"Leaders of schools, colleges, universities and community organisations [to] take a whole organisation approach to the mental health of their students, young people and staff, so that it permeates every aspect of their work and is embedded across all policies, cultures, curricula and practice."
2035 Vision, Children and Young People’s Mental Health Coalition
The development of a whole university approach to mental health is informed by frameworks for health promotion including the Ottawa Charter, the Okanagan Charter for Health Promoting Universities and Colleges, 2015 and the Healthy Universities framework. The last of these, developed in the UK with support from the Higher Education Funding Council of England, aspires to create: “a learning environment and organisational culture that enhances health, wellbeing and sustainability”, an approach to make the setting itself a healthier place for people to live, work and play, combining healthy policies, in a healthy environment with education programmes and initiatives.
The whole university approach also refers to current initiatives in schools and colleges specifically related to mental health and wellbeing. An early review of evidence on the whole school approach to mental health suggested that effective programmes are “likely to be complex, multifactorial and involve activity in more than one domain.”1 Further reviews of the evidence in schools and colleges have reinforced the finding that isolated interventions or services are inadequate to address the ‘wicked’, multifactorial challenge of mental health. The model for educational settings has more recently been further detailed with frameworks for implementation in for example Public Health England’s work with the Coalition for Children and Young People’s Mental Health Promoting children and young people’s emotional health and wellbeing: a whole school and college approach (2015). Government policy has adopted the whole school/whole college approach to mental and emotional health in schools with the Children and young people’s mental health and wellbeing taskforce (2015) identifying a national commitment to “encouraging schools to continue to develop whole school approaches to promoting mental health and wellbeing”. This is reflected in National Institute for Health and Care Excellence guidelines and Ofsted inspection requirements. The Green paper on Children and Young People’s Mental Health due at the end of 2017 will seek further implementation of this model.
Finally the whole university approach looks to models of psychosocial education such as Positive Education which has been defined as ‘education for both traditional skills and happiness’.2 Positive and other psychosocial approaches emphasise the importance of learning environments in the acquisition of emotional skills including Seligmans five routes which include meaning, relationships, positive emotion, accomplishment and engagement alongside knowledge and technical skills. Positive university models have sought to apply positive methodology across the various environments of a higher education institution: learning, social, community, faculty and administration and residential. Further information is available from the International Positive Education Network.
Mental health in higher education has multiple determinants and consequences. It constitutes an increasingly complex challenge for leadership, a matrix of risk, regulation, emergent policy and opportunity, arguably no longer susceptible to conventional planning and delegation.
Adoption of a whole university approach requires strong and strategic leadership, engagement of multiple constituencies and partners and sustained prioritisation. It asks universities to reconfigure themselves as health-promoting and supportive environments in support of their core missions of learning, research and social and economic value creation and to embed this across all activities.
Most importantly it entails a joined up approach to transform cultures and embed mental health initiatives beyond student services.
The UUK model describes four domains:
COMMUNITY: Empowering communities, and promoting community awareness and cohesion are central to health promotion. Involve students and staff in all stages of the improvement journey, recognising the importance of peers and colleagues, joint development of activities and resources, transparency in decision-making and evaluation.
LEARNING: Curricula and teaching practices have a significant impact on mental health. Introduce learning communities to foster connectedness and motivation, enhance the role of the personal tutor, offer flexibility in course design and assessment and in adjustments all to understand and support the needs of diverse students. Encourage regular feedback on learning and academic practice including the use of analytics should reinforce the connection between students and staff.
LIVING: Social, physical and digital environments all bear on mental health. Regularly audit and enhance these environments in order to regulate, support and improve healthy cultures within them. This includes policies on respectful communications, discrimination, harassment, behaviours, consideration of physical space and built environment, support for activities including sports and clubs, liaison with local community, businesses and residents.
SUPPORT: Universities already develop and resource a range of support services appropriate to the needs of students. Regularly review these to ensure they meet the needs of those experiencing mental health difficulties, provide access to appropriate services, signpost advice on other issues such as finance or housing, and link effectively with academic policies.