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Our approach to mental health is broken – but universities can fix it

  • 19 December 2018
  • By Will Allen-Mersh

A guest blog kindly contributed by Will Allen-Mersh from Spill

Mental health is, by all accounts, having a bit of a moment. The last few UK governments have consistently upped investment and support in the area. A raft of celebrities – from Stephen Fry to J.K. Rowling – have spoken out about their diagnoses. Depression and anxiety, once completely taboo subjects, are now common hashtags across Instagram and the subject of advertising by a raft of brands from Ford to Lloyds Bank. It looks like the stigma around conditions like these is slowly lifting, at long last.

However, it’s not a case of a rising tide lifting all boats. Only 17% of people in the UK have a diagnosable mental health condition. Yet 87% describe their mental health as less than good, and almost three in four were so stressed or anxious at some point last year that they felt “unable to cope”. Those with a formal condition are merely the tip of a much larger – and growing – iceberg: the undiagnosed strugglers.

The system is tackling the wrong issue. Nearly all medical research into mental health focuses on treatment; less than 4% looks at prevention. Much of the impetus is on improving prescription drugs for the most extreme cases, rather than therapies for earlier-stage interventions. Headlines in newspapers, when they do come, protest about the NHS waiting times for those with diagnoses. Our medical system only helps those it can label.

Those without a label are suffering in silence. While people with a formal condition are most likely to talk about it and seek help – thanks to more widely accepted terminology and the prevalence of prescribed medication – the undiagnosed strugglers do not have the language to speak out. We live in an era when it’s easier to say ‘I’m having panic attacks’ than ‘I’m having a really hard time getting by’. Depression and anxiety have been medicalised and therefore separated from the self; struggling is internalised and therefore perceived as shameful. No wonder, then, that on average we tell people we’re fine 14 times every week – but only mean it twice. We’ll do anything to hide our problems: a survey by Spill, an online counselling provider, showed that 74% of us would rather receive a mild electric shock than open up about how we’re really feeling.

Silence is deadly – especially for young adults. Suicide is the leading cause of death for young men and women, with 95 university students taking their own lives last academic year. 18-24 year-olds are the most likely demographic to have below-par mental health. But the majority of suicide cases involve people with no mental health diagnosis who made no contact with mental health services or their GP. The problem isn’t what we do when people ask for help – it’s that they’re not even asking.

Universities are in a unique position to help. Like companies, they have a certain amount of budget to provide early-stage mental health services like counselling and peer support free at the point of use, and therefore more likely to be used than private services requiring payment at the point of use. But unlike companies, they are home to a large number of the people who most need the help of such mental health services: 18-24 year-olds. Universities also have a special responsibility for their student body. As well as imparting knowledge to students, universities should take care of and help them develop as whole people – the trickier emotional and mental aspects included – as called for by a HEPI paper on the ‘Positive and Mindful University’. The obstacles, as universities will be quick to point out, are that much of students’ emotional suffering is unidentifiable, and that offering mental health services at scale becomes prohibitively expensive – as evidenced by the fact that 21 universities in the UK have waiting times of more than four weeks.

Technology can overcome these obstacles both in terms of identifying signals and providing a scalable mental health support service. Thanks to electronic and centralised entry systems for many campus buildings, universities are now sitting on a trove of data on students’ everyday behaviour. Whilst the unnecessary use of this data would contravene privacy ethics, buried within it may be valuable early-warning signals that would be unethical to ignore. Students who later go on to take their own lives often exhibit certain behavioural traits in the preceding months, such as fewer visits to the library or a sudden drop-off in lecture attendance. Through the use of electronic data these traits can be picked up on, and support can be offered in time.

Spill provides scalable mental health support to progressive organisations around the UK including Time Out, Rightmove and Hargreaves Lansdown. Our app lets users exchange messages with a fully-qualified counsellor or psychotherapist, anonymously and at great length. It’s a safe space to share problems and get professional advice. Most importantly, and what we’re most proud of, is that it’s built specifically for the people who really need it: young adults who wouldn’t otherwise go out and seek help. 89% of our users are under 27 and 78% have never received any kind of mental health support before.

We’re a technology company, yes, but we don’t believe unquestionably that technology is our salvation. If face-to-face counselling could be easily accessed by everyone who needed it, we wouldn’t need to exist. But technology does have a historical knack for putting previously inaccessible resources into the hands of large numbers of people at a fraction of the cost. So if students aren’t getting to the support they need, then maybe the support can come to them.

Spill is looking to partner with a forward-thinking university and roll out our services to students in 2019. If you or someone you know might be interested, get in touch with [email protected]

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