Oxford’s mental health care lottery

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A significant proportion of students who have suspended their studies for mental health reasons have expressed their dissatisfaction at the level of support provided by their colleges during their period of suspension.

In an investigation conducted by The Oxford Student, 72 percent of students indicated that they felt that they were not provided with sufficient levels of support during their period away from college. This contrasts with the average satisfaction levels of students with regards to the support provided by colleges during the process as a whole, taking into account their actions before, during and after periods of suspension when applicable, which gave a more sympathetic view towards college pastoral care.

21 students who have suspended their studies for mental health reasons responded to the survey. The Oxford Student was unable to calculate the precise sample size that this represents as, due to the decentralized nature of the process, there are no figures for the number of students who have suspended their studies for mental reasons currently at the University. The Oxford Student does know, however, that roughly 200 students per year suspend for both physical and mental health reasons.

Students were given the opportunity to indicate their levels of overall satisfaction with the standard of care provided by their colleges on a numerical scale, 1 being satisfied and 5 being dissatisfied. The average rating was 2.9. The responses to the survey are not, however, indicative of a homogenous experience, but rather highlight the wide disparities in student satisfaction.

The dissatisfaction with college support during the suspended period seems to stem from a lack of contact with the college during this time, leading to feelings of isolation amongst some students. One respondent stated, “I had almost no contact with college during my suspension, and I ended up feeling quite isolated from it. This made me very nervous about coming back.”

Another stated that “I had no contact with college, or my subject tutors, until I had to email my requirements to them, from which point onwards all contact has been largely negative.”

91 percent of respondents stated that no one was appointed to support them during their suspension, whilst 48 percent said that they received little or no form of support whatsoever.

A smaller proportion of students singled out difficulty in accessing college facilities as a reason for their dissatisfaction. 10 percent of respondents mentioned the exact word “unwelcome” in describing how they felt when returning to college during their period of suspension, however the survey reveals the striking differences in access to college facilities during the suspension period.

The survey also reveals the contrasting experiences of students both before their suspension period and upon their return to college.

25 percent of students said that their college was “fairly unsupportive” in re-integrating them upon their return to Oxford, whilst 38 percent described college as “unsupportive”.

A common theme in the responses describes the belief that colleges mistakenly assume that the returning student has completely recovered, sometimes leading to a lack of proactivity in re-integrating the student into their college environment. One student commented that “I think it would have been helpful to have more acknowledgement that I wasn’t completely fine, and that reintegrating was going to be really difficult. To some extent, I felt I had to put on a show of being completely recovered and immediately settled in order to justify my return; medically-proven recovery was, after all, in the conditions of my return.”

The fact that students are often required to be signed off by their doctors to prove that they are “medically fit to study” was picked up on by another respondent who argued that this “was unreasonable given that my diagnosis is chronic.”

43 percent of students said that they didn’t think that their college adequately understood the ongoing nature of their condition; with one commenting “I think that college could do with more education into the severity of depression and eating disorders.”

Some were sympathetic to the difficulties that colleges face in dealing with such a complex issue, with one respondent stating, “The diagnosis/diagnoses have morphed/multiplied almost constantly since sixth form, so I don’t think anyone can be criticised for not understanding what was actually going on.”

Once again, levels of satisfaction to colleges’ handling of students prior to their suspension was mixed, with some students offering high praise for their college whilst others were evidently deeply unhappy.

Some were keen to appreciate the efforts of college in offering them alternative arrangements to help them cope with their condition. “They put a lot of thought and effort into supporting me, including allowing me to rearrange courses and tutorials as I swapped between medications and tried to maintain a stable working environment. They did their best to work alongside my psyche team at the time and were looking for additional ways to provide support,” said one of the respondents.

Despite a healthy amount of positive feedback, there were still a number of students who were less than pleased with their colleges’ provision of care prior to their suspension. Respondents often cited the fact that colleges fail to initiate discussions even when they are aware that the student is having difficulties as an area that could potentially be improved. One commented, “they worked very much on the basis of me having to approach them. It is often very difficult when suffering mental health issues to reach out for help, and given that College were already aware of my mental health diagnosis, it would have been helpful for them to be more proactive rather than reactive.”

Confidentiality was also often mentioned as an issue, with one respondent stating, “My family were informed of events that I had explicitly requested be kept private. This was done with the very best of intentions, but nonetheless difficult.”

Others voiced their dissatisfaction more strongly. “They had no respect for me as a person at all,” explained one student. “They also played a part in making sure the entire college knew by telling my friends lots of stuff that I didn’t necessarily want them to know – the College head had meetings with them all about me without telling me – and the only reason I found out is because one of my friends told me.”

In response to the findings of the investigation, a University spokesperson stated that mental health care is a priority for the University: “We aim to provide, at both college and University level, some of the most comprehensive support systems of any university.

“Students with diagnosed and enduring mental illnesses can access study support from a team of specialist mentors – all of whom are qualified psychologists, psychotherapists, or counsellors – through the Disability Advisory Service.

“We look regularly at our welfare procedures and systems to see how they could be improved and we welcome all student feedback on their experiences, particularly when they have faced health challenges.

“On the specific question of informing families, students are adults and we have a duty to respect their right to confidentiality. University guidelines clearly state that we would only contact a student’s family, without a student’s permission, when that student had been assessed by a medical professional as lacking the capacity to make the decision for him or herself.”

What is most evident from the responses to the survey is the extreme differences in student experience and satisfaction across the University. Charlotte Hendy, OUSU Vice-President for Welfare, stressed the discrepancies apparent in the standard of care provided by different colleges. “This survey highlights the disparity between colleges when it comes to the facilities, services and support offered to students who suspend for non-disciplinary reasons. OUSU is currently working on this as a priority.

“On Tuesday, Rachel and I held a successful information and equipping evening for over 60 students who wish to begin conversations around this topic within their college. We are also currently talking to relevant staff from across the collegiate University to begin a dialogue around this issue, and to highlight areas where provision can be improved.”

The wide range of personal experiences and differing levels of support provided by colleges was an issue also recognised by the respondents themselves. One respondent was appreciative of their own experience but admitted that others may not have been quite so fortunate: “Overall my experience of college support during my rustication has been incredibly positive, and though I understand that some other students at my college have not had quite as much support as I have.”