Tim Francis (Mental Health Commissioning Manager) shares his views on the work the students produced
Mark Blackmore (Time to Change) shares his views on the work the students produced.
Mental Health Challenge academic Professor Paul Farrand featured in Daily Mail as part of #headstogether campaign!
Mental Health: The Treatment Gap
This is a fascinating challenge that will broaden your understanding concerning barriers to accessing mental health treatments. You will gain insight into ways that inform how some of these barriers may potentially be overcome and it is hoped that some of the ‘outputs’ that you produce during the week may actually help to inform some solutions.
The mental health treatment gap represents the difference between the prevalence of a mental health difficulty and the number of people accessing evidence based treatments. With the prevalence of mental health difficulties increasing across the world, the treatment gap is having a significant impact on the individual, their families, society and the economy and places general levels of wellbeing under threat.
Within this Challenge you will work with other students in small groups, each focusing on a particular barrier you identify as contributing to the mental health treatment gap. In doing so it is hoped you will develop a better appreciation of the specific barrier, and be encouraged to consider potential solutions to help improve access to psychological therapies to enhance wellbeing. In 2017, several outputs went on to directly help inform service development and shape understanding or practice of professionals working in this area (for example see the video testimony from Tim Francis, Mental Health Commissioning Manager in the right column of this page)
You will have the opportunity to network with a range of external stakeholders and share their perspectives. You will also be exposed to the work of clinical researchers and training academics within the Clinical Education, Development and Research (CEDAR) group within Psychology. Members of CEDAR have national roles within the NHS England Improving Access to Psychological Therapies programme. These inform and support research, training and service development collaborations helping to understand and improve access to psychological therapies on a worldwide scale with clinicians and academics from countries such as Hong, Kong, the USA, Sweden and Japan.
To introduce you to each of the enquiry group areas for 2018, we have an exciting range of professionals and academics specialising in this area. These include Andy Bacon (NHS England lead for Armed Forces Mental Health and Healthcare), Mark Sawyer (Head of Wellbeing Services) at the University of Exeter alongside someone from the Reading Agency and Professor Melvyn Hillsdon from Sports and Health Sciences, University of Exeter. Students may also have the opportunity to interact with members of the Lived Experience Group with direct experience of using services for mental health difficulties.
A wide range of other exciting experts have been involved in previous years. See the full list of previous experts for more details.
Students worked in interdisciplinary diverse groups within their chosen theme. Having taken inspiration from the speakers, the students spent the week carrying out their own project looking at what could be done to reduce the mental health treatment gap. Student groups in the ‘why people don’t seek help’ theme came up with ideas for increasing the likelihood of individuals seeking mental health support. Students in the ‘computer based self-help’, ‘reading’ and ‘physical activity’ groups focused on how each of these areas could improve wellbeing, and how participation in each of these areas could be improved. All students produced outputs as part of their project, which included campaigns, posters, educational programmes, and a video. Each of the outputs are shown below.
On the Friday of Grand Challenges Week, students presented their projects to all other students on the Challenge and an expert panel. The panel included Tim Francis (Mental Health Commissioning Manager), Mark Blackmore (Time to Change) and Tina Henry (Public Health). In the afternoon, the students showcased their work at an exhibition in the Forum, which was attended by students from all Challenges, University staff and members of the general public.
The timetable for the 2017 Challenge shows how the week was structured.
Click on each of the images below to see the outputs that the students on the 2017 Challenge produced.
Why People Don't Seek Help: Language and Wellbeing
Students in this group looked into why students at Exeter might not want to access help from Wellbeing Services and thought that the language used on the website may be off-putting. They rewrote the text using more welcoming language, and then ran a study (as described in their poster) to assess the perception of both the original and the revised text. They found that respondents preferred the revised text, suggesting that language use affects the perception of psychological treatment. They are looking to carry their project forward by discussing their findings with the Head of Wellbeing Services and the Director of Education and Student Support.
Why People Don't Seek Help: Parent Awareness
Students in this group created an initiative to educate both teenagers and parents about mental health, and hoped that this would promote healthy dialogues that allow the child to feel comfortable in expressing their feelings. Their idea was for year 9 students to carry out group projects based around mental health as part of their PSHE lessons. The teenagers would express their research through creative means, such as drama, dance, art, cookery, songs etc, and this would all be presented at an annual showcase, which parents would attend.
Students in this group also wrote a 3200 word Mental Health Treatment Gap action plan for their initiative.
Why People Don't Seek Help: Stop Romanticising My Diagnosis
Students in this group came up with a campaign, which was not an end in itself, but a message to change the terms of debate in which mental illness is discussed. They felt that images of depression in the media are romanticised, and that people are only engaging with the issue superficially. They are campaigning for mental illness to be conveyed in realistic, concrete terms rather than vague, distorted and romanticised imagery, and created this poster. The future aims of the campaign are to publicise their hashtag #morethan1picture further to get more people sharing personal stories, and increasing awareness of the realities.
Why People Don't Seek Help: Mind the Treatment Gap
Students in this group came up with a public health campaign to improve understanding and awareness of the most prevalent mental health issues. Their aims were to empower people to talk about their difficulties more easily by giving visibility to what is usually invisible, and to reduce stigma by increasing the understanding of the perspectives of people with mental health difficulties. They did this by producing a series of posters which pictured common scenarios. They decided to link their project with the Mental Health charity, Mind.
Why People Don't Seek Help: Kidz Kind
Students in this group produced a protocol for an educational workshop, aimed at children aged 8-9. The workshop they designed comprised of two sessions, with the goals of helping children to understand emotions, teaching them strategies for coping and raising awareness of mental health to reduce stigma. As part of one of these sessions, they designed a board game. The group felt that the stigma surrounding mental health was one of the most significant reasons for people deciding not to seek help, and so wanted to create something to break this stigma. They chose to target young children to break the stigma from its grass roots. This is the poster and presentation they produced.
Computer Based Self Help Therapy
Students in this group looked into online delivery of mental health therapies. They found that there were a lot of different apps available for improving wellbeing, and that online treatment was potentially more accessible, flexible and cost-effective than face to face treatment. However, they felt that there is still a lack of awareness that computer based therapies exist. They produced a video to promote the use of online treatment as a coping strategy, showing a day in the life of two people with depression; one using a mental health app and the other not using an app.
Reading to Improve Wellbeing: Fresh Reads
Students in this group created an interactive book club, based on the rationale that reading fiction has a positive impact on an individual’s ability to understand themselves and others, making them more skilled in social interaction. The project focuses on improving the wellbeing of students, through reading and discussing short stories and poems. The website will feature a different theme each month, with literature which resonates with these themes. The themes chosen will be in line with the academic year, i.e the September focus would be loneliness or homesickness and the exam period theme would be stress. This is their promotional poster. They are hoping to continue the project in this academic year.
Reading to Improve Wellbeing: The Bibliotherapists
Students in this group produced a scientific proposal for an experiment, which explored the effects of different kinds of reading (either aloud, or silently) on wellbeing, specifically anxiety. Different roles were assigned to individuals in their group, based on their educational background. For example, English and Classics students researched the best form of literature to use in the study, whereas the Science-based students provided the scientific framework and rationale to be used for the study. They produced a poster to present the proposal for their experiment, which could potentially pave the way for future findings into the beneficial effects of reading.
Physical Activity to Enhance Wellbeing: 'Mind your Head' Gets Active
Students in this group came up with the idea of a free graded exercise programme, based on the principle of behavioural activation. They recognised that participation itself could be challenging for someone with mental health problems, so they tried to make it as user friendly and accessible as possible. They created a leaflet which explained their concept, and general benefits of being more active. They also created three walking/running routes around Exeter which people could do at their own leisure or with one of the established groups. They are hoping to continue this project in collaboration with the Mind your Head Society.
Physical Activity to Enhance Wellbeing: Brain Peeps
Students in this group focused on raising awareness of how physical activity could combat susceptibility to mental illness. To do this, they planned an event to run during Freshers’ Week. They would have facilitators based in the Forum approaching people and asking them for suggestions and testimonials about how to become more active and how physical activity has helped them before. They would encourage people to write their tips and ideas on their poster. They would also discuss common misconceptions with people, for example that physical activity doesn’t need to be intense exercise.
Enquiry groups are the subtopic of the challenge that students focus on for Grand Challenges Week. These are the enquiry groups that are running in 2018. You will be able to choose from the following enquiry groups when you sign up to Grand Challenges.
In this enquiry group you will be encouraged to explore a range of specific barriers that reduce the likelihood of people from populations, varying by characteristics such as age, gender, ethnicity, religious beliefs and professional backgrounds, seeking treatment for a mental health difficulty. To set the scene, the introduction to this group will focus on specific barriers experienced by Armed Forces Veterans and their family members when seeking mental health treatment from the NHS. However, within your specific group you will be encouraged to follow your own interests and knowledge to identify a specific population of your choice. You will also be encouraged to use your new understanding to inform an output that may help inform wider awareness of barriers or develop an intervention to address patient level barriers for the specific ‘harder to reach’ population your group has chosen.
Despite significant investments in services to support the wellbeing of university students, service delivery and provision can always be enhanced to close the treatment gap or improve student wellbeing more generally. This enquiry group will give you the opportunity to draw upon the published literature and research in this area. Or indeed your own personal experiences as students may enable you to think about some of the ways you feel the wellbeing of university students could be enriched, services adapted to meet the range of diverse needs placed upon them or service acceptability enhanced. Outputs have the potential to help inform on-going developments and service enhancements in student wellbeing and could be used to help shape or inform development of a University of Exeter ‘Student Wellbeing Steering’ committee that is currently being established. Or indeed directly ignite your own interests to get more involved.
The number of people seeking mental health treatment places the NHS under immense pressure. Whilst the delivery of psychological therapies must be overseen by the National Institute for Clinical and Health Excellence, there is potential to supplement evidence-based therapy by considering other innovative ways to improve wellbeing. This enquiry group will explore ways in which non-fiction in the form of self-help books based on Cognitive Behavioural Therapy is currently used to support the delivery of psychological therapies. Additionally, this group will also consider how reading fiction could help people better appreciate issues relating to the experience of their mental health and potentially enhance wellbeing. Outputs have potential to inform national programmes such as ‘Book Prescription’ schemes or local initiatives such as ‘Recommended Reading for Wellbeing’. Dr Johanna Harris (English Department), is currently leading research looking at ways reading could be used to help ease the transition into university life.
Across England, the Improving Access to Psychological programme has invested heavily in the delivery of evidence based psychological therapies through NHS service providers. However, such a narrow focus is not suited to everyone and this is a limitation, especially when other evidence-based approaches exist. For example, the National Institute for Clinical and Health Excellence now recommends the use of physical activity programmes for the initial treatment of milder levels of depression. The focus in this enquiry group is upon examining the use of physical activity, not only for the treatment of depression but also as a way to maintain or enhance wellbeing. This focus may help inform group outputs focusing on areas such as ways to promote physical activity as a treatment for people with mild depression or generally raising awareness regarding the benefits of physical activity for mental and physical wellbeing.