As the number of students experiencing mental health difficulties continues to grow — evidenced by the 210% increase in students dropping out of university and a 94% rise in students seeking counselling — universities are under pressure to understand and effectively address this problem. The traditional challenges that many students face, clearly still apply. It can take time to settle into a new place, make friends, and adjust to the pace of university life. But narratives are emerging around specific student groups, such as international students, postgraduate students, or those studying certain subjects, and the type of issues that they encounter that can impact negatively upon mental wellbeing.
At the University of Nottingham, staff and students have reflected upon the specific support needs of health sciences students; how the training involved for those undertaking these subjects may cause additional stress and create barriers for accessing other support initiatives. This includes continuous assessment periods, lengthy work-based placements throughout all years of the programmes, and the requirement to work outside the traditional academic year. This led to the establishment of the Bridge Network — a student-led peer support network for those studying the health sciences. We spoke to one of the founders, Dr Anne Felton, to find out more about this work.
Who was involved in the decision to start the Bridge Network, and why was it established?
The Bridge Network was conceived by Sabrina Carter, at the time a 3rd Year BSc Nursing student, and myself (a Mental Health Nursing academic at the University of Nottingham's School of Health Sciences). The idea grew from our mutual interest in student mental health and from working together on activities to promote good mental health. I have many years’ experience of working with students who have their own lived experience of mental distress, who may be attracted to work in the caring professions. I was aware that students could feel alone in this experience. As a mental health nurse with a research and practice interest in recovery, I was also impressed by innovations, such as peer support, that were creating waves in mental health care, and saw an opportunity for such approaches to be integrated into universities where student mental health is a growing challenge.
During her training, Sabrina has organised a mental health awareness workshop for students and staff in the School, coinciding with a national mental health day. I supported her with this activity, which was very well received by students and staff in the School. The workshop created a welcoming space for conversations about mental health. As a result of this collaboration, we developed the idea for the Bridge Network.
What are the benefits of having an academic member of staff and a student running the project?
Both parties bring a unique set of experiences and expertise to the development. The principles underpinning peer support recognise that it is shared experience that brings a mutual understanding, therefore the project would have been impossible without the joint leadership of students. However, my involvement as an experienced member of academic staff has facilitated the negotiation of organisational barriers, access to resources and provided consistency to the project (Sabrina has now graduated from the course), and worked towards minimising any additional workload for student contributors. Bringing together this type of different expertise also mirrors the 'co-production' approach which is part of the recovery philosophy influencing mental health care.
How has the project been funded?
The Bridge Network was originally funded by a University of Nottingham Cascade grant. This fund is open to students and staff at the University for projects that benefit students, the community or alumni, alongside enabling students to develop their skills. The fund encourages crowd funding a small part of the grant which, in the case of the Bridge Network, was a really effective way to raise awareness of the development both within and outside the University. The funds were largely to cover setup costs for piloting the Network but once it is established, it should become sustainable without further funding.
What type of training is given to student volunteers?
During the pilot, volunteer student peer supporters completed four days of training provided by the peer education team at the Institute of Mental Health. This focussed on principles of peer support, communication skills and planning for the Network. The initial funding injection provided the opportunity to pay for external experts to deliver the training but also share their expertise for establishing new peer support initiatives. A 'train the trainers' approach is planned for the next cohort of peer supporters with additional input from the mental health nursing academic team who are able to share knowledge of the principles of peer support, mental health and recovery.
Do you work with any external organisations or experts?
In addition to our work with the Institute of Mental Health peer education team who provided the training and some initial consultation on the project ideas and plans, a University counsellor has also been involved in establishing the network and, alongside myself, provides regular supervision for the peer supporters.
Why might a student access the Network, and what support is available to them?
The Network provides a safe and supportive place for people who have lived experience of mental or emotional distress. The peer supporters provide input into developing the values of the Network,which is emphasised for its inclusivity for all who are affected by these issues. We run group support sessions every other week on a Wednesday afternoon, usually kept free within timetables for student and sporting activities. As part of the pilot, each group session focuses on a different topic which may be a source of stress for students, for example placements, ‘fitting in’, and assessments.
Support provided by the peers in the group is non-directive and recovery focused, and does not seek to replace existing services. This involves encouraging students to think about their strengths, providing role models for recovery, coping and support for self-disclosure for people experiencing mental health difficulties. Students can also gain from shared experiences, including those of the peer supporters. As part of the training, student peer supporters were updated on the mental health and welfare services available at University so they can signpost students for assistance.
How is the availability of this service promoted to students, and staff?
We have used a multi-pronged approach to spread awareness of the Network. A Twitter account was set up as part of the original crowdfunding campaign and used along with the School's own Twitter account to raise the profile. I also send out emails to students across the School, via the student engagement manger, initially to advertise the launch of the Network, and then to provide ongoing, updated information on the group sessions. Student peer supporters post on student Facebook pages, and posters are placed in key locations around the School. The launch and details of forthcoming group sessions also appeared in School and student newsletters.
Peer supporters are also planning to run a lecture tour to introduce the Network to each cohort at the start of a teaching session. The Director of Teaching and Learning in the School has been a strong advocate of the initiative and has raised the profile at Teaching and Learning events. Personal tutors have also been contacted with information about the Network so that they can signpost students to this support.
How are students able to share their experiences of being involved with the project?
As we are still piloting the network, this will be a core activity once we are more established. However, there are plans to submit the project for a mental health conference in which students can present the work and contribute to dissemination through publication. These plans were part of the initial funding proposal. Sabrina’s and my involvement in this work has highlighted pockets of innovative practice, often led by students across the University, and the potential to organise more formal ways to link this together, for example, through a conference or interest group. The Network is also interested in how it can link with national developments around student mental health.
What are your plans for the Bridge Network in 2018?
This year will see the piloting of the first Network groups. There is a plan to evaluate these by undertaking focus groups with those who have participated, and conducting interviews with peer supporters to explore what benefits the Network may offer.
The next cohort of student peer supporters will be recruited and trained, to ensure the sustainability of the Network as existing peer supporters’ begin to graduate. There are also hopes that the visibility of the Bridge Network within the School acts as a springboard for further awareness-raising events, ensuring that the conversations about student mental health continue, and providing further opportunities to challenge the stigma that persists.
Indicator 2.4.1 of the ProtectED Code of Practice 'Student Wellbeing & Mental Health' measures requires member universities to formally enable peer-to-peer support for students.