Mapping patterns of inequality in students’ access to mental health services in London

There has been a fivefold increase in the number of students declaring a mental health difficulty to their institution over the last decade, leaving student services struggling to meet demand. There is universal concern about the increasing prevalence of suicide and self-harm in this demographic group. It is likely that problems accessing appropriate mental health care are not borne equally across the student population in London, but this question has not yet been investigated.

This PhD project explored whether mental health services in London are meeting the needs of university students, and identifying whether service provision could be improved, and if so, how this might be done. Qualitative interviews with students and professionals were conducted, and data from a UK population cohort dataset was used to address this aim.

The evidence generated by our research will lead to a fundamental change in mental health policy at UCL.  This research including systematic review and peer support work, were submitted as evidence in response to a call to propose a new model and principles for organising mental health services at UCL. The policy will re-frame the problem to a population perspective, focusing service provision on prevention of mental disorders, by minimising distress/maximising mental wellbeing, to promote health across the population.

The outputs of this research are a series of recommendations and principles for service redesign. The proposal is now with senior leaders at UCL ahead of stakeholder engagement to test the policy.

Our research examining development of a peer supporter role at UCL has informed ongoing scaling up of this role. We identified problems in early implementation of the role, relating to low uptake among students seeking support. Findings showed concept of peer support unclear to students, and effort involved in reaching intervention challenging. In current scaling-up, students themselves supported to lead development of role/service, and make decisions about entry points/availability of intervention/training provision. Peer supporter role now explicitly part of UCL’s policy, providing opportunity for role to be sustained over time.

Preliminary findings from all studies have been communicated via webinars to local NHS and university professionals, students at UCL, and via the UCL "Student Health and Wellbeing" Community of Practice. Peer support training has been provided to students at UCL as part of scaling up activities.