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Leaving friends and family at home and building a new life in a different city can be tough – especially for the first time. Throw in the stresses of university work, and it’s little wonder that many students feel the strain. One in five students have a mental health diagnosis, according to a recent survey of nearly 40,000 students. Nearly half say they’re often anxious, and a third are frequently lonely. There’s no question that there’s a student mental health crisis on campus – the challenge is how to deal with it.
The obvious answer is upping the number of counsellors on campus, but with budgets tightening at lots of universities, this isn’t always easy. Sara Elkhawad, welfare officer at Newcastle University students’ union, says counselling will inevitably be underfunded. “We have 28,000 students, and only so many counsellors. Even if you increase the number of counsellors by 10, it’s only going to help a certain number of students.”
To plug the gap, a number of universities, including Newcastle, are starting to promote apps to help manage students’ mental health or offer support and guidance. But do they work?
Amelia Trew, student wellbeing officer at the University of East Anglia, believes the apps are “empowering” because they allow students to take control of their wellbeing in their own time. She encourages students to use different apps for different purposes: for instance, its in-house app OpenUpUEA is focused on wellbeing, while another, Enlitened, acts as more of an academic support service.
Lots of students have welcomed the additional support that apps offer. “It’s just a platform to express what you’re feeling in an anonymous way. I think of the app as a first step in getting help,” says Victoria Williams, an English student at Exeter University. “For some people, going to a wellbeing centre or speaking to a mental health expert can be quite daunting.”
Many students find this intuitive as they are accustomed to interacting with friends on their phones, says Elkhawad. Apps can also benefit autistic students, who can be more comfortable communicating through phones than face-to-face. “There is this narrative of counselling being the only way to [make] mental health improvements or better yourself, and it’s fundamentally wrong,” she says. “It’s really difficult speaking to someone you’ve never met before in your life about your personal issues.”
But some students are less convinced. “It’s quite patronising for people to assume [that apps are] how you tackle such a complicated and nuanced problem,” says Martha Griffiths, a University of East Anglia student who has experienced mental health problems. “When you come down to severe mental health crises, apps can’t help with that. They can’t give you what students need, which is actual contacts and serious support. It’s a great way of universities saying they’re doing something without addressing the serious problem.”
Til Wykes, professor of clinical psychology and rehabilitation at King’s College London, shares some of Griffiths’s concerns. “Many [apps] haven’t been tested in a randomised controlled trial,” she says. Indeed, a recent study by American and Australian academics found that only around one in 33 mental health apps had research to justify their claims of effectiveness. Just three in 10 claimed to have expert input in development, and only 20% were tied to a government body, academic institution or hospital.
Wykes believes that apps can have a place in monitoring and treating mental health, but that they should be in addition to, rather than in place of, more traditional counselling and advice services. “If you talk to people, they actually say they’re happy to interact with an app but not if that means they won’t have access to a person if they need it,” she says.
Part of the problem is that mental health apps are often developed by non-experts. Wykes worries that designers are driven by the wrong incentives: they want to find ways to keep people using the app, despite the fact that excessive phone use has been linked to mental health problems. She also worries that apps are often designed without consulting people who have experienced mental illness.
“It’s quite well documented in literature that many mental health apps don’t have that good evidence or peer-reviewed research to back up what they do,” admits Tim Rogers, clinical director at Big White Wall, which connects 25,000 students across 80 UK universities with peer support overseen by trained monitors. He adds: “However, that’s not universal, and things are changing.”
Apps are necessary, he argues, because of the strain on existing mental health services. For example, the NHS runs an Improving Access to Psychological Therapies (IAPT) programme to help people access to talking therapies. “One of the goals of IAPT is to reach about 25% of people who have a mental health problem,” says Rogers. “But what that means is 75% of people who have mental health issues don’t benefit from face-to-face talking treatment. Even if you threw all the money in the world at the problem, you’d need to find the right numbers of suitably qualified psychological therapists of different kinds, and that’s an issue too.”
Technology, then, can ease the problem – but it shouldn’t be the only solution. Elkhawad sees students coming in daily to access welfare and wellbeing services, and is generally sceptical of technological quick fixes. “It’s not a binary, one-or-the-other system of mental health support,” she says. “There are lots of options we should be promoting and investing in equally, rather than giving loads of support to one and nothing for the other.”
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