An investigation by Cherwell has found that the number of students accessing the University’s counselling service has been steadily increasing over the past decade, up by 7.4 percentage points since 2012. According to a Cherwell survey of 100 students, mental health care services are inadequate to treat the mounting mental health care issues they face. University Counselling Service data, however, suggests that students described their experiences and counsellors more positively.
Reports that mental health issues are on the rise in young people have become familiar headlines over the past several years. Between 2011 and 2022, the suicide rate has risen by 16%, with young people suffering at historically high rates. In a 2022 survey by the mental health charity Student Minds, 57% of respondents self-reported a mental health issue and 27% said they had a diagnosed mental health condition.
Oxford is not immune to the problem. Oxford’s Counselling Service Annual report stated that the percentage of students presenting with anxiety has increased from 16.7% in 2017/18 to 33.7% in 2021/22. One student responded to the Cherwell survey with: “Sometimes it feels like the Oxford system is intentionally designed to keep you stressed and under pressure – no reading week, compact terms, two essays a week, finals as eight exams over three weeks dictating your entire degree.”
Across colleges, a common narrative among students is that being at Oxford is hard on mental health – and that University mental health resources are lacking. In a Cherwell survey, nearly two thirds of respondents said that their mental health had significantly worsened or somewhat worsened since coming to Oxford. Over 95% of respondents said that the University itself played a very significant or significant role in this change.
While student mental health has recently worsened across all UK universities, Oxford and Cambridge in particular have been criticised in the media and by their student bodies for the effects of their intense academics and social lives on student mental health. 47% of Cherwell survey respondents across all colleges said either academic workload or exams was the foremost factor impacting their mental health.
Is student mental health the University’s responsibility?
While young people are experiencing rising cases of self-reported and diagnosed mental health issues, it is unclear what the role of the university is in managing students’ mental health.
Legally, the subject is largely untested. The UK Government has published that universities “have a duty of care” to their students. But in May 2022, a court case between the parents of a student at the University of Bristol who died by suicide determined that there was “no statute or precedent” concerning a duty of care owed by a university to its students to take reasonable steps to avoid causing injury.
According to Freedom of Information (FOI) requests sent by Cherwell, at least fifteen colleges and the central University employ in-house counsellors and nurses. However, Oxford’s mental health care resources are not designed to treat serious illness. If Oxford counsellors believe a student to require more serious medical care, they are encouraged to refer them to the University’s medical consultant, a psychiatrist, who may ultimately refer them to NHS secondary resources.
Oxford’s Counselling Service Annual Report stated: “It is not the role of our medical consultant to treat mental health problems of students, but to advise on the most appropriate course of action, i.e. to hold and work with the student within our service or to advise the student’s GP to make a psychiatric referral.”
The report further acknowledged that while this system used to work well, in recent years, many students face “very long waiting periods to access NHS psychiatric services” and the university psychiatrist has been under “pressure to ‘hold’ students over much more extended periods.” One student responded to the anonymous Cherwell survey with: “I have been waiting 1.5 years to speak with a counsellor at the uni service, so [I] have sought help elsewhere.”
Oxford’s mental health care system may be under-used
Colleges and the central University have invested significant resources into mental health care. According to the FOI requests, the highest spent on welfare in 2022/23 was £398,000 by Balliol college – the planned budget for 2023/24 is £425,000, an increase of 6.78%. Many colleges explained that they don’t have specific budgets for mental health or even welfare, with Corpus Christi adding: “If money is required for welfare it is made available to us.” St Annes further stated that their budget “is mainly staff costs.”
A University report has stated that the percentage of students accessing Counselling Services has grown steadily from 7.4% in the 2012/13 academic year to 13.8% in 2021/22. Based on the Cherwell survey of 100 students, 41% stated that they had accessed college mental health support in their time at Oxford and that 30% had used university-level services; however, there may be a self-selection process.
There are also significant discrepancies in the demographics making use of services, indicating that some may be under-utilising them. In 2021/22, 65.6% of students using University counselling services were female and just 34.3% male, in spite of equal rates of anxiety for each gender and far higher rates of male suicide. While ethnic makeup of students using University mental health services was largely proportionate to their representation in the general student population, Chinese students were far under-represented.
The issue, then, may lie in students accessing the resources available to them. The majority of students receiving College and University support have gained it through self-referral, though parents, peers, and College welfare representatives (elected, trained peers) can also refer College members to services, too.
Students report being generally aware of the services available to them. 41% of students surveyed by Cherwell reported being very aware of the services available to them within the university, while another 54% were somewhat aware.
University, college, and other resources
The Cherwell FOI requests to Oxford colleges also revealed that most colleges currently employ, at a minimum, a nurse as well as at least one position partly dedicated to student welfare. At some colleges, including Christ Church, the chief welfare staff member is “employed 50 per cent as College Chaplain and 50 percent as Welfare Coordinator” – a set-up one student said should be changed so as to “not be linked in any way to the Church.”
University services, though less accessed by students, are generally well-received according to reports from the University. Once students are referred to University services, wait-times before receiving care averaged at 9.4 days in 2021/22, with 42% of students seen in less than five working days. The majority of students described their wait as “manageable.”
Once care is received, student reports are also largely positive. The 2021/22 Counselling Service Annual states that 96% of students who accessed the Service described their counsellor as good or very good at listening, understanding, and making helpful contributions. Empirically, Counselling sessions resulted in significantly lowered emotional difficulty for students.
The University said: “Prior to counselling 38% of students described their level of emotional difficulty as ‘severe’, and 1% as mild. Following counselling this was reversed, with 1% of students describing their level of emotional difficulty as ‘severe’, and 41% as ‘mild’.”
Private mental health resources targeted at Oxford students can fill demand that university resources by nature cannot. A student comment said that Oxford Nightline, a phone listening service run by students in Oxford, made them feel heard “without any risk of repercussions from the university or tutors.” A spokesperson from Oxford Nightline said that they offer a platform where students can express themselves “without fear of judgement or unwanted advice” and are open during hours when other support is not available.
