Mentality Campaign Survey Report 2015
imperialcollegeunion.org
Contents 03 04 05 08 11 15 15
Introduction About the survey Section One Section Two Section Three Recommendations Further reading
To find out more about our student-led campaigns at the Union, visit
imperialcollegeunion.org/campaigns All information correct at the time of going to print in May 2015.
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Mentality Campaign - Survey Report 2015
Introduction Bethany Davison Campaign Leader, Mentality I suffered from depression during my first year at Imperial. I lacked energy and motivation, I felt worthless, helpless and hopeless, but worst of all I felt alone. Thanks to the support of my family, my tutor and the Counselling Service at the College, I got better and I returned to Imperial adamant that no student should feel that same loneliness that I felt. The initial aims of Mentality were to increase awareness of mental health and the services at Imperial, reduce the stigma of mental health and to support students by making it as easy as possible for them to get the help they needed. However, as things started to progress and I started meeting other students who had had a mental health condition at Imperial, it became clear that my own positive experiences were not the norm. I heard too many stories where the support given was just not good enough or non-existent. Not only did we need to raise awareness of the services available but we needed to call for improvements. This survey was designed to gather information about many aspects of mental health at Imperial. We wanted to find out about: AA Prevalence of mental health issues at Imperial amongst students AA Symptoms and causes AA Student awareness of the services provided AA Student opinion on these services, what did they find helpful/unhelpful AA What improvements students would like to see
From looking at the results of the survey, we have put together a list of recommendations which we believe would greatly improve the state of mental health at the College. There are many people without whom Mentality wouldn’t be the success it is. I’d like to thank the students who form the Mentality team, Elise Rattigan, Emily-Jane Cramphorn, James Grant, Jess Chapman, Nnebs Oji, Peter Marinov, Sophie Middleton, Valle Varo and Will Underwood. I am constantly inspired and touched by your enthusiasm and passion. A special mention to Peter and Sophie who wrote the survey, especially Sophie who also wrote a large proportion of this report. I’ve also had incredible support from staff at the Union who have been invaluable in their guidance and knowledge. Thanks to Sky Yarlett, Representation and Campaigns Coordinator, and Andrew Keenan, Education and Welfare Manager for all the time and effort you’ve put in, helping us to organise things and pushing Mentality forward. Thanks also to Chris Kaye, Deputy President (Welfare) and Tom Wheeler, Union President - without the support of the Union, Mentality would not be where it is. Finally, I’d like to thank those who encouraged me to start Mentality in the first place and those who have supported us this past year, from filling in our survey to volunteering at events. You have already helped to make a difference and I hope you will continue to support us over the coming years.
The initial aims of Mentality were to increase awareness of mental health and the services at Imperial, reduce stigma and to support students by making it as easy as possible for them to get the help they needed.
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About the survey The survey was started by 1,115 students, and most questions have around 900 responses with a full survey completion rate of 79%. The survey was open from 5 March 2015 to 19 April 2015. It was mainly distributed through peers and online media but also had a physical presence in the form of posters and leaflets.
Respondents
SEXUAL ORIENTATION
Total number: 1,043
Percentages below are out of total results
52+47+1 70+13+17
OTHER
GENDER FEMALE
47%
1%
MALE
52%
1%
INTERNATIONAL (NON-EU)
47%
1%
Gay
4%
Bisexual
7%
Queer
1%
Straight/Heterosexual
86%
In another way
2%
FACULTY
INTERNATIONAL (EU)
FEE STATUS
Lesbian
HOME/UK FEES
70%
Aeronautics
2%
Biochemistry
4%
Bioengineering
2%
Biology
9%
Business School
2%
Chemical Engineering
2%
Chemistry
5%
Civil Engineering
1%
Computing
7%
Earth Science & Engineering
4%
EEE
7%
EIE
1%
Joint Mathematics and Computing
0%
Materials
1%
Mathematics
5%
Mechanical Engineering
7%
Medicine
19%
Other
2%
Physics
20%
STUDY TYPE
YEAR 1
YEAR 2
YEAR 3
YEAR 4
YEAR 5
TOTAL RESPONSES
Undergraduate
34%
24%
19%
17%
7%
892
Postgraduate Taught
83%
6%
2%
4%
6%
53
Postgraduate Research
39%
18%
28%
11%
3%
89
22%
0%
11%
33%
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33% 2015 4Staff/Alumni Mentality Campaign - Survey Report
Section One: The prevalence of mental illness and distress at Imperial. Mental Illness We asked respondents to outline their experience of mental health conditions, and the results are outlined in the table below.
Answer
Responses
%
I have never suffered a mental health condition
156
15%
I have experienced some mental stresses but do not feel I have a mental health condition
413
39%
I feel I have a mental illness but haven't been diagnosed with a mental health condition
170
16%
I have been diagnosed with a mental health condition and feel this diagnosis still applies
153
15%
I have been diagnosed with a mental health condition in the past but feel this no longer applies
57
5%
Would not like to say
12
1%
I have a friend/family member who has experienced a mental health condition
89
8%
We asked everyone how they would describe their mental health, and 94% (1050) people responded. 20% of respondents have been diagnosed with a mental illness, a higher percentage than a recent National Union of Students (NUS) survey in which 16% (216) stated a mental health diagnosis. A higher proportion of female students (26.6%) than male students (14%) had a mental illness. This is unsurprising as although overall rates of psychiatric disorder are almost identical for men and women, women are more likely to experience depression and anxiety disorders. These are the most common disorders at Imperial, which can be seen in the table on the next page. Smaller differences were seen between Postgraduate and Undergraduate students with 23.9% and 19.5% having a diagnosis respectively. Worryingly, 16% of responders feel that they have an undiagnosed mental illness. This could reflect a need for better access to and knowledge of services for students. Further research could focus on what barriers these respondents have faced in receiving a diagnosis. The majority of responders (39%) said that they have experienced some mental stresses but do not feel they have a mental health condition. This perhaps reflects the stressful, high pressured environment at Imperial and is an important population to target with Stress Less and other wellbeing events.
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Section One Diagnoses If respondents stated they had a mental illness they were then asked to disclose their diagnosis. One hundred and twenty five people responded with 52 people having multiple mental health conditions. Depression and anxiety were the most commonly diagnosed reflecting the general population. Other diagnoses include OCD, PTSD, Autism spectrum disorders and ADHD. Further research could explore whether diagnosis was given before or after starting at Imperial and whether students felt comfortable disclosing this on their application forms.
Responses
%
Depression
84
67.2
Anxiety
53
42.4
Eating disorder
20
16
Bipolar
6
4.8
Schizophrenia
1
0.8
Personality disorders
3
2.4
Other
23
18.4
Mental stresses experienced and how often
We asked everyone if they experienced symptoms of mental distress and when. Stress was the most commonly experienced with 636 (69.5%) respondents experiencing stress at least once a week and 85 (9.3%) all the time. This is much higher than in the NUS survey in which only 31% of students experienced stress at least once a week. Imperial students are much more likely to experience stress as a regular occurrence in comparison to students at other universities. This highlights that there is a specific culture or behaviours perpetuated at Imperial that increases stress. Through informal discussions with students and Academic Reps we see that the pressure is both rooted amongst the competitive peers as well as from lecturers and academics. Other symptoms experienced at least once a week were lack of energy/motivation (67%), feeling unhappy or tearful (46.3%), anxiety (51.2%) and repetitive thoughts (46.6%). These were also much more prevalent than in the NUS survey (34%, 35%, 40% for the former respectively). Regarding symptoms seen as severe, thoughts of self harm had been experienced by 36.92% of respondents at least once a year and suicidal thoughts by 35.19% over the same time period. This is again much higher than the NUS survey with only 14% and 13% respectively experiencing these symptoms at their time at university.
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Mentality Campaign - Survey Report 2015
Section One It is clear to see that students at Imperial have more features of mental distress than other UK universities. One way to measure how serious symptoms are is to consider their impact on a person’s life. We asked “How was your performance affected during your periods of mental distress?” on a scale from 0 to 10 (0= not at all, 10= greatly).
RESPONSES FROM ALL STUDENTS
2429+ 2720+ 2528+ 2720+
PHYSICAL HEALTH
4.964 OUT OF 10
SOCIAL LIFE
5.892 OUT OF 10
ACADEMIC PERFORMANCE
5.652 OUT OF 10
RELATIONSHIP WITH FAMILY
4.240 OUT OF 10
Social life was the most affected with students on average rating it 5.9/10; this was closely followed by academic performance (5.7/10). These two aspects are arguably the most important parts of university life and contribute highly to student satisfaction.
Imperial is a world class institution and prides itself as such. If it is to keep its reputation as such the institution must recognise the negative impact that current levels of mental distress is having on the experience and achievement of students. When taking into account only the answers of students that experience thoughts of self-harm and suicide at least once a week (111 respondents), it shows that performance is more notably affected in all areas. This shows a need to address the less common but severe problems as well as the common symptoms experienced by students. Their answers are demonstrated in the graph below.
RESPONSES FROM SUB-SET
PHYSICAL HEALTH
6.336 OUT OF 10
SOCIAL LIFE
6.991 OUT OF 10
ACADEMIC PERFORMANCE
6.981 OUT OF 10
RELATIONSHIP WITH FAMILY
5.178 OUT OF 10
As we have seen above, students at Imperial college are experiencing mental distress at a higher level than other UK universities and this has an impact on their lives. The next step is to explore the reasons behind this. As demonstrated in this section, students at Imperial seem to be experiencing mental distress at a much higher rate than students across the UK, this is having a profound on aspects of their life, including academic, physical, social and personal. Finding out what is behind this was the next part of the research. Knowing what is contributing to this feeling of mental distress would allow us to identify if there was a pattern or something unusual happening.
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Section Two: The causes We asked respondents “Which of the below have contributed to your feelings of mental distress (stress, low mood etc)”. Respondents were able to select more than one option. The most popular option was “Exams and revision” which was selected by 77% of respondents.
REASONS WITH OVER 25% 90% 80% 70% 60% 50%
Other reasons to note were: AA 35% - Future job uncertainty AA 24% - Accommodation/housing AA 24% - Financial difficulties
40% 30% 20% 10%
ur se ts w or k de el ad at lin io es ns hi p pr ob le m Lo s w se lf Pe es rs te on em al /f am Fu i l y tu ev re en Jo t b U nc er ta in So ty ci al pr es su re s
e
The full list of reasons and their responses are shown in the graph above. Of the five most common causes of mental distress reasons based in academia counted for four of them. It is clear from this, that many students’ mental health is negatively affected by the pressures put on them from academic work and university life.
Pe r
so
Co
na lr
m itm en
an c
om rc
ot d an
yi ng st ud
Ba la n
ci ng
G
ra de
s
/a
ca de
he
m
Ex a
ic
m
pe
an
d
rfo
rm
re vi s
io n
0%
8
All respondents, regardless of whether they identified as having a mental health condition were asked what contributed to their feelings of mental distress. Among the general student population, the top five reasons cited were: AA 77% - Exams and revision AA 64% - Grades/academic performance AA 60% - Balancing studying and other commitments AA 53% - Coursework deadlines AA 45% - Personal relationship problems
Mentality Campaign - Survey Report 2015
It is also interesting to note how there are many students who recognised one or more causes of mental distress but who do not identify as having a mental health condition. This shows that stress and periods of feeling low are student-wide problems, not confined to those who have a diagnosed mental health condition.
Section Two We can also compare how different sections of the student population responded to this question.
Male vs Female Female - 522 responses
Male - 573 responses Exams and revision
73%
Exams and revision
82%
Balancing studying and other committments
60%
Grades/academic performance
73%
Grades/academic performance
56%
Balancing studying and other committments
61%
Coursework deadlines
52%
Low self esteem
56%
Personal relationship problems
44%
Coursework deadlines
55%
There is a striking difference between male and female responses, with a very marked percentage difference between males and females regarding exams and revision (73% compared to 82%) and grades/academic performance (56% compared to 73%). Low self esteem is a much greater factor for the female population which did not previously appear in the top five reasons overall.
Postgraduates Speaking to Postgraduates, we had anecdotal evidence from the Academic and Welfare Officers within the Graduate Students’ Union of the particular causes of distress amongst Postgraduate Taught and Postgraduate Research students. The academic pressure they feel is also reflected through these results, alongside the pressure of being in an academic career. Top five reasons amongst Postgraduate students: AA 57% - Balancing studying and other committments AA 57% - Grades/academic performance AA 52% - Future job uncertainty AA 49% - Personal/family event AA 48% - Personal relationship problems Others to note:33% - Financial difficulties AA 23% - Publication pressure AA 19% - Relation with supervisor Here, future job uncertainty features more prominently than before alongside other personal issues. When isolating responses from Postgraduates (14% of overall responses), we can see that pressures faced by Postgraduates differ significantly from those of Undergraduates.
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Section Two LGBT students Top five reasons: AA 77% - Exams and revision AA 65% - Grades/academic performance AA 63% - Balancing studying and other committments AA 58% - Low self esteem AA 55% - Coursework deadlines Others to note: AA 38% - Issues related to sexual orientation The reasons for mental distress among the LGBT community generally follow that of the general student population. However the strong prevalence of issues related to sexual orientation shows that more needs to be done to help those students who are struggling with/questioning their sexuality. Low self esteem is higher amongst the LGBT students that answered the surve compared to other student groups.
Home vs International students Home (UK) - 742 responses Exams and revision Grades/academic performance Balancing studying and other committments
80% 65% 62%
International EU - 174 responses
International Non-EU - 138
Exams and revision
74%
Exams and revision
68%
68%
Coursework deadlines
59%
Grades/academic performance Balancing studying and other committments
60%
Coursework deadlines
52%
Coursework deadlines
55%
Low self esteem
47%
Personal relationship problems
42%
Grades/academic performance Balancing studying and other committments Personal relationship problems
58% 53% 43%
As these results show, low self esteem is a much higher factor for home students than international students. Additionally, many more home students find exams and revision a cause of mental distress.
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Mentality Campaign - Survey Report 2015
Section Three: The services available We asked “Who did you tell about your feelings and/or symptoms of mental distress when you experienced them?” (see pink box). Respondents could select as many options that were applicable.
Who did you tell about your feelings and/ or symptoms of mental distress when you experienced them?
As demonstrated in the illustration on the right, the majority of students spoke to their friends about their feelings of mental distress.
58% - told friends 45% - told family 28% - of told no one 20% - Doctor/GP 13% - Personal tutor 10% - Student Counselling Service 7% - Other health professional 6% - Other 6% - Other Academic member of staff 1% - Helpline 1% - Disability Advice Service 1% - SU Welfare Officer
Most worryingly almost 30% of students told no one. Some of this number may be because students felt they could get through it alone. Many will feel isolated or that the stigma of mental health prevents them from talking about it. Having a strong support network amongst peers is good, however it is unclear if students are getting the appropriate amount of support. Looking at these results it is concerning that students are not seeking professional help. We further explored this by trying to find out if they were aware of the services offered at Imperial (see blue box). This is an indication of students awareness at face level, however it might be worth looking into how we bring together these services so that at a time of crisis or need a student know what is available to them. Often students don’t know that mental health may count as a disability and that they could get help for it. Of those who did access services at Imperial we asked them how easy they found to access these services (see grey box). The statistic around those that did not access any services may be misleading, as well as students who chose to not access services as they didn’t feel it was appropriate. However, within this number there will also be students that had been put off by the appearance of it being difficult and/or long waiting times.
Are you aware of any of these services at Imperial offering mental health advice and support? 76% - Personal tutor 73% - Imperial GP 63% - Imperial College Counselling services 43% - Students’ Union Welfare Officer 42% - Hall Wardens 34% - London Nightline 27% - Student Advice Centre 24% - Disability Advisory Service 19% - The Chaplaincy
How easy was it to access support services at Imperial? 69% - Did not access 10% - Easy but long waiting time 7% - very quick and easy 6% - Difficult, didn’t know where to look 5% - Difficult with long waiting times
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Section Three We then asked students to tick the service they used and rate it out of the 10 (0 = terrible, 10 = brilliant). The results in the graph below show the average score out of the all the responses for each particular service. 7
6.5
6.37 6.06 6
5.61
5.6
6.09
5.81
5.75 Average = 5.5
5
4.5
4
4.7
4.6
4.5
3
2
1
0
Imperial GP
Personal tutor
Imperial Psychologist Psychiatrist Counselling Service
Disabilities Hall Wardens Occupational Advisory Health Service
Student Welfare Officer
London Nightline
Student Advice Centre
Chaplaincy
The average rating of these services was 5.5 our of 10, which shows that services at Imperial have a long way to go before they are rated ‘good’ rather than ‘okay’. The number of responses for each service varies.
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Mentality Campaign - Survey Report 2015
Section Three What did you find particularly helpful about the service you used? There were 107 responses in total, producing nearly 1,500 words of text. Below are some statements from students on their experiences.
I just needed an outlet to talk to Personal tutor clear and good and give me a boost, I just wish I’d advice and support. Counselling contacted them sooner. felt safe. GP knew what she was talking about and showed real care.
Comfortable environment and they really helped me to alleviate a lot of my anxiety before exams and then I had a good meeting once I had finished my exams.
Personal tutor was amazing, he talked to me and we decided together that I would take an interruption of studies and then helped me get back into the swing when it was time for me to come back.
GP was very understanding and did not belittle me in any way, I felt I was being taken seriously and was directed immediately to the current support services.
Welfare officer and wardens great to chat with and just have someone to listen, not necessarily analysing everything I say, just being there for me.
The IC Health Centre were sympathetic to underlying medical condition causing my poor mental state at that point and helped me to quickly find a solution.
What did you find particularly unhelpful about the service you used? Common themes in what students found unhelpful were long waiting times for the Counselling Service and feeling like they were misunderstood by the Personal Tutor. Below are statements from students on their experiences; while it shows a variety of different interactions with the services, most of them show the impact that a negative experience will have on students, that it ripples further than the first thought.
Counselling - I asked for an appointment, the first available is in months and in the meanwhile I’m left alone and I don’t know what to do. So close to the exams is going to be more than useless.
Welfare Tutor - used the phrase, “only the weak students need help” to my friend when she had to see her for help. At first I took this with a pinch of salt but when I had to go and see the very same (socalled) Welfare Tutor, I was left with no doubt that she probably did use those words...if that is the attitude of the Welfare Tutor, it doesn’t give a lot of confidence about what other help Imperial can offer me or other students.
Counselling - felt like was just against a ticking clock the whole time because they don’t have enough time/staff for students which I guess is not their fault.
One Imperial GP told me to “stop being silly” when I had self harmed severely and taken an overdose, another was kind and started me on the medication which helped a lot...but it shouldn’t be a lottery whether you’re going to get good care.
I felt I may have intruded on the time of the tutor.
IC Health Centre has a long waiting list and you have to be re referred if you are ill when there is an appointment. Also, if you miss an appointment with your GP they don’t check up on you despite it being about mental illness, the fact that you don’t turn up should raise a red flag.
My Personal Tutor, although a good tutor, had no advice to offer and seemed uncomfortable and out of his depth when I said that I was struggling. Hall warden belittled my illness when I went to seek help for problems with my roommate that were leaving me constantly sleep deprived and depressed.
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Section Three The Counselling Service The Counselling Service report from 2013/2014 states that 540 students attended counselling, which is an increase of 6.7% on the previous year. Alongside this the number of sessions offered rose by 7.4% to 2,598 sessions. According to the end of year report the peak times for initial meetings/assessments are October, November, January and March. It is at these times that students may need to wait longer for an initial appointment than the usual time span of seven working days. The peak times for individual appointments follows a similar pattern with peaks in October, November, March, May and June. In 2012/13, 50.2% of students waited over seven working days from first contact to initial meeting and 10% waited over 14 working days. In 2013/14 the Counselling Service reported that 24.4% of students waited over seven days and 6% waited over 14 working days. This improvement is brilliant and reflects the hard work of the Counselling Service.
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Mentality Campaign - Survey Report 2015
Recommendations On services available
Recommendation 1
Recommendation 3
A clear document aimed at signposting students to relevant services in relation to stress and mental health. As part of this, there should be a clear path to this information on the College website,and it should be part of the welcome pack distributed to every student.
College to put students’ mental wellbeing as a strategic priority over the next five years, and commit to: AA Investing in a student peer support group, working with Imperial College Union and Student Minds AA A review of the training that Personal Tutors receive, ensure that Personal Tutors have regular refresher sessions, and that they are given a support network to ensure they can share best practice. AA The Union and College to review the training given to Hall Wardens and Hall Seniors. AA Ensure that mental health first aid training is provided to students who may be in welfare positions, including Club and Society Chairs. AA Create support network for academic, Welfare and Personal Tutors. In addition to this ensure that Personal Tutors are trained in anonymity and confidentiality.
Recommendation 2 While the Counselling Services waiting times have improved over the last year, we think that ensuring extra provisions were put on at key times - often leading into exam or deadlines. This problem isn’t just isolated to the Counselling Service but also extends to the Health Centre and GP. They should: AA Look into the feasibility of introduction a self assessment form for students to fill in ahead of the initial assessment to ensure students are getting help they need. AA To look into ‘out of hours’ support. AA Ensure that support is in place for students at Charing Cross, and that sufficient support is given to other non-South Kensington campuses is in place.
Recommendation 4 Recommend to the Counselling Service and Health Centre if a student misses an appointment that it should be followed up and the student should be checked on.
Further reading Mental Distress Survey 2013, National Union of Students. Available online at www.nus.org.uk/Global/ Campaigns/20130517%20Mental%20Distress%20Survey%20%20Overview.pdf.
Mentality Campaign - Survey Report 2015
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