Challenges to addressing student mental health in embedded counselling services: a survey of UK higher and further education institutions

Figures & data

Table 1. Duration of existence of embedded counselling service (in years).

Sector & size	Duration of existence of embedded counselling services (years)
	N	Mean	SD	Min-Max
HE	65
Small	22	20.23	11.25	2–50
Medium	22	27.29	9.42	14–48
Large	21	28.43	9.23	8–46
FE	37
Small	14	14.32	6.90	2–25
Medium	13	16.20	3.99	9–23
Large	10	17.44	5.15	12–26
SFC	11
Small	4	13.50	6.02	7–20
Medium	4	11.50	6.58	3–18
Large	3	18.67	7.09	11–25

Table 2. FTE of therapeutic staff across HE, FE and SFC counselling services.

Service size	N	High-intensity	Low-intensity	Groupwork	MHA	Unpaid	Total
HE
Small	18	1.86	0.09	0.08	0.95	1.37	4.35
Medium	19	3.71	0.43	0.01	1.92	0.62	6.69
Large	18	4.38	0.32	0.00	1.86	1.35	7.91
Total	55	9.95	0.84	0.09	4.73	3.34	18.95
FE
Small	11	1.11	0.09	0.12	1.00	0.13	2.45
Medium	10	0.93	0.44	1.11	0.76	0.63	3.87
Large	9	1.08	0.00	0.00	–	0.37	1.45
Total	30	3.12	0.53	1.23	1.76	1.13	7.77
SFC
Small	3	0.75	0.00	0.00	–	0.20	0.95
Medium	4	0.37	0.00	0.00	–	0.69	1.06
Large	3	1.00	0.00	0.00	–	0.22	1.22
Total	10	2.12	0.00	0.00	–	1.09	3.23

MHA = Mental Health Advisor defined as ‘someone whose specific role is to assess the impact of mental health needs on academic ability and provide information about mental health issues and the services/support available’. Missing data (HE: small = 4; medium = 3; large = 3; FE: small = 3; medium = 3; large = 1; SFC: small = 1; medium = 0; large = 0).

Figure 1. Three-year trend of student referrals for higher education, further education, and sixth form college counselling services (n = 92). *SD (HE: 2011/12 = 258; 2012/13 = 291; 2013/14 = 613; FE: 2011/12 = 54; 2012/13 = 72; 2013/14 = 98; SFC: 2011/12 = 33; 2012/13 = 38; 2013/14 = 42).

Table 3. Percentage of student referrals for mental health support at HE, FE and SFC counselling services.

	N	Percentage of student referrals
		Assessment only^a	High-intensity	Low-intensity
HE	52
Small	16	6.5	81.7	11.8
Medium	18	15.5	69.6	14.9
Large	18	8.7	82.3	9.0
FE	20
Small	7	10.7	85.9	3.4
Medium	7	13.4	86.6	0.0
Large	6	7.0	93.0	0.0
SFC	7
Small	2	3.7	96.3	0.0
Medium	2	7.3	91.0	1.7
Large	3	0.0	100.0	0.0

^aThe ‘assessment only’ category does not include students who scored below the cut-off to receive counselling (i.e. high-intensity) as those students have been included in the low-intensity group. Moreover, for services that included the assessment in the first counselling session, respondents were instructed to only include students that did not go on to receive counselling. Missing data (HE: small = 6; medium = 4; large = 3; FE: small = 7; medium = 7; large = 6; SFC: small = 2; medium = 2; large = 0).

Table 4. The typical and maximum number of attended counselling sessions recorded in 2013/14.

Service	Typical attended sessions (n)				Maximum attended sessions (n)
	N	Mean	SD	Min-Max	Mean	SD	Min-Max
HE	60
Small	20	4.40	3.17	1–12	24.50	7.50	12–34
Medium	19	3.15	1.64	1–6	22.92	10.76	6–46
Large	21	3.29	1.64	1–6	23.20	6.74	11–36
FE	31
Small	12	3.62	2.04	1–7	20.29	5.90	16–32
Medium	10	3.40	2.30	1–6	17.21	9.33	8–32
Large	9	4.20	2.17	1–6	28.25	11.50	14–39
SFC	6
Small	3	5.50	6.36	1–12	25.50	7.78	20–31
Medium	2	4.75	2.36	1–7	25.00	10.23	10–32
Large	1	3.00	na	1–6	na	na	na

Missing data (HE: small = 2; medium = 3; large = 0; FE: small = 2; medium = 3; large = 1; SFC: small = 1; medium = 2; large = 2).

Table 5. Wait period (in working days) for the initial assessment and between ongoing counselling sessions in higher education, further education, and sixth form colleges.

Service Size	N	Initial waiting period				Ongoing waiting period
		Mean	SD	Min	Max	Mean	SD	Min	Max
HE	57
Small	19	6.83	4.56	2.00	18.00	17.64	10.48	18.00	33.00
Medium	18	6.74	2.78	3.00	12.40	16.57	8.51	12.40	34.00
Large	20	6.14	3.59	0.00	12.50	16.97	13.90	12.50	43.59
FE	29
Small	13	8.05	3.83	4.00	13.20	8.58	3.53	13.20	15.00
Medium	9	9.12	4.80	4.00	13.50	17.50	6.61	13.50	25.00
Large	7	6.36	1.67	4.80	8.00	10.98	9.46	8.00	27.50
SFC	5
Small	3	7.50	3.54	5.00	10.00	20.00	14.14	10.00	30.00
Medium	2	7.63	4.39	3.00	12.50	8.00	2.65	12.50	10.00
Large	0	–	–	–	–	–	–	–	–

Missing data (HE: small = 3; medium = 4; large = 1; FE: small = 1; medium = 4; large = 3; SFC: small = 1; medium = 2; large = 3).

Figure 2. Use of alternative support in higher education counselling services. A = Small services (n = 18); B = Medium services (n = 20); C = Large services (n = 20).

Table

Term	Definition and additional information provided
1. Counselling	The questions in this survey refer to the academic year 2013-2014, unless otherwise stated. For any questions which refer to “counselling” such as “counselling staff” or “access to counselling services”, please include information on psychotherapy unless it has been explicitly stated to be separate. Thank you for your time and cooperation for completing this survey.
2. High intensity	Counselling, psychotherapy, CBT, therapeutic group work
3. Low intensity	Psychological Wellbeing Practitioner, wellbeing workers
4. Groupwork	Psychoeducation, healthy campus, education, low intensity groups
5. Full-time equivalent of therapeutic staff	Therapeutic contact including supervision is assumed to be 25 hours per FTE staff member. To calculate the contribution of volunteers (including their supervision) is; 3 hours = 0.12; 3.5 hours = 0.14; 4 hours = 0.16; 4.5 hours = 0.18; 5 hours = 0.20; 5.5 hours = 0.22; 25 hour week = 1 FTE
6. Mental Health Advisor (MHA)	For example someone whose specific role is to assess the impact of mental health needs on academic ability and provide information about mental health issues and the services/support available
7. Number of referrals to counselling; How many students used your service and attended at least one counselling session?	Including drop-in, self-referral, and excluding partner institutions
8. Unattended counselling sessions	Sessions in which the student did not attend or cancelled after referral
9. Waiting period for assessment after first contact	Not including emergency/crisis counselling