Accessing mental health support at university: breaking down the barriers

To ensure student mental health research is focused on the issues that matter to students, it is crucial that students themselves have an active rather than passive involvement in research. As such, our research project was participatory in nature, putting myself and three other Royal Holloway students with lived experiences at the centre of the research, under the guidance of Dr Eilidh Cage. 

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While discussing personal and peer experiences, we recognised how important it is that students who are struggling with their mental health have access to appropriate support. Such support can help reduce the risk of impaired academic functioning and drop-out. However, recent reports highlight that many students are not seeking or using mental health support, despite needing it. As such, we noted the importance of understanding the barriers students face when seeking help for their mental health. By understanding these barriers, we may be able to promote better mental health and help students reach their academic potential. Challenges with accessing support could also be linked to issues with the standards of available services. Therefore, our project aimed to identify barriers preventing students accessing support, as well as examine their experiences of NHS mental health services and perspectives of peer support. 

We collected data from 376 UK students via an online questionnaire. In our sample, participants reported high rates of depression, anxiety and stress. In fact, 40% self-reported a diagnosed mental health condition and 44% suspected an undiagnosed condition. 

While factors including educational impact and mental health symptoms interacted with help-seeking, self-stigma was identified as a particular barrier to accessing support. Self-stigma refers to an individual’s own internalised attitudes, adopted through exposure to stigmatising views within society and then applying them to one’s self. Self-stigma can bring feelings of shame surrounding mental illness and, as highlighted by our study, reduce help-seeking. 

Despite the barriers, since being at university over half (55%) had accessed support for their mental health. However, many noted that NHS mental health services required improvement. To gain a richer understanding of the barriers students face, even once support has been sought, we asked participant how they felt these services could be improved. We found that waiting times, better access to alternative treatments and facilitating more patient-centred communication were the most frequently reported areas of improvement.

We were also interested to hear views on other forms of support beyond NHS services, specifically peer support. Most participants (77%) felt peer support would be beneficial for their wellbeing. Particularly, they thought it would be valuable for normalising experiences and promoting belonging for those with mental health problems. However, while a third of participants reported they would use peer support, most were unsure. Many reported concerns with confidentiality, trust, emotional barriers and lack of professionalism. As such, peer support services may be beneficial for some students, but it is essential peer facilitators are appropriately trained, and peer support should not be used as a replacement for professional services.

Together, these findings can inform future initiatives to break down barriers preventing students from accessing the support they need. These initiatives could include university-wide efforts to create an accepting and understanding environment to help combat self-stigma. There is also a need to address issues with NHS services, including chronic underfunding and understaffed workforces. Simultaneously, peer support could help foster supportive environments within universities and contribute to challenging mental health stigma. 

Overall, we believe that these findings are worthy points of focus for future student mental health policies, so we can break down barriers and ensure future students have access to the support they require. 
 
This blog post was written by Rachel Batchelor within the participatory research team. If you would like to discuss the research project further, you can contact the corresponding author Dr Eilidh Cage at Eilidh.Cage@rhul.ac.uk; Twitter: @DrEilidh. ​