The Tab Mental Health Survey: A Response

TIM SQUIRRELL reflects on the results of The Tab’s Mental Health Survey.

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You can view a full University statement in response to this article here.

The original details of the survey can be found here.

Looking at the 1,749 responses to the Mental Health Survey, it’s almost impossible to know where to start. There are so many people suffering from so many conditions, and so many of the institutions that are supposed to help them are failing them to the extent that an unacceptable number of students are left in a worse state than that in which they began.

Many people have pointed out to me that the survey may suffer from self-selection bias: the people who are most likely to answer are those who have been affected by mental illness in the past. In response to this, I don’t think it would be over-reaching to say that almost all students in Cambridge will, at some point, have been affected by mental illness, whether it be their own or that of a friend or acquaintance.

There is no minority demographic who are affected by mental illness and who answered the survey: the article was viewed 7000 times (many of which will have been repeats) and the survey had 1,749 responses. That is not the response of a small number of people with a vested interest in changing the system; that is 15% of all undergraduates in Cambridge. This is not a niche issue.

In addition, the representativeness of the sample is corroborated somewhat by the statistics on degrading (or intermitting, if you prefer) provided by the university. FOI requests for 2009-10 and 2010-11 suggest that around 300 undergraduates degrade per year. Since Cambridge has a population of 12,000 undergraduates, this means that 2.5% of undergraduates degrade per year. The vast majority of our 1,749 respondents were undergraduates, amongst whom there was a degrading rate of 5-6%. If 300 students degrade per year, this means that approximately 900 of the undergraduates in the university at this point will have degraded. This is 7.5% of the student population, give or take, which would appear to corroborate the data.

The headline statistic is that 46% of Cambridge students are depressed. To break this down, 21% have been diagnosed with depression, and another 25% think they may be suffering undiagnosed, but for one reason or another have not sought medical attention. Putting this into perspective, a high-quality systematic review has put the national average prevalence of depression at 6.7%. The difference is shocking.

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One of the most striking parts of the results is the difference between genders. 58% of respondents were female, suggesting that women are more likely to talk about emotional and mental issues than men. This is borne out by the rest of the results, too. The rate of diagnosed to undiagnosed depression amongst women was around 1:1, compared to 1:2 in men, and this is broadly reflected for other mental illnesses.

In testimonials, male students often said they felt uncomfortable talking to anyone about their problems, fearing they wouldn’t be taken seriously, or that the issues weren’t serious enough to merit attention. Women are more likely to suffer from depression (49% compared to men’s 41%), as well as panic attacks (17% to 8%) and anxiety (46% to 30%).

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Eating disorders, though, are where the gender difference is most marked. 11% of Cambridge women have been diagnosed with an eating disorder, and a full 23% either have been diagnosed or feel that they may have one. Eating disorders are known to flourish in competitive, high-pressure environments, so this is hardly surprising, though it is worth noting that this statistic may be slightly skewed by self-selection bias. That doesn’t make it any less awful.

Amongst men, the rate of eating disorders was 6%, only 1 in 6 of whom are diagnosed. This corroborates evidence to suggest that eating disorders in men are underdiagnosed, undertreated and misunderstood.

Moving on to look at the prevalence of mental illness in colleges, there are some standout statistics. Trinity and Homerton in particular appear to have unusually high rates of depression, as well as all-cause mental illness. Coincidentally, these were also two of the colleges whose welfare systems came in for the most criticism from their students, along with Emmanuel and Newnham. Also worthy of note is that Murray Edwards has a particularly high level of eating disorders (28%), higher than the average rate for Cambridge women as a whole.

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The responses regarding welfare are telling. Students have been treated by their tutors, DoSes, supervisors, counsellors and even college nurses in ways that reveal a startling inadequacy in the way we train those who are in pastoral contact with the student population. Students suffering from clinical depression have been told that they must be fine because they’ve been seen “smiling and laughing with their friends”; anecdotal evidence suggests certain college nurses showed some lack of understanding regarding serious issues such as schizophrenia and suicide.

Certain college counsellors have received some glowing reports, with the services at Homerton and Murray Edwards coming in for praise in the survey responses. However, certain other colleges’ services left a great deal to be desired. Feedback strongly suggests that there is something amiss, with students reporting some counsellors appearing “shocked and overwhelmed” by their accounts; being “patronising”, “judgemental”, and the treatment they received “old-fashioned and unhelpful”.

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Confidence in the college nursing system appears to depend entirely on the individual nurses provided by each college. The nurse at St John’s comes in for universal praise; the only criticism is that she is leaving this year and students are therefore worried that the quality of care provided will drop. The nurses at Pembroke and King’s also received excellent feedback.

However, some nurses were slammed by students, who have, among other things, been told that they are a “burden to their friends” or that they are “attention-seeking” or “time-wasting”; they have been “ignored”, informed that they are a “danger to themselves and the college”, and had their friends told to “stay away” from them. To expect students to feel comfortable talking to the college nurse when there is the possibility they will be lambasted as an “attention seeker” or told that they “don’t deserve their place at Cambridge” is laughable.

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Some Senior Tutors also come in for criticism. Students report having been “patronised”, “forced to degrade”, to obtain prescriptions for anti-depressants and stay on drugs in order to graduate. They have been subjected to serious confidentiality breaches wherein members of the college staff have passed on information about their condition without their consent, as well as speaking to their friends – without the student’s knowledge, and after specifically telling the student that they must not talk to their friends for fear of burdening them – regarding their mental health, and with no regard for the burden of secrecy this places on those friends.

This is not an attack on any one individual. This is an indictment of the system as it stands. Cambridge is a place that is plagued by high rates of mental illness – higher than many of us feared. This said, the systems that are in place to support students who have mental health problems must work as well as possible. This is simply not the case at the moment.

The things that will have made you the angriest in this article will have been the individual cases, the times when one student was treated appallingly badly by one person. What’s important to remember, however, is that it’s the system within which people work that allows awful things like this to happen.

Back in April, the Vice Chancellor said that mental health training is the responsibility of each individual college. This uncoordinated approach has allowed us to reach the terrible status quo you see today. This is what we must change. We cannot go on like this. We deserve better.

In response to the survey and its findings, a university spokesman told The Tab:

“Mental health and depression are significant issues within any student body, as the recent NUS national survey has shown, and the University of Cambridge and its colleges take them very seriously.

“Collegiate Cambridge provides a level of support both to mitigate stress and tackle depression that is unparalleled in most other universities. 

“We would be very disappointed and concerned if this flawed polemic misled students needing and seeking help into not asking for it.  The Collegiate University is always keen to improve the support it provides for students where it reasonably can.

“To that end we would be happy to talk to student representatives about concerns that they believe may arise from this survey.”

You can read the full statement here.