Students' Mental Health Needs: Problems and Responses. Nicky Stanley and Jill Manthorpe (eds). London: Jessica Kingsley, 2002, 224pp. £15.95 pb, ISBN: 1-85302-983-1

This edited book is aimed at academic, administrative and student support staff in higher education, providing the reader with a variety of perspectives including personal accounts, chapters on contributory factors to illness and outlines of innovative services. The personal accounts are of shame, anger and hopelessness made worse by the fearful or frankly hostile responses of bewildered tutors and inadequate interventions from counselling services. Not that contact with external psychiatric services was that rewarding either. Seeking help entirely outside the educational system does nothing to encourage that system to adapt to the special educational needs of students.

The key, of course, is to bring together good mental health care with sensible adaptations to the educational system without lowering the standard required of the student, to make it more likely that students’ work progresses in spite of ongoing health difficulties.

Two chapters stand out for me as illustrations of how this might be done. In the first, Barbara Rickinson and Jean Turner describe a comprehensive system of supportive services at the University of Leicester. Mental health awareness is built into staff development, and compulsory training is provided for all tutors in the recognition and management of stress. Consultative support is provided to tutors by a Student Support and Counselling Service that also delivers a broad range of interventions for students ranging from workshops aimed at helping first year students adjust to life at university to confidential counselling for students with mental health problems. A consultant psychiatrist is also available one session a week.

From a rather different perspective, Kathryn James describes a joint initiative between a mental health trust and New College Nottingham for people suffering from severe mental illness, providing opportunities for more than 300 referrals a year from adult mental health, addictions and forensic services. Guidance workers help potential students choose a course and provide ongoing support. The courses themselves are designed and run by the curriculum team at the university responsible for teaching that subject.

The past decade has seen a rapid expansion in the numbers of students in further and higher education. Enrolments are up 55%, and even higher for part-time courses where, for example, enrolments for women have increased by 88%. With this expansion has come increasing recognition of mental health problems in the student population and calls for better integration of educational and health care. This book is part of that call. While superficially of limited appeal to the general psychiatrist, it has much to interest those who work in higher education or who have an interest in improving access to educational services for their patients.