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What works to tackle inequalities in student mental health?

29 Jul 2022 | Sarah Chappell Sarah Chappell, Senior Research Officer at the Centre for Transforming Access and Student Outcomes in HE (TASO), shares her thoughts on tackling inequalities in student mental health after TASO’s recently published report.

Students already facing inequalities in higher education (HE) are likely being further disadvantaged due to mental health issues. Our recent report indicates that students from low income backgrounds: from Black, Asian and Minority Ethnic (BAME) backgrounds, mature students, LGBTQ+ students and care-experienced students are all at greater risk of suffering from poor mental health whilst in HE. These at-risk groups are already underrepresented and/or disadvantaged in HE: having poorer outcomes in terms of entry rates, likelihood of dropout, attainment, and/or progression to employment or postgraduate study. This suggests that mental health issues may exacerbate disparities in HE outcomes for these groups.

TASO has been set up to support the sector in closing equality gaps in HE, and subsequently a large focus of the report was on reviewing the evidence of what works to support specific at-risk groups with their mental health concerns. We also administered a survey and held focus groups with a wide range of sector stakeholders, and these, combined with interviews with HE students who have experienced poor mental health, contributed to an overall picture of current mental health support in HE.

What does the evidence tell us?

Although there has been a huge rise in the number of students disclosing a mental health issue (UCAS, 2021), evidence suggests that mental health concerns remain underreported, particularly among the most at-risk groups. UCAS data shows that around 50% of students with a mental health condition are choosing not to disclose in their application to HE. The most cited reason is fear that it will affect the outcome of their application. This emphasises the need for more research focusing on interventions that encourage disclosure and help-seeking behaviour, particularly in male students and those from BAME backgrounds.

Our report corroborates previous evidence demonstrating that psychological and mindfulness-based interventions are successful in tackling mental health issues within HE settings. Overall, however, mental health support appears to be focused on the student population as a whole and there is a paucity of evidence regarding interventions targeted at at-risk groups. Nonetheless, some studies show that initiatives can be tailored to address specific mental health concerns, including those related to race, gender and sexuality.

Peer support groups and networks, emulating group therapy processes, show evidence of promise in effectively supporting the mental health of students, and lend themselves to supporting specific sub-groups. For instance, there is evidence to suggest a positive effect on those experiencing race related concerns, in addition to those with experience of care. Given the issues identified around disclosure, these initiatives are likely effective due to students being more comfortable to talk about their mental health with their peers.

What don’t we know?

It’s evident from the consultation held with sector stakeholders that what was found in the literature doesn’t necessarily represent what is happening within HE providers. Whilst there is a lack of evidence on mental health interventions to support specific at-risk groups, two-thirds of the institutions surveyed target at least one specific student group in their mental health support. Learners who identify as LGBTQ+, or from BAME and low-income backgrounds were the most commonly targeted groups. It’s clear then that HE providers are delivering support to those who most need it, however, perhaps due to a lack of robust evaluation of interventions and the sharing of findings, we aren’t hearing enough about what works.

Focus groups with stakeholders revealed that HE providers find it difficult to demonstrate causal links between the mental health support they provide and HE related outcomes, including attainment, retention and progression. This is also reflected in the evidence base, where links between mental health interventions and HE outcomes are seldom measured. Given what we know regarding the link between poor mental health and poor HE outcomes, it’s important that evaluations of initiatives reflect both these issues.

What’s next?  

TASO is uniquely positioned to support the sector in addressing some of the gaps identified in the evidence. We are currently scoping out a research project with UCAS in which we will test interventions to promote disclosure of mental health conditions in HE applications, particularly for at-risk student groups. We hope that the findings will be applicable to encouraging post-entry disclosure and help-seeking behaviour within institutions as well.

We have also recently been appointed to lead a Consortium of five partners to help HE providers identify and make use of effective practice to support student mental health. The work will lead to the creation of a central, online hub to share what works and provide evaluation guidance. The first stage of the project will be to synthesise evidence and practice in this area, and we will be issuing an open call to the sector over the coming weeks to capture the work that is happening. We really encourage HE providers to respond to the call, so that we can build a fuller picture of mental health support. For the next stage of the project, TASO will be selecting HE providers to partner with to provide support and guidance for evaluating existing mental health interventions. This will be particularly important to help providers assess the impact of their mental health practices on longer-term outcomes.

Ultimately, it’s imperative that we further identify what works, and what doesn’t, to support student mental health and tackle inequalities. Existing practice within HE providers needs to be pooled to maximise impact and better serve students.

 

Sarah currently leads on TASO’s student mental health research theme. Sarah has worked in the education sector for several years, including in student support. More recently Sarah completed a MSc in Psychology, where the focus of her dissertation was around meaning in life, mattering, and the impact on mental health.

We feel it is important for voices to be heard to stimulate debate and share good practice. Blogs on our website are the views of the author and don’t necessarily represent those of Advance HE.

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