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Letter from London
|How to cite this article:|
Ruddock A. Letter from London. Natl Med J India 2020;33:55
Autumn in the northern hemisphere is a season of decay. The feeling is often wistful as trees surrender their leaves, making for sharp silhouettes against skies that are suddenly darkening by six, then five, then four. But it is a time of beauty too; of sudden colour and the knowledge that this seasonal decline is a necessary preparation for spring. Although I am no longer part of the education system, its legacy seems to endure through my association of autumn with new beginnings even as the landscape around me suggests the opposite.
Students around the country are currently experiencing this dissonance, especially those leaving home for their first term at university. Embarking on an entirely new chapter of life against a backdrop of falling temperatures and encroaching nights. We know an increasing amount about the impact a lack of natural light can have on our health––all adults in the UK are now advised to take a vitamin D supplement between October and March, when there is insufficient ambient ultraviolet sunlight to naturally maintain healthy levels. But the mental health of university students is jeopardized by many more factors than the change of season.
The number of young people dealing with mental health problems in the UK is growing. Their number in higher education has increased since a government commitment in 1997 that 50% of school leavers in the UK should go to university. No surprise then that the absolute number of students with mental health challenges has grown considerably. What needs more attention is the association between the current political economy of British higher education and the growing proportion of students struggling with their mental health.
Over a period of 18 months from October 2016, 12 students at Bristol University are believed to have committed suicide. This series of tragedies exposed a mental health crisis among students around the country, and the lack of capacity of many universities to respond to it. Mental health obviously encompasses a range of conditions that vary in their complexity and severity. Among students, it is chronic anxiety in particular that appears to be spiralling. In some cases, young people arrive at university with a history of mental health problems that have not received adequate attention. A recent study by the charity Young Minds found that more than two-thirds of young people had to manage their mental health without support and––unsurprisingly––very few felt equipped to do so. Pressures to achieve at school, anxiety about appearance, and family problems were the most common factors adversely affecting the mental health of young people under the age of 25.
The modern university experience adds new dimensions to these pre-existing risks. The number of students at universities may have risen, but so has the price they pay to be there––in more than one sense. Undergraduate students now leave university with an average of £50 000 in debt. The fetishizing of higher education means that few decently paid jobs are accessible without a degree, at the same time as employment opportunities have dried up in the wake of the 2008 financial crash. Yet more and more young people are paying to become employable. In order to do so, many of them take on at least one part-time job to fund the university experience that they are too anxious and exhausted to make the most of.
Adequate support services at universities are crucial for responding to this crisis. That means well-trained and properly resourced professional services, rather than expecting faculty to act as counsellors as well as teachers. Not only are university faculty often ill-equipped to respond appropriately to the mental health needs of students, in many cases they are struggling with their own mental health too. Many of the symptoms of our financialized higher education sector afflict staff, as secure employment disappears and faculty are compelled to strike in order to protect pensions.
A recent freedom of information request by former Liberal Democrat MP Norman Lamb revealed that many of the 110 universities asked could not supply data about the demand for and investment in mental health services. Only a few universities had information about how long students waited on average for counselling. The longest wait reported was 43 days, over half the length of a university term. Anyone's mental health can deteriorate to a tragic extent in 43 days.
Lamb argues that universities should be bound by law to meet the mental health needs of their students. Universities say that they are trying but need more resources and more integration with the National Health Service (NHS). These positions are not necessarily at odds with one another. But now enter ‘resilience’: perhaps my least favourite word in the contemporary lexicon. Resilience has been put to work as a managerial tool that deflects accountability for mental health from institutions onto individuals in a manner that perfectly reflects the callousness of late capitalism. The development of resilience is often a stated goal of mental health services for young people. Stripped back, this means equipping young people to shoulder the alienation and despair they will encounter as part of modern British society. The financialization of higher education entrenches this scenario even as many committed teachers introduce students to alternative ways of imagining ourselves.
The current situation begs a fundamental question about the commensurability of a utilitarian approach to education and concern for the mental health of student-consumers. Autumn brings the hope of new beginnings, but it brings trepidation too.