Osborn, Thomas George; (2023) Understanding the Vulnerabilities and Opportunities in Higher Education Students’ Access to Mental Health Care. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

The mental well-being of students in higher education institutions (HEIs) in the UK is a pressing public health concern. Growing alarm surrounds the escalating prevalence of mental disorders, and challenges in obtaining appropriate mental health care among this demographic. Despite the urgency of this issue, there remains a dearth of empirical research in the British context and ambiguity regarding best practices to address it. This thesis presents a rigorous mixed-method empirical study focused on the UK environment. Chapter 3 conducts a systematic review and meta-analysis, amalgamating existing empirical evidence to discern the most frequently utilised mental health service models by HEI students. In Chapters 4 and 5, a qualitative investigation aims to grasp health care professionals' perceptions and experiences of student mental health challenges, their interventions for distressed students, and the factors influencing their approaches within their work environments. Chapter 4 explores the interview data via a reflexive thematic analysis, while Chapter 5 introduces the theoretical framework 'candidacy', elucidating the salient phenomenon uncovered in the Chapter 4 interviews. Chapter 6 offers a retrospective examination of UK cohort data, aiming to identify disparities in cumulative mental health service usage between university attendees and non-attendees up to the age of 24, bridging a specific knowledge gap identified in Chapter 3. Chapter 7 unveils the outcomes of a feasibility study of the implementation of a university peer support service, a proposed mechanism to enhance mental health care accessibility for HEI students. The comprehensive discussion in Chapter 8 coalesces the insights from the empirical chapters, suggesting that while accessibility to relevant health care has perhaps advanced for students with common mental health issues, it has deteriorated for those with severe mental health challenges, certain international students, and those from select 'non-traditional' backgrounds in recent times. In culmination, the thesis offers precise, actionable recommendations for enhancing accessibility for HEI students, charting the course for imminent research in this domain.

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