In 1998, the University of Leicester’s Educational Development and Support Centre undertook a major survey of the psychological well-being of Leicester students, and of their help-seeking behaviour. The primary purpose of the survey was to inform the activities of a HEFCE-funded project that aimed to enhance and further develop existing provision for students experiencing mental health difficulties and to raise awareness, knowledge and skills of the university community. The driver for the project was the increasing concern being expressed both locally and sector-wide, about the possible increasing incidence of mental health difficulties amongst the student population.
The framework for the project was the whole institution and not just those who were service users: the focus was on the higher education environment, not the ‘condition’. The hope was that by improving our understanding of the pressures of university life, and of the concerns and behaviours of all students and all staff, we would be able to begin to improve the learning environment, and be better able to support those in greatest difficulty. The first major task was thus to design and administer a questionnaire.
An extensive literature review had indicated that very few broadly-based student surveys had been undertaken, although there had been a number of studies of specific issues such as drug use, alcohol use and eating disorders; medical students in particular had been the subject of a many enquiries. One exception is a survey undertaken at Columbia University in the US in 1986 and 1988, and although the time gap and the many differences between the UK and the US systems were acknowledged, it was felt that it was important to be able to provide some context for our study, and a basis for comparison. Thus one section of our questionnaire was based on the Columbia survey instrument (with some very minor changes); this section listed 61 issues covering personal, academic, career, general, psychological and sexual health and family matters and asked respondents to indicate the extent to which each issue had an impact on their own stress levels on a scale from not-important to crucially important. The other sections addressed alcohol and drug use, eating disorders, and help-seeking; extensive biodata were also collected. The Brief Symptom Inventory, a self-report instrument that has been extensively used to provide an initial evaluation of a range of mental health problems, was also included with the Leicester questionnaire.
The survey was piloted on a small group of students, and then administered in lectures in the spring of 1998. This involved significant amount of co-operation from staff, and were very pleased with their positive responses and with the level of support they gave in organising what was a very complex process. This method of survey administration ensured a very good response rate of approximately 80 percent (n = 1620) from the target audience – all full-time second year students, and select groups of 1st, 3rd and taught postgraduates. In the same year, a brief postal survey of staff was undertaken, focussing on their experiences of, and reactions to, students in difficulties. After an initial analysis of the student survey data, we commissioned an experienced market researcher to run focus groups with students who had expressed a willingness to be contacted for further information; four sessions were held with a total of 30 participants.
In the spring of 2001, the student survey was repeated using the same instrument (with a small number of very minor changes) and the same methodology. On this occasion the target audience was exclusively 2nd year students, and a response rate of just over 80 percent was achieved (n = 1118). Later in the same year, a very slightly adjusted version of the questionnaire was sent by post to all registered full-time research students. Inevitably, the response rate was much lower (30 %): responses were received from 118 students.
The results
These surveys have generated a significant amount of data, of which only a small part can be reported on here. I shall focus on a number of key issues – see slides.
Basic summary reports are available from the project web-site: http://www.le.ac.uk/edsc/sphp but I shall cover some areas not reported in detail here.
I will then briefly touch on the ways in which our research informed our practice.
ã Annie Grant 2002