Nathan is a 20-year-old arts student. He had depression before he came to university, and felt well-supported by his family, but it has been difficult living and studying away from home.
“Suddenly you come to university and you’ve not got your family around you. So you need your friends, which is tricky because they are busy and stressed themselves.”
Nathan (who did not want his real name to be used) has a history of self-harming and has received support from the student mental health services, which he says are over-subscribed.
When he visited them three weeks ago to try to get counselling, he was told there was a waiting list and he would not be seen until after Christmas. He was offered a 20-minute drop-in session but he says he feels he needs more than that.
Nathan is a student at the University of Bristol, where it emerged this week that three teenagers, all believed to be first-year students, had died within weeks of starting their studies this term. The cause of death in each case will be decided by a coroner, but relatives of two of them have indicated that they killed themselves.
The deaths at Bristol, one of the most prestigious universities in the country, have resurfaced concerns about a crisis in student mental health and the capacity of universities to respond to it. A recent Guardian investigation revealed that the number of students seeking counselling at university has gone up by 50% in the past five years.
“The pressures on students to be successful in all aspects of their lives are completely unrealistic,” said one head of student services. New students were particularly vulnerable as they negotiated the social pressures of freshers’ week and the academic expectations of their courses.
“Not only are they expected to be A* students, they are expected to be living the life, to be good looking, to have the right clothes and to do the right social activities.”
Students have a lower suicide rate than the general population but it appears to have grown. Figures from the Office for National Statistics show that in 2014 there were 130 deaths by suicide of full-time students aged 18 and over in England and Wales. This compares with 112 in 2011; and 75 in 2007. The increase can be explained in part by the growing university population, which now stands at 2 million.
A survey by the National Union of Students last year, revealed that nearly eight in 10 student respondents (78%) had experienced mental health difficulties over the previous year and a third (33%) said they had had suicidal thoughts. Other surveys have shown that one in five students are self-harming.
Ruth Caleb, the chair of the Universities UK mental wellbeing in higher education working group and head of counselling services at Brunel University, said most, if not all such services were seeing students who had had suicidal thoughts. Although student deaths by suicide were rare, they happened across the sector and had a devastating effect,” she said.
“It’s absolutely heartbreaking. It raises awful feelings. It just makes you feel very, very sad and wish you could have done something to support the student, but quite often they’ve not come forward.”
In Bristol, up and down the chilly hills of Clifton on Thursday morning, news was slowly filtering through as students made their way from seminars and lectures to the student union. Not everyone knew. “Three?” exclaims one girl, clutching a pile of books on film noir. “I had no idea,” said another.
Nathan had heard about the deaths, as had his friend Bella, a second-year English student who knew one of the students because they came from the same area and used to go to the same parties. “It’s weird,” says Bella. “It was so unexpected.”
“For everyone involved it’s shocking,” said Mark Ames, director of student services at Bristol. “We have 22,000 students, so in any one year we would expect to have to manage the fact that some of our students will die while they are with us.
“In common with any other university, on occasion we do have a student death that unfortunately the coroner might conclude was death by suicide. But our numbers over the years do not suggest we have a trend here. Unfortunately, what we have is a coincidence.
“As far as we are aware there’s no link between the deaths – although we are very aware of the risks of clusters in these kind of events.”
In the last academic year Bristol had one death by suicide; there were none the year before that, and one the previous year.
When told about Nathan’s experience, the university apologised and urged him to contact their services again.
“Like every university counselling service, we are over-subscribed for individual counselling,” a spokesman said. “Many of our counselling interventions can begin immediately. We assess the needs of each student to work out what is the most appropriate intervention for them.”
Universities are aware that the first few weeks in higher education can be challenging for vulnerable new students.
“Anybody changing their life is going to be anxious,” Caleb said. “Quite often you’ve moved geographically. It’s a completely different life. You are out of your comfort zone, you don’t know anybody. You have to come out of your room and make friends.”
Bristol puts on live performances in freshers’ week by a New Zealand organisation called UniSmart which provides a one-stop student survival guide, including information about welfare and wellbeing, and there are welcome talks from staff who oversee halls of residence. But some students the Guardian spoke to said they would have liked more information about the mental health support services available. Others said they felt well looked after.
Bristol, like the rest of the sector, has witnessed a marked change in the support needs of new students over the last few years. The number of students who lack the necessary “resilience” to meet the challenges of independent living and study has grown, according to Ames, and many more arrive having already been diagnosed and treated for a mental health condition.
Ben, who is in his first-year of a law degree, is one such student. Originally from the north, he feels a long way from home. He informed the university before arriving that he had a history of mental health problems, but has heard nothing since, and though he said he felt well now, he would not know where to go for help.
“I feel it should be a bit more proactive,” he said. “It’s daunting coming to university. The course is intense. You are bombarded with all this social stuff, but it can get quite lonely. You can go into yourself.”
A fifth-year dentistry student said she felt well supported by the university. “The university do send out regular emails about if we are not coping well, or if we feel stress. There’s definitely support available on the website.”
Two second-year medical students agreed they felt well supported, though they thought medics benefited from a particularly close-knit community. Others said it depended on who you ended up living with.
Mental health and wellbeing are a growing priority across the sector, but experts say more needs to be invested in services in some universities. A report in September by the Higher Education Policy Institute thinktank said some institutions needed to triple their spending on mental health services to meet demand.
The University of York has been more open than most about the challenges of providing mental health support after it emerged that there were five student deaths by suicide between February 2015 and January 2016. A university report into student mental ill health included data from ambulance callouts to the university, which showed that in the first few weeks of 2016, up until 9 February, there were 12 callouts for incidents of self-harm or attempted suicide – half of all callouts to the university. In the previous year there were 134 emergency callouts, of which almost a third (32%) were for self-harm or suicide attempts.
A spokesperson for the university said: “As the number of students considering higher education grows, we must anticipate mental health vulnerabilities by encouraging openness between staff and students to talk about these issues in a supportive environment.
“Over the next three years we are investing £500,000 in mental health support services and awareness campaigns across campus. This includes expanding our in-house counselling service, with the addition of two new members of staff, to ensure that those who need urgent appointments can be seen very quickly.”
The universities umbrella body, Universities UK, is working on a strategy aimed at improving the mental health and wellbeing of students.
“It’s up to universities to make student life as stress-free as possible,” said Caleb, who is on the steering group. “Universities are trying to do their best and still we are seeing a high level of mental ill heath coming through. Some students you are very concerned about and you need to look after them very carefully. Sometimes it’s the ones who have not disclosed [that they are having are problems].”
Siobhan O’Neill, a professor of mental health sciences at Ulster University, agreed: “It’s not just about the services provided, it’s about students coming forward. We find that students are reluctant, particularly the ones at risk of suicide, to ask for help.”
Students are under more pressure than ever, she said.
“There’s student fees and debt. Students and their families are risking more by going to university. The stakes are much higher.” Then there are the additional pressures from social media and “social perfectionism”.
She added, however, that it was important not to be alarmist – most young people do well at university and manage the transition from home to independence successfully. “For most it’s a really good time – sometimes the best years of your life.”
- In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here
Bristol student deaths highlight campus crisis in mental health
