Around 2015 the University seconded a Mental Health Advisor from the local NHS in response to increased mental health disability disclosures year-on-year, and increasingly complex mental health need.  Over the past 5 years our team has grown to four MHAs with a fifth MHA proposed as part of the Health & Wellbeing Strategy to develop mental health training across the University.  In 2017 we employed our first Psychological Wellbeing Practitioner (PWP), which was a big success.  With funding gifted from SU in Durham we were able to fund another PWP for a FTC of 2 years (now extended to 3 years) from August 2019.  Within this funding we have also been able to employ on another FTC 2 part-time counsellor posts (also extended to 3 years).  The provision of specialist counselling for students who have experienced sexual assault has also been increased over recent years.  We are very grateful to RSACC for continuing to provide this within our service.

The ‘Counselling Service’ comprises three separate teams of professionals. Students can self-refer to Counselling (which includes PWPs) and they will be triaged to the most suitable team; the Mental Health Advisors only accept referrals from University staff. MHAs cannot provide treatment, as we have no medical or multidisciplinary support, but offer advice to students with diagnosed and undiagnosed mental health difficulties which are complex, enduring and/or present possible risks to the student or others.  The MHAs are attached to Colleges and:

• Liaise with local and students’ home NHS services to help students access specialist support
• Assess students’ fitness to return to study after a break, for professional course requirements; they also assess students’ fitness to go on field trips and other offsite activities and help them to plan necessary support
• Coordinate University support for students with complex needs; the MHAs carry small caseloads of students needing ongoing support; this may be regular or as needed through their time at Durham.

The Psychological Wellbeing team offers information and guidance on self-help resources available to students to help them manage their own psychological wellbeing. These resources include: Apps, Self Help Guides, Webinars, Support Groups. It is the role of the Psychological Wellbeing Practitioners (PWPs) to help students identify the resources most appropriate to their needs and to keep in touch to monitor their progress and wellbeing.

• PWPs are available for 15-minute online Guidance sessions for information on the above resources and signposting to other services.
• PWPs also offer 30-minute initial consultation to discuss students’ needs in more detail, to offer psychoeducation on mental health difficulties like anxiety and low mood and to discuss supported engagement with the online cCBT programmes SilverCloud.

The main difference with counselling is that counselling sessions may be appropriate when students are ready to commit time to develop insight into longer-term difficulties and work towards change. PW support focuses mainly on psychoeducation and coping strategies.

There is a 6 session cap for counselling sessions as research shows that 4/5 sessions is the optimum level of appointments for real change to take place.  From our own data collection for many years before the cap was introduced, the average number of sessions each year landed around the 4.5 – 5 mark.  Such a cap is also used to provide a more equitable service that is more easily accessible to all who need it.  If no cap existed, those students who approached the service first would receive all the help they need, causing gridlock for those students approaching the Service later in the term/year.  This way, all students who wish to access Counselling will be able to do so.

For the majority of students using the Service, up to 6 sessions is usually enough for them to get the appropriate help they need.  Many who work with the PWPs and Counsellors don’t need more than 1-3 sessions.  Occasionally there are students who would benefit from further work beyond the scope of the Counselling Service.  Here we would support a student to get further ongoing support, either through another organisation, the NHS, or if they have the means to help them with choosing their own private therapist (we do not recommend therapists).

The PWP team tend to work with a lower intensity range of presenting issues, and they may refer on to Counsellors if it is indicated that a talking therapy is more appropriate after initial consultation.  Counsellors work with a varying intensity of presentations and are trained and skilled in working with higher intensity needs.  However, ethically we need to consider that the work undertaken in a time-limited way is appropriate.  If much longer-term work or NHS input is needed then Counsellors or MHAs can support the students to access this help.

The additional things that MHAs and PWPs do have already been covered.  Counsellors in addition to 1-1 sessions occasionally offer an opportunity for a house group to have a one-off debrief session if they have all been affected by the same issue/concern.  Mainly however, the other main offering from Counsellors is group support.  We have several groups running this term: Hearing difficulties; Long Term Physical Health Conditions, PGR, Bereavement.  We are always willing to consider the viability of any groups and have tried to run groups for Carers, Student Parents and International Students.  The uptake for these unfortunately wasn’t enough to sustain them or make them a useful resource for such few numbers.  If there is the interest in the student body, and the skills in the team, we are happy to consider any group topic.

We currently have one BAME counsellor, we have had a BAME counsellor previously too.  We actively encourage applications from under-represented groups whenever we recruit into the Service, and will continue to do so.  

The MHAs are responding to increased need by focussing on priority areas of complex case-management and supporting College and academic department staff with students of concern for example by arranging increasing numbers of informal support meetings to coordinate University support around a student with mental health difficulty.

During this particularly difficult time we have been able to employ more Counsellors on short-term contracts to help with the increased demand.  The whole Service seeks to be innovative in their approach to what we can offer that will meet the needs of all students requiring professional support, e.g. Groups, as described above.  We are open to students’ ideas of what may be helpful, within the limits of our abilities and resources.  We are extremely grateful for the additional resources so far given by the University to support students during the pandemic, but realise that resources can’t just keep growing indefinitely.  We need to think creatively and innovate. 

PWPs have provided more webinars, more online resources and the modules on SilverCloud keep expanding, all of which meet a great need.  Not all students want face-to-face counselling as a way to get the help they need.

When a student uses the service for Counselling or PWP support, they are sent a link to give feedback on their experience.  We encourage this, but response rates aren’t high.  We appreciate students have a lot to do without completing another task!  However, for students who haven’t used the service if they have any ideas or want to check things out they can email COUNSEL-SERVICE C.N. counsel.service@durham.ac.uk and emails will be forwarded to the management team.