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Mental health Overview

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My journey into mental health began alongside my A-levels, six years ago when I was nineteen. Terrifying thoughts plagued my mind; thoughts of harming myself, harming others and tearing down any relationships I had at the time. I was sitting in the car with my mother one day when I broke down, and ‘came out’ about some of my thoughts. You could say that this was the first hurdle, but I would like to add that it was the first of many, and there are many still to come.

Although I now feel more comfortable to talk about my mental health than I did, I do so with the fear that some day it could hold me back from things important to me in future life: that dream job, maintaining relationships with people close to me and raising children. Six years later I feel able to discuss the full extent of my story with most people I come into contact with; many people don’t and won’t ever. This story is mine, and it is one of many that are out there. I didn’t realise at the time, but I now know that I wasn’t alone.

I am happy to say that mental health is a topic that has slowly been gathering momentum over the past decade, however, there is still so much more to do. With national statistics suggesting that one in four people will experience mental health problems in any given year [1], I wanted to use my year as VP Welfare & Community at Nottingham Trent Students Union to make mental health a priority and to see how mental health affected our students.

With all that university brings it is an unsettling time for most. Add personal circumstances into the mix and it is unsurprising that students are under a lot of pressure. From homesickness, to balancing employment, university and social

commitments, there is a lot going on and many things that can affect your mental state.

The results in this report highlight to me that mental health is a huge topic that requires a lot of attention. With 90.87% of respondents either having a personal experience of mental health problems, knowing somebody else who did, or both, it is fair to say that mental health has a huge reach, and can impact on the lives of many.

This report aims to provide an insight into the magnitude of mental health problems at Nottingham Trent University and goes some way to offer recommendations. I hope this report will be the starting point of changing perceptions of mental health at NTU.

Yours Sincerely,

Katie WrightVP Welfare & Community

Preface

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The report presents key findings that emerged from the results of a survey released earlier in the year. The aim of the survey was to gather information about the mental health of students at NTU and their perceptions about mental health in general. The survey uncovered the following statistics:

• 90.87% of respondents either have a personal experience of mental health problems; know somebody else who did; or both.

• 78.84% of respondents said that they know someone who is currently experiencing, or has previously experienced a mental health problem.

• 51.45% of respondents knew somebody with an experience of depression.

• 45.23% of respondents considered themselves to have had some form of mental health problem at some point in their life.

• Of the respondents who have experienced a mental health problem, 76.15% have an experience of depression, 36.70% have experienced anxiety and 11.01% an eating disorder.

• 40.59% of respondents that belonged to a sports club said they have personal experience of a mental health problem.

• 51.09% of respondents that belonged to a society said they have personal experience of a mental health problem.

• 40.66% of respondents viewed the term ‘mental health’ as neutral. Other options were positive, negative or both.

• 58% of respondents that answered yes to being personally effected by a mental health problem said that they hadn’t felt comfortable speaking to anyone about it.

• Of the respondents that had mental health problems, 76.67% have not sought help from services within the union or university.

The survey findings highlighted a need for more to be done at NTU surrounding issues related to mental health. There is a clear need to tackle the stigma related to mental health and also to find new ways to promote the services offered by NTU, the NHS and any other reliable external services. The report also demonstrates the need for education on the topic to be a priority. The report concludes with a number of key recommendations for the Students’ Union and University to move forward with.

Executive Summary

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ContentsPreface

Executive summary

Introduction

Students’ contact with people with mental health

Cross section of mental health problems at NTU

Students attitudes to mental health

Where did students seek help?

Recommendations

References

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This report comes as the result of a survey carried out by NTSU in the academic year 2013/14.

The survey was live for the duration of November 2013 and asked the respondents about their experience of mental health problems; both personally, and any experiences they may have of other people’s. The survey also endeavoured to gain information about opinions of the term ‘mental health’, and also barriers in seeking help.

The survey was open to all students at NTU and after promotion, yielded 241 responses, just under 1% of the student population. All data was submitted anonymously through and online form, although there was an option for respondents to leave their e-mail addresses in order to receive updates and to be invited to partake in further study.

The responses were fairly evenly spread, encompassing each of the nine schools and coming from a range of people of different ages. Many respondents belonged to sports clubs, societies, or both.

The report presents each key area of findings, grouping responses to questions of a similar nature together, teamed with NTSU’s suggestions on what these results may mean.

If the research were to be carried out again we would collect a larger amount of data in regards to demographic; we would also try and obtain more responses. These adjustments would allow us to gain a more accurate understanding of any trends, and subsequently any problems at NTU.

Mental health is a complex subject with no simple solution. However, this report closes with some recommendations drawn from the results within the report; we hope them to be realistic an achievable and we hope for them to be a key component of changing perceptions of mental health, and people with mental health problems at NTU.

Introduction

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Of the 241 respondents, 78.84% said that they know someone who is currently experiencing, or has previously experienced a mental health problem and 7.88% were unsure.

The only trend to emerge from the results of this section is illustrated in figure 1; showing

that, as people get older, there is less chance that they won’t know anybody with a mental health problem. This indicates that as time progresses, people are more likely to have come into contact with somebody with a mental health problem.

Students’ contact with people with mental health

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Students’  contact  with  people  with  mental  health    Of  the  241  respondents,  78.84%  said  that  they  know  someone  who  is  currently  experiencing,  or  has  previously  experienced  a  mental  health  problem  and  7.88%  were  unsure.    The  only  trend  to  emerge  from  the  results  of  this  section  is  illustrated  in  figure  1;  showing  that,  as  people  get  older,  there  is  less  chance  that  they  won’t  know  anybody  with  a  mental  health  problem.  This  indicates  that  as  time  progresses,  people  are  more  likely  to  have  come  into  contact  with  somebody  with  a  mental  health  problem.      

                             

If  the  figures  are  broken  down  further,  an  insight  into  the  respondents’  awareness  of  different  mental  health  problems  can  be  seen.  See  figure  2.  

                                   

0.00%  

5.00%  

10.00%  

15.00%  

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18   19   20   21   22  

Percentage  of  R

espo

ndents  

Age  of  Respondent    

Figure  1:  Respondents  that  answered  ‘No’  to  the  question  ‘Do  you  know  anybody  with  a  mental  health  problem?’  

 

51.45%

 9.54%  

2.49%  

0.41%  

9.96%  

4.56%  

1.24%  

7.88%  

2.07%  

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misinterpreted  as  m

h  do

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Percentage  of  R

espo

ndents  

Mental  Health  Problem  

Figure  2:  What  is/was  the  nature  of  the  mental  health  problem  of  the  person  who  was  experiencing  the  problem?  

 

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Students’  contact  with  people  with  mental  health    Of  the  241  respondents,  78.84%  said  that  they  know  someone  who  is  currently  experiencing,  or  has  previously  experienced  a  mental  health  problem  and  7.88%  were  unsure.    The  only  trend  to  emerge  from  the  results  of  this  section  is  illustrated  in  figure  1;  showing  that,  as  people  get  older,  there  is  less  chance  that  they  won’t  know  anybody  with  a  mental  health  problem.  This  indicates  that  as  time  progresses,  people  are  more  likely  to  have  come  into  contact  with  somebody  with  a  mental  health  problem.      

                             

If  the  figures  are  broken  down  further,  an  insight  into  the  respondents’  awareness  of  different  mental  health  problems  can  be  seen.  See  figure  2.  

                                   

0.00%  

5.00%  

10.00%  

15.00%  

20.00%  

18   19   20   21   22  

Percentage  of  R

espo

ndents  

Age  of  Respondent    

Figure  1:  Respondents  that  answered  ‘No’  to  the  question  ‘Do  you  know  anybody  with  a  mental  health  problem?’  

 

51.45%

 9.54%  

2.49%  

0.41%  

9.96%  

4.56%  

1.24%  

7.88%  

2.07%  

1.24%  

1.24%  

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1.24%  

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3.32%  

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depressio

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 anxiety  

schizophrenia  

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self  harm

 mental  breakdo

wn  

misinterpreted  as  m

h  do

n’t  kow

 

Percentage  of  R

espo

ndents  

Mental  Health  Problem  

Figure  2:  What  is/was  the  nature  of  the  mental  health  problem  of  the  person  who  was  experiencing  the  problem?  

 

If the figures are broken down further, an insight into the respondents’ awareness of

different mental health problems can be seen. See figure 2.

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Figure 2 represents the percentage of the total number of respondents that knew somebody with mental health problem. As the graph shows, 51.45% of respondents knew somebody with an experience of depression. This could suggest that depression may affect more people, but it may also be an indication that people with depression feel less stigmatised, and therefore able to disclose this information.

The other listed mental health problems appear to be less well known, with 9.96% of total respondents knowing somebody with anxiety, 9.54% bipolar, 7.88% eating disorders and a lot less for the others, although it is still important to note that students do have some awareness of these issues.

In order to collect these results, respondents were able to type their own answer to the question, rather than by a drop down menu or tick box. This meant that we collected some responses that didn’t strictly fall into the mental health category. They are listed below:

• Pick’s Disease• Autism• Dementia• Dyslexia• Alzheimers• Down’s Syndrome• ADHD

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Of all 241 respondents, 45.23% identified as currently having, or to have previously had, some form of mental health problem and 17.01% were unsure.

45.23% of people is almost double the national statistic which approximates that 25% of people are affected in any given year [1]. An additional survey of the national student population on mental health also approximated the percentage of students diagnosed with mental health problems at 25%[2].

It is worth reiterating that at no point did the survey prescribe the definition of ‘mental health’ so this is a subjective judgment from

the individual filling in the survey and may not match medical definitions.

Looking further into the individual mental health problems that people have experienced, we see that of those that answered yes to having a mental health problem, 76.15% have an experience of depression, 36.70% have experienced anxiety and 11.01% an eating disorder. Interestingly, no one said that they have a personal experience of schizophrenia. This is a contrast to national statistics that suggest schizophrenia affects 1 in 100 people [3]. The survey also yielded a very low percentage (0.92%) of people who suffer with addiction problems. See Figure 3.

Cross section of mental healthproblems at NTU

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Cross  section  of  mental  health  problems  and  NTU    Of  all  241  respondents,  45.23%  identified  as  currently  having,  or  to  have  previously  had,  some  form  of  mental  health  problem  and  17.01%  were  unsure.      45.23%  of  people  is  almost  double  the  national  statistic  which  approximates  that  25%  of  people  are  affected  in  any  given  year  [1].  An  additional  survey  of  the  national  student  population  on  mental  health  also  approximated  the  percentage  of  students  diagnosed  with  mental  health  problems  at  25%[2].    It  is  worth  reiterating  that  at  no  point  did  the  survey  prescribe  the  definition  of  ‘mental  health’  so  this  is  a  subjective  judgment  from  the  individual  filling  in  the  survey  and  may  not  match  medical  definitions.    Looking  further  into  the  individual  mental  health  problems  that  people  have  experienced,  we  see  that  of  those  that  answered  yes  to  having  a  mental  health  problem,  76.15%  have  an  experience  of  depression,  36.70%  have  experienced  anxiety  and  11.01%  an  eating  disorder.  Interestingly,  no  one  said  that  they  have  a  personal  experience  of  schizophrenia.  This  is  a  contrast  to  national  statistics  that  suggest  schizophrenia  affects  1  in  100  people  [3].  The  survey  also  yielded  a  very  low  percentage  (0.92%)  of  people  who  suffer  with  addiction  problems.  See  Figure  3.    

                                   

 40.59%  of  respondents  that  belonged  to  a  sports  club  said  they  have  personal  experience  of  a  mental  health  problem  whilst  42.57%  said  that  hadn’t.  This  differs  from  people  that  don’t  belong  to  a  sports  club,  of  which  48.57%  of  respondents  said  they  had  experienced  mental  health  problems  and  34.29%  said  

0.00%  10.00%  20.00%  30.00%  40.00%  50.00%  60.00%  70.00%  80.00%  

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Mental  Health  Problem  

Figure  3:  What  is/was  the  nature  of  the  mental  health  problem  you  have  experienced?  

40.59% of respondents that belonged to a sports club said they have personal experience of a mental health problem whilst 42.57% said that hadn’t. This differs from people that don’t belong to a sports club, of which 48.57% of respondents said they had experienced mental

health problems and 34.29% said they hadn’t. This is an indication that people who are in a sports club are either less likely to be affected by a personal mental health problem, or less likely to disclose any issues.

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When it comes to respondents in societies, the figures indicate that compared to the results for sports clubs, there is a higher percentage of members that experience mental health problems, with 51.09% saying they do, 34.78% saying they don’t and 14.13% unsure about their mental health. This could suggest that students in societies – often groups based around common interests – may have more of a support network that enables members to speak more openly regarding any problems.

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Of the 241 respondents, 16.60% said that they viewed the term ‘mental health’ as positive and 16.18% said they viewed the term as negative. 26.14% thought that the term ‘mental health’ could be both positive and negative, but interestingly, 40.66% of people thought of the term as neutral.

Upon further analysis of the statistics, an insight was gained into whether having direct or indirect experience of a mental health problem changes a person’s perception of the term.

Of the people that answered yes to knowing somebody with a mental health problem, 40%

of them thought of the term as neutral and 27.37% thought of the term as both positive and negative. Of the people who were unsure if they know anybody with a mental health problem 63.16% thought of the term as neutral, interestingly only 5.26% of them thought of the term as negative. Of the people that didn’t know anybody with a mental health problem, 31.25% thought of it as neutral. At 28.13% this group yielded the highest percentage of respondents that thought the term as negative, suggesting that there may be an element of misunderstanding or ignorance in people that have had no contact with people with a mental health problems, or are unaware. See Figure 4.

Students’ Attitudes toMental Health

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 Students’  Attitudes  to  Mental  Health    Of  the  241  respondents,  16.60%  said  that  they  viewed  the  term  ‘mental  health’  as  positive  and  16.18%  said  they  viewed  the  term  as  negative.  26.14%  thought  that  the  term  ‘mental  health’  could  be  both  positive  and  negative,  but  interestingly,  40.66%  of  people  thought  of  the  term  as  neutral.      Upon  further  analysis  of  the  statistics,  an  insight  was  gained  into  whether  having  direct  or  indirect  experience  of  a  mental  health  problem  changes  a  person’s  perception  of  the  term.    Of  the  people  that  answered  yes  to  knowing  somebody  with  a  mental  health  problem,  40%  of  them  thought  of  the  term  as  neutral  and  27.37%  thought  of  the  term  as  both  positive  and  negative.  Of  the  people  who  were  unsure  if  they  know  anybody  with  a  mental  health  problem  63.16%  thought  of  the  term  as  neutral,  interestingly  only  5.26%  of  them  thought  of  the  term  as  negative.  Of  the  people  that  didn’t  know  anybody  with  a  mental  health  problem,  31.25%  thought  of  it  as  neutral.  At  28.13%  this  group  yielded  the  highest  percentage  of  respondents  that  thought  the  term  as  negative,  suggesting  that  there  may  be  an  element  of  misunderstanding  or  ignorance  in  people  that  have  had  no  contact  with  people  with  a  mental  health  problems,  or  are  unaware.  See  Figure  4.    

                                   

Of  the  respondents  who  have  personal  experience  of  a  mental  health  problem  36.70%  thought  the  term  to  be  neutral  and  21.10%  viewed  the  term  as  negative.  Of  the  people  who  were  unsure  if  they’ve  had  a  mental  health  problem,  58.54%  thought  of  the  term  as  neutral  and  of  the  respondents  with  no  experience  of  a  mental  health  problem  37.36%  thought  of  the  term  as  neutral.  Surprisingly,  20.88%  

Figure  4:  ‘Do  you  know  anybody  with  a  mental  health  problem?’  against  ‘How  do  you  view  the  term  ‘mental  health?’  

0.00%  

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How  do  you  view  the  term  'mental  health'?  

Yes  

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I  Don't  Know  

Of the respondents who have personal experience of a mental health problem 36.70% thought the term to be neutral and 21.10% viewed the term as negative.Of the people who were unsure if they’ve had a mental health problem, 58.54% thought of the term as neutral and of the respondents with no

experience of a mental health problem 37.36% thought of the term as neutral. Surprisingly, 20.88% of the people with no experience of a mental health problem thought of the term as positive. See Figure 5.

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of  the  people  with  no  experience  of  a  mental  health  problem  thought  of  the  term  as  positive.  See  Figure  5.    

                                   

Another  result  worth  noting  is  that  of  respondents  that  belong  to  a  sports  club,    20.79%  of  those  who  have  or  have  had  mental  health  problems  viewed  the  term  as  negative,  however;  only  12.86%  of  those  who  haven’t  experienced  mental  health  problems  see  the  term  as  negative.      Although  the  term  was  mainly  thought  of  as  neutral,  on  one  hand  this  could  indicate  that  the  term  is  seen  more  as  a  descriptive  term  than  one  that  is  weighted  by  opinion;  however,  the  respondents  that  think  it  to  be  neutral  could  be  the  group  that  may  not  understand  that  mental  health  is  relevant  to  them  and  are  yet  to  develop  a  strong  opinion  about  the  subject.  Arguably  this  could  be  a  group  worth  targeting.                                  

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Figure  5:  ‘Do  you  consider  that  you  have/have  had  a  mental  health  difficulty?’  against  ‘How  do  you  view  the  term  ‘mental  health’?’  

Another result worth noting is that of respondents that belong to a sports club, 20.79% of those who have or have had mental health problems viewed the term as negative, however; only 12.86% of those who haven’t experienced mental health problems see the term as negative.

Although the term was mainly thought of as neutral, on one hand this could indicate that the term is seen more as a descriptive term than one that is weighted by opinion; however, the respondents that think it to be neutral could be the group that may not understand that mental health is relevant to them and are yet to develop a strong opinion about the subject. Arguably this could be a group worth targeting.

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Have you felt comfortable speaking to others about the way you are feeling?When asked if they had felt comfortable speaking to others about the way they are feeling, 58% of respondents that answered yes to being personally effected by a mental health problem said that they hadn’t felt comfortable opening up to anyone.

Who did you feel most comfortable to speak to?Of the respondents that had felt comfortable enough to confide in somebody, 49.37% chose to speak to a friend or partner, and 21.52% spoke to a mental health professional. Shockingly, only 2.53% felt comfortable enough to speak to a GP, and even more shockingly, 1.27% felt comfortable to confide in someone like a teacher or lecturer. Other results included family, a person known to have had a similar experience and colleagues.

Why did you not feel comfortable to speak to others?Upon being asked why the respondents didn’t feel able to seek help, of the group that said they didn’t feel comfortable speaking about their problems, 44.59% cited stigma, feeling judged and also embarrassment as a reason to not speak out. 10.81% of responses came from people feeling unsupported: some people felt that their friends weren’t able to support them whilst others felt that they weren’t aware of where to go to access the support they needed.

Not being able to explain their feelings, finding it difficult to talk about, mental health being a personal issue and not wanting to be a burden are amongst some of the other reasons that people weren’t able to seek help. Some of the qualitative responses were touching and

interesting to read, the following are some of those responses to ‘Why did you not feel comfortable to seek help?’:

“Sign of weakness”“Everyone will think you’re stupid”“Didn’t think they would believe me.”“People wouldn’t understand it as a health issue”“Selfish to discuss your problems”“I don’t want people to think negatively about me, or that I’m looking for attention”

And one particularly eye-opening response simply said:

“…because people like me get sectioned.”

Have you sought help from the Students’ Union or University?Of the respondents that had mental health problems, a staggering 76.67% have not sought help from services within the union or university. Of these respondents 13.98% said that they weren’t aware of the services at NTU or NTSU, whilst 29.03% felt that they didn’t feel the need to access the help.

4.30% of respondents felt that availability was an issue, with one respondent feeling there would be a language barrier, and 2.17% of respondents who hadn’t sought help didn’t have confidence that the services would help them. Worryingly, confidentially was a concern, and others felt that their problems weren’t severe enough to seek help. Stigma still remained a concern for 8.6% and 6.45% were receiving the support from other services.

Where did studentsseek help?

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4.30% of respondents felt that availability was an issue, with one respondent feeling there would be a language barrier, and 2.17% of respondents who hadn’t sought help didn’t have confidence that the services would help them. Worryingly, confidentially was a concern, and others felt that their problems weren’t severe enough to seek help. Stigma still remained a concern for 8.6% and 6.45% were receiving the support from other services.

Some of the reasons people listed are as follows:

“Didn’t know I could but I wouldn’t use it anyway because it’s awkward”“Unable to contact them”“Too many middle men between asking for help and actually receiving this”“I don’t know what services can help”“Being frightened of being asked to leave”“Feel stupid when people have more serious issues than me”

Respondents who didn’t feel that they had a mental health problem were asked about how comfortable they would feel speaking to other if they were to find themselves struggling with a mental health problem. 46.15% of respondents said that they would, 19.78% said they wouldn’t and 34.07% weren’t sure. This is an encouraging response; however there may be a slight naivety here, as the responses from people with lived experience would indicate that opening up about a mental health problem is not that easy.

When asked what might stop them seeking help, the number of responses was significantly lower than other questions so the statistics may not be as accurate as they could be, however, the following responses were given:

“Worried about it being taken further, and confidentiality”“Wouldn’t think people would understand”“I’d rather speak to a professional”

The final response suggests that there is a lack of understanding about the type and quality of support available at NTU.

When respondents were asked which services they were aware of at Nottingham Trent, the following results were seen:

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Which services at NTU are you aware of? %Counselling 68.88

Student Support 70.95

Chaplaincy 27.39

Student Advice Centre 68.88

Wellbeing Room 29.05

Mental Health Support Team 33.61

None of the above 4.98

Respondents were asked a number of questions to establish how they would prefer to access support. 64.32% said that in the first instance, they would like to access support online, 31.54% said in person and only 4.15% said over the phone; although it is unclear in which format the support would be preferred.

When asked which different type of support they would prefer, 80.60% of respondents said that they would prefer to receive professional support over peer support, be that from peers with training or not, and 97.30% of respondents said that they would prefer one-to-one support over a group situation.

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Following on from the results in this report, a number of recommendations have been made that encourage a more inclusive, open-minded community at Nottingham Trent University. Completion of these recommendations is by no means all that needs to be done, but we believe they are a good place to start.

Recommendation 1: Create an environment void of stigma and judgement.Mental health is currently seen as a subject surrounded by stigma, this too frequently leads people to feel like they’re tackling their problems alone. Moving forward, we recommend that NTU and NTSU take a pro-active approach by working collaboratively on a program of events throughout the year that will entice discussion about the topic, thus creating an environment where mental health can be freely discussed without fear of discrimination.

Recommendation 2: A joint campaignCommunication is a crucial first step, however education is an imperative part of changing perceptions. There are many opportunities throughout the academic year to communicate with students, particularly during Welcome Week. We recommend a joint campaign between the Students’ Union and University whose primary objective is to educate students on the topic, but will also contribute to creating an environment where mental health problems are accepted.

Recommendation 3: Work with relevant charities We recommend that both the Students’ Union and the University work with relevant charities to raise the profile of the campaign and also promote the charities to students of NTU. There are a large number of mental health charities that operate within Nottingham; many of who can offer additional services, support and opportunities for students.

Recommendation 4: Facilitate opportunities for personal development. We recommend that both the University and the Students’ Union work together to facilitate opportunities that enable students to develop the skills and confidence to offer support to any person suffering with their mental health.

Recommendation 5: Promotion of support services.At NTU, we are lucky to have access to such valuable services, and although many people are aware of them, there is room for improvement. We recommend that the Students’ Union and University work together to promote how NTU can support students.

Recommendation 6: Support for student-facing staff. Attendance rates and a change in quality of work are two key signals that a student may be feeling under pressure meaning that student-facing professional and academic staff are likely to see a change before anyone else. Therefore we recommend that the University ensure that all student-facing professional and academic staff receive adequate training in order to feel equipped to support any students that need help.

We believe that by working through the above recommendations, we will be able to create an environment that is accepting and comfortable for students that are affected by mental health problems. We also believe that as there is more communication about mental health, students’ beliefs that NTU is committed to supporting them will strengthen.

Moving forward, we look forward to working with the University in the implementation of the above recommendations and any other actions that prioritises the mental health and wellbeing of the students of NTU.

Recommendations

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1. Time to Change, 2008. Mental health statistics, facts and myths. [online] Available at: <http://www.time-to-change.org.uk/mental-health-statistics-facts> [Accessed 20 June 2014].

2. Priory, 2013. UK students suffer in silence when it comes to mental health. [online] Available at: <http://www.priorygroup.com/latest-from-the-priory-group/item/news/2014/02/17/student-mental-health-research> [Accessed 20 June 2014].

3. Mental Health Foundation. Schizophrenia. [online] Available at: < http://www.mentalhealth.org.uk/help-information/mental-health-a-z/S/schizophrenia/> [Accessed 20 June 2014]

References