on. Meetings and Professional Development UMHAN meetings are held three times a year, they allow members the opportunity to network with other mental health advisers and mentors, discussing current topics, sharing best practice and contributing to the continual professional development of its members.   Policy Development, Research and Publications: UMHAN is at the forefront of developing policy and practice around mental health across the sector and members regularly contribute to new research, papers and publications. Members therefore have both the opportunity to contribute to these developments and access to a wealth of professional experience, expertise and guidance from across the sector.  Benefits of membership for Higher Education institutions: Membership of UMHAN will provide your institution with a very cost-effective means of contributing towards continued professional development of staff in demanding roles. Options of both individual and institutional membership packages are available to new and existing members. Mental Health Advisers often feel isolated from professional support, whilst trying to undertake extremely challenging roles. UMHAN goes some way to addressing the duty of care which an institution has towards an individual performing such a role.  Members will have access to information about best practice from across the sector which will be relevant to supporting institutions in meeting these duties. 

I Chose To Disclose Disclosure rates are extremely low – just 1 in 125 students disclose a mental health difficulty (Equality Challenge Unit report) Equality Challenge Unit: 78% of student respondents with experience of mental health difficulties who had received support or adjustments said this had a positive or very positive effect on their studies and other experiences at university. #IChoseToDisclose Campaign aims to empower students to make an informed decision by clarifying the process of disclosure. The campaign has been used on campuses and recently UMHAN wrote blog posts for UCAS about the process of disclosing.

University Mental Health Day A national campaign on campuses across the UK to get students and staff talking openly about mental health ​Started by UMHAN in 2012 and supported by Student Minds and the Alliance for Student-Led Wellbeing An opportunity to bring together all the key players in student mental health In 2016, over 70 universities participated, including more than 3000 students and 650 members of staff. Using the hashtag #UniMentalHealthDay, our social media reach was 6,629,405 people.

University Mental Health Day 2018 1st of March 2018 Theme: Community Improve students’ and staff's awareness of support and promote a sense of belonging. Improve understanding among students and staff of the role the environment and community can play in protecting student mental health. ​Raise awareness of the specific challenges students face with regards to support for their mental health and influence education institutions and health providers to work collaboratively so all in higher education can thrive.​ See https://www.unimentalhealthday.co.uk/ or sign up to our newsletter for more information - guides to running events coming soon!

University Mental Health Advisers Network website: www.umhan.com email: umhan@live.co.uk facebook: /umhanuk twitter: @UMHANUK phone: 01865 264170 University Mental Health Advisers Network 16-17 Turl Street, Second Floor, Oxford, OX1 3DH   Registered charity number: 1155038