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The Scottish Government's Action Plan to address student mental health, through effective collaborative working across colleges, universities, NHS Boards, Integrated Joint Boards, Public Health Scotland, Health and Social Care Partnerships, and the Third Sector.

Introduction

The Student Mental Health Action Plan (the Action Plan) is a roadmap for enhancing student mental health and wellbeing within the Scottish further and higher education systems.

It builds on the broader Mental Health and Wellbeing Strategy and sits alongside its companion documents, the Mental Health and Wellbeing Workforce Action Plan and the Mental Health and Wellbeing Delivery Plan. These overarching documents explicitly emphasise the significance of supporting student mental health and wellbeing, in a trauma-informed way, and the role of those who work with students. They also commit to ‘work with colleges and universities to ensure the mental health and wellbeing needs of students are met, and utilise investment in supports and services with a focus on early intervention’ and to ‘explore opportunities to improve acute services pathways and promote the value of embedding student mental health agreements within institutions through NUS Think Positive’.

The Student Mental Health Action Plan and its five actions are informed by Public Health Scotland’s Three Levels of Prevention:

Level One – Health promoting measures which reach to all sectors of the student population to create resilience and wellbeing in all students, regardless of whether they have any mental health distress or condition. These can be informed by the Five Ways to Wellbeing.

Level Two – Intervening early if a student is at risk of a particular outcome or problem or if the student has started to struggle with a condition or negative experience or emotions. Action here is about enabling access to the early help they need from a diverse range of community-based services.

Level Three – Supporting students who have established mental health problems and conditions so that they do not deteriorate and are able to function at a good level throughout their academic journey. This will require close working with appropriate health professionals, further student empowerment to manage conditions, access to timely clinical care, and support for continued engagement in studies.

To achieve these objectives, the Action Plan acknowledges the provision already in place in college and university campuses, highlights the opportunity for institutions to work with the Third Sector, local government and other healthcare providers around prevention and emphasises the need for strengthening partnerships between institutions, student bodies, local NHS Boards, and Health and Social Care Partnerships (HSCPs). This collaborative approach builds upon existing successful partnerships and the effective student-institutional collaborations already in place through NUS Think Positive's Student Mental Health Agreements.

This Action Plan, while recognising the diversity of students as well as the multitude of different learning environments in colleges and universities, outlines a strategic approach to fostering collective support for student mental health and wellbeing. It emphasises the need to give students the tools to effectively manage their own mental health and wellbeing and their right to receive equity of access to more intensive help and support when this is needed and clinically appropriate. It acknowledges the profound impact of trauma and underscores the expectation that all actions related to college and university mental health and wellbeing be trauma-responsive.

To address the multifaceted needs of students, the Action Plan focuses on five key areas, identified as priorities for action by stakeholders and research (Thriving Learners):

• Promoting mental and physical health and wellbeing to prevent mental ill health: Enhancing student awareness of physical and mental health, raising awareness of available resources which support mental wellbeing.
• Early intervention: Helping students and institutions to develop early intervention strategies, identifying potential mental health concerns and providing timely support to address emerging issues. This can be achieved through fostering a supportive and inclusive, trauma informed, whole institution approach which recognises the barriers that can prevent students accessing support and reduces levels of mental health stigma.
• Provision of services: Improving access to mental health services to ensure students have appropriate and accessible options for support. Institutions and NHS Boards should work together to ensure that students with more complex mental health needs can access the services and treatments they need.
• Partnerships and collaboration: Strengthening partnerships between institutions, student bodies, healthcare providers, and community organisations to create a comprehensive network of support for students.
• Data collection and evaluation: Regularly collecting and analysing data to monitor progress, identify areas for improvement, and inform future interventions.

Student mental health and wellbeing

Across Scotland, students, in particular younger students, face a unique set of challenges as they transition from secondary to tertiary education. These can include adapting to new learning styles and assessment methods, adjusting to independent living away from home, managing finances, and building new social networks. While these experiences can be exciting, rewarding, and help to build skills and resilience, they can also contribute to mental wellbeing concerns.

A 2020 study by Think Positive found that students are most likely to have concerns about mental health at the start of their studies while See Me’s 2022 Scottish Mental Illness Stigma Study highlighted the negative impacts of stigma on accessing services and study retention in further and higher education.

These issues have been compounded by the lasting social and medical effects of the Covid-19 pandemic.

The Student Mental Health Action Plan is informed by the Thriving Learners research, conducted by the Mental Health Foundation in collaboration with Universities Scotland and Colleges Scotland, which further highlights the significant impact of mental health challenges on students. This Action Plan outlines the Scottish Government’s response to the research in support of student mental health and wellbeing.

Scotland’s student population comprises over half a million full-time and part-time students enrolled in colleges and universities. The Thriving Leaners reports highlighted that college and university students are diverse with, for example, around 60% of university and college enrolments being under the age of 24. The most recent Higher Education Statistics Agency (HESA) data for 2022-23 highlighted that 17% of students in Scotland had a disability. The Thriving Learners survey of college students found that 23% of respondents described their sexual orientation as LGB+, 16% as bisexual, 7% as gay or lesbian, while 67% of respondents described themselves as straight.[1] 5% of respondents in the college survey identified as being transgender.

The Thriving Learners research revealed that nearly three-quarters of university students reported low wellbeing, over a third experienced moderately severe or severe symptoms of depression, and nearly half felt the need for professional help due to a serious psychological issue. A similar trend was observed for college students. The research also revealed that different cohorts of students face their own unique challenges. In colleges, for example, a significant number of bisexual, gay or lesbian students had high rates of depressive symptoms, while transgender students had noticeably lower wellbeing and general health than students who did not identify as transgender. A major issue for black and minority ethnic students was accessing culturally appropriate services.

A recent report by Student Minds highlighted that international students are concerned about a range of issues including their own mental and physical health as well as academic performance and making friends. There is also evidence that there is a disproportionate number of international students being admitted to hospital for psychiatric treatment.

Equally, postgraduate research students whether domestic, from the rest of the UK, or from across the world, can also face particular issues such as loneliness, anxiety, and difficulty maintaining a healthy work-life balance. Part-time and distance learning students are also likely to face similar issues around loneliness and work-life balance.

These findings, from a range of reports, underscore the necessity of addressing student mental health concerns. While much of the research was conducted during the pandemic, its implications remain relevant given the lingering effects of Covid-19 and continuing pressures around the cost of living.

Essential to the success of the Action Plan is what Universities UK describe as a whole institution approach whereby ‘all aspects of university life promote and support student and staff mental health.’

The Action Plan outlines key areas for collaborative action to address these challenges, and the need to support students to effectively manage their own mental health and wellbeing, with a focus on the three levels of prevention / early intervention.

Student financial support

We recognise that financial stress can be a significant contributor to student mental health concerns. Providing adequate financial support and information on issues such as council tax can help alleviate these anxieties, especially in the face of increased living costs.

In response to increased costs, the Scottish Government has taken strong measures to assist students including uplifts to the undergraduate support package and, in 24/25, the provision of a Special Support Loan and uplifts to the postgraduate support package.

Students, including those with a mental health condition and those with Additional Learning Needs, who may have extra costs because of their impairment, can also apply for financial support whilst studying a course of Higher Education through the Disabled Students’ Allowance (DSA). Further information on DSA including eligibility criteria is available from the Student Awards Agency Scotland.

Students studying a course of Further Education can receive an additional element of funding called Additional Support Needs for Learning (ASN). It can be used to support a disabled student who, because of their disability, is obliged to incur additional personal expenditure arising from their attendance at college. ASN is administered by colleges and the amount allocated to students through ASN varies depending on the student profile and their needs. In addition to ASN, disabled students can also receive student support (as a bursary, childcare, hardship).

In 2021-22, the Scottish Funding Council (SFC) issued clarification that students with disabilities, supported learners and students whose educational development does not match a standard progression model may be supported over an extended timeframe and on a non-standard pattern of progression. This support from the SFC is ongoing. The Scottish Government firmly believes that by addressing the root causes of financial stress and promoting wellbeing strategies, we can empower students to achieve their educational goals and contribute meaningfully to society.

Local services, acute care, and access challenges

Stakeholders have raised concerns about the accessibility of community services and referral pathways for students to NHS Scotland community and specialist mental health services.

Colleges and universities provide various therapeutic supports and preventive measures. These include, facilitating access to student sport and exercise, institutional access to a range of wellbeing and support services, the provision of chaplaincy services, and institutional support for student associations which, in turn, provide a framework for a wide range of student clubs and societies which foster a sense of community and belonging.

We recognise the autonomy of institutions and the need for locally-based responses to local challenges. Institutions need to identify what works best for them. That said, we commend the efforts already made by colleges and universities in promoting mental wellbeing and suicide prevention. We continue to encourage them to meet the expectations set forth by Universities UK; and to consider the recommendations of Student Minds, and the ongoing work of the Charlie Waller Trust.

These interventions, however, cannot offer comprehensive psychological, psychiatric, or acute treatments nor should they be expected to do so. We also acknowledge that other issues which affect student mental health and wellbeing, such as gender-based violence, will also require that institutions have in place support mechanisms and referral pathways to professionals.

The Mental Health and Wellbeing Strategy and attendant Delivery Plan 2023-2025 acknowledge the limits of what institutions can do. Accordingly, we will work with institutions to enhance their understanding of their roles, identify key partners, and highlight available resources and funded supports, enabling better connections.

The five actions set out in this Action Plan seek to address the challenge of supporting good mental health for students, including helping students to develop resilience and to support their own mental health and wellbeing. The Action Plan underscores the importance, not just for institutions to work to address these issues, but for the NHS Boards, local authorities, and Health and Social Care Partnerships to work with them to do so.

Student voices

This Action Plan sits within a suite of documents under the Mental Health and Wellbeing Strategy which was informed by student voices and the Action Plan itself was shaped through early engagement with the Student Mental Health and Wellbeing Working Group. Membership includes NUS Think Positive and NUS Scotland. These student representative organisations also contributed to the Action Plan at its consultation stage.

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