There has been understandable concern about the increased number of suicides among university students and whether higher education institutions are providing sufficient support for students with mental health issues. According to figures from the Office of National Statistics, the number of student suicides in England and Wales almost doubled between 2007 and 2017 (from 75 to 134), with a record number of students taking their lives in 2015. Dr Ian Marsh, a Senior Lecturer in the School of Allied Health Professions, talks to Inspire about some new University initiatives aimed at safeguarding students from the risk of suicide and discusses his own academic work focusing on suicide prevention.
Prior to his academic career, Ian worked in an NHS community mental health team. He is academic lead for the Kent and Medway Suicide Prevention Steering Group, and has worked with local prisons, schools, mental health services and many other statutory and non-statutory services on prevention initiatives and staff training. He explains the background to the worrying situation which has prompted universities to take a more active role in the promotion of students' mental health and wellbeing: "There have been several national newspaper stories about universities that have had a number of student suicides. For example, York, Bristol and Cardiff have been in the news recently following a series of student deaths. I think that universities across the whole higher education sector are becoming more aware that suicides among their students is an issue that needs to be addressed."
"There have been several national newspaper stories about universities that have had a number of student suicides."
Universities are actively engaging with the problem and establishing their own strategic responses, including here at Christ Church: "Lots of universities are waking up to this as an issue. A recently published think tank report by the Institute for Public Policy Research explored the increase in demand for student mental health support services, the rise in student suicides and the fact that some universities are starting to think about prevention/awareness strategies.
"At Christ Church, we are working in partnership with the University of Kent, and the universities' respective students' unions, to provide a Suicide-Safer Community approach. Strongly supported by the Vice-Chancellor and the Senior Management Team, it's a university-wide initiative involving not just student support and wellbeing services but every student-facing role.
"We have established an external strategic group, which will work across the two universities and students' unions. The group will be chaired by Professor Helen James (Senior Pro Vice-Chancellor, Education, Enhancement and Student Experience) and involves partnering with a range of external stakeholders, including among others, Canterbury City Council, the Samaritans, Kent and Medway Suicide Prevention Group and Kent Police. We've also set up an internal implementation group, which will ensure we work across the University and Students' Union in co-ordinating our practical responses to this important agenda.
"I think universities have become much better at recognising the problem…"
"The Suicide-Safer Community project has been launched to tie in with the awareness raised by national events, such as World Suicide Prevention Day and World Mental Health Day, and there have been a number of activities taking place at the start of term, with more planned throughout November. The project also ties in with the University's approach to mental health for staff and students, which includes raising awareness of mental health, supported by the roll-out of mental health first aid training and specific suicide awareness training for staff and members of the Students' Union. Making staff and the Students' Union more aware of the risk of suicide and providing training on mental health issues can both be seen as suicide prevention measures. We've developed a It's Safe to Talk about Suicide leaflet and the local Samaritans' branch have offered to provide additional support in the event of a student death. So there is work going on in terms of awareness, education, training, and support for students and staff."
Ian's personal inspiration for working in this field stretches back to his time working in community mental health: "After my first degree at the University of Hull, I trained as an occupational therapist in Derby. I was originally from the North Kent/South London area and came back to work here after my training. For 10 years I was employed within a community mental health team in Faversham, which involved working with people with long-term mental health issues and also people with anxiety and depression and those in crisis. I became very interested in suicide prevention through my role in the team. It used to puzzle me that suicide was seen as primarily a psychiatric issue when lots of service users I encountered framed the issue very differently – they would talk about making a rational decision to die in the context of experiencing a lot of suffering in their lives. That's how I developed an interest in suicide prevention.
"I did a Master's degree in Psychological Counselling and my thesis looked at clinicians' experiences of working with suicidal people and the effects of a client suicide. I then undertook a PhD focused on how thinking has changed about suicide over time. Until the 19th century, suicide was seen as a sin and a crime. However, it then became medicalised, which considerably changed the way we think about suicide and continues to influence what we do now. My PhD thesis was published by Cambridge University Press, which meant it received some international recognition and that put me in touch with lots of other researchers in the discipline from all over the world.
"We want to work better with our local mental health services, GPs and primary care providers to ensure we have the best joined-up support for students in crisis."
"Since my PhD, the primary focus of my research has been the exploration of critical perspectives on suicide. I have been working alongside anthropologists, historians, psychologists and psychiatrists, as well as social justice activists and people who have had their own experiences of suicidal thoughts or attempts, or who have been bereaved by suicide. It's very broad and interdisciplinary. Last year, we published the book Critical Suicidology and recently PhD student Annie Hayford and I organised a conference at Christ Church to explore current research on suicide prevention, which had 44 presenters from 14 different countries, so it was very international. From that conference, there is another book in development called Suicide and Social Justice."
Ian teaches on the undergraduate degree in Occupational Therapy and also teaches students in Health Promotion and Clinical Psychology at the University's Salomons Centre for Applied Psychology. In addition, he offers advice and training to other groups: "I provide suicide prevention training to the paramedics and have been working recently with adult nursing staff around self-harm and suicide."
Despite the clear challenges, Ian feels that universities are starting to make tangible progress on this most pressing of issues: "I think universities have become much better at recognising the problem and those in student-facing roles are now more aware, so that if there are concerns about students who are feeling isolated or are struggling, they may be able to offer more support. We obviously want to help students in distress and have services that are responsive to student needs. As well as increased awareness and training for University staff, we want to work better with our local mental health services, GPs and primary care providers to ensure we have the best joined-up support for students in crisis."
Images: Jason Dodd