UoB/Well: Digital innovation and student-led initiatives as a way of improving student mental health provision

The University of Bradford has used digital innovation and student-led initiatives to encourage South Asian students to engage with mental health provision.

In May 2021, the University of Bradford (UoB) launched its ‘Digital solutions to cultural barriers to accessing mental health support’ project, funded by the Office for Students (OfS) as part of the mental health funding competition.

In partnership with MyWellbeing Improving Access to Psychological Therapies (IAPT), the University of Bradford Union of Students and the Working Academy, the project uses digital innovation and student-led initiatives to address issues of stigma and other cultural barriers that might prevent South Asian students from engaging with mental health provision.

According to UoB’s data, South Asian students make up 58.5 per cent of the student body but accounted for only 36 per cent of the users of campus-based mental health services in 2019-20 (36 per cent in 2018-19 and 38 per cent in 2017-18).

This disproportionately lower take up of support was subsequently analysed alongside data from UoB’s academic appeals process, where 72 per cent of retrospective appeals based on undisclosed mental health issues were made by South Asian students.

These statistics highlighted that students from a South Asian background may be less likely to reach out or actively engage with mental health support at the point of need, and that this may contribute to academic difficulties during their studies.  

Following conversations with student leaders and staff working in this field, a potential challenge was identified that mental health was not spoken about openly in the South Asian community, and in turn, this might contribute to mental ill health or longer term mental ill health. Feedback from student focus groups suggests that stigma plays a strong role in determining help seeking attitudes and behaviours. 

Encouraging students to engage with mental health support services and be open about any difficulties they face could have multiple benefits for the student and university community. A part of the challenge for this project was to deliver mental health and wellbeing support in the 'preventative' space, working upstream before individuals encounter mental health difficulties or crisis. This involves awareness raising, education and encouraging conversations about mental health, working with an inclusive, social model.  

This case study focuses on two out of the three project strands.

1. Digital innovation: UoB/Well app

Working Academy (WA) was responsible for the co-design and co-development of the unique mobile web app, with UoB students and graduates working as part of the app development and design team.

The mobile web app component of the project was developed in two phases:

1. Phase one: The app's design and features were scoped through an initial discovery phase and focus group consultations with students.
2. Phase two: Scoped through Student Mental Health Ambassador (SMHA) discussions, and a focus group with University Mental Health Advisers.

Although targeted at South Asian students, and specifically designed to address cultural barriers and contexts, the 'UoB/Well' app is available to all students.

The app is active and hosts an array of online support. It signposts students to multiple services, including informal access to SMHAs. It supports students to remain in tune with their mental wellbeing and engage with preventative, self-help support; recognising the times they may benefit from increased support; and offering a low-risk access point to university and NHS mental health services.

Resources available to students through the app include:

• blogs written by SMHAs
• psychoeducational information
• a searchable directory
• articles and videos
• self-help guides.

The UoB/Well app is the first step towards seeking help and improving access to mental health support for South Asian students. The app does not diagnose a condition or substitute care from a mental health professional; however, it is supporting students' overall mental health. It is educational, informative, culturally sensitive, and a first step in working to overcome issues such as stigma.

2. Student-led initiatives: Student Mental Health Ambassadors (SMHAs)

Extending peer support provision through the creation of SMHA roles has been the primary means by which student-led initiatives have been delivered in the project.

This is a non-clinical, paid role and the team of SMHAs were actively recruited from across the student community, with a particular piece of recruitment work focusing on students from the South Asian student community.

SMHAs act as role models to normalise conversations around mental health and self-care. They work to overcome social and cultural barriers to access, facilitating discussions and encouraging students to share experiences and support each other.

A visible presence on campus – with their roles identifiable through branded hoodies – has been an integral part of the role’s remit and indeed success.

Their role includes:

• supporting and guiding students by triaging or signposting them to different services (for example counselling, mental health advice, the wellbeing app and peer wellbeing schemes)
• creating engaging content for the wellbeing app
• leading wellbeing events on campus, in line with national wellbeing days such as University Mental Health Day and Mental Health Awareness Week
• facilitating regular student drop-in sessions at different locations across the campus, many of these running specifically for South Asian students
• organising external agencies to deliver training and workshops
• running information stalls to help improve access and increase the mental health literacy of students.

SMHAs have also connected with charities focusing specifically on the South Asian community, which has provided further opportunities for effective collaboration.

The training programme for the SMHA roles was co-produced by students, based on the topics and skills they felt they needed to feel confident in the role. It was delivered by a range of partners, including the university’s Counselling and Mental Health Service.

SMHAs have also been given the opportunity to complete Mental Health First Aider (MHFA) training, enabling them to achieve a recognised qualification in supporting people in mental health distress or crisis.

1. Digital innovation: UoB/Well app

Early indications are that the app is addressing the disproportionate take up of mental health support on campus.

Unpublished internal data suggests that, compared to before this project intervention, more South Asian students are now open to seeking counselling and mental health support when faced with challenges, such as career or academic-related issues. This is in part because of an improved understanding of what these services are and how they might be able to help them.

Anecdotal feedback from students engaged with the project suggests they value the co-produced content, self-help guides, directory and the blogs written specifically by South Asian students. This aspect is also being evaluated through project surveys and questionnaires.

2. Student-led initiatives: Student Mental Health Ambassadors (SMHAs)

The project team believes the SMHA role has been a huge success and exceeded expectations. Data gathered from surveys, feedback and SMHA reflective logs suggests that this approach is working well and has led to an increase in referrals to services such as the University Counselling and Mental Health services.

The 2021-22 data is not a complete year, however, at the time of writing there has been a five per cent increase (to 41 per cent) in the proportion of South Asian students accessing the service. This could signify a cultural change with support seeking behaviour among South Asian students at the university.

Qualitative feedback from students who have attended events led by SMHAs suggest that students supporting students is a valuable source of wellbeing provision and is having a transformative effect on all those involved in the exchanges. Students appear to be gaining confidence to seek help - SMHAs regularly report how they have had advised peers to seek professional support through the university services.

The first cohort of SMHAs reported having had low levels of confidence around seeking support for their own wellbeing prior to beginning their role. Through analysis of the comments received in their reflective logs, a typical comment from ambassadors included:

'The role has helped this group gain a better understanding [of] their own mental health as well as learning valuable strategies to support others. SMHAs have themselves accessed mental health support because of knowing more about the services/support available to them and awareness around mental health and the stresses students face.'

Next steps

Progress has already been made to ensure the learning and good practice established through the project continues beyond the life of the funded period:

• Full project evaluation will take place with the learnings and good practice shared across the sector, with the aim of those elements that are replicable being utilised by other higher education providers.
• The app will continue in the long term, with ongoing development and content creation by the SMHAs. The app has been setup in a sustainable way with minimal ongoing costs and maintenance requirements to ensure financial feasibility beyond the lifespan of the project. 
• Funding to ensure the ongoing work of SMHAs as a paid student opportunity has been secured, and this role has been planned for as part of future ‘business-as-usual’ operations within the university.
• A new Student Wellbeing Officer post has been developed which will assume responsibility for some elements of this project (the app and management of SMHAs) following the project’s completion. This will ensure continuity of the project work and that the focus on wellbeing events and initiatives as part of the broader student experience continue to thrive on campus.