Last week, I explored the most serious mental health issue in Cambridge, the enormous pressure students find themselves under, through a series of interviews with the most senior figures of the university’s welfare systems. This week I have looked into what support services are available, and whether they are responding adequately to.

Mental health services around the country are overstretched. The Cambridgeshire NHS is no exception, but we are fortunate as a university to have access to several other means of support, some unique to Cambridge.

For starters, the same college tutorial system that provides a more individualised educational experience also allows for individualised pastoral care. Senior Tutors Richard Partington and Dr Jane McLarty explained to me that the primary aim of college pastoral networks is “reassurance and triage”: identifying, addressing and referring issues as they emerge. For that reason, having access to a Tutor, a DoS and a Senior Tutor vastly increases the likelihood of a student stepping forward to talk to someone about their issues, and provides at least two perspectives on any situation or crisis.

Furthermore, Senior Tutors’ experiences with a huge range of issues and circumstances are invaluable in the most serious situations. While members of the tutorial system are very careful about confidentiality and consent when sharing information, other members of college staff are also invaluable: college nurses and counsellors have a frontline role, as do our wise and tireless porters. Even housekeeping and kitchen staff play a role, often spotting early warning signs.

Our colleges also fund a huge portion of university welfare services. They provide the largest portion of funding to the University Counselling Service (UCS), and in the case of the Disability Resource Centre (DRC), they fund half of the International Disabled Students Fund and half of an Aspergers Advisor post, which, according to the Head of the DRC John Harding, “isn’t replicated in many other universities”.

On the subject of university services, it seems we are comparatively well off there too. Students entering the university with existing conditions are supported by the DRC. Harding explained to me that rather than providing therapeutic support, the role of the DRC is based around a single question: “What support does a student who falls under the legal definition of disability require in order to have equal or fair access to their education?” For the most part, this means producing ‘student support documents’ for each individual, liaising with colleges and departments and running training sessions for tutorial and other staff. These efforts often benefit the student body as a whole since part of the task is to ensure that teaching practices throughout the university support and encourage a healthy, integrated learning and working culture, ensuring that students aren’t effectively hindered by their environment. Harding is particularly keen on making lecture recordings automatic and available for all.

If the role of the DRC is to prevent problems, the role of the UCS is to treat them. A university counselling service has different goals than other such services, says head of the service Géraldine Dufour. “For me the mission of a university counselling service is to support the students in achieving the best in terms of their education and studies. So we have to sort of really think about the whole picture, and not just think of this person without the relationship to the context.” Just like the problems they treat, the UCS offers a range of services from self-help to basic counselling, and from group workshops to individual counselling. Most resources are aimed at treating anxiety, depression and relationship difficulties, with fewer resources for dealing with serious or chronic mental illnesses, although two dedicated mental health advisors are available and the service maintains very close relationships with local NHS services. The UCS is also closely involved with wider university: staff attend college inductions, run tutor training sessions and mental health first aid workshops, advise on intermission and ‘fitness to study’ assessments, and sit on several university committees.

On the whole then, we have an incredible level of support available to deal with the problems academic pressure creates. Richard Partington describes how “probably the support for mental health and welfare in Cambridge is, in terms of sheer resource, greater than any other UK university.”

However, the picture is not entirely rosy. All of my interviewees were open about the existence of problems. Each admission, though, was immediately followed by an explanation of how that problem is being tackled.

In fact, the topic which Géraldine Dufour was most keen to discuss with me was the problem of demand. The service is one of the busiest in the country, seeing about 8.5 per cent of the student body, or 1600 students, in a year. Thankfully, the service is also one of the biggest and best-funded. “There are only about three services that are this big… we really are very well-resourced. It’s not to say that there’s no room for improvement – people will always want different things, and we have to adapt and reflect on the work we do, but we really are very well resourced.” Dufour has only been in the position of Head of Counselling for 18 months, but has done an enormous amount of work in that time, although she stressed: “I don’t want to give the impression that I’ve turned things around, because they didn’t need turning around.”

The biggest complaint she faced was the waiting list, a problem she feels has been addressed through the very hard work of her staff. Student self-referrals usually receive a response within 24 hours, and the resulting appointment timetable is “a work of art”, which is why students are strongly encouraged to reply to emails promptly, check their junk mail, and prioritise their appointments. As a result, the waiting list is now fairly short; Géraldine told me that in Michaelmas there is “hardly any wait”, and that “In Lent term, our busiest term, most people are seen within one working week, creeping up to perhaps two right at the end of term.” However, Dufour still spends a large amount of time dealing with FOI requests about the waiting list. Despite their hard work and a comprehensive follow-up process for feedback, the service’s biggest problem is dealing with the media: “My team works so hard; they really care about the students, and everything we see is ‘the student services didn’t do this, or didn’t do that’.” In effect, the team’s hands are tied, as anonymous reports can’t be followed up and details of individual cases can’t be disclosed: “That’s the difficult thing about the UCS, is you can’t answer back… you can’t defend yourself.” For that reason, Dufour prefers students to come and see her first. “If there are issues, don’t take them to the student press... I can do something about it.”

The DRC also faces very high demand, but its biggest issue currently is the changes to disability funding on the horizon. Disabled students’ allowances – the major source of funding for assistance and adjustments – are to be slashed by the government. John Harding explains that “...the whole premise of these changes is a rebalancing of responsibility between government and higher educational institutions, so it effectively cuts a lot... about 70 per cent [of those services] which [are] currently funded by DSAs will not be in two years’ time.” Discussions are already well underway between the DRC, the university, and colleges to replace this funding by establishing what is currently being called the ‘reasonable adjustment fund.’ Harding hopes that students “won’t necessarily notice the change” when the reasonable adjustment fund takes on the financial burden.

The biggest issue faced by the college pastoral care system is that it is composed of many staff with vastly different levels of experience and training. Although Richard Partington and Dr McLarty told me that they are working on training to ensure that tutors do not attempt to do too much work instead of referring students on, it’s clear that everyone is aware of cases where things have gone wrong. The situation was best summed up by John Harding, who described how “...there’s a lot of expectations on tutors who potentially don’t have the skills or training to support students with particular difficulties. And some of the cases we deal with directly where we’re advising colleges and departments where things haven’t been handled as well as they could have been and somebody has said something that is not particularly helpful, or in some cases you could argue is discriminatory.” He talked about how difficult it is to prevent all such instances, but stressed the importance of them being reported: “...hopefully those cases get some exposure and we learn from them, which isn’t helpful for the individual student but hopefully will be helpful for the students who are following on behind.”

Tutor training is one issue that is difficult to tackle properly at a college level – university support is required. Tutor training is currently on the agenda of at least two university-level committees dedicated to student welfare. Though their work takes place out of the student eye, most of the significant mental health reforms in the last few years have originated in these committees, the work of which I will examine in the final part of this series.

Last week: The invisible safety net