Tag Archives: Student

Sussex health trust apologises for failings before death of student

A health trust has apologised “unreservedly” for failings in the case of a 21-year-old student whose body was found in a burnt-out car after she absconded from a mental health ward.

How Janet Müller, a German national in her final year at Brighton University, ended up in the boot of a torched Volkswagen Jetta is a mystery. She died from inhalation of fire fumes within hours of going missing. Christopher Jeffrey-Shaw, 27, was convicted of manslaughter and imprisoned for 17 years.

Speaking publicly about the young woman’s death for the first time, her mother, Ramona Müller, 47, said she blamed Sussex Partnership NHS foundation trust for errors that led to her “bright, intelligent and beautiful” twin daughter being able to abscond from Mill View hospital in Hove, twice in one day before her death.

It was not the first time a patient had climbed over an 8ft garden wall and it was a known awol risk, her mother said. “It’s just the first time it ended that badly,” said Müller, who raised Janet and twin sister, Selina, in Berlin.

She had allowed her daughters to come to the UK “because I thought it was safe there. They wanted to do it for their education. So, I tried my best to make it possible for them. I raised them on my own. And then, finally, someone just comes along and takes her life.”

Müller, who was studying international event management, had no previous mental illness but became unwell ahead of her final exams in March 2015, and was admitted to the hospital 10 days before her death.

Her twin, who was studying at Kent University, visited her there and reported her to be agitated and desperate to leave. Her mother said she begged staff to allow Janet home to Germany, or allow her to visit or speak to her. “I tried to call a million times, I tried to speak to Janet.” But, she says she was always reassured: “Janet is fine, she is safe, don’t worry,” and was told her daughter could soon be transferred to a hospital near home in Germany. She never managed to speak to her before her death.

Janet first absconded from the female-only ward on the morning of 12 March 2015, and was found by a farmer in a field and returned by police.

She absconded again later that night and is thought to have gone over the wall, the inquest heard. CCTV footage showed her walking in the early hours of 13 March in Brighton. Her body was found in the car near Ifield golf club near Horsham in West Sussex.

When she learned her daughter was missing, Müller, a paramedic and teacher at a school in Berlin, flew to the UK to search for her. She was met at Eastbourne station by Selina. “I told her: ‘Don’t worry. We will find her.’ And she said to me: ‘Mama. They’ve found her. She’s dead.’”

The family have no idea how she came to be in the car. She had been severely beaten before being burned alive. An inquest found she died from fire fumes inhalation. She had no known connections to Jeffrey-Shaw. “There are so many unanswered questions. Why did she end up with him, not knowing him at all?” said her mother.

Jeffrey-Shaw, who has previous convictions for blackmail and harassment, was charged and convicted of manslaughter at Guildford crown court, but his trial yielded no answers. He admitted setting the car alight, but claimed he did not know the student was in the boot. He told the court he had been involved with drug dealers who borrowed his hire car for a robbery which went wrong and who ordered him to torch it.

The judge, rejecting his account, said the only reason he was not guilty of murder, “is because you did not have the human decency to check if the person in the boot of your car was dead or alive”.

An inquest jury, which agreed a verdict of unlawful killing, found lack of communication between healthcare staff, insufficient records and inadequate risk assessment were contributory, with no extra measures taken after she first absconded, and staff shortages and building works also factors.

Janet’s mother and sister have settled with the trust after issuing a civil claim under the Human Rights Act.

Sam Allen, the trust’s chief executive, admitted: “We failed in our duty of care to Janet, for which I am truly sorry.”

In a public apology, she said: “I want to give my personal assurance that we have worked hard to address the shortcomings identified following Janet’s tragic, untimely death.

“Words of apology from me cannot bring Janet back. The awful events that happened after she absconded from our care will forever be borne by her family.”

Janet’s mother said it had been “a long, hard fight” to get the trust to admit its mistakes, but she had been determined “to get justice for Janet, to force them to make changes, to speak out. Janet’s voice has to be heard, and things should not and must not happen again.”

The family had been devastated by Janet’s death, her mother said. Janet’s sister had abandoned her studies in UK. Once part of a close threesome, both feel responsible for not having done enough to save Janet, she said.

She hoped now the same mistakes could not be repeated. “For us it is too late. Nothing can change what happened to us. Janet will not come back. No apology, nothing, can do that. It’s all too late,” she said.

Action, not more reports, needed to tackle student mental health | Ketters

The Universities UK report Minding Our Future highlights what those of us who work with students have known for many years (Call for urgent action to improve mental health services for students, 11 May). Mental health services are not integrated, and they do not always follow the person if he or she relocates, assuming that services are available for younger people and that they are able to access them. 

Governments of all political persuasion express their commitment to reform, and their deep regret and sorrow when life is lost, or serious harm occurs. Such expressions are of little if any comfort to those in need of support and services. Nor do they provide any strength to families and friends who lose loved ones. At what point did we decide that support for vulnerable young people was not a priority? When did we decide that the politics of austerity and outsourcing were more important than their lives and wellbeing?

Please, no more reports telling us what we already know. As the fifth strongest economy in the world, the provision of well-funded, integrated and personalised mental health support services for all generations is achievable. Until we commit to such a policy, we will continue to read tragic stories of suicide and self-harm.
Professor John Williams
Professor of law, Aberystwyth University

Your report rightly draws attention to the enormous problem of providing appropriate support to students experiencing periods of mental distress. I ask myself: “What happened?” In 1999, when I worked in HE, the heads of university counselling services produced the report Degrees of Disturbance: the new agenda; the impact of increasing levels of psychological disturbance among students in higher education, which was taken very seriously by the Committee of Vice-chancellors and Principals (now Universities UK).

The report addressed the very same issues as Minding Our Future. Many institutions took this seriously. They introduced mental health awareness training for staff at all levels and recommended urgent expansion of counselling and support services. I was involved at the Open University in developing and delivering some of this training over the following few years. Last week’s report makes depressing reading. Things seemed to be improving at the beginning of the century. The deterioration in student support services must reflect the massive change in social priorities that has occurred, alongside huge financial austerity pressures on education, health and social services, under the Tory governments since 2010. There is an urgent need to halt the damage.
Chris Youle
Winchester

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

Action, not more reports, needed to tackle student mental health | Ketters

The Universities UK report Minding Our Future highlights what those of us who work with students have known for many years (Call for urgent action to improve mental health services for students, 11 May). Mental health services are not integrated, and they do not always follow the person if he or she relocates, assuming that services are available for younger people and that they are able to access them. 

Governments of all political persuasion express their commitment to reform, and their deep regret and sorrow when life is lost, or serious harm occurs. Such expressions are of little if any comfort to those in need of support and services. Nor do they provide any strength to families and friends who lose loved ones. At what point did we decide that support for vulnerable young people was not a priority? When did we decide that the politics of austerity and outsourcing were more important than their lives and wellbeing?

Please, no more reports telling us what we already know. As the fifth strongest economy in the world, the provision of well-funded, integrated and personalised mental health support services for all generations is achievable. Until we commit to such a policy, we will continue to read tragic stories of suicide and self-harm.
Professor John Williams
Professor of law, Aberystwyth University

Your report rightly draws attention to the enormous problem of providing appropriate support to students experiencing periods of mental distress. I ask myself: “What happened?” In 1999, when I worked in HE, the heads of university counselling services produced the report Degrees of Disturbance: the new agenda; the impact of increasing levels of psychological disturbance among students in higher education, which was taken very seriously by the Committee of Vice-chancellors and Principals (now Universities UK).

The report addressed the very same issues as Minding Our Future. Many institutions took this seriously. They introduced mental health awareness training for staff at all levels and recommended urgent expansion of counselling and support services. I was involved at the Open University in developing and delivering some of this training over the following few years. Last week’s report makes depressing reading. Things seemed to be improving at the beginning of the century. The deterioration in student support services must reflect the massive change in social priorities that has occurred, alongside huge financial austerity pressures on education, health and social services, under the Tory governments since 2010. There is an urgent need to halt the damage.
Chris Youle
Winchester

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

Action, not more reports, needed to tackle student mental health | Ketters

The Universities UK report Minding Our Future highlights what those of us who work with students have known for many years (Call for urgent action to improve mental health services for students, 11 May). Mental health services are not integrated, and they do not always follow the person if he or she relocates, assuming that services are available for younger people and that they are able to access them. 

Governments of all political persuasion express their commitment to reform, and their deep regret and sorrow when life is lost, or serious harm occurs. Such expressions are of little if any comfort to those in need of support and services. Nor do they provide any strength to families and friends who lose loved ones. At what point did we decide that support for vulnerable young people was not a priority? When did we decide that the politics of austerity and outsourcing were more important than their lives and wellbeing?

Please, no more reports telling us what we already know. As the fifth strongest economy in the world, the provision of well-funded, integrated and personalised mental health support services for all generations is achievable. Until we commit to such a policy, we will continue to read tragic stories of suicide and self-harm.
Professor John Williams
Professor of law, Aberystwyth University

Your report rightly draws attention to the enormous problem of providing appropriate support to students experiencing periods of mental distress. I ask myself: “What happened?” In 1999, when I worked in HE, the heads of university counselling services produced the report Degrees of Disturbance: the new agenda; the impact of increasing levels of psychological disturbance among students in higher education, which was taken very seriously by the Committee of Vice-chancellors and Principals (now Universities UK).

The report addressed the very same issues as Minding Our Future. Many institutions took this seriously. They introduced mental health awareness training for staff at all levels and recommended urgent expansion of counselling and support services. I was involved at the Open University in developing and delivering some of this training over the following few years. Last week’s report makes depressing reading. Things seemed to be improving at the beginning of the century. The deterioration in student support services must reflect the massive change in social priorities that has occurred, alongside huge financial austerity pressures on education, health and social services, under the Tory governments since 2010. There is an urgent need to halt the damage.
Chris Youle
Winchester

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

Action, not more reports, needed to tackle student mental health | Ketters

The Universities UK report Minding Our Future highlights what those of us who work with students have known for many years (Call for urgent action to improve mental health services for students, 11 May). Mental health services are not integrated, and they do not always follow the person if he or she relocates, assuming that services are available for younger people and that they are able to access them. 

Governments of all political persuasion express their commitment to reform, and their deep regret and sorrow when life is lost, or serious harm occurs. Such expressions are of little if any comfort to those in need of support and services. Nor do they provide any strength to families and friends who lose loved ones. At what point did we decide that support for vulnerable young people was not a priority? When did we decide that the politics of austerity and outsourcing were more important than their lives and wellbeing?

Please, no more reports telling us what we already know. As the fifth strongest economy in the world, the provision of well-funded, integrated and personalised mental health support services for all generations is achievable. Until we commit to such a policy, we will continue to read tragic stories of suicide and self-harm.
Professor John Williams
Professor of law, Aberystwyth University

Your report rightly draws attention to the enormous problem of providing appropriate support to students experiencing periods of mental distress. I ask myself: “What happened?” In 1999, when I worked in HE, the heads of university counselling services produced the report Degrees of Disturbance: the new agenda; the impact of increasing levels of psychological disturbance among students in higher education, which was taken very seriously by the Committee of Vice-chancellors and Principals (now Universities UK).

The report addressed the very same issues as Minding Our Future. Many institutions took this seriously. They introduced mental health awareness training for staff at all levels and recommended urgent expansion of counselling and support services. I was involved at the Open University in developing and delivering some of this training over the following few years. Last week’s report makes depressing reading. Things seemed to be improving at the beginning of the century. The deterioration in student support services must reflect the massive change in social priorities that has occurred, alongside huge financial austerity pressures on education, health and social services, under the Tory governments since 2010. There is an urgent need to halt the damage.
Chris Youle
Winchester

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

Action, not more reports, needed to tackle student mental health | Ketters

The Universities UK report Minding Our Future highlights what those of us who work with students have known for many years (Call for urgent action to improve mental health services for students, 11 May). Mental health services are not integrated, and they do not always follow the person if he or she relocates, assuming that services are available for younger people and that they are able to access them. 

Governments of all political persuasion express their commitment to reform, and their deep regret and sorrow when life is lost, or serious harm occurs. Such expressions are of little if any comfort to those in need of support and services. Nor do they provide any strength to families and friends who lose loved ones. At what point did we decide that support for vulnerable young people was not a priority? When did we decide that the politics of austerity and outsourcing were more important than their lives and wellbeing?

Please, no more reports telling us what we already know. As the fifth strongest economy in the world, the provision of well-funded, integrated and personalised mental health support services for all generations is achievable. Until we commit to such a policy, we will continue to read tragic stories of suicide and self-harm.
Professor John Williams
Professor of law, Aberystwyth University

Your report rightly draws attention to the enormous problem of providing appropriate support to students experiencing periods of mental distress. I ask myself: “What happened?” In 1999, when I worked in HE, the heads of university counselling services produced the report Degrees of Disturbance: the new agenda; the impact of increasing levels of psychological disturbance among students in higher education, which was taken very seriously by the Committee of Vice-chancellors and Principals (now Universities UK).

The report addressed the very same issues as Minding Our Future. Many institutions took this seriously. They introduced mental health awareness training for staff at all levels and recommended urgent expansion of counselling and support services. I was involved at the Open University in developing and delivering some of this training over the following few years. Last week’s report makes depressing reading. Things seemed to be improving at the beginning of the century. The deterioration in student support services must reflect the massive change in social priorities that has occurred, alongside huge financial austerity pressures on education, health and social services, under the Tory governments since 2010. There is an urgent need to halt the damage.
Chris Youle
Winchester

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

Action, not more reports, needed to tackle student mental health | Ketters

The Universities UK report Minding Our Future highlights what those of us who work with students have known for many years (Call for urgent action to improve mental health services for students, 11 May). Mental health services are not integrated, and they do not always follow the person if he or she relocates, assuming that services are available for younger people and that they are able to access them. 

Governments of all political persuasion express their commitment to reform, and their deep regret and sorrow when life is lost, or serious harm occurs. Such expressions are of little if any comfort to those in need of support and services. Nor do they provide any strength to families and friends who lose loved ones. At what point did we decide that support for vulnerable young people was not a priority? When did we decide that the politics of austerity and outsourcing were more important than their lives and wellbeing?

Please, no more reports telling us what we already know. As the fifth strongest economy in the world, the provision of well-funded, integrated and personalised mental health support services for all generations is achievable. Until we commit to such a policy, we will continue to read tragic stories of suicide and self-harm.
Professor John Williams
Professor of law, Aberystwyth University

Your report rightly draws attention to the enormous problem of providing appropriate support to students experiencing periods of mental distress. I ask myself: “What happened?” In 1999, when I worked in HE, the heads of university counselling services produced the report Degrees of Disturbance: the new agenda; the impact of increasing levels of psychological disturbance among students in higher education, which was taken very seriously by the Committee of Vice-chancellors and Principals (now Universities UK).

The report addressed the very same issues as Minding Our Future. Many institutions took this seriously. They introduced mental health awareness training for staff at all levels and recommended urgent expansion of counselling and support services. I was involved at the Open University in developing and delivering some of this training over the following few years. Last week’s report makes depressing reading. Things seemed to be improving at the beginning of the century. The deterioration in student support services must reflect the massive change in social priorities that has occurred, alongside huge financial austerity pressures on education, health and social services, under the Tory governments since 2010. There is an urgent need to halt the damage.
Chris Youle
Winchester

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

Mindfulness boosts student mental health during exams, study finds

Mindfulness training helps build resilience in university students and improve their mental health, particularly during stressful summer exams, according to research from the University of Cambridge.

The study, which involved just over 600 Cambridge students, concluded that the introduction of eight-week mindfulness courses in UK universities could help prevent mental illness and boost students’ wellbeing at a time of growing concern about mental health in the higher education sector.

University mental health services have experienced a huge surge in demand, with the number of students accessing counselling rising by 50% between 2010 and 2015, exceeding growth in student numbers during the same period.

According to the study, published in the journal The Lancet Public Health, the prevalence of mental illness among first-year undergraduates is lower than among the general population, but it exceeds levels in the general population during the second year of university.

“Given the increasing demands on student mental health services, we wanted to see whether mindfulness could help students develop preventative coping strategies,” said Géraldine Dufour, one of the report’s authors and the head of Cambridge’s counselling service.

Mindfulness, an increasingly popular method of training attention on the present moment, has been shown to improve symptoms of anxiety and depression. Until now, however, there has been little robust evidence on its effectiveness in supporting students’ mental health.

The Cambridge students were randomly assigned to two groups. Both were offered access to the university’s usual support and counselling services, as well as NHS services. One of the two groups was also offered the mindfulness course, which consisted of eight weekly, group-based sessions, plus home practice including meditation, “mindful walking” and “mindful eating”.

Researchers found the mindfulness participants were a third less likely to score above the threshold commonly regarded as meriting mental health support. Even during the most stressful period of the year, summer exams, distress scores for the mindfulness group fell below their baseline levels, as measured at the start of the study. The students without mindfulness training became increasingly stressed as the academic year progressed.

Researchers also considered whether mindfulness had any effect on exam results, but their findings were inconclusive.

“This is, to the best of our knowledge, the most robust study to date to assess mindfulness training for students, and backs up previous studies that suggest it can improve mental health and wellbeing during stressful periods,” said Dr Julieta Galante, of Cambridge’s psychiatry department, who led the study.

“Students who had been practising mindfulness had distress scores lower than their baseline levels even during exam time, which suggests that mindfulness helps build resilience against stress.”

Prof Peter Jones, also from Cambridge’s department of psychiatry, added: “The evidence is mounting that mindfulness training can help people cope with accumulative stress.

“While these benefits may be similar to some other preventative methods, mindfulness could be a useful addition to the interventions already delivered by university counselling services. It appears to be popular, feasible, acceptable and without stigma.”

Campus confidential: the counsellors on the frontline of the student mental health crisis

I am walking through Nottingham’s Arboretum park on a bright cold afternoon with 10 other people, all of us in complete silence. At first I find the whole thing so awkward I have to suppress an embarrassed laugh. But as we make our wordless way through the dappled shade, I feel an atmosphere of calm and thoughtfulness envelop us like a protective cloak.

The others in my group are undergraduate students, chaplains and other staff of Nottingham Trent University (NTU), all taking part in a mindfulness walk, intended to bring some space and quiet reflection into students’ hectic lives. Guided by the chaplains (who speak occasionally), we pause as a group to consider questions in the booklets we have been handed: “who am I?”, “where am I going in my life?” and “what brings me a sense of excitement?” Left to our silence, we note down our answers. Stopping by a rubbish bin, we ask, “What rubbish am I carrying with me in my life?” We tear off our answers and throw them in the bin. It sounds silly, but weeks later I still feel lighter for casting off that scribble on a scrap of paper.

Back in the bustling City Campus of NTU, students and staff weave their way around each other, a mass of hoodies and headscarves, skullcaps and backwards caps, hipster beards and hi-tops. Posters advertise a programme of free yoga, craft classes and eating-disorder information sessions: my visit coincides with Wellbeing Week, designed to raise awareness of mental health and encourage students who need help to seek it. This is just one part of NTU’s strategy to meet a dramatic rise in the need for support.

Last month, the Institute for Public Policy Research (IPPR) published a report revealing that nationally, the number of first-year students who disclose a mental health problem has risen fivefold in the past decade. A record number of students with mental health problems dropped out of university in 2015, the latest year for which figures are available. In the same year, 134 students killed themselves, the highest number on record. Similarly, the number of UK students seeking counselling has rocketed by 50% in the past five years, to more than 37,000, according to figures obtained by the Guardian. This trend is reflected at NTU: wellbeing services received 38% more referrals last year than in 2014/15.

The student services area in the atrium at Nottingham Trent University.


The student services area in the atrium at Nottingham Trent University. Photograph: Fabio De Paola for the Guardian

There are many reasons mental health problems may arise at university. It is a time of transition: people are no longer living in the family home, but not yet fully independent either. Added to this, some might experience the big fish – small pond effect, where teenagers who are used to being recognised for their achievements find themselves in a more competitive yet more anonymous environment. Difficulties that have been repressed throughout school can bubble up when students leave their support network behind. As Glenn Baptiste, a mental health adviser at NTU says, “Sometimes it might look like it’s a problem that’s occurred within university, but that’s not always the case. If students come here with ongoing issues that they’ve not discussed, the university environment can make life difficult.”

Even students who have previously sought help may find the move to university makes access more complicated, as they move from adolescent to adult support services. According to a report by the Joint Commissioning Panel for Mental Health, a third of students who had access to child and adolescent mental health services (CAMHS) found their care was interrupted in the transition to university. Nearly a third more lost access to their support altogether.

Student Services manager Alison Bromberg says the most common mental health problems reported by NTU students are anxiety and depression. Bromberg can see how the challenges young people face today play their part in this rise – the burden of student debt, economic uncertainty, global political upheaval, apocalyptic climate change – “but,” she says, “I also think that a lot of work has happened and is still happening to reduce the stigma around discussing mental health and emotional needs. I think it’s making it more possible for people to come forward and ask for that support.”, global political upheaval, economic uncertainty, student debt

Glenn Baptiste, 
an adviser at Nottingham Trent, helps students develop strategies to manage their mental health and their studies.


Glenn Baptiste, an adviser at Nottingham Trent, helps students develop strategies to manage their mental health and their studies. Photograph: Fabio De Paolo for the Guardian

In a small office, Sam, a fourth-year student at NTU in her early 20s, sits twiddling a pen and jiggling her knee. She comes across as articulate but nervous, giggling occasionally after speaking. One day, she was in the kitchen of her shared student flat, chatting with her housemates, when out of the blue she felt as if she couldn’t breathe. The same thing happened again in a lecture, and again and again. Assuming it was linked to her existing health problems – migraines and a minor heart condition – Sam booked an appointment with her GP. It never crossed her mind that it might be psychological. “When he told me it was panic- and anxiety-related, it was a bit of a shock,” Sam says. At the same time, she noticed a problematic pattern in her studies: she would do well in the first term, but then stop going to lectures and end up failing her summer exams and having to resit them.


One day, Sam couldn’t breathe. ‘It was a shock when the GP said it was anxiety-related.’ Now she is breaking that cycle

This year, however, she has managed to break that cycle with the help of Baptiste, who has a background in community mental health, counselling and cognitive behavioural therapy (CBT). An adviser rather than a therapist, Baptiste’s job is not so much to counsel Sam as to help her develop strategies to manage her mental health and studies. Sitting in on their session, I can see how his calm manner relaxes Sam as she listens to his practical advice. They work through her primary anxiety at the moment: an upcoming presentation. She fills in a worksheet that breaks down her fears into her core belief about the presentation (“I won’t be able to answer the questions”); her thoughts arising from that belief (“I will look stupid and get a bad grade”); the feelings provoked by those thoughts (“nervous, panicky”); and the physical reaction and behaviour that follow (“I’ll stutter and shake, and I’ll forget to breathe. Then I’ll want to leave”). At times, Sam tries to race ahead, to write a feeling in the box for thoughts, and Baptiste gently corrects her. Finally, he says, “We know these all feed into each other, so what do we need here in the core belief box? Something realistic and balanced: presentations are difficult for you, so accept that, but you know you have done them in the past. In the build-up, tell yourself this healthy core belief, and that will give you the ability to manage your thoughts, feelings and behaviour.”

For Sam, this CBT-style approach clearly works. She smiles with quiet pride as Baptiste points out that, according to her self-assessment forms, her mental wellbeing has drastically improved over the last five months, from a rating of 20% to 48%. He tells her that such an increase is, “of huge significance, and that’s down to you. Historically, in the last three years, this is the period when you drop out. We’re rewriting history. Well, you are.” The session is very practical, positive and solution-focused; there is no suggestion of delving below the surface and into her past to explore where these problems might stem from. Some students I spoke to wanted therapy to explore these deeper questions and find the meaning behind their issues; but Sam tells me she is not interested in therapy that might ask these sorts of questions: “I’m just interested in finding ways to deal with it, seeing if I can try to resolve it, rather than looking at why it started.”

Advice leaflets in the student services area at Nottingham Trent.


Advice leaflets in the student services area at Nottingham Trent. Photograph: Fabio De Paola for the Guardian

Sam is one of more than 2,000 students who received help over the last academic year at NTU, an average of 80 a week; or more than 11 students every day. Student services manager Alison Bromberg says this is not just a problem for universities: “Whatever is happening in society will happen in university, so whatever you see here is reflected in the country.” The statistics back her up: in February, in a survey by the Association of Schools and College Leaders, 55% of schools reported an increase in stress and anxiety among their pupils. A 200,000-strong study found that young people in the UK have the poorest mental wellbeing in the world, with the exception of Japan.

Rosie Tressler, CEO of student mental health charity Student Minds, tells me, “The 2016 Student Academic Experience Survey provided strong evidence that [undergraduates] have lower levels of wellbeing than the rest of the population, with roughly one-third reporting psychological distress, and we know that the median age of higher education students overlaps the peak age of onset for mental health difficulties.” In other words, evidence suggests many people with mental health disorders first experience symptoms between the ages of 18 and 25.

***

In September 2016, the thinktank the Higher Education Policy Institute (Hepi) published a report stating that some universities needed to treble what they spend on mental health support, warning that the number of student suicides was on the rise. ONS figures show that in the last 10 years, the number of student deaths by suicide has risen by more than 50%. This is not fear-mongering; it is a deeply serious problem, says Ged Flynn, CEO of Papyrus, a charity for the prevention of young suicide: “We hear daily from young people having suicidal thoughts and from those who are concerned about them. University life can add to the pressures that young people already experience these days.”


The counsellor tells Sam her mental wellbeing is hugely improved, ‘and that is down to you. You are rewriting history’

When I asked students around the country about their experiences of mental health, they talked about stressful deadlines, difficulties forming new relationships, balancing a job with studies, financial worries and social pressures. They also painted a picture of patchy provision: while some received prompt and effective help, others described underfunded services, excruciatingly long waiting times and dismissive attitudes. One student talked about desperately trying to get a counselling appointment when booking opened at 9am, only to find that all the slots had gone when she got through at 9.03am. A final-year student at another university wrote that she is experiencing increasing anxiety and can’t get help: “A good counsellor I saw in my first year has left, and they are not recruiting any more, so there are lots of students chasing very few appointments. They refer you on or offer leaflets. It seems very inadequate.”

Alex, 21, was a student at a Midlands university when she was diagnosed with bipolar disorder, anxiety and severe depression. She says services are able to deal only with the most seriously distressed students: “Because of the strain on the service, if you weren’t suicidal at the current time, you weren’t helped. You had to be five minutes from death or you had to wait weeks. You had to be at your worst.”

The counselling she was eventually offered was helpful, but she felt the eight-week wait was too long and the six weeks it lasted too short. For long-term therapy on the NHS, she was told she needed to wait a year, by which time she would have graduated and moved home. “So it’s kind of pointless,” she says. For others, such as George Watkins, 21, who is at Cardiff and has had anxiety and depression for eight years, the experience has been more positive: “It is since coming to university that I have made the most progress. I came off the crippling medication, came through suicidal patches and have now come more or less out the other side.” After having a breakdown around the time of his GCSEs, Watkins didn’t leave his house for six months, and then didn’t leave his small town in Dorset for three years.

Nottingham Trent’s wellbeing team, including adviser Rachael Sisson, helped more than 2,000 students last year.


Nottingham Trent’s wellbeing team, including adviser Rachael Sisson, helped more than 2,000 students last year. Photograph: Fabio De Paola for the Guardian

“Going to university was the best thing that could ever have happened, but probably the hardest thing I will ever do, mentally,” he says. “All of a sudden, I didn’t have my support, I was surrounded by people, it was very intense. There is a massive prevalence of drink and drugs, and it’s hard not to feel a bit of an outcast if you don’t take part in all that.” Watkins benefited from a supportive mental health service, but says it is bursting at the seams. “The team here does a fantastic job, but there is not enough funding to meet the demand.” He points out that, if one in four people has a mental health problem, as a recent YouGov survey found, that equates to 7,500 of Cardiff’s 30,000 students: “That is far more than our services here could handle.” He has now been elected as the university’s mental health officer, and is campaigning for more funding. “I’m not going to kid myself that we’re going to have some kind of utopia. What I’d like to see is a good level of support that’s accessible to everyone. That’s the best we can do.”

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The 2016 Hepi report notes that in some institutions the funding for counselling services is less than £200,000. (The average pay for university vice-chancellors now exceeds £275,000.) However, it also notes that several institutions, including Imperial College London, the University of Leeds and Brunel are trialling new methods for dealing with the ever-growing need for better support. NTU’s work to develop specialist training is also mentioned.

Over the last two years, Alison Bromberg and her team have implemented a new system designed to make it easier for students to access help, starting with a single port of call for all inquiries. Crucially, it’s not just students who can get in touch: friends, family or staff members can alert support services if they think a student may need help. This change in policy was because “young people in transition don’t always find it easy to come forward”, explains Bromberg. A student, or someone concerned about a student, fills in a simple form on the wellbeing website. They then receive a call or email within two days and, where appropriate, then arrange a face-to-face meeting. For some students, that might mean accessing an online system that offers self-help modules on managing issues such as depression, anxiety and body image (this system is also used by the NHS). Students may also have the opportunity to work with an adviser such as Baptiste, receive counselling (usually up to six sessions) or work with a support officer who can liaise with academic staff. “It is distinct from a more therapeutic approach that some students get solely from counselling,” says Bromberg. “But we’re quite clear that they are distinctive offers.”


Sisson calls and introduces herself in an upbeat way. ‘It sounds like you’re feeling a bit by yourself,’ she says

NTU has invested in three new members of staff on its wellbeing team, including adviser Rachael Sisson. I sit with her in a small room where large windows let in the sunshine. She works through the messages that have come through the online form, prioritising those most in need and phoning them first, making notes on her pad as she listens. She has a warm but professional style that I imagine would be a tonic for a student in distress.

Sisson phones and leaves a message for one student who is worried about his flatmate, whom he describes as being very emotionally volatile. She cannot contact the flatmate without his express permission, so, as with most third-party referrals, she will encourage his concerned friend to raise the issue directly. She reads about another student who has written to request counselling after experiencing issues for a few years. She makes some notes on her pad before she dials: GP? Academic staff? She introduces herself in an upbeat way and asks questions. “It sounds like you’re feeling a bit by yourself,” she says, gently, and offers him a wellbeing appointment – a 50-minute, face-to-face session.

This might be the first time these young people have ever spoken to anyone, and I’m glad that it is Sisson’s voice they hear on the end of the line. “I hope I come across as approachable and interested in their situation,” she says, “and through that I build a bit of a rapport. They’re in touch about really personal, sensitive issues, so I try to make that as easy as possible.” Sisson’s background in social work means she is well trained to talk about these kinds of problems; but Bromberg recognises that the whole university must be prepared to respond appropriately when faced with a student who is struggling. Her team has opened mental health first-aid training to all staff, to teach them how to listen calmly and hold silences for longer than feels comfortable. If universities can intervene at the right time, it can have a huge impact. Claudia de Campos, a child and adolescent psychotherapist and visiting lecturer at the Tavistock clinic in London, explains: “The things that we can’t talk about take on a life of their own, and seep through in ways we are not aware of. If something can be thought about and made sense of, spoken and elaborated, it loses its hold – and, depending on the nature of the problem, is less likely to get passed on to the next generation.”

For George Watkins at Cardiff, the stigma is exacerbated by so-called “lad culture”, where putting on a brave face pushes some to ignore their feelings. Things may be changing, but as Midlands student Alex says, with more than a hint of exasperation: “Reducing stigma is a huge deal, but even if we reduce it loads, it will be pointless if there is no money in any services to get anything done, and people who seek help are told, ‘Go and have a good sleep – see how you feel.’”

At NTU, Alison Bromberg still thinks there is cause to feel optimistic about the future. “I do. I actually do. It feels as if we’re embracing a much more holistic framework across the sector.” She cites proposed changes to the university curriculum, such as creating course content for all students on subjects such as coping with change and understanding stress and anxiety. “We’ve got to make sure mental health becomes everybody’s business. That’s the journey we’re on. And I think we’ve come a long way.”

Some names have been changed.

In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at befrienders.org.

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The student sex ‘scandal’ that laid bare Egypt’s population problem | Ruth Michaelson

When a group of Egyptian university students submitted a magazine on sex education for their final-year assignment, they hardly imagined they would fail their course and spark a media backlash.

Yet that is exactly what happened when the project, submitted to the media and mass communications department at Cairo’s al-Azhar University, was rejected as unsuitable. Articles about the “scandal” appeared in the local media, and the students feared expulsion.

In a statement, the group said: “We assure everyone that our magazine, Secrets, is a social magazine.

“We stress that the project doesn’t deal with pornography or sex education in general, but rather with social problems. Harassment, myths and superstitions, addiction to pornography sites, the loss of wives’ rights, calling for teaching materials for sex education in schools and universities … we discussed these topics without any indecency, as we have learned from our professors.”

The defence fell on deaf ears. Eventually, after resubmitting a magazine about sport, they passed their course. The students still fear reprisals, though, and declined to discuss the issue when approached.

The Arab world’s most populous country is experiencing a population boom that experts say has been caused by a lack of access to education and contraceptives.

In May, Egypt’s national statistics agency, the Central Agency for Public Mobilisation and Statistics (Capmas) announced that Egypt’s population had officially hit 93 million. The agency had previously said the population was expanding at a rate of 1 million people every six months.

This growth is often celebrated, but there is a danger it may stretch Egypt’s strained economy and infrastructure beyond breaking point.

The number of people living in Cairo, Egypt’s overcrowded capital, is expected to increase by 500,000 in 2017.


The number of people living in Cairo, Egypt’s overcrowded capital, is increasing by 500,000 a year. Photograph: Mohamed Abd El Ghany/Reuters

In a recent interview, Egypt’s president Abdel Fatah al-Sisi said: “Population growth is a big issue and is a challenge no less dangerous than the challenge of terrorism. Poverty drives people to extremism.”

Yet the former general and his government have done little to stem the growth in Egypt’s population, which at its present rate could hit 140 million by 2030.

Major General Abu Bakr al-Gendy, the head of Capmas, said the figures are of grave concern. “Overpopulation is a disaster in Egypt,” he said. “There has been always the debate as to whether overpopulation is a blessing or a curse. In our case, it’s absolutely a curse.”

Gendy said better sex education and access to contraceptives are key. “These are essentials to limit overpopulation,” he said. “But we prefer to call it ‘population education’, warning against the effects of early marriage, calling for birth control and asking parents to limit their birth rate through awareness.”

Egypt removed sex education from school curriculums in 2010. Instead, teachers are expected to lead class discussions on a subject that, say critics, is often ignored. Women, who are expected to be responsible for birth control, bear the brunt of this lack of knowledge. In 2011, 67% of young Egyptian women reported that they were shocked, tearful or afraid when they first got their period.

A lack of sex education also leads to other harmful practices, such as female genital mutilation, which affects 87% of Egyptian women aged 18-49.

Dalia Abdel-Hamid, a researcher specialising in gender and sexuality at Cairo’s Egyptian Institute for Personal Rights, describes the lack of sex education as “a missed opportunity”.

Tradition is clashing with modernity over birth control in Egypt, with lack of sex education and access to contraceptives blamed for the population explosion.


Tradition is clashing with modernity over birth control in Egypt, with lack of sex education and access to contraceptives blamed for the population explosion. Photograph: Alamy Stock Photo

“In terms of raising awareness, the government’s programmes address a target audience that is harder to convince,” she said. “Instead of addressing the growing number of youth to try to educate them, they address parents or older couples. They wait until it’s too late to try and convince them.

“Morality has a lot to do with the choice of family planning methods. Doctors and clients themselves are not willing to use condoms, and doctors have extremely negative attitudes towards emergency contraception. This leads to many unwanted pregnancies – and when you’re in a country like Egypt, with restrictive abortion laws, that’s an even larger number of unwanted pregnancies.”

To compound matters, contraceptive pills – traditionally the preferred choice of Egyptian women across the class spectrum – have started to run out. Foreign imports slowed during the 2016 economic crisis, and many women have been unable to maintain their usual brand of contraceptive at the pharmacy. The choice is now locally made pills, considered of lesser quality, or none at all.

“The population growth rate has to reach an equilibrium with economic growth to keep a decent living standard,” said Gendy, who pointed out that economic growth – currently 2.3% – would need to be at 7.8% to cope with the current level of overpopulation. “When you want to improve living standards, you need three times the economic growth.”

Yet concerns about population growth often conceal worries about an expanding lower class. “Many government officials still blame poor people for having larger family sizes,” said Abdel-Hamid. “There are comments like a population increase eats up all the benefits of development.”