Young and carefree? The students living with mental illness

Below is an article I wrote in May/June last year, so forgive any outdated references and ages.

Unfortunately, I was unable to get this article published in the national press, which is a shame.

It's far from perfect, but I hope that even in this small way of being published on this small blog, it can do a bit of good in decreasing stigma and opening eyes.

IB

Young and carefree? The students living with mental illness

Hayley-Dawn Tearall speaks with a maturity beyond her years, despite being just 18 years old. But her sunny smile and matter-of-fact manner hide a secret. Since the age of 12, Hayley has suffered from clinical depression. In only January this year, she attempted to take her own life.

“It wasn’t a big plan, it was quite spontaneous. I have made plans before but haven’t acted them out. Some days I’ll sit and plan my funeral and think about what I’d want to happen to make things easier for my family,” Hayley says.

A stack of A-level revision notes lie by her chair in the Sutton café where she works, and where we meet to talk about her experiences of mental illness.

“When I was younger, about 12, I used to think about it a lot. I’d think, I want to die. I used to have a journal and the amount of times I had written those words in it... But when you’re 12, it’s not easy to do.”

Hayley did not need to go to hospital after taking an overdose that January afternoon and for months, she kept the secret between herself and her GP.

“I felt there was a massive overreaction because nothing had actually happened. My GP responded quickly and was very helpful but I wasn’t 18 at the time so he couldn’t really do anything,” Hayley says. She is not upset or emotional in any way, chatting as if we are just talking about a bad day at school.

“My family didn’t know until recently, I think. I’m still not sure my dad knows but I think my mum does. She mentioned it a couple of weeks ago in passing.”

Like 20% of the student population, Hayley has a mental health problem. 13% of those have had suicidal thoughts and a staggering 92% of students surveyed by the National Union of Students (NUS) in May have suffered mental distress at some point during their studies.

There’s no simple explanation behind it. According to the NUS, the pressures of keeping to coursework deadlines accounts for the majority of mental health problems among students, above exam stress, workload and academic performance.

Perhaps unsurprisingly in the years since student course fee rises and cuts to funding, the same amount of students are suffering from distress as a result of financial difficulties.

Despite the staggeringly high proportion of students with mental health issues, 64% have never used any kind of formal service to help them, whether that be the university’s own counselling practice, GPs or mental health professionals.

Quen Took, 21, has battled with depression and psychosis ever since he can remember. About to take his second year at the University of Exeter for the fourth time, he has found that the quality of his care has varied dramatically.

“During my school years I was obligated to see the school counsellor, who was one of the most horrendous people I have ever met. Everyone who went to see her felt worse afterwards. That was my first experience of any kind of mental health support,” he says.

“It does colour your attitude to getting help in the future. Mental health professionals who deal with children and teenagers need to remember that their initial dismissal is going to have a knock-on effect on this person throughout their adulthood and it may make them less willing to seek help later on. Children and teenagers with mental health problems need to be treated with a lot more respect.”

Seven years on from her first GP visit, Hayley’s depression still takes hold on a regular basis, despite receiving support during much of that period.

But her care has been fragmented, changing care services five times and antidepressants four times since turning 18 in February.

“It would be good to have something permanent in place, to have a weekly session where I know I’m going to get on with the person I’m seeing and that I’m going to get somewhere with it,” Hayley says.

Hayley and Quen’s experiences point to an underlying inconsistency in the quality of mental health care for young people, which may be contributing to the large number of students who do not seek any formal help for their mental distress.

NUS Disabled Students’ Officer, Hannah Paterson, says: “We are currently meeting with mental health organisations in a bid to bring all stakeholders together to examine the standard of mental health care in UK universities. We’re hoping to make an announcement in the coming weeks on the shape this will take.”

Alice*, a 33-year old PhD student in the field of mental health at the University of Central Lancashire in Preston, has tried almost every avenue of support for her anxiety and depression, which has never been properly diagnosed. Some support services were better than others, but ultimately none lasted long enough to help her.

“I went to see a student counsellor when I started at the university to do a conversion course before beginning my PhD. It did help quite a bit so after therapy I asked my GP to come off antidepressants,” she says.

“The first time I had done this years ago they had brought me off them over a few months but this time it was over weeks. I felt awful. I was having suicidal thoughts and it went on for months. After I came in to some inheritance in December, I used it to pay for private therapy, which I’ve been receiving ever since.”

Alice has been on and off medication, on and off different courses of therapy since her first year at university as an undergraduate at the University of Manchester studying History. But she thinks she has suffered from mental health problems since she was at school.

“At high school, I went to the doctors with symptoms that nowadays would have pointed to mental health problems. At the time though I was just told I was trying to skive off school. There was no recognition that children can have these problems,” she says.

“I’ve had a difficult time in getting a diagnosis. They’ve grudgingly given me medication but it makes me wonder if it is depression or whether it’s something different. Sometimes I wonder if I just have a bad personality.”

The British Association for Counselling and Psychotherapy (BACP) at Universities and Colleges reports that out of over 1000 students in 53 higher education institutions who had received in-house counselling, 84% said that counselling helped them to continue their studies with 81% doing better academically as a result.

A spokesperson from BACP Universities and Colleges said: “BACP recognises the value of counselling in supporting the student population, who may be more vulnerable than other young people as they face the challenges of adapting to a new environment, the demands of their courses, potential isolation, peer pressure to misuse drugs and alcohol, and the additional stress of financial pressures.”

The figures from the BACP reveal that student counselling services do at least provide a crutch for those with poor mental health to rely on as they try to finish their degrees. But it is alarming that over half of all students experiencing mental distress are left to struggle alone. Why is the proportion so high when these figures reveal the benefits of therapy?

Charity Mental Wealth UK believe the stigma surrounding mental illness goes some way to dissuading students from seeking help.

A spokesperson says: “More work needs to be done to help create a culture of openness about mental health on campuses across the UK.  Unfortunately many students are still not open to talking about mental health, misunderstand what it means or what to do if they experience poor mental health.

“In Mental Wealth groups in over 30 universities, students interested in mental health, many with personal experience, aim to demystify mental health by challenging discrimination as well as hosting discussions, information days and organising campaigns to stimulate positive change.”

Alice says she hides how she is really feeling from people, so much so that her GP once took her off antidepressants because he did not believe she needed them.

“I put on a clown face, which is what I call it when I’ve been crying and crying but become really enthusiastic and positive when I’m around people. There’s something circus like about it. It’s an act and it feels over the top.

“The doctors didn’t understand that with depression, there are points where you feel numb all the time and cry for hours. But you become adapted to it. If you’re crying all the time can’t get on in life.”

Ms Paterson, who regularly visits campuses across the UK to talk to students about disability and mental health issues, says many students suffering from distress don’t know what is available for them.

She says: “While there are mental health services provided by universities, students do not seem to be using them. Whether this is due to lack of knowledge or standard of care is difficult to identify.

“We need to work on de-stigmatising mental health issues to ensure that people will seek help for their problems. If you have a persistent headache you will see the doctor. We need to make mental health care as standard as physical health care.

“It’s also vital that institutions commit to informing their students about mental health care and indeed providing a universal standard of mental health care.”

Georgia*, 22, dropped out of the University of Westminster where she was studying architecture with interior design in her first year in 2011 after becoming anorexic and bulimic in the summer of 2010. She says she was not made aware of any onsite counselling services, instead privately paying for a psychiatrist and nutritionist.

“I asked my tutors for help because at that point I was eating less than 150 calories a day. But I was told to get on with my work and that everyone else manages. If I hadn’t started that course severely unwell, I reckon I would have done well. But there was no way I could physically do it anymore,” she says.

“In February, I got the tube to go to a site I was working on and broke down in tears. That was it. I got on a train to Norfolk, where my family are from, and I never went back. That was the end of all my studies. My hard work down the toilet.”

Two years on, she is working in Portsmouth at a recruitment website company. She had to stop private care, which varied dramatically in quality, after she left London because she could not afford the fees anymore.

“I haven’t got the money to do it and the care I did receive has put me off. But if I came into some money, it would be the first thing I would get.”

There’s no answer to the problem of getting more students to seek help for their mental health problems, particularly when the experiences of so many who have had support have had varied experiences. It’s clear that the combination of inconsistent quality of care and a reluctance to talk about mental illness is a lethal one, resulting in the large proportion of students who don’t even attempt to seek formal help.

Hayley is taking a gap year before she goes to university, having accepted a conditional offer from the University of Southampton.

Like many other 18-year-olds, she is nervous about leaving her hometown and her friends. But she is more worried that her depression will affect her ability to revise.

“That’s why I’ve come to the café to revise, to get out of the house and actually do my revision. I struggle a lot with motivation even though I know my exams are so important and if I don’t do it, I won’t get into uni and that will be my fault.”

With nothing planned for her gap year after a year-long placement fell though, she’s been thinking about travelling.

“Sometimes I think there’s no point planning my gap year because I might not be here anymore - but logically I think to myself that I probably will be so I should plan something for the year. I might feel better tomorrow.”

*Some names have been changed.

Samaritans provides confidential emotional support to anyone in crisis, around the clock, every day of the year. Trained volunteers listen, without judgement and without giving advice.

You can contact Samaritans by calling 08457 90 90 90 or visiting your local branch.