What role should staff play in preventing student suicide?

The debate surrounding a “statutory duty of care” for students in universities can be frustrating – because it is often framed alongside notions that students aren’t adults, and that universities (and their staff) should act as parents.

So a coroner’s report into the suicide of a student at Southampton University is important reading – because while it stops short of recommending “in loco parentis”, it does raise questions about the “awareness, understanding and curiosity” of academic staff around the mental health of students.

Acute anxiety

Matthew Wickes was an an engineering student who died by suicide in June 2022. The inquest in Winchester concluded that he died by suicide while suffering from an acute anxiety crisis.

Wickes was a third-year student who had been struggling with the pressures of study following successive lockdowns, as well as suffering from long Coid. He was also neurodiverse – something that he’d not disclosed formally to the university.

In this case the coroner issued a statutory Prevention of Future Deaths report on the basis that there is a risk that future deaths could occur unless action is taken.

In the report Christopher Wilkinson accepts that Wickes’ condition was not known by the university. Like so many students he was diagnosed after he began on his course, and did not disclose his condition to the university – and so formal codified reasonable adjustments were not able to be put in place.

Wilkinson doesn’t make any explicit recommendations around encouraging disclosure – although OfS’ revised guidance for the preparation of Access and Participation Plans in England this year very much does.

I’ve also been interested to read about some of the recommendations coming from the two National Unions of Students in Finland, who are calling for mandatory mental health “check ups” on entry to university to be delivered in partnership with the country’s student health service both to help catch issues earlier, and signal the support that is available and the approach that would be taken if a student does become, or comes to a realisation that they may be, disabled.

Capacity to notice and respond

But despite the lack of disclosure, Wilkinson does raise concerns about the “level of awareness, understanding and curiosity” of academic staff around the mental health of students – particularly in the post-pandemic climate – where “interruptions to their study and dysregulated student life have had a significant impact on their mental health”.

The message seems to be – it was likely that there would be significant, long lasting mental health impacts from Covid and its lockdowns, which ought to have generated a strategic response in terms of staff capacity to recognise them.

Many now feel that Covid is in the past – but again, OfS’ revised guidance for APPs makes a similar point. It already said that it expected providers to consider how they can improve the mental health of their students – and there are now explicit lines on addressing known intersectional gaps in the likelihood of declaring mental health conditions, and addressing how poor mental health outside of a declared condition may affect outcomes for specific groups of students differently – and taking action accordingly.

Understand at scale, and act at scale, is basically the whole ethos of the “risks to equality of opportunity” aprioach.

There is a thread in this and similar cases that is about capacity to “notice”. Wilkinson noted the university’s processes for “raising a concern” by academic staff through student hubs, and the university talked in the inquest about a new “early warning system” involving triggers around academic absence or changes in study or support behaviours. But Wilkinson’s worry was more basic:

I am concerned that in not ensuring that academic staff are at least armed with the ability to spot or to know when to make initial enquiries of students or are clearly guided on how best to do so (particularly with regard to an understanding of the needs and skills required to liaise with students with neurodiversity), there is a risk that an over-focus on academic policies and procedures will endure and that those students who are struggling to adhere to them will be missed or overlooked.

For example, during the inquest the university had said that all staff were offered training on mental health management and provided with guidance on how to support students. But Wilkinson said:

I am concerned that aspects of this are not made compulsory for academic staff … It remains unclear as to who or how many staff have actually viewed or undertaken the online training around student mental health.”

This goes right to the nexus of staff fears where pastoral support is concerned. On the one hand staff may feel inequipped, that they were not employed to undertake that kind of spotting role, and will not want to be blamed for not spotting a problem.

But while the coroner isn’t saying that all staff or all personal tutors should be counsellors or mental health experts, he is effectively saying that all students ought to be able to expect that the staff that teach and support them have a basic level of awareness and competency over student mental health.

It’s hard, here in 2024, to disagree – however alien to the traditions of staff development that such a notion might be in some universities. The “noticing” thing, and making adjustments without a disclosure, are also crucial components in the Abrahart case, which was in the High Court just before Christmas and will produce its judgement soon.

Perhaps inevitably, Wilkinson doesn’t get into the capacity and workload issues that face staff. They are important, and plenty of staff will argue that they are a barrier. But there’s an important differentiation to be made between that and what is still about a debate about the role of staff.

Wider issues

As well as the academic support issues, I’d add the mental health considerations for teaching and assessment. Mental health can still tend to be seen as “extra curricular”, a notion rightly coming under increasing scrutiny. Advance HE’s excellent Education for Mental Health Toolkit challenges it well.

Even if an issue is identified, Wilkinson identified concerns with the interventions in place (particularly for neurodiverse students given an apparent focus on group based interventions) and also discussed concerns over the existence, frequency and accuracy of the recording and minuting of academic meetings with students:

It was of concern to me that the university was unable to locate or provide clear minutes of supervisory catch ups, progress checks or agreed guidance or actions for Matthew. It was of further concern that the academic staff supporting and mentoring him in his third year had not provided written evidence of his progress or agreed minutes of actions etc to him.

Those concerns, again, go to the heart of the debate – Wilkinson isn’t suggesting that academic staff treat students as teachers would in a school, but clearly is nudging towards systems that better manage support and progress of students:

Whilst it is recognised, particularly in a third year of study, that there must be a balance between independence and appropriate support, it would in my view be important for any student and university academic team to have a clear record of achievement or progress. This must be able to be reflected back to the student and recorded in such a way as to ensure that both student and tutor are clear and agreed as to progress that has been achieved and as to what needs to be done to move forward. The absence of such information and appropriate support, which can lead to feelings of isolation and desperation, must be avoided at all costs.

Can we afford it? Can we afford not to?

Parts of the sector will worry that resourcing can’t match expectations implied here as additional expectations on staff, especially with industrial relations and funding in such a parlous state. That is a crucial question – as are early warning systems, reasonable adjustments, encouraging disclosure and intervention design.

I also wonder whether models that change or enhance support for individuals fail to recognise the way in which traditional ideas of achievement, competition and academic culture – especially in the Russell Group – are just not viable in an age of increasing (and increasing awareness of) neurodiversity.

But it seems to me that the essential debate that the sector needs to have is what it thinks HE academic staff need to be able to understand – and whether, on balance, the “awareness, understanding and curiosity” of academic staff in general over mental health ought to reach a minimum standard.

If yes, questions of resourcing and making staff training do come into sharp focus. If no, we will need systems that deliver this kind of support in other ways – perhaps through coaching models that are separate from academic teachers and teaching. Either way, the unspoken model of the all-round “amateur”, combining teaching, research, supervision, pastoral support and external engagement, feels increasingly problematic and dated, however fondly regarded.

As I noted here last year, one of the things that links conclusions in these cases is a reach by coronors for “someone” to notice and act when a student is struggling in a context of more Disabled students, less “immersed” student experiences, growing support needs and creaking workloads.

If I’m right – and those reaches are based around coroners’ experiences of (much) low(er) staff student ratios of the past – in a mass age HE will need better and more radical alternatives than learner analytics and more compassionate comms.

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A University of Southampton spokesperson said:

We were all deeply saddened by Matthew’s death and our thoughts remain with his family, friends, and all those who knew and loved him.

We hear and understand the coroner’s concerns and are committed to providing our students with what they need to feel safe and supported during their time here.

A new system to identify changing patterns of attendance at timetabled taught sessions is now in place and this will help us identify those students who may need further support.

There is more work to do and we will make sure that our wellbeing support continues to evolve and improve.