Theme 16: Cohesiveness of support across the provider

What does it cover?

• Collaboration and cohesiveness across and between student support service teams
• Collaboration and cohesiveness of response between student support services and academic staff
• Collaboration and cohesiveness of response between student support service teams and other professional services staff

Principles of good practice

16.1 Universities ensure cohesion and appropriate collaboration between different support services.

16.2 Universities ensure cohesion and appropriate collaboration between support services and academic teams.

16.3 Universities facilitate appropriate sharing of information across the institution to support individual students.

16.4 Universities ensure effective signposting and triage across the institution.

16.5 Universities work to develop a shared vision and understanding between different parts of the university community, towards mental health.

Why is this theme important and what matters?

Ensuring a cohesive, holistic response to mental health across the organisation is important for a number of reasons. Cultural differences and misunderstandings between support services teams and others, such as academic and halls of residence teams, can create gaps in support that put students at risk ^[1, 2] . Inconsistent advice, improper, ineffective or non–existent signposting and promises made by one part of the institution that cannot be fulfilled by another, can have negative impacts on student mental health and belief that the university can provide the support they need ^[3].

Alternatively, when different teams are able to collaborate and work well together, support to students improves and is more effective ^[1, 2, 4].

In healthcare contexts, consistent work between teams is vital to ensure good quality care, support and intervention ^[5]. These same principles apply within the university. If information is not appropriately communicated between different parts of the institution, this can result in students not being assessed and supported appropriately by relevant services. As a result, students at risk may be missed or go unsupported for unnecessarily long
periods of time.

This is not to say that all information should be available to the whole university. The confidentiality of counselling and mental health services is crucial if they are to be effective, safe and accessible. For example, students may be less likely to access services if they believe that their information will be shared with their lecturer. As a result, this may increase risk to them ^[6]. Information sharing across the organisation may be asymmetric but it should
be clear, effective and result in students in need being assessed and supported as quickly, effectively and efficiently as possible.

This cohesion must begin within support services themselves. Staff in the Charter consultation highlighted that differences of philosophical view, conflicting approaches to mental health and perceived competition for resource can cause conflict between separate support services teams. For example, between counselling services and wellbeing or mental health teams. Students in the consultation said they can be negatively impacted when support services do not work well together. They described experiences of being ‘bounced’ between teams, having to join lengthy waiting lists each time and a lack of co–ordinated response to their needs. This resulted in severe delays to students receiving support and diminished their belief that their university cares about them or that the support would ever help them^[3].

Support services require effective triage mechanisms to ensure students reach the most appropriate teams first. There is a need for partially porous boundaries between teams, that ensure students receive consistent responses and can move seamlessly from one team to another without additional delays. Additionally, when students require support from multiple sources, there are pressing reasons for teams to be able to work collaboratively, to reduce risk and ensure effective, consistent support^[7] . To achieve this requires the development of a whole team ethos, in which differences of view, language and approach can be negotiated and agreed ^[8].

It is important that support teams and the interventions on offer are complimentary, provide consistent messages and a cohesive vision, to ensure student confidence, belief and trust. This extends to the service offer of different teams and any proactive interventions or campaigns within the university.

This cohesive ethos must be supported across the university, ensuring that gaps between support service teams, academic teams and other professional services, are addressed through the development of shared interests, principles, culture and language. Signposting and referrals benefit when staff outside support services understand the services on offer and trust the teams providing them^[1, 4].

Without this understanding, staff who are not mental health professionals may find themselves responding to an episode of severe illness, without knowing what support is available or how to access it. This can have significant negative consequences for both the ill individual and the member of staff ^[1, 2].

The consultation revealed that a number of universities have sought to improve contact between academic staff and support services. This has included:
• Providing dedicated phone lines into support services for academic staff to seek advice when they are concerned about a student.
• Bringing academic and support staff together in working groups to think holistically about support services.
• Using support staff to deliver training to academic staff and vice versa.

These approaches are promising but there is a need to ensure that others, who are likely to encounter students experiencing poor mental health, can also develop the understanding and relationships with support services, such as security staff, librarians, halls staff and study skills advisors.

References