Mapping patterns of inequality in students’ access to mental health services in London

There has been a fivefold increase in the number of students declaring a mental health difficulty to their institution over the last decade, leaving student services struggling to meet demand. There is universal concern about the increasing prevalence of suicide and self-harm in this demographic group. It is likely that problems accessing appropriate mental health care are not borne equally across the student population in London, but this question has not yet been investigated.

This PhD project explored whether mental health services in London are meeting the needs of university students, and identifying whether service provision could be improved, and if so, how this might be done. Qualitative interviews with students and professionals were conducted, and data from a UK population cohort dataset was used to address this aim.

The mental health of students in higher education institutions (HEIs) in the UK is a pressing public health concern. Growing alarm surrounds the escalating prevalence of mental disorders, and challenges in obtaining appropriate mental health care among this demographic. A rigorous pragmatic mixed methods study was conducted to gain insight into the UK context, where research is limited.

The findings suggest while access to relevant healthcare has perhaps advanced for students with common mental health issues, it has deteriorated for those with severe mental health challenges, certain international students, and those from select 'non-traditional' backgrounds in recent years. Results have been disseminated in academic journals and conferences, and to stakeholders in London universities.

This evidence has informed the development of the university’s integrated whole-organisational approach to mental health. Its implementation will be studied to understand what transferable lessons can be learnt for other organisations aiming to address mental health problems.

The research has made a significant impact, directly influencing policy, service development, and wellbeing strategies across the higher education and healthcare sectors.

The findings have shaped UCL's new organisational wellbeing and mental health principles, which affect more than 50,000 students and staff. These principles have set a foundation for developing university wide principles for mental health including better mental health awareness, support, and innovative interventions within the institution, creating a healthier and more supportive environment for the entire university community.

Furthermore, the research results played a vital role in the establishment of UCL's NHS University Clinic, which now serves hundreds of students annually. By shaping the development of this clinic, the research has contributed to bridging the gap between university mental health services and the NHS, offering a service tailored by student preferences made easily accessible care to students in need a reality. This clinic has become a crucial resource for addressing the mental health needs of students within the university setting, ensuring that they receive appropriate care when and where it is most needed.

The study’s influence extends beyond UCL. It was also instrumental in shaping the London School of Hygiene and Tropical Medicine's (LSHTM) ‘Pentacell’ wellbeing strategy. This strategy benefits more than 250 students each year and has been recognised for its success, receiving multiple awards, including two CASE Circle of Excellence Awards for volunteer and student engagement. This ongoing initiative highlights the tangible, positive effects of the research in promoting student wellbeing, offering a model for other institutions looking to improve their mental health provisions.

On a national level, the research has informed the forthcoming guidance from the Government's Higher Education Mental Health Implementation Taskforce. This guidance is expected to benefit 167,580 students (5.7% of the UK’s higher education population) who report mental health conditions. By contributing to this high-level policy work, the research has had a direct impact on the development of strategies that could reshape how mental health services are delivered across the UK higher education sector.

The researchers continue to collaborate with the Taskforce, offering technical advice on student mental health and implementation research. This ongoing involvement ensures that the findings remain relevant and continue to shape future national policies and interventions. The research has thus far contributed to meaningful changes within institutions and beyond, ensuring that students’ mental health needs are met more effectively. The real-world application of the research has created long-lasting benefits, improving both policy and practice in student mental halth care.