Who’s responsibility is it?

A child with mental illness I progressed through university and into work in much the same way as many others of my age .That it took me longer than normal did not signify to me as after years of illness I had worked hard to gain the grades and finally attain a degree just like my peers, however for much of that time I had been very unwell and so I had taken the time to look after my health as well as my studying. I was not alone and many of my peers were struggling too.

 Estimates vary, but research suggests that 20% of children have a mental health problem in any given year, and about 10% at any one time. (Lifetime Impacts: Childhood and Adolescent Mental Health, Understanding The Lifetime Impacts, Mental Health Foundation, 2005) as quoted on Mental health foundations website 

Rates of mental health problems among children increase as they reach adolescence. Disorders affect 10.4% of boys aged 5-10, rising to 12.8% of boys aged 11-15, and 5.9% of girls aged 5-10, rising to 9.65% of girls aged 11-15. (Mental Disorder More Common In Boys, National Statistics Online, 2004)

So it is no wonder with the push into education that the numbers of students with mental health conditions is rising, however what is more striking is that common mental health disorders among the 16-34 olds are also on the rise as can be seen in the Adult Psychiatric Morbidity Survey of 2007 (page 41 table 2.4Prevalence of CMD in past week in 1993, 2000 and 2007, by age and sex

All adults in the age range 16-34 (other age ranges have been excluded)

Disorder	1993	2000	2007
Mixed anxiety and depressive disorder	8.3	9.9	10.5
Generalised anxiety disorder	3.1	3.1	3.9
Depressive episode	2.3	2.0	2.2
All phobias	2.2	1.6	1.7
Obsessive compulsive disorder	1.5	1.3	1.9
Panic disorder	1.0	0.6	1.4
Any CMD	15.7	16.7	18.2

However it does not break down into working, studying, not working. Please not that these statistics are several years old. In all likelihood this trend has continued.

Certainly the number of suicides among students has risen (from an article in the guardian )

…the Office for National Statistics revealed that student suicides have risen by almost 50% in the past five years.

A startling increase, however they are not alone as there have been increasing numbers of suicide in young adults who are not in education.

But who’s responsibility is it to make sure that everyone gains the treatment and support that they need to maintain their good mental and physical health?

I have often bemoaned companys for not having any formal mental health policy but have never been convinced of how much of a duty of care they actually have.

Typically my argument runs along the lines of the adult being responsible for themselves and their health both mental and physical and as an employer their responsibility is to ensure that the environment and staff, attitudes and behaviour are safe or healthy. And that the company has established procedures and an open door policy to monitor and educate staff about mental health and the possible problems that could be faced and ways to accommodate and adjust the environment to allow for those with issues. However I wouldn’t go as far as saying they have to have on site councillors or access to talking therapies as these seem to be so far into the remit of the NHS that signposting is all that would be required.

So I am shocked when I read pieces about students and how this does seem to be expected for university’s or colleges.

Am I naïve?

I find it difficult to understand how they are being singled out for this particular issue and no one else is. Yes suicide rates are rising in students, yes mental illness also is rising but then it is also doing so for everyone else and really when did it become the university’s issue to provide care, ie counselling for mental health.

I don’t care what anyone says getting access to therapy is slow and painful and waiting lists can be 8 months or more but really does this mean that the university has to pick up the bill. Employers don’t!

So do universities have a higher duty of care?

I don’t know and if that be the case why is not expected for those companies employing young adults to have the same duty of care?

I feel that this comes about because of the circumstances and changes that students encounter at this stage that their counter parts who go into paid employment or apprenticeships do not.

For instance the amount of debt that the average student is incurring

• The pressure to succeed is greater as they have debt
• Many are taking on paid work to ensure that they stay at university despite working a full week on their studies.
• Most are living away from home for the first time

Therefore it seems likely that students will need support and universities need to consider this however, it’s not like young adult unemployment isn’t high and the job market sluggish at best.

The real issue for me is that for whatever reason these students are not accessing treatment via the NHS and I have to say the biggest problem I had at university was getting the health professionals to take me seriously. Their attitude was more that I was making it up and no matter what I said they seemed to think it was an overreaction and it took several visits to convince them that I had a bigger problem. My tutors on the other hand were responsive and understanding.

I find it strange that universities are being asked to do so much more than others and not surprising that some have chosen not to. The important thing is that each and every student has a GP and has access to every service that they can offer just like everyone else whether working or not.

If I was working then I would be expected to go to my GP and not my employer to sort out my health issues.

It really annoys me that most of the articles seem to focus on one demographic, in this case students, yes the increases are horrific but if you’re going to insist that universities sort this problem out then maybe you should also be insisting that employers do the same and see where that gets you.

I not suggesting that universities shouldn’t sort out there pastoral care/ welfare services and make them a more joined up system as this would ease the problems but it really is the persons/ students responsibility to take the advice and to seek out the services they need.

Harsh, yes but then all the people who are not students are doing that

Of course we all know the NHS doesn’t seem to be able to get it right but why burden an institution with something that a national health service hasn’t gotten right despite having been established for over 100 years?

Why not concentrate on improving their services so that they are freely available to everyone instead of trying to tailor make one from scratch in each location. In this manner they would at least be starting from a knowledge base and a service that although faulty can be improved more readily than implementing something new.