Theme 14: Leadership, Strategy and Policy

What does it cover?

• University wide strategy
• University policies and procedures
• Visible and effective university leadership committed to improving mental health

Principles of good practice

14.1 Universities have a strategic whole university approach to mental health that is embedded in day to day practice and culture.

14.2 Universities have an approach to mental health and wellbeing that is robustly evidence informed.

14.3 Universities have an approach to mental health and wellbeing that is co–produced with staff and students, seeks to mobilise the whole community and considers mentalhealth across the whole–university.

14.4 Universities’ approach to mental health and wellbeing is evident in other strategies, policies, procedures and practice.

14.5 There is visible leadership and commitment to mental health across the entire organisation.

14.6 Universities approach to mental health is clearly linked to and part of core institutional missions

Why is this theme important and what matters?

A whole university approach to mental health requires a commitment to ongoing improvement, embedded across the whole institution and evident in practice, processes, behaviours and culture^[1]. While real and sustainable change in universities requires engagement from the whole community, and multiple interventions by a range of actors, the role of strategic leadership is undeniable ^[2].

Change can be more consistent, effective and long lasting if it is supported by a cohesive vision and sense of purpose that can be understood and shared by the whole community^[3].

University leaders play a significant role in helping establish shared culture, structure and environment that supports change and individual wellbeing ^[1, 4]. Leaders can ensure that their university takes a strategic approach to mental health, that this is identified as a priority and that appropriate resources are allocated. They can also influence the value the community places on wellbeing through public modelling.

Importantly, this requirement extends beyond Vice Chancellors or Principals. Many universities were designed with a deliberately distributed power structure (5, 6). As such, a genuine leadership commitment to mental health must include Governors, Deans, Heads of Departments, the Professoriate and local leadership teams ^[7, 8, 9].

An institution wide, mental health or wellbeing strategy (or strategies) can be a key tool in delivering a whole university approach. However, a strategy is not an end in itself. Participants in the Charter consultations have cautioned that written strategy documents can sometimes be disconnected from reality on the ground and ‘sit on a shelf’ with no influence over day to day practice. Our consultation highlighted a number of factors that determine whether a mental health strategy is of genuine importance to an institution:

1) The quality, depth and breadth of the strategy;

Since the publication of the Stepchange framework ^[1], there has been an
acknowledgment that successful mental health strategies must take a ‘whole university approach,’ properly considering every aspect of university life. An effective mental health strategy goes beyond a reaction to mental illness, seeks mental wellness of the whole population and acknowledges the impact of environment, culture, community and day to day activity ^[10]. Unless mental health is considered across the institution, there will inevitably remain pockets of poor practice, missed opportunities for improvement and the potential for activity that actually causes or contributes to harm.

2) How the strategy was created and who was involved;

Communities are by definition complex and composed of differing needs and interests. Improving the wellbeing of any community, therefore requires engagement and interventions from a range of actors drawn from across the community, representing different groups, experiences and views ^[11].

A successful strategy will, therefore mobilise the whole community.

For that reason, strategies that are co–created with staff and students from across the university are likely to be more realistic, relevant and effective^[12].

Co–creation can help ensure that the strategy has properly considered the needs and views of each area of the university and that the whole community has ownership from conception.

Charter participants highlighted that for a mental health strategy to be effective, it must be robustly informed by research, internal evidence and comprehensive evaluation of current practice. This must persist beyond the original drafting of the document, responding flexibly to new findings and understanding, to ensure the ongoing development of healthy environment, interventions, culture and support.

3) How well connected the strategy is to core university missions and whether mental health is also considered in other relevant strategies, policies and procedures;

If a strategic approach is to be genuinely embedded across the whole community, it cannot exist as a side consideration to core university missions. There must, instead, be a clear relationship between the core focus of an institution (e.g. teaching and research) and the mental health and wellbeing of staff and students. If core mission and the wellbeing of the community are not connected, then wellbeing will always be a secondary consideration, which may be sacrificed in pursuit of other organisational goals. Charter participants believed that when mental health and wellbeing are genuinely embedded this can be evident through the consideration of mental health in other strategy documents (e.g. teaching and learning strategies, workforce management strategies) and operational policies and procedures (e.g. disciplinary policies, complaints processes, mitigating circumstances arrangements and fitness for university life policies).

Students and staff in the consultations highlighted the importance of policies being designed with wellbeing in mind and ensuring that they do not disadvantage or pose a risk to mental health or those experiencing mental illness. This was particularly the case for policies that specifically address mental health in some way, such as fitness to study policies^[13, 14] .

4) Whether there is clear evidence of the strategy shaping day to day activity;

More important than the existence of a written document is that sustained, positive, cohesive change is underway and likely to continue in future. Some of this may be reflected in the day to day processes by which universities run and some in the behaviour of the whole community, in the soft gaps that cannot be covered by university governance documentation.

How staff and students feel, behave and how they respond to and communicate with each other are important elements in any successful whole university approach. While a healthy culture can be difficult to document and measure, it nevertheless remains an important aim of an effective mental health or wellbeing strategy.

Suggested resources

Universities UK – Stepchange: mentally healthy universities

References