• Jamie

We’ve built a new type of Mental Health Service, and it’s just for Students; here’s why.

There is much to learn from technology companies, and of how they have used innovation to reduce life’s burdens. Unfortunately, in digital health, there is too often a tendency to simply cut and paste into an app what happens offline, and the problems in our health services remain embedded in digital solutions. Somehow, we have failed to embrace the principle of the ’hack’, of taking a problem and investigating how we could build solutions afresh. And when it comes to problems, the NHS has finally realised that it is failing badly one particular group: students. Over the last decade there has been a 6–7x increase in students disclosing a mental health condition, and even if some of this is down to a reduction in stigma, and then a greater ability to report problems, it is massively concerning. Student services are now overwhelmed by the demands, and students themselves report the stress of waiting for a referral for support, and the very long waiting times for psychological therapy. The therapies available though University Services have historically been brief, and if more is needed, a referral to the local adult mental health services may involve yet more delay.

Students present a specific challenge to health services; they are a highly mobile population and at some of our greatest Universities they are almost exactly 50% of the year at University and 50% of the time at home or elsewhere. A young person with a mental health condition, who has received help from services at home, may not know where to turn for support on starting university. Their home service may also not know how to advise them. They will have to register with a new GP, and it may take some time for their health records to reach the new GP, and of course some records even get lost along the way. They then have to repeat any traumatic history to new professionals, and repeatedly. If offered therapy, it is not so unusual for the first appointment to be offered just before the end of term, as they then return home for many weeks. Local budgets, policies and procedures may play their part, but it is agonising to witness that the suicides of some students may have been prevented by better communications and integration of care.

All of this would be hugely challenging to anyone with a settled life, a fixed home, income and supportive relationships. Yet students heading off to university have just left the stability of school, are now leaving home, and are saying goodbye to friends who are going to other universities. They then move into a new residence, ratchet up their skills in the management of money and self-care, and meet a whole group of new people who are similarly unsettled. In addition, some will have travelled to a new country and lose the comforts of a mother tongue for expressing themselves.

So, the problem is clear; a population of gifted young people, of great potential, face the enormous stress of multiple life changes, whilst discontinuities in our health services means that getting any support will be slow, if at all. For students, the impact of so many transitions can be overwhelming, especially for the mind, and even knowing what now is normal, not easy to work out. The specificity of these stresses and opportunities warrants dedicated support; even the NHS now recognises that students are an atypical (not my word!) population and need something more specific to their time of life.

It is not hard to see how digital technologies could help with much of this, as support is less tied to where you are, or even what time of day it is. But there is a further element to consider in our search for the ‘hack’ or solution. In a ground-breaking study from Victoria Rideout and Susannah Fox in the US (https://www.hopelab.org/reports/pdf/a-national-survey-by-hopelab-and-well-being-trust-2018.pdf), there was confirmation (if it were needed) that young people make use of online resources to support their mental well-being. Seeking support from health peers occurred in 39% of all 14–22 year olds, of which 91% said it was ‘at least somewhat helpful’, and 20% said it was ‘very helpful’. “Youth lead the way in the social revolution that is underway in health,” the authors write, ”indicating that…almost twice as many young people as adults in the US turn to each other for advice in making health decisions.”

The final part of our solution may be obvious, but still relatively scarce in digital health; young people will use their smartphone for almost everything and expect a rich user experience. Digital health services should align themselves with the developments of the digital world, and a good user experience is vital to success.

So, taking all of this into consideration we have built something that at least starts to solve many of the problems outlined above.

I would now like to introduce you to the TalkCampus mental support service for students. It is itself an evolution of the hugely popular TalkLife App.

It’s features at launch include:

· A mobile optimised service, with a user experience familiar to those who use messaging apps.

· A culture of support from ‘health peers’.

· ‘Safety by design’ safeguarding.

· Sophisticated machine learning to identify, support and escalate anyone at risk.

· Trained volunteers who enhance the peer support.

· Personalised recommendations of the support available at your University.

· Notifications to University support Services of those needing more support.

· 24/7 support whether you are at home or University, over the lifetime of your course; no brief measures.

· An advisory board on global mental health experts to advise on strategy

· A world class research programme to continuously improve the support available.

The introduction of the smartphone means that help is now (literally) at hand, whatever your needs, whenever you need it and wherever you are. You no longer need to find an up to date directory of what is available and you can hear from ‘people like me’ what helped. There are no more cliff edges between home and University, or holes between services to fall through. TalkCampus can accompany you on one of the most amazing journeys of your life.

We will all do better, when our amazing students are supported in reaching their potential, and become the people our world wants and needs.

Big Shout-out to Anne Collier of Net Family News (https://www.netfamilynews.org/) for sharing the Rideout & Fox research on peer support!

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