Snake oil or panacea: can technology improve student mental health?

Rising numbers of student suicides and dramatic increases in demand for support services have led to claims of a university mental health crisis. Earlier this month, a survey revealed students were significantly more anxious than other young people. The issue has become a focus for regulator the Office for Students, which recently announced funding for projects investigating solutions. Even Theresa May chose to spend her remaining time as prime minister announcing a £1m competition to come up with innovative ways of improving student mental health.

Many of these responses depend on technology. How universities can use data to identify at-risk students, whether new apps developed to support those with mental health problems actually work, and what the benefits and limits of technology might be was the subject of a roundtable discussion, held at the Guardian’s offices in London earlier this month and supported by Jisc, the digital agency for universities. The roundtable involved senior academics, technology experts and others with in-depth knowledge of student mental health.

All the participants agreed that talk of a university mental health “crisis” was unhelpful. Three quarters of mental health problems are established by the age of 18, which means many people go to university with existing problems. Rachel Piper, policy manager at the charity Student Minds, called it a “cultural shift” – a time when young people face a number of challenges, such as leaving home, independent living and an increase in incidences of sexual assault.

Dominique Thompson, a GP and former director of service at the University of Bristol Students’ Health Service, said increasing reports of distress were an understandable response to wider problems, including increased competition for graduate jobs and helicopter parenting.

In fact, the suicide rate among students is actually lower than for the general population of that age, pointed out Til Wykes, professor of clinical psychology and rehabilitation at King’s College London.

“Mental health is complex and you cannot isolate it,” said Steve West, vice-chancellor of the University of the West of England. “You have to think about whole people and you have to work with their work lives, university lives, social lives. The whole context is complicated.”

The panel agreed that technology could only provide part of the solution. Students experience a variety of stresses at university, which all require different kinds of help, said Wykes. “A debt counsellor might be a better option for some people than a digital solution,” she said. Often, Thompson argued, students did not want to interact digitally – they wanted to talk: “The reality is, we are humans and like talking to other humans.”

But not always, argued Henry Jones, chief executive of Big White Wall, which provides a platform for people to access online peer support anonymously. He said most students using his platform were attracted by the offer of anonymity, and that young people could talk just as easily through technology.

Wykes said evidence for the effectiveness of most mental health apps was scant. Young people needed to be involved in researching and testing apps properly and in understanding what the real chances of success were; otherwise, if they failed to work, they could end up being even more miserable. Users also needed to know how apps would use their data, particularly in light of the Cambridge Analytica scandal. “These are intelligent people. We cannot just keep selling them […] snake oil. We need to know it works.”

Professor Dame Til Wykes, professor of clinical psychology at King’s College London. Photograph: Anna Gordon

Piper warned that students sometimes felt they were being fobbed off with digital solutions and questioned the basis on which universities adopted these. She wanted students to be more involved in developing mental health support, which should be targeted at preventing – not just responding – to mental health problems.

West agreed “the evidence base for much of what’s going on at the moment doesn’t exist”, and said it would take time to compile since it demanded studies tracking students from school through to employment. The decision-making process behind introducing new apps could be “murky”, he acknowledged. While universities were trying to make services work together better, he was worried that any future squeeze on resources could put this at risk.

Fragmenting support between face-to-face and technology was something that concerned Annie Meharg, chief commercial officer of XenZone, which has been supplying online counselling services since 2001. She argued that a more streamlined approach is essential.

And what about using technology to track students’ engagement with libraries and social events in order to pick up early warning signs through changes in behaviour, suggested Calvin Benton, co-founder of the Spill app, which connects people with online therapists.

Catherine Grout, head of change at Jisc said her organisation is encouraging universities to get better at data curation. “If you have rich data – with all the appropriate constraints – you have a much better chance of getting the support to students they need,” she said.

Staffordshire University is one university adopting data analytics to target information to students and give them personal recommendations for activities and societies. Andrew Proctor, the university’s director of digital services, said that far from substituting for conversations, this approach used AI “to make more human and social connections”.

Rachel Piper, policy manager at Student Minds. Photograph: Anna Gordon

Jones added that the most useful application of technology was the simplest: to enable services to work faster and better. “Technology can do amazing things,” he said. “It can provide access. It can provide anonymity. It can provide safety.” Demand for mental health support – particularly one-to-one support – dramatically outstrips supply but students using his app could talk to others, monitored by clinicians, 24 hours a day.

West challenged the extent to which universities are expected to monitor and support their student’s mental health now that the government has urged them to act in loco parentis. “The role of the university in part is preparing people for the world beyond university,” he said. “Life is tough and one of the things we have to do is prepare people for that uncertainty and that future.”

Piper countered: “It’s OK for universities to be better than the rest of the world.” As workplaces, they could be models for supportive environments for employees. “It doesn’t have to be the harsh environment reality that exists outside,” she said. “It can be better.”