The Greater Manchester Universities Student Mental Health Service
Background
Following a Greater Manchester Student Mental Health Summit in June 2017 facilitated by the Greater Manchester Health & Social Care Partnership (GMHSCP) to review practical actions that could be taken to improve student mental health across Greater Manchester, a GM University Task Group was set up. The Task Group was comprised of the five universities in GM, GM Health and Social Care Partnership (GMHSCP), a number of voluntary sector partners, the student voice and clinical leads to identify what works well, what are the gaps and challenges to current structures and provision, and to propose a solution.
An initial 2-year pilot was commissioned and following review in 2021 has been funded until 2024.
About the Service
The GM Universities Mental Health Service has developed an integrated, single referral pathway for students of the five GM Universities. The care pathway is based on the I Thrive needs-led framework with service access based on need rather than limited to diagnostic category.
The aim of the service partnership is to provide proactive support and interventions to students to enable them to fulfil their university ambitions and experience. Students with pre-existing mental health problems or those whose mental health problems emerge whilst at university will be supported to succeed and to manage their mental health challenges.
This partnership model enables care to be aligned with the needs of students presenting with more complex, co-morbid and chronic conditions. The needs of the people who access this tier of care are significantly more likely to have several presenting problems, some which they will have had since childhood and for which they may have low motivation to change. They are likely to have significantly higher rates of interpersonal difficulties, i.e. recorded personality disorder, with the main life-limiting problems of anxiety disorders, co-morbid with depression, low self-esteem and relationship difficulties.
The therapeutic provision is capable of meeting the needs of people with such combinations of life-limiting difficulties. The predominant clinical need within the pathway matches the range of problems described with similarly associated high levels of functional limitation and elevated risk of self-harm.
We are a team of trained and experienced mental health professionals working daily towards the recovery of students who are experiencing mental health difficulties such as psychosis, self-harm and suicidal thoughts, anxiety, depression, Post-Traumatic Stress Disorder (PTSD), ADHD, Autism, eating disorders and emerging personality disorders. This is provided through timely access to evidence-based interventions through a multi-disciplinary team approach.
The Service partnership has identified a need in students’ mental health that traditional service models based on criteria would not have accepted. Either there are disproportionate mental health needs in a student population, or we are identifying an unmet need in the general population.
The students referred to our service present with complex mental health needs often with ongoing risks. Common themes include histories of neglect and abuse through childhood and adulthood, drug/alcohol misuse, severe mental illness e.g. Bipolar Disorder and psychosis, and current self-harm/suicidal ideation. They are frequently exhibiting symptoms associated with complex trauma presentations including difficulties with attachments and emotional regulation.
The service partnership strives to provide trauma informed care that is focused on the student within a strengths-based recovery program to support activities and clinical interventions to promote wellbeing, build social capital and develop psychological coping strategies. Over the last three years we have worked to develop a more coherent trauma informed service and environment that benefits students and staff and continue to work to develop the 5 principals of Trauma Informed Care (Harris and Fallot, 2001):
- Safety
- Trust
- Choice
- Collaborative
- Empowerment
Referral Pathway
Referrals to the service will be via the university the student attends. The University’s Mental Health Counselling and Wellbeing Services are the only teams that can refer to the GM Universities Student Mental Health Service. Referrals will be via these existing university services. No urgent pathway is commissioned into the service.
When a member of the university Counselling and Wellbeing Services sees a student for their first appointment, a key goal for that session will be to confirm whether their needs are appropriately met by the service, in line with the service criteria or if referral to the GM Universities Student Mental Health Service is required.
Population covered
The GM Universities have a collective student population of approximately 115,000 students, approximately 25,000 of which are international students.
Inclusion criteria
- Adults aged 18 years and over with no upper age limit
- Students of the University of Manchester, Manchester Metropolitan University, University of Salford, University of Bolton and the Royal Northern College of Music
Priority groups
Students who have:
- Complex mental health needs
- Self-harming behaviour
- Complex mood disorders and those with
- Emerging or diagnosed Personality Disorder
The management of more severe mental ill health, risk management and crisis de-escalation/ support linking into NHS Services and University Counselling and Wellbeing Services to create a whole pathway.
Summary of what the service will and will not be
The Service will:
- Be student focused and responsive
- Provide a range of pathways building on the existing Mental health Counselling and Wellbeing Services within the partner Universities
- Take referrals only from the Universities Mental Health Counselling and Wellbeing Services
- Offer a specialist service to students experiencing significant difficulties
- Provide a flexible ‘step up’ ‘step down’ approach with the Universities Counselling and Wellbeing Services
- Provide a range of psychological interventions and support
- Facilitate referrals to secondary care mental health services where appropriate
- Develop through co-production with the Universities and be informed by students with lived experience
- Be accessible to students across all 5 of the GM Universities that have commissioned the service
- Operate throughout the year, term time and holidays, except Bank Holidays
The Service will not:
- • Be accessible via open referral
- Replicate the full range of NHS Mental Health services including emergency services
- Replace existing counselling and mental health provision within the partner universities
- Operate at weekends or out of hours