Further education colleges often forced to refer students in mental health crisis to A&E, survey finds

Three quarters (74%) of further education colleges in England have been forced to refer students experiencing mental health crises to Accident and Emergency (A&E) departments in the past academic year, according to research.

Research carried out by the Association of Colleges (AoC) also revealed that the number of college students with mental health issues is increasing. Of colleges that responded to the survey, 85% reported an increase in students with disclosed mental health issues in the past three years, while 81% also reported having significant numbers of students with undisclosed mental health difficulties.

The survey also showed that 97% of colleges provide education on wellbeing as part of extensive work to support students in maintaining mental wellness. Additionally, the majority have dedicated counselling and welfare staff to support and refer to specialists students who are experiencing mental ill health.

But, due to the substantial reductions in college funding in the past 5 years, most colleges have had to make reductions in non-teaching services and only 40% of colleges surveyed are now able to support a full-time counsellor or mental health worker on campus. 

The research revealed a postcode lottery in the relationship between colleges and their local mental health services. While most colleges generally have a good relationship with their local child and adolescent mental health services (CAMHS) and adult mental health services, not all do: 48% said their relationship with local clinical commissioning groups, which procure mental health services, was ‘non-existent’.

Ian Ashman, president of the AoC, said: “Accident and emergency units are overloaded and overcrowded and it is not right that colleges are forced to refer so many students to these services, which are often not the most appropriate place for them. Colleges don’t want to add to the current problems A&E services are experiencing, but they are sometimes left with no choice because there is a lack of investment in joined up specialist support for young people and adults in the community.

“Colleges do excellent work in helping students to stay well and to support those with mental ill health. However, where they have good relationships with their local mental health services, they are able to do much more to address issues before they become serious. Effective intervention by such partnerships can avoid students developing more serious problems or getting to the point of a mental health crisis.”

The AoC is calling on local NHS commissioners and trusts to use mental health service funding to develop closer relationships with colleges. A significant proportion of 16 to 18-year-olds and adults study in colleges and, by working with colleges, local CAMHS teams could support the young people who are most at risk and prevent them suffering a crisis, the AoC believes. Adult services can do the same. Education and training are also recognised as contributing to wellbeing.

“Admitting young people and adults to A&E because they are having a mental health crisis could be preventable, if only the right services were available in the community,” said Ashman. We know that more and more young people particularly are suffering with some form of mental illness and we need to make sure that the services they need are available at the time that they need them.”

The AoC wants local mental health services and colleges to develop better working relationships and it is asking colleges to prioritise student wellbeing. 

It has designated this as a year of mental health and is working with colleges and NHS agencies to create resources and best practice guides to demonstrate the positive relationships colleges have with local mental health services and to enable these to be developed and maintained. The AoC has also called on the government in its Spring Budget submission to increase college funding to allow them to properly fund services to students and to include college staff in the programme of mental health awareness training of schoolteachers, recently announced by the Prime Minster.