Cynulliad Cenedlaethol Cymru

I'd like to welcome Members to the meeting of the Children, Young People and Education Committee today. The public items of this meeting are being broadcast live on Senedd.tv, and a Record of Proceedings will be published as usual. Aside from the procedural adaptation relating to conducting proceedings remotely, all other Standing Order requirements for committee remain in place.

We will be welcoming students from the University of South Wales specialist community public health nursing programme in the public gallery today, so I hope they find the meeting interesting. The meeting is bilingual, and simultaneous translation is available from Welsh to English. Buffy Williams MS has sent her apologies and Jenny Rathbone MS is substituting, so thank you very much, Jenny—welcome to the meeting today. Ken Skates will be joining us from item 3 onwards. Are there any declarations of interest from Members? Sioned.

I just want to say that my husband is a professor employed by Swansea University.

Thank you, Sioned.

We'll start off now on mental health support in higher education. This is our first evidence session on this topic. I'd like to welcome our witnesses this morning: Orla Tarn, president of National Union of Students Cymru; and Joe Atkinson, press and public affairs consultant, NUS Cymru. Thank you for joining us today—you're very welcome here.

We've got quite a few questions to put to you this morning, so we'll make a start. Perhaps, first of all, you could—. How would you summarise the current situation in terms of the mental health and well-being of students in higher education, and are there any unmet needs in terms of students' mental health? Orla.

Yes, of course. Thank you so much for having us today, and thank you, Chair, and the rest of the committee for inviting us to give evidence on this vitally important issue. Student mental health has been one of the big priorities of NUS Wales for several years now, and we think this inquiry represents a real opportunity to create real and lasting change for current and future students. 

To answer your question on the current situation, be in no doubt that we are in the midst of a student mental health crisis here in Wales and across the rest of the UK. That crisis has been exacerbated by the pandemic, and now the cost-of-living crisis, but student mental health has been in decline for at least a decade now. There are a number of factors that have played into that decline, which I'm sure we'll get into throughout the session. But what I hear when I've been talking to students, when I talk to students' unions, and what I myself have experienced first-hand as a student and then a sabbatical officer at a Welsh institution, is that student mental health support is inadequate to deal with the sheer numbers of students who are struggling with their well-being. 

There is a lot of good work being carried out within institutions to try and improve the situation, and plenty of innovative projects being run by some really brilliant staff members, but there is so much more that we can do to ensure that services, both on campuses and in the NHS, can better cater to students. So, yes, there are clearly still unmet needs across the sector. There has been a 450 per cent rise in students disclosing mental health conditions in the last 10 years according to UCAS. And before they reach higher education, young people are experiencing mental health issues at a higher rate. We need to make sure that the whole system is geared up to deal with the sheer volume of students who need to make use of the support services.

Thank you, Orla. And just to say, as well, thank you very much for the paper that you provided the committee with as well, before this session.

No problem.

How well do you think we understand the extent of mental health challenges among the student population? Do you think that our data and wider intelligence could be improved?

I don't necessarily think we have a picture on the full extent of the student mental health crisis in Wales. For one, there is a lack of Wales-wide data, and we often have to rely on UK-wide data when it comes to identifying the specific issues that students are facing. That's a problem in itself, because each university student body is unique and faces its own set of challenges that need addressing by student support services. Data collection might improve if proposed changes to the national student survey go ahead. There's a proposal to add a question on mental well-being provision within the NSS that may give more of a picture of what students are receiving. That would be aimed at students who actually make use of services already, so should be seen as part of a range of data collection exercises. It's also important not just to rely on data from institutions but also to go to students directly, and also student unions that deal with students with complex mental health issues on a daily basis. While there has been a massive increase in students declaring mental health issues, some students from certain backgrounds are still reluctant to disclose that. I think their peers and student unions are maybe better placed to identify and help in those circumstances, compared to institutions themselves.

It is important to collect raw data from students, and I think it’s good that the committee is conducting its own data gathering as part of this inquiry, and we’d encourage you to reach out to the student communities to make sure that your survey goes as far as possible. We can offer support with that as NUS Wales, and we'd also urge the committee to consider what more Welsh Government can do to improve its own data collection as part of the inquiry.

Thank you very much, and thanks for the offer of that. I'm sure that we will take you up on that offer to help us get as many students replying to our consultation as possible, so, that's really helpful. Are there any particular groups of students you think are more vulnerable to poor mental health, and do you think that more targeted support to those groups, or more universal approaches, would be the most effective at tackling those inequalities?

Yes, of course. I'd just flag as a content warning to anyone watching the session that some of our responses today will discuss sensitive subjects such as suicide and severe mental health problems.

I think we definitely need to take a targeted approach to mental health support, because there are so many groups of students for whom the default approach just doesn’t work. For example, LGBTQ+ students report higher rates of mental health issues, and this is especially acute for trans students and non-binary students. Research by TransActual, a trans charity, in 2018, found that within the past year, for example, 70 per cent of non-binary people had experienced depression, 71 per cent of trans people, including 79 per cent of non-binary people, had experienced anxiety, and 46 per cent of trans people, including half of non-binary people, had considered taking their own lives. While I was mental health officer at Cardiff student union in the 2018-19 academic year, I discovered that, within university systems, even systems designed to support students with mental health challenges, many trans and non-binary students have reported having to misgender themselves on forms, use dead names, which results in significant additional dysphoria and distress for these students. Tailored support in this case, for example, will remove a number of barriers to those students accessing support when it is so urgently needed.

Students who are black, Asian or of other ethnicities have poorer mental health on average than their white peers because of oppression and cultural stigmas within their backgrounds, and, as a result of these stigmas are often less willing to reach out for support, either because they do not recognise mental illness as it’s not talked about in their cultures, they don’t feel listened to, or because the only help available comes from white professionals who do not understand their experiences of racism and discrimination. The lack of representation within student support service staff teams further adds to this, as these students do not really feel those services are accessible to them.

International students, again, disclose having a mental health condition to their institution at a much lower rate than home students, and that, again, can come from cultural stigma or fear about their immigration status being affected, particularly where this might impact sponsor relationships. Distance learners, including mature students and students with caring responsibilities, can struggle to access services that are very much geared towards catering for on-campus students and are marketed towards younger students. Students returning to education later in life, students with children and students with caring responsibilities often struggle to access support services and are merely signposted elsewhere, receiving very little support as a result of not being able to access them within opening hours or as a result of not feeling listened to or understood by staff more used to dealing with 18-year-old school leavers. And a huge number of these students study, for example, across allied healthcare courses and prop up the NHS, and yet many withdraw every year owing to a lack of support.

Postgraduate students, particularly postgraduate research students, often feel that existing counselling and well-being support is heavily targeted towards undergraduates due to, for example, marketing around undergraduate assessment periods and support packages on offer. I had these conversations a few years ago, and sometimes even alternative messaging and advertising these services can be extremely helpful to reaching wider groups of students.

A lot of the neurodiverse students I speak to feel that they don’t get enough support. Many have not received the grounding information on how, for example, to access disability services before they arrive at university. And many again may feel misunderstood where information is not presented to them in a digestible format that they’re able to interpret and process. Many have said that they struggle with the small number of contact sessions they’re offered by institutions, as this is not really enough time to explore the difficulties they’re facing, with neurodiverse students feeling often more isolated as a result of social difficulties, this can be quite damaging.

I think, to round off, institutions and NHS services need to take into account all of these different groups when designing and targeting support. It's also worth remembering that no student body is the same—each institution needs to adapt its provision to suit its demographic. For example, the needs of a student at University of Wales Trinity St David, which tends to have a greater proportion of mature students, will be very different to students at Cardiff University, and that'll be very different to a student at Aberystwyth or Wrexham. So, I think a universal approach doesn't necessarily work, and institutions themselves need to take into account the needs of all of their students when designing that tailored support. 

Thank you, Orla, that's really helpful. We'll now move on to some questions from Members, and now, it's Laura Jones. Laura. 

Thank you, Chair. As you say, mental health predated the pandemic, but you did say that it exacerbated it. What have you heard from students about the long-term impact of the pandemic on their mental health and well-being? And how has the pandemic affected different groups of students? Thank you.

Thank you for that question. So, the mental health impact of the pandemic has been well documented, but it was extremely tough for a lot of students. During the pandemic, 64 per cent of students in Wales told us, as NUS Wales, that their mental health was worse than prior to the COVID outbreak. Themes within that were loneliness, isolation and an inability to make friends owing to COVID restrictions. The student experience has been really different over the past couple of years. So, your university years are formative, certainly for younger students who are living away from home for the first time, but COVID has really impacted their ability to make friends and take part in the wider university community. 

If you look at the impact, for example, on disabled and neurodiverse students, many of them had to relearn skills and put in place coping mechanisms every single time the lockdown rules were changed. Other students struggled in terms of how they could work. They might have found it difficult, for example, to conduct their studies from home for a range of reasons: from there not being enough space to work to not being able to afford books and other equipment to simply struggling to focus on learning in the same place all the time. Students really struggled, again, with their finances because of the impact of COVID on the hospitality sector that many students work in on a part-time basis. We'll come on, more broadly, to finance later on, but we can all understand how money troubles can really impact someone's mental health. 

Home situations changed for many students. They came out of the pandemic with different family income situations, owing to lost jobs and, of course, people lost relatives and other people close to them, which had a significant impact. We have a generation now of college and school leavers coming into universities who haven't had the same opportunities to socialise in their cohorts, and I know that student unions and universities are now putting in place things like consent education to counter that impact slightly. The pandemic really set student mental health back and I'm quite concerned that the cost-of-living crisis is already having a similar impact and that will only get worse as well. 

In terms of affecting different groups of students, to go on to the second part of your question, everything I said about the mental health needs of different groups of students previously applies here as well, and those impacts, which I chatted through earlier, were only exacerbated by the pandemic. There was a pointed impact on international students, who either couldn't return home or couldn't get back to Wales to continue their course. Some had to take enforced interruptions of study because they couldn't get back to campus. This caused a significant number of difficulties, both in terms of extending visa applications and having to apply for last-minute visas to meet the return-to-campus deadline, but also presented challenges in applying for graduate route visas at the conclusion of their studies, should there have been delays in completing their courses for any reason.

I know that I touched on neurodiverse students earlier, but they often thrive on routine and they've really struggled with constant rule changes and different levels of lockdown. And I think part of the problem—and I know we touched on this earlier—is that mental health services and institutions tend to be quite uniform and pitched to one type of student: they tend to be neurotypical home students who are coming out of school and are fairly young. But any student who doesn't fit into that category tends to have to adapt themselves to the service, when, in order for them to receive the support that they need, it really should be the other way around.

Thank you for your comprehensive answers, Orla—they really are fantastic and helpful. You say that we need to do more; what do students need from their providers to mitigate the impacts of the pandemic on their mental health and well-being, do you think?

I really think that students need their institutions to consider all demographics and all learning styles within the student body when designing services. No two students are the same, just as no two student bodies are the same. We need to see, additionally, appropriate communication with each demographic. There's not really much point in sending important e-mails in Welsh and English to a Chinese student, who really needs to receive the complex information in their own language so that they can fully understand, to make the right decisions themselves and make those informed choices that may impact their study later on down the line.

Students, additionally, need to feel listened to and understood by their institution and also feel a part of that institution's learning community. Across much of the sector, students often feel like numbers to their institutions, with recruitment targets being set, and often students are being dealt with as pieces of a machine rather than as human beings. I think students really need to feel confident that when they do reach out for mental health support, they will be treated as a human being that is suffering, as opposed to a number in a waiting list.

It can be said that it's largely too far past the fact to mitigate the impacts that the past two years have had on the mental well-being of hundreds of thousands of students, but clear communication is paramount in reducing the impacts going forward. Students need clear lines of communication to easily be able to interpret any changes to their routines and any other alterations that will have an impact on them and their studies so as to reduce the likelihood of uncertainty and distress, because students have had a lot of uncertainty and distress in the last two years, and that has, I'd say, had a profound impact on their mental well-being.

Absolutely. Do you think, Orla, there are particular opportunities or challenges arising from the pandemic in terms of how teaching and university support services are delivered? For example, how do students feel about more widespread blended learning, online support services, that sort of thing?

Absolutely. I think there are plenty of lessons to be learnt in terms of how teaching and support services can be delivered for different groups of students, and I think there's a real value for certain groups of students in the technologies and flexibilities that were implemented during the pandemic. There was very much a keenness from institutions to get back to normal as soon as possible as we emerge out of the pandemic. But I think we need to give students more of an option about how they can access their education and their support going forward, because it can be very beneficial for them on a number of levels to have an element of flexibility, including for their mental well-being.

For example, many students with disabilities find remote learning very beneficial, and it encourages them to learn more efficiently and effectively. There are also, for example, in teaching methods, lessons to be learned from changes to assessment methods. Many students have reported feeling more confident in their learning or understanding of the subject matter as a result of assessment methods used during the pandemic—for example, open-book exams or coursework assignments. A swift return to in-person examinations across the board has not left a significant amount of time for assessing the validity of alternative assessment types or to investigate the impact of those. So, I think it's a measured approach that's required in order to actually assess what can be learned from the last few years in terms of support services, and also teaching methods as well, to an extent. We know what we know well, but it's about challenging that based on what we have learnt over the last couple of years as well, to work out what really is best for students in Wales.

Thank you, Orla. That's great. Thank you, Chair.

Thank you, Laura. Now, questions from Jenny Rathbone. 

Good morning. I just want to set the mental health of students into the wider context of society, and I wondered whether you were familiar with Estyn's peer-to-peer sexual harassment report that came out in December, which really catalogues the extent to which young people are being harmed by remarks made both in school and online, which for some people means that they've got used to bullying other people, and for other people, it'll be really undermining people's confidence, which obviously impacts on their mental well-being.

I think that's a really important context in which we understand the mental health problems that young people may bring with them when they transition to university, when they may be moving out of the family home for the first time. I just wondered what support student unions are able to give newly arrived students to try and break down some of these harmful behaviours.

Student unions do a great deal to support students transitioning into higher education, and a big part of what they do is promoting community and bringing like-minded students together through things like societies, which give students a way to meet new people who have similar interests, and that they may be able to form a support network out of.

Student unions provide freshers' packages, often with huge numbers of returning student volunteers, to help students get settled in during those all-important first few weeks, which have been shown to be critical in a student's overall outcomes at university. Student unions are really important for making students feel part of their university community, and NSS results show that learning communities do really enhance overall student satisfaction. Students, for example, who feel more part of a community are more likely to be satisfied and, therefore, have better mental health.

In terms of how student unions manage to do that, I'm not sure there will ever be enough funding for student unions to be able to do what they do on such a tight budget, but funding has progressively decreased in recent years per head, so they're having to make money go further—

We face a cost-of-living crisis, so people are under pressure all over the world in all institutions. I absolutely acknowledge that freshers' fairs do a great job in enabling people to get in touch with other people who may be interested in chess or whatever it might be—

Sorry, Jenny, can I just come in on the point you made around peer-on-peer sexual harassment? Just to say and make sure everybody's aware that, obviously, this committee did an inquiry following Estyn's report. It was our first inquiry on peer-on-peer sexual harassment, and we will be debating that report in the Senedd later this month. So, I'm sure everybody will be able to put into that debate as well and, hopefully, many will watch that, because we have had the response from Welsh Government as well.

Excellent. Clearly, universities pick up the pieces. I absolutely acknowledge that freshers' fairs are great, but there's also quite a lot of pressure on students to do things that, potentially, can be quite harmful. I represent Cardiff Central, so I've got three universities, and some of the pressure on young people to go out and get so drunk they don't know how to get home is a culture. There's pressure on people to take alcohol as a way of (a) hiding their insecurities, and (b) to keep up with the crowd. I just wondered if the student unions have done any work on trying to undermine that culture of excessive drinking. 

I may need to provide supplementary information for this question after the fact, just as I don't have a huge amount of data to hand. But I know from experience that a number of student unions are actively promoting sober socials as a method to increase the accessibility to students who may come to university not drinking for cultural reasons or not drinking due to personal preference. From personal experience, I didn't drink when I first went to university, that was my choice, and I was more than welcomed into that community without partaking in alcohol culture. It was my personal preference at the time.

Societies, for example—I know we've talked about it briefly—run sober socials across the country, and there is a big push for student unions to be running those events that not only are inclusive of students who do drink alcohol, but also students who don't drink alcohol, for example. A number of student unions run Give It a Go programmes across the country, which promote low-commitment, low-cost trips and events for students to try something new and to meet new groups of people, all non-alcoholic, as an example. My former student union ran weekend trips that students could go on and really connect with new people over a longer period of time. Student unions are always coming up with new initiatives to be able to do this.

That's hugely as a result of a really powerful staff force in student unions across Wales, but also as a result of sabbatical officers who come in every single year full of fresh ideas from the student body. They spend that year trying to implement their ideas for the benefit of the student community. Those ideas are completely refreshed every single year when elections happen and new officers start, and we're really lucky to have that system in place where staff and sabbatical officers can work together to really progress outcomes for students and to try and enhance the student experience in a very much inclusive way that means that no student is left behind.

That's really excellent information. Thank you very much indeed for describing that. Obviously, the role you used to hold as the mental health officer was, in itself, a new post, I think, created just shortly before you arrived, and that is indicative of how well student unions are listening to the needs of students, because peer-to-peer support is probably the most effective way of dealing with what is a really complex problem.

Could you just say a little bit more about what you said earlier about each institution needs to adapt its provision to suit its intake? Obviously, there's quite a big difference between people who choose to go down the further education, perhaps more technical qualifications route and those who go into the more academic subjects in universities. Could you just elaborate a little bit more on how you think—? Higher education tends to have more people who are living away from home whereas in further education people tend to be living in some sort of family setting. How do you think these institutions are doing that—in light of the fact that, in Cardiff, we've got the south-east Wales mental health university liaison service—so that they're all learning from each other?

I think there is a really important line to be drawn there. You've touched on the mental health university liaison service, which we'll speak a little bit more about later, which I think personally is a very valuable service to have in those institutions. I think when we were talking earlier about a universal approach versus a tailored approach from an institution to an institution, something that suits an 18-year-old who has come away from home for the first time and is really struggling with, for example, homesickness or low-level depression, is going to be very different from a 40-year-old student who's returned to education for the first time after leaving college 20-something years ago that is, at the moment in their situation, surrounded by a group of 18-year-olds and struggling to fit in and feeling very isolated in that community. I think there are very much different approaches that need to be taken by institutions where you have, for example, a high proportion of mature students versus a very much younger population. But also, within that, it's about making sure that a student can access support that is tailored to their needs. As I mentioned, black students, for example, might not feel comfortable going to a support service that has entirely white staff members within it, because they don't feel that they will be appreciated and understood by that. 

But also, when we're looking at the lines between FE and HE, it's very difficult to adopt that consistency because of the poor transition rates between child and adult mental health services within the NHS as well. That two-way conversation that should be happening between institutions and the national health service potentially can't happen as well over those barriers as a result of the transition difficulties between CAMHS and adult services. I think what's really important in terms of comparing the two is that the same standard that students can expect to receive is present in all education settings, just how they receive that support might be slightly different based on how they are going to be most receptive to that support that they are receiving.

Thank you. My last question relates to the role of the Welsh Government. Clearly, the point you've just made about the poor transition between child and adolescent mental health services and adult mental health services is an important one where the Welsh Government has a main role, but are there other ways in which the Welsh Government could facilitate collaboration between the NHS—? There's also the transition between schools and colleges and universities and further education generally. What role could you envisage for the Welsh Government? Because we're clearly in listening mode here.

Thank you for that. I think this is a fairly good time to bring in the recommendations of the working group that my predecessor as NUS Wales president, Becky, worked on. A working group brought together representatives from universities, colleges, student services, mental health charities and student unions to work through some of the barriers faced by students and to identify what good practice really looks like in this area, beyond higher education and further education. I really urge the committee to look at the recommendations of the working group, but I'll chat through some of them now.

Some of those recommendations were, for example, to encourage institutions to have well-being policies for equipping every student within institutions to exercise self-management and self-care; considering and including student voices in the development of health policy; requiring student and staff voices in design and delivery of local services; including student populations in healthcare planning; reviewing and mapping mental health services across Wales for students in post-16 education in order to identify gaps, and publishing a guide of that support available; updating and providing clear guidance on information sharing between health services and education institutions in relation to mental health—

I'm sure we'll pay proper attention to those recommendations, so I don't think you need to read them. Is there anything else you want to say that's not actually in that report?

I think, additionally, financial support would be a really good start for students, but also a forum by which these conversations can be facilitated between schools, colleges, universities and also workplaces and mental health services within the NHS. I think, additionally, potential widening of the scope of University Ready projects. At the moment, it's very much geared up for 16 to 18-year-olds, and the content necessarily isn't suitable for lots of groups of students, including mature students, international students, and also the 50 per cent of students in Wales who are not from Wales and can't necessarily make use of that programme. It can be incredibly complicated and a tricky transition to come into HE as a mature student who's been working or caring full time, so expanding programmes such as this to all age groups would be very beneficial in this space. And that ties into our recommendations in terms of the consideration of how unis can work with post-16 colleges and schools to support learner mental health in advance of that transition, particularly for those already with mental health conditions, going to changing support networks and available services.

Okay. Thank you, Orla. Thank you, Jenny.

Thank you.

Thank you, Jenny. Diolch. Questions now from Sioned Williams. Sioned.

Thank you very much for your question. It's very difficult to tie down one main factor that contributes to student mental health, as mentioned earlier, as students are all incredibly different, and students as a collective face a very unique mix of pressures on their mental health, and those pressures can be exacerbated by a number of things. Of course there are academic pressures—these have always been a factor of university life. I think there's more pressure these days. The value of a degree isn't what it once was because more people are going to university, so there's more pressure on students to get a first-class honours, and then there's more pressure to pursue a Master's, which comes with financial implications as well. Finances are a massive part of this—I know you touched on that there—and I’m sure you can understand financial pressures are particularly acute on students right now. Students are spending more of their money on rent. Three years ago, for example, the average student rent in Wales took up 53 per cent of the Welsh student support package for undergraduates; now it takes up almost 60 per cent. And the housing that students are paying for also has a big impact. We did a survey last year that found that 65 per cent of students have struggled with their mental health because of issues with their house, over half experienced damp and mould in their accommodation, and a significant amount also experienced regular disrepair, landlord disputes, pest infestations—the works.

In terms of friendships and relationships, certain factors such as the pandemic have impacted students' abilities to forge friendships in the last couple of years. Of course, friendships and networks are things that can mitigate the impacts of those other things, of the financial and the academic stresses, so anything that gets in the way of students making friends will make mental health issues worse.

I think there is some excellent work going on around bringing students together. So, for example, a number of student unions I've seen from the start of this academic year have been running regular sessions to bring students together to talk about their mental well-being, to talk about things that are impacting them and to chat through any difficulties they have.

We have student night lines, for example, that run up and down the country, which enable students to talk to other students out of hours. It's more of a listening service than anything that can provide support, but that tends to be quite helpful for students and as a baseline for peer support is fairly helpful.

There are also a number of initiatives running from student support services. I know the mental health university liaison service is one of those that is running that really does help to bridge the gap for a number of students between their institution and the national health service.

But, I do think, in terms of higher education providers promoting ethoses of good mental health, that starts with not just the staff in student support services, but with the staff who are delivering teaching to students and how they're able to promote that ethos of good mental health. Unfortunately, we've got a situation in higher education where staff are regularly taking strike action and action short of a strike because they are overworked and underpaid. That has impacted significantly on the student experience over the last few years, but students appear to be extremely understanding of the rationale behind this action. But, from my experience, and from speaking to other students, I don't think university staff who are delivering teaching currently have enough time or mental capacity of their own to instil a positive ethos of good mental health and well-being in the classroom. For example, from the University and College Union 2021 workload survey, academic staff are working on average 51.3 hours per week just to get their work done; staff on fractional contracts are often working two to three times the hours they are paid for; and 33 per cent of respondents in a HE survey said that their workload was unmanageable, which is contributing towards poor mental health across staff in higher education providers. If we want staff to start trickling down positivity, then those staff need to be supported to do so by taking into the account the fact that they are often struggling equally as much as students. To put it in simple terms, we have a fairly mentally unhealthy sector in higher education. That's not just in Wales but across the rest of the UK, but if we want to make changes in Wales, we need to address that. It's not just students who are struggling with their mental health, with their workload andtheir finances; it's the staff too—the staff that they see at the front of the lecture theatres, leading their tutorials, leading their seminars, and that they're dealing with on a daily basis as they go into universities and institutions to learn.

It's not necessarily a good combination, if we want to promote a healthy mental health ethos across the board, because everyone seems to be struggling. As a lot of services often say, you can't pour from an empty cup, in terms of delivering mental health support. So, if you're struggling yourself, you're less able to impart that positivity onto other people. 

Thank you for your question. In terms of students in general, too often students don't necessarily know about the support available or where to access that support until they're getting towards crisis point and they really need to see someone. Students are frequently bombarded with information in their first few weeks at university or with their provider. They have so much information to take on board that the vital information is often lost in a flurry of worry about everything else. Often, students won't remember where to go for help when they need it, nor will they remember how to recognise that they do in fact need help until they get to a certain point. What needs to happen is signposting from staff at a very early stage of identification of mental health struggles within students, targeted reminders at pinch-points within the year, whether halfway through the first term, when homesickness might be really setting in for some students, particularly those who have moved away, or at exam periods, and regular communication with students as well, across social media and in their lectures, to ensure they’re aware of the full range of support out there, and that they know exactly where to go if they’re experiencing certain difficulties.

I know we talked about this at length earlier—you just mentioned it there—but different students will be receptive to these reminders in different ways, and it’s important that not just the services are tailored, but also how we’re reaching students to alert them to the fact that those services are there. If students are ending up in mental health crisis before they think to go to someone, that’s going to create more of a backlog for services, which can be avoided if they access services when they’re experiencing those low-level mental health symptoms that could then escalate. So many students just carry on and don’t seek support because they don’t think they need to do it, they don’t know the services, what services are there, and they need to be reassured that what they’re experiencing deserves recognition and treatment, and that they shouldn’t suffer in silence. I think this further ties to the importance of students knowing they can speak to real people about their struggles, so that they don’t feel like burdens on a severely overstretched system.

Yes, of course. So, the cost-of-living crisis is my No. 1 priority as NUS Wales president. Inflation is running in double digits, energy bills are now double what they were last winter, student rent is rising faster than house prices, and the value of the student support package has only risen in Wales by around 3.5 per cent this year. From the students I’ve spoken to over the last two weeks, this is woefully inadequate given the pressures on student finance this year, and that’s before you consider the fact that half of all HE students in Wales can’t access the Welsh finance system. Students from England, Scotland, Northern Ireland have a less generous support package, and international students receive no help at all. Students have also been frozen out of support that’s already been announced. They’ve had a postcode lottery to access financial tax rebates, there’s a risk landlords won’t pass on energy bill discounts, and full-time students can’t access universal credit either, even though they may be desperately in need of that. I’ve met a load of students over the last few weeks at freshers’ fairs. A student in Carmarthen told me they had just £100 left of the first part of their student loan and student grant package, until January after paying their rent and their bills for the first semester. I’ve met apprentices working up to 10 part-time jobs on very low hours to make ends meet, and some people budgeting £10 a week to feed themselves, with ever-increasing food costs, and also in order to have some semblance of a student experience and not be isolated from their peers. The cost—

We need to see Welsh Government support for students in terms of payments for students to ensure that they have more money to be able to actually survive on while they’re at university, so that they’re not suffering with their mental health as a result of worrying where their next meal is going to come from, or how they’re going to travel to campuses. We want to see action on spiralling student rent. The Scottish Government has implemented a temporary rent cap that includes student properties, for example, and we want to see the Welsh Government follow suit. And third, we need to see more investment in higher education mental health around Wales. Students, for example, are being kept up at night worrying about their money, worrying about the next rent payment, et cetera. We need to have more funding for universities and student unions to boost existing services and reach more students, and that’s all before action the UK Government needs to take to raise student support in line with inflation, et cetera. So, I hope that answers your question.

Online resources such as Student Space are valuable when taken as part of a range of interventions, but a number of students have not heard of Student Space, so there needs to be more promotion behind that. I also think, based on what I said earlier about students needing to speak to real people, that's a great first step to push them towards Student Space, but students need to know that they're able to link to person-to-person support, whether that happens to be a face-to-face appointment or an appointment over Zoom, because unless they speak to real people, they will feel like burdens in a system where there is no time for a person to speak to them. And that, while it may be trying to help, may only exacerbate their mental health condition or escalate that further if they don't feel that they're worthy of the support that they need. 

Diolch, Sioned. Questions now from James Evans. 

Diolch, Cadeirydd, and thank you very much. Mine was on access to services. Do you think that students understand the role that university support services have, in comparison to the services that the NHS delivers with regard to primary mental health services and what the GPs can offer students? 

I don't think that students understand the different roles particularly well. They are often, from the moment they set foot in their institutions, pushed towards the university services, and there's often very little talk about the NHS services on campuses. We need a system where it really is not the student who has to do the work about dictating where they should be going, but whichever service they approach can then make a good recommendation and know where to point them. And some students do know the difference, but usually only when they're being passed between services and having to retell their story time and time again to access a service that's going to be right for them.

So, students, for example, who approach their university often find themselves being passed between the institution and their NHS services, because they're too unwell to be seen by their university, for example. But, when they are passed between the two, they're having to reshare their information at each contact, thus having to motivate themselves to follow up on this quest for support time and time again, and for a student who is struggling significantly with their mental well-being, that's often far easier said than done. 

I know that we've mentioned the mental health university liaison service a couple of times, but across the rest of the board, there's a missing middle of students who are deemed too ill for institutional services, but not ill enough for the NHS. I've heard these referred to as category D students with recurrent or atypical mental health issues impacting their daily lives, so sub-crisis level. And these are the students who are targeted by that university liaison service in Cardiff, but, really, that information sharing is vital for students to be able to access a whole breadth of services, but also having reached out to one service and then signposted to the rest of them. 

You've probably answered the rest of my questions, and in the interests of time, I don't need to go over them for you to reiterate yourself. But one thing I do want to ask is: do you think that it would be easier if students were given guidance from the start about what support services were available and where they could go for that support, and that it should be more uniform right across the university sector in Wales, because it is a bit piecemeal, and every individual university does things slightly differently? 

I think, absolutely, more guidance is always appreciated. I think it would take a lot away from the initial stress and uncertainty about how to access these services, and it's one of the recommendations that we came on to in our working group. We'd probably recommend, for those recommendations, that the committee speaks to the Association of Managers of Student Services in Higher Education, the student services organisation, about ensuring a consistent approach for all students. We've worked closely with them on our policy recommendations and found it very useful. 

Yes, that's fine. And just one further question, it's on funding—something you said earlier about additional funding for students. I've had a lot of friends—I didn't go to university myself, but a lot of my friends went to university, and a lot of them got second jobs while at university to supplement income, but I realise that there are some courses where that isn't possible because of placements. You've got nursing where you're not allowed to have a second job, and engineering, et cetera—some of those core courses where you've got to go on those week placements. So, instead of having more blanket support, do you think that perhaps more targeted support to those students who haven't got options to do something else to supplement their income probably would be a good start for the Government to look at?

I think it is vital that students who don't have that option have got the support in place. However, I think it would be wrong of me to say that they're only ones in need of the support at this time. Every student I've spoken to over the last two weeks is incredibly stressed about the cost of living. It's causing significant mental health difficulties as a result of students just constantly in a state of anxiety as to how they will afford their food for the next month, afford to pay their rent, et cetera. There are some students who will find it more difficult than others to go out and get a part-time job in order to supplement their income, such as those you've mentioned, but there are also some areas in Wales where the number of part-time jobs available to students is very minimal compared to the number of students in that area. So, I think perhaps we can potentially come back to the committee and write in with more data on that, but it sounds like a useful place to start.

That's fine. I was going to ask a final question, but I have one slightly more—I'm just flicking back through my papers here. In the recommendations that you contributed to in your joint working on student mental health, you did reference information sharing, and you talked about it slightly earlier, about this going between health providers and education providers, so there's this back and forth between everyone, and they keep having to relive their stories. And you said that there are misconceptions around GDPR and data protection legislation. Can you just be a bit more specific about what you mean about those misconceptions and how you think Government could help address those problems? And after that, I'm done, so, diolch.

So, all too often, a student approaches, as I mentioned, their institution, tells them what they're going through, which is often quite difficult for that student, to then be told, 'We can't help', and pointed towards a GP. The student goes to their GP, tells their story again, again causing significant distress, only to be passed on to primary care services, where they have to go through that again, only to be signposted back to the university. I think a lot of the time, students are fairly unsure about information sharing in terms of, if they speak to their university, who is going to be informed of that? If they speak, for example if they're on placement, to occupational health, who's going to be told about that? I think that there are a number of misconceptions in terms of where information is shared, so students might think that if they've spoken to their university, they'll automatically be signposted on to NHS services, which just does not happen. But also, students are very—. There are a lot of misconceptions, particularly among healthcare students, that, if they do speak to the university and access those support services, they may be risking their future on their course as a result of information sharing and then be deemed not fit to practice, for example.

I think, what Welsh Government can do to support that is develop policies similar to, as an example, the information sharing that is done on students' consent within the mental health university liaison service, across institutions, to ensure that students can be connected from their institution to the NHS quickly and effectively, thus receiving the best possible care. But also more information from institutions, if a student is on one of these courses, that potentially, you could be deemed unfit to practice, for example. There is some reassurance for students that they can, in fact, reach out for support if they do need it, because I know, from speaking to healthcare students, just as an example, it can be incredibly distressing feeling like you can't turn around for support when you really need it, as a result of not being able to necessarily access that without facing consequences later down the line.

And just some final questions from me—. Before I go on to that, just to say that we will be speaking to AMOSSHE as well, just so that you are aware of that. How would you like the new commission for tertiary education and research to ensure that students are engaged in its work on well-being in the post-16 education sector? Do you have any particular concerns or suggestions for the commission as it begins its work?

It's obviously really important that the new commission has structures in place so that it can consult with students, consulting with students' unions, and also with us at NUS Wales. It's very early days, but I think it's important that the commission have staff whose job it is to engage with students, whether that's on well-being or wider student experience.

On the other side of things, I think it will be really important for the commission to properly hold institutions to account on the mental health support provision they provide, and consider what it is that the students are experiencing when they go for support services, not just the number of cases that universities are taking on, and what is being offered as a blanket measure by the university or the institution. We need to be looking at, for example, waiting times across institutions, we need to be taking into account the cultural competency of care that's being offered, and how well services work for different groups of students. And I think all of this can feed well into the commission's approach for mental health and well-being.

Okay. Thank you. Your paper to the committee mentions that you look forward to feeding in to the administration and monitoring of the new registration condition for education providers relating to well-being. How would you like to see that registration condition developed, and how could it ensure consistency across that post-16 education that you've mentioned, with regard to that well-being support?

So, we're really pleased to see mental health and well-being support included as a registration condition for the new commission. At NUS Wales, we're here and ready to work with Government on this condition. It's really important that the student voice feeds into this, so I'd also recommend that student unions and students themselves are consulted about what their needs are when developing the condition itself. The condition shouldn't just make sure that institutions are delivering a certain amount of support, but that that support is tailored and suitable for the entire breadth of an institution's student body. I'd also refer back to the things that I've said previously about making sure that services are culturally competent, and I think Welsh Government can do this by consulting with people who have on-the-ground experience, such as disability officers, black, Asian, minority ethnic officers, LGBTQ+ staff leads at student unions and student support experts like AMOSSHE.

Thank you, Orla. How do you think the Welsh Government and the Higher Education Funding Council for Wales currently work with student unions and organisations and the wider student population in designing and delivering initiatives to support student mental health, and how do you think that engagement could be improved with students?

So, Welsh Government and HEFCW have worked with and funded SUs in recent years in relation to mental health services and well-being support for students. Student unions really appreciate the funding given during the pandemic and the winter of well-being funding earlier this year; that was very much appreciated and well used. The problem is that these funding streams have often been short-term ones, and that has really limited what unions have been able to do with the money. So, for example, at my students' union, we had two months to spend our allocation of the winter of well-being funding, and we were so grateful to receive this money and achieved a lot with the funding, but it would be wrong for me not to say that the impacts could have been more considered and more widespread with more time to spend that money and more time to be strategic about how we were investing and how we were spending that. This sort of funding is really valuable, but if it was made more long term it would give student unions some certainty in being able to spend it on long-term projects that could help students over a number of years, and really help future generations of students, as well as the students currently engaged at their institutions.

In terms of working with students on an individual basis, I don't think a lot of students understand how Welsh Government and HEFCW impact their studies. There's definitely room for improvement on student engagement, and that needs to come by looking at student demographics, and implementing, as I've mentioned before, a tailored approach so that decision makers have a full picture of student need in all demographics across Wales. 

Thank you, Orla. I think that's the end of the questioning today. Thank you very much for coming along and giving us such comprehensive answers to our questions. It's been our first evidence session, so we're really glad that you were able to join us. If there are any extra things—examples that you've touched on and some of those recommendations in papers that you've mentioned—where you would like to provide us with any further information, we'd very much welcome that. But, thank you so much for joining us. You will be provided with the transcript in the coming weeks and, again, I hope you'll take an interest in the committee's work. Diolch yn fawr.

Diolch yn fawr.

Brilliant. Okay. Just to say to Members now that we will have a short break and return by 10:20.

Welcome back, everybody, to our mental health support in higher education inquiry. This is our second evidence session, and I'd like to welcome our witnesses who are here for this session. We have Elizabeth Treasure, vice-chancellor of Aberystwyth University and chair of Universities Wales; Ben Calvert, vice-chancellor, University of South Wales, and representing Universities Wales; Sophie Douglas, policy adviser, Universities Wales; Tom Snelgrove, director of learner experience, Coleg Sir Gâr, and representing ColegauCymru; and Ceri Wilcock, who is deputy director, student experience, from the Open University in Wales. So, you're all welcome. Thank you very much for joining us for this session today. As you can imagine, we have lots of questions to put to you. If I can remind Members and the panel to be as succinct as possible in these, because we want to get through as many questions as possible. And I will make a start. Perhaps you could summarise the current situation in terms of the mental health and well-being of students in higher education, and do you think there are any unmet needs in terms of students' mental health? We'll start off with Universities Wales.

Bore da, bawb. Thank you very much, Chair. Yes, even before the pandemic, we were seeing an increase in the number of students arriving at university who declared a mental health condition, and so the latest data from UCAS, where students can declare at the time of application, showed a 450 per cent increase between 2011 and 2021. Now, that's before they’ve even joined university and, of course, it's optional, and we know that there are many more students who choose not to disclose their mental health issues. Anecdotally, institutions are telling us that student services are feeling an increase in students presenting in crisis, and we know that there are increasing numbers of students struggling, often with conditions that have emerged before they come to university. So, I think it is important to state that this is not a student-specific issue; rather, it is a young-person issue.

The role of university support services is, essentially, to work with students to remove barriers to their academic success and signpost to appropriate support on the NHS when needed. In terms of unmet needs, we know that child and adolescent mental health services are already stretched, and there may be students whose needs are not yet being met at that stage and who are transitioning out of adolescent services into adult health services. University support services are not the appropriate place for clinical mental health interventions, so there's a danger that we have students who need more support than we can provide who are waiting for that support on the NHS. Transition is a theme we will come back to: transitioning from adolescent mental services to adult mental health services, transitioning from pre-university education to higher education. Those transition points are absolutely key.

Some students may not indicate in advance, as I've already said, that they have a mental health condition, and that can be for a whole variety of reasons, which I'm sure we'll pick up as we go through this session. And that means we may not meet their needs for support initially. Now, it's also worth highlighting that, while the majority of our students come from Wales and from England, we do have a significant number of international students who won't yet be in receipt of support from the Welsh NHS, and that makes the situation even more complex. And then again there is the transition between different parts of the health sector, from an English GP or a home Welsh GP to the university GP, and, again, that's about transitions and about moving between services and is something that we need to look at. Thank you.

Thank you. Tom.

Diolch. Bore da, pawb. Thank you, Elizabeth. Just to reiterate some of the issues that Elizabeth raised—many of those are very true as well within HE provision, within colleges within Wales. However, just some of the data that we've also got within FE colleges that have HE provision: colleges reported an increase in mental health problems even prior to the pandemic, again very similar to what Elizabeth said, but the increase in mental health services has seen as much as 96 per cent more learners accessing these services since 2020, and that's quite significant.

In terms of the effect of COVID, the mental ill health of HE students has increased due to some of the wider connotations of learners coming to study within an FE setting—so, that has included learners who study within colleges—who often have children at home, are managing households and have employment; so, the added issues within that of slightly older people studying within the colleges sector. Thank you. 

Thank you, Tom. Ceri. 

Thank you. Good morning, everyone. Yes, I'd echo what colleagues have said. I'd suggest that it's not merely just a young person issue, and, certainly, our students, who tend to be slightly older, mature students who are studying part-time and, as Tom said, managing multiple responsibilities and balancing different commitments, certainly struggle with mental health. And I'd also stress that declaring a mental health condition is not the same as experiencing poor mental health. And the current pressures around the cost of living and the pandemic have created a situation where, certainly, many students are reporting to student services with mental health difficulties. 

Thank you, Ceri. How do you think our data and wider intelligence could be improved with regard to student mental health and well-being?

I'll pick up that one on behalf of Universities Wales. 

Thank you. 

Okay. Thank you, Chair. In terms of the data that we do have available, as Elizabeth has already alluded to, we have access to the UCAS data, where students are able to declare if they have a pre-existing condition. It's worth noting not all students will apply via UCAS, and not all students necessarily will choose to declare, for a variety of reasons. Upon enrolment, students can then indicate whether they have a mental health condition, and then student services can proactively offer information and well-being support and signpost to further support where appropriate. And obviously, it doesn't stop at enrolment; students then have the opportunity, at any point, to access student services. 

All of this data does depend upon the student themselves choosing to declare and choosing to seek out support, which is proportionate, given that students are adults, legally, and they can choose to seek out that support. In terms of data though, there are some scenarios where data sharing between health and education services is the gap and the challenge at the moment. So, for example, if a student arrives at A&E in crisis, they can be discharged from A&E without the university necessarily being informed that that student has experienced a crisis to the extent that they were in accident and emergency. They could be discharged straight back to their halls of residence, where they live with five other 18-year-olds, and have no support put in place.

Orla mentioned earlier the liaison service that has been established in south-east Wales. That is seeing the health service being able to report back to the liaison service, so the university is informed when a situation like that has occurred, and that's something that I think we would like to see potentially expanded. A recommendation that we made earlier this year, in the joint work that we did with Colleges Wales, with the Association of Managers of Student Services in Higher Education and NUS Wales, included a query as to whether population health assessments are bearing in mind the transient population of students who sometimes live in particular areas, and then sometimes, outside of term time, won't be there, and to what extent are NHS resources able to factor that in. So, that might also be something else that is worth exploring in terms of the data that we have available. 

Okay. Anybody else? Tom, did you want to come in? No. Ceri? No, fine. Lovely, thank you. Do you think targeted support for groups, particularly groups of students who are more vulnerable to poor mental health, would be helpful, or that more universal approaches would be better for tackling inequalities? Do you think that a targeted approach, or just a more universal approach—? Which do you think would be better?

I can pick that up, if that's okay.

Yes, Ben. Thank you.

I think our—. Actually, our overall position is that we would like to make our institutions places in which anybody can succeed—succeed in their educational studies and present to us, wholly and authentically, as themselves. So, I think our general approach is to try and make this whole-institution, and it's really important that we do that, that we don't just think about, 'Have we got services for students who've got particular mental health challenges, where they might need specialist support?' but actually that we think about creating a community and an environment in which students are successful. So, it's both, I think. It's both that, how do we make sure our learning and teaching, how do we make sure our personal support for students, the way we make sure they feel like they are part of a community when they arrive, in which they can present themselves, is sound, and that students are known and that we have good interaction with them. I think, in many respects, most of the work that UUK is pushing for is that whole-institution approach, then supported by specialist services as and when they're required.

Of course, though, there are particular groups that we know present with more challenges. So, the evidence and the data, from Student Minds for example, demonstrate that LGBTQ+ students are more likely to experience mental health problems. So, the recommendations there are about how do we understand and how are we culturally competent with those groups in understanding those challenges and make sure they can present and they can talk to us.

There is evidence to say that young men, or black and minority ethnic students, are often less likely to seek out that support. So, again, how do we create environments in which those people feel that they can talk to us, that they can present? We can do that through information campaigns, but we can also do that by making sure that on our academic programmes of study we have good pastoral support, good programmes of personal academic tutoring, personal academic coaching and so on, in which we won't miss things out.

There are also other groups of students, I think, where it's probably more challenging, particularly students who are in dispersed living environments, perhaps students who are on placements, who are in work-based learning settings. Again, UUK has recently produced some guidance on how they can become more aware of what support is available to them through university services, creating peer support networks, embedding well-being in our placement briefings, training and our resources.

So, I think it's both, really. It's about having a whole-university approach in which everybody sees their role in creating an environment in which well-being flourishes, whilst providing specific bespoke support. I think I would also say that there isn't anything unusual about universities that isn't also there in society. We take populations of students from society. So, where there are social challenges for particular groups, they manifest themselves in universities. So, I think it's just worth us stating that.

Okay, thank you, Ben. Anybody else?

Could I just add on to that?

Yes, Ceri.

I completely agree with that whole-institution approach—it's fundamental in supporting positive mental health and well-being for students—and agree that a combination of both is crucial, really.

Thank you, Ceri. Questions now from Laura Jones. Laura.

Thank you, Chair. As has already been said, mental health of course predates the pandemic, but it has exacerbated it, as we all know, and as Tom said—96 per cent—people accessing mental health services has increased post pandemic. I just want to know from you how significant you think that the long-term effects are of the pandemic, and what they will be on students' mental health and well-being, and is this different for different groups of students, as was just alluded to?

I'll start with that, Laura. The pandemic has undoubtedly affected the well-being of students and staff. I think we need to remember staff in this dynamic as well, across higher education, just like the wider population.

Let me just say a couple of words about staff. They are tired. They've gone the extra mile again and again over the last couple of years, and staff in all parts of the university are tired, just like the wider population. Now, at the moment it's difficult to quantify the impact it's had on us all, but we think different groups will have experienced different challenges, with varying degrees of impact upon their mental health and well-being. So, the obvious is that students studying remotely will have experienced the loneliness and isolation that many of us have experienced during lockdown, and, of course, we also have issues with educational provision having been different for students in the run-up to their moving to us, and there may be some extra catch-up to do, additional support, in terms of studying methods, reintroducing exams, if that’s the appropriate method of assessment, or other ways of assessment. So, I think there’s more general academic support to do.

And another thing around the 18-year-old population, and it will be interesting to hear what Tom says in connection to FE on this, is also the lack of socialisation and how that has helped their maturity over the last two to three years. At this early stage in the term, we’re starting to see that some of the social development has been less than we would have expected in previous years for that traditional student body.

Obviously, part-time or mature students or those undertaking placements, as Ben said, have I think had particular challenges of working in that pressurised environment while also balancing studies and possibly caring responsibilities for family members—home schooling and so on. So, I think it’s important that the long tail of impact from the pandemic has got to be worked through over the next couple of years for that generation of young people and older people who have undergone significant educational and social disruption. So, it’s going to be a few years before we’ve worked all of that in, and we are adjusting our induction processes to reflect this. So, for example, there's ‘Be Bangor Ready’. Bangor has got an online module, ‘Be Bangor Ready’, to create that full induction process through the course of a student’s first year—find your people, know your campus and get to know your student union—in order to increase the confidence of first-years before arriving on campus. Thank you.  

Thank you. Anyone else?

Tom. [Interruption.]

Laura, did you want to say something, or do you want me to—?

No, you carry on, Tom. Sorry, I couldn't see you. 

Okay. Elizabeth, I think we’re seeing that issue regarding resilience coming through, definitely, and the maturity of some of the learners coming from school is also definitely an area that we’re looking to develop more than we would have, potentially, three years ago, and you’ll probably see that in two years’ time. So, I do echo those thoughts, but just to say we’re seeing it from an FE perspective at an earlier age as well.  

Ceri. [Interruption.] Sorry, Tom. I thought you had finished. 

Just in terms of the effects of the pandemic, I would just reiterate the fact that, as colleges, we've got a distinction between the needs of students in more traditional HE settings in that we've got learners who are typically older. If I give you an example, in my own college of Coleg Sir Gâr, 60 per cent of learners are over the age of 26. So, they range from 26 to 78. The pressures of attending college whilst trying to home educate their children, manage a household, hold down employment or not hold down employment have had a great effect on them over the pandemic, and limited support and contact with people as well has also been a big factor within that. What we are seeing is potentially some learners coming back to higher education now who may have been through the loss of a job or a change of career due to the pandemic as well. That's just another effect of it. 

Okay. Ceri. 

Thank you. Just to echo what Tom said, our students are facing multiple challenges because of their different types of responsibilities. I'd also echo what Ben said about universities taking a wider cross-section of society, and we know the pandemic has deepened existing inequalities, and I think that intersection of mental health need with other categories of students and deprivation is certainly playing out. 

Thank you. Laura.

Thank you. How do you think the pandemic has affected the post-16 education sector as a whole and its ability to support students with their mental health, like the ones you've just outlined, with all those outside factors and responsibilities having that impact? Thank you.

Perhaps, if I can pick this up, I think at the moment it's hard to know what the impact fully is. I think we're still working our way through that. This year is the first year where things have felt like they've returned back to something like normal actually. We've suddenly got lots and lots of people back on our sites. It's suddenly feeling wonderfully vibrant and busy again. But, actually, we've got other challenges as well, and I think this is one of the issues for me. We're talking here about pandemic—that's not past tense yet at all, but we've got another crisis, which is the cost-of-living crisis, which is coming along. I actually think that, for some of our students, that will be harder, being honest about it, particularly where we've got populations of students who are older. At USW, a third of our students are over the age of 30. Look at our nursing cohort. Our nursing cohort average age is over 25. These are people with life, family commitments, and I think the cost-of-living crisis will be as, if not more, challenging for them. So, I think it's both—we're learning from the pandemic, but we're also picking up other issues now. 

In terms of what we've learnt, it's maybe a little bit too early to say. I don't even think we can say with confidence what students' disposition now is to their learning completely, because, for some students over the pandemic—. It's like life, isn't it? I'm an extrovert, so I actually missed social interaction. For people who are perhaps more introverted, they probably found quite a lot of value in being able to do their work in a different way, remotely and so on. And I think, as to those different dispositions, we're not quite clear how this will settle yet. So, as we really look at what's worked in flexible learning, what's worked in blended learning or teaching and learning and the shift to digital and so on, I think it's not yet clear exactly how that will settle and I think we're finding our way through that. So, even in USW, we're now asking ourselves that question: what does this mean for us for future patterns of learning and how do our students and learners feel about that?

I think that, as has been mentioned before, there was that socialisation piece. We were in a highly regulated environment in which rules on what you could and couldn't do were laid out very clearly during the pandemic. A young 18-year-old coming into a hall of residence now in a more normal environment, well, again, what issues are there going to be there in terms of them socialising themselves as adults in a new living environment? I think that's something where we'll need to see how that happens as well. And I think the pandemic placed pressure on students and staff alike, particularly those, as I said, who have got other responsibilities in their lives. 

So, I think it's a little bit too early to say, and we've now got other challenges that compound it. And I think one of the things there for me is, we did a really good job, I think, in Wales of coming around that issue during the pandemic—really good. We had fantastic working relationships between Welsh Government, between institutions, between our trade unions and our students' union. There's something in there—there's a little bit of magic in there that we need to try and keep going through normal times as well and not think we just do that in times of crisis. At the moment, I think we still have to do that in the cost-of-living crisis, but there's something about how we collectively work together through these issues that I think is really, really important.

Thank you. Before I bring anybody else back in, just to say, Ben, as you mentioned nurses, that we do have a group of registered nurses undertaking the specialist community public health nursing programme at the University of South Wales in the public gallery today, so they have heard what you said as well. 

Right, did anybody else want to come back on that question? No. Laura, back to you.

Thank you, Chair. And as you said just now, Ben, the collectively working together is something good that has come from the pandemic, and there are some good things that have come from it. On that thread, in terms of helping students who are struggling, what are the panel's thoughts on flexible delivery and learning? Should that be maintained in some circumstances? And what are the benefits and challenges of delivering stuff online? Thank you.

Is that to ColegauCymru, Laura?

Well, it was, but a couple of people have touched on it, so whoever wants to, really, respond.

I'm just aware of time, but, Tom, do you want to start?

Yes, I'll start and I'd echo Ben's thoughts. There have been some huge benefits from what's happened through the pandemic, and working collaboratively and together has definitely been one of those, and I think, from a ColegauCymru perspective, and looking at HE learning within FE colleges, the remote delivery and online and flexible learning delivery has definitely been a benefit due to the nature of some of the difficulties that the older learners do find in attending colleges, so they've been able to do that more. However, the side-effect of that, then, has seen potentially the social isolation becoming more difficult.

But, like I said, I think some of the benefits are there as well. I think we need to look at that. So, many of the colleges around Wales have been able to implement different identification, robust processes to be able to triage learners, and assessment processes are now in place that were always talked about and in the pipeline but potentially have been brought forward because of the pandemic. Also, being able to deliver remote support during the pandemic has also been an added advantage, which, potentially because of the pandemic, may not have happened so quickly.

Perhaps if Universities Wales or Open University want to add anything, you could put that in writing for us, just because we're short on time. Laura.

Okay. Final question to Open University: as a provider of distance learning, what are your learnings and reflections on best practice, maintaining engagement and embedding a culture of positive mental health among your students post pandemic? Thank you.

Thanks, Laura. I think I'd say it's absolutely possible to thrive at university with a mental health condition, and flexibility is key to that—flexibility that is designed into the system and allows students to ebb and flow as their mental health fluctuates. Even though we're distance learning, we spend a lot of time creating student community, making students feel that they belong, engaging them on multiple platforms, and I think Ben's absolutely right that students, even within my own institution, are not a homogenous group; there are diverse needs and diverse populations of students, and we need to create opportunities for them to come forward and disclose any issues around mental health and well-being through multiple points. Likewise, we need to be able to interact with them and create that sense of community in a way that works for them at a time that works for them, and I think there are possibilities created by technology that allow us to do that, but distance doesn't necessarily mean we don't do in-person and supportive one-to-one engagement with students.

Lovely. Thank you, Ceri.

Thank you, Laura. I'd just to remind everybody as well, Members and panel, if we could be as succinct as possible because we just have got so much to get through. Right, questions now from Jenny Rathbone. Jenny.

Thank you very much, and thank you very much for your excellent evidence so far. As you've already said, there is a mental health crisis amongst young people generally, not just those going to university or college, and schools have obviously had to catch up really fast on this. Technology has many positives, but it's also had a lot of negatives in terms of online bullying and the celebrity culture that no ordinary person can possibly match up to, as well as the excessive drinking and vaping culture that you are being handed on by other organisations. So, I wondered if you could just tell me a little bit about how you work with the students' previous provider of education in terms of understanding the individuals who are going to be in your care.

Ben.

Jayne, I can answer that, if that's okay. Firstly, I think it is a challenge—I wouldn't deny that it's a challenge. This takes us to the area of transition. So, actually, somebody in a school context or an FE context is known within that context, has support within that context. How do we bridge that support when they move? So, I think it is a challenge, and some of that's about data—do they declare their conditions to us when they arrive, if they've come through the UCAS system, and so on? If we look at it in a regional context, many institutions do have very good, long-standing relationships with colleges and sixth forms, and some of those are very formal. So, USW, by way of example, we've got 2,000-odd learners that are in a strategic alliance with five FE colleges in south-east Wales, where they would progress to us. Being honest about it, that makes life a little bit easier because we get to know them in another way. Their academic staff get to know our academic staff. I was speaking to some the other day where they were talking about their students being nervous about coming to university to top up their degree, so they dealt with that by coming to the open day with their students. They came along, bussed them up, came with them and they could see that they knew the staff at the university; they were part of the family.

So, there is something about having formalised relationships that can be helpful, but it doesn't, of course, apply to everybody. Many of our students don't come to us from Wales; many come from organisations in England, schools in England, colleges in England and so on. That direct sharing of information, therefore, becomes more challenging.

So, really, it becomes about how we then capture that when they enrol and what we do to make sure that they feel knitted in to the institution quickly through the processes that we have. But, overall, I think, in the context of tertiary education reform, there is an opportunity here for us to both ask questions about data flows from schools and colleges through to universities so that it becomes more seamless, and also just, frankly, about how do we build better ongoing working relationships across the system between schools and universities.

But we do lots of this, lots of outreach, lots of civic mission activities that are engaging with schools, but I always think this is an area we can improve, and, if we can formalise some things, it makes it easier.

Fine, thank you. Elizabeth Treasure, in your opening remarks, you highlighted the 450 per cent increase in the number of students who are declaring that they have a mental health condition on their application forms. Clearly, that's a significant statistic, and it could be a positive in the sense that people are feeling able to declare that they have a mental health problem, whereas previously they never would have done, because of the stigma attached and the possible impact on their future careers. So, I just wondered if somebody could tell me about the suicide rate and whether that's gone down as a result of people's greater willingness to disclose their mental distress.

Anyone from Universities Wales?

I think it would be best, Jenny, if we wrote to you on that—

Okay.

We don't have—

That's absolutely fine. I understand you want to be accurate on that—

Yes, thank you.

—but you can see that our ability to talk about this is, obviously, helping us really define the size of the problem. What more do you think the Welsh Government can do to facilitate collaboration between providers to support transitions to higher education, or, indeed, further education? You've already given some excellent examples in your paper of really good things going on. Is there anything else you want to add to that, or I can move on to my next question if that's—? If anybody wants to elaborate—

I think Tom would like to come in, Jenny.

Fine, please. Is that Sophie?

Tom. Oh, Sophie—.

I—

I'm struggling; I'm on a small screen, so—.

We'll go to Sophie first, and then we'll come to Tom.

Thank you, Chair. I don't want to repeat anything; I think we have covered a number of recommendations. One thing that I have picked up in talking to directors of student services, around the fact that not all students necessarily will declare in advance, is, potentially, a concern among students considering applying to university that, if they do declare a mental health condition, the university may be less likely to offer them a place. So, I think there's some important work to be done there to make it very clear that that is something that cannot and will not happen and that there is no reason—. A university cannot lawfully not provide an offer due to that particular situation. So, possibly some kind of information campaign—universities are already working with schools, but just making that point extremely clear.

Something else that we have recommended in our policy recommendations earlier this year is around considering where the transition does happen from adolescent mental health services to adult mental health services around the same time as students may be embarking on their higher education journey. Do we need to consider some kind of transition service in mental health provision so that this cliff edge isn't occurring all at the same time? That's something else that we have suggested may need to be considered, and I would echo Ben's suggestions that, with the reform of tertiary education and the role of the commission, I think there certainly is an opportunity for a focus on where we can smooth over some of the cracks in transitions.

Thanks. Tom.

A lot of—. Sorry, Tom, you wanted to come in.

Sorry, Jenny, I think Tom wants to come in, yes.

Thank you. It was just to—. Again, not to reiterate any points, but within the college sector, or HE sector within FE colleges, for the older population of learners, the transition from school isn't so much of an issue because it's probably been quite a large period of time. But it is that outward working with different multi-agencies within health that is problematic. We don't often get that information—very similar to what, I think, Elizabeth said earlier, or Ben said, regarding an 18 or 19-year-old who has been in emergency services. There are quite often catalogues of information that we don't get, but would help the transition from adult mental health services in local authorities to colleges and would be really beneficial.

Okay. I think we're coming on to that later with another Member. Just to pick up on the transition and what universities can do to help young people look after their mental health, a lot of young people are starting to live on their own suddenly for the first time and, if they don't eat well and they consume industrial quantities of alcohol or don't have nearly enough sleep, they're clearly going to suffer depression and that can lead to much more serious problems. How can universities promote good living, if you like, amongst its students? Elizabeth, did you want to come in on this?

I think we've got to—. The intersection between someone's personal life and their work life—. I think we've got to model good behaviour. I think we've got to model what we expect, encourage sleep: work hard, play hard and appropriately, and sleep—and don't forget to sleep, I think, very, very critically there. I think this is around building a community. Again, we're talking so much of the time about the standard 18-year-old, but they are adults and we've alluded to the fact—I'm sorry, I'm rambling a little bit—that they are moving from being in, in many cases, but not all, a protected environment to starting their own adult life. I think we need to look at student activities and working with our student unions to model a good way to live.

I just want to refer back to the cost-of-living crisis and some of the issues around good eating. I've got some examples of how costs are shooting up, which we may come on to later, and I think there are real pressures on the student loan system. The Welsh Government progressive system, based around the real living wage, is very helpful, but for our English students it's going to be very challenging, particularly as their parents will also be coming under that cost-of-living crisis and may not be able to top up the loans in the same way. So, I think there is a lot of work to do there and I think we need to work through it very quickly over the next few months to see particularly how the cost-of-living crisis affects them.

Thank you very much, Elizabeth. Thank you, Jenny, as well. Perhaps, Elizabeth, if you could send some of that information in writing to us and keep us updated of that as we're going on with our inquiry, we'd really appreciate it. Thank you, Jenny. We'll move on to questions now from Sioned Williams.

Who from Universities Wales wants to answer that?

I'd be happy to come in on this point, Sioned. Universities Wales, as part of Universities UK, fully endorses that report and that recommendation, developed with PAPYRUS, Prevention of Young Suicide. I think what's important in this guidance is the suggestion of a number of things that universities can do, so that—. The basic legal principle is, in any situation that is deemed to, effectively, be life or death, support services can contact the next of kin with or without the consent of the student, because that will override the student's consent, as it were. There are a number of things universities can do that are recommended within this guidance around making it clear how and when a situation may arise, and making it clear that the contact that they name doesn't necessarily have to be a parent. For some students, it may not be appropriate for the person contacted in that scenario to be a parent. So, there's plenty of guidance in there. And this is the first time some sector-wide guidance has been provided, and we will be encouraging our members who are already doing a number of these things to bear in mind anything that can help to strengthen the student services offer that they already provide.

Sophie.

This is something that I think we will need to write to the committee on and verify before I comment.

Okay. Thank you.

'You can't pour from an empty cup.' 

Universities Wales. Anybody?

Ben, do you want to pick this one up, or would you like me to? Sorry, we're—. I'm very happy to pick this up.

[Inaudible.]

Thank you. I think the important thing is to provide support for staff. Where we're concerned is that there is a limit to what universities can do. We are not health organisations, and it would be inappropriate for us to become health organisations, Sioned. So, we need to have, as you say, front-line staff well prepared with things such as mental health first aid training, referral routes, and making sure that that transition in and out of the NHS is appropriate, where appropriate, and to create the overarching environment whereby students feel supported and feel safe and know where to go for support. 

You then referred to the cost of living as it affects our staff. We are concerned. Through the previous administration, we were all encouraged and have all become real living wage payers. We are all real living wage employers, and I think that's very important. And I think we all know just how difficult it is. There is a limit to our finances, as well as to the staff's finances. So, leading an institution, it's making sure that the money I have available to me provides appropriate salaries to the best of my ability to staff, based as a minimum around the real living wage, and that we provide as much support as we can.

But the problem is we could double our support and not meet the whole need of what students are asking, and it's challenging.

Elizabeth. 

I'm just looking at Ben's face—go on. 

I'll kick off with this one, if that's okay, Elizabeth, and then you can come in. Of course, we are looking to see what we can do, but, again, this a response in a moment in time, isn't it? We are, and I know many universities are, actively considering how we use our financial resources as best we can to do this. So, at USW, we will be announcing—I won't say what they are now—this week some things to our students about what we're going to do to help support them through what's going to be a tricky year. For us, that will focus on some basics: making sure that we have campuses that are warm that people can go to, that are good for study, so that they can come in, they don't have to be at home, they don't have to be spending money on energy themselves, they can work comfortably; that they're fed, and that they're fed at a rate that they can afford; and that we provide additional targeted support for students around student hardship. There are 101 things we could do, if we had the money to do it. I think we did have really good and very helpful support from the Welsh Government, targeted support, during COVID. I think this is as challenging, and I think this is as problematic, particularly for certain groups of students where there are potential, I think, retention issues in critical services for Wales.

We had a conversation with staff from the NHS, from Health Improvement Wales. We're concerned about retention of our nurses, because of the fact that they are older, and they have got these wider responsibilities, so we don't want them to drift away from being great nurses. So, what can we do to provide support for students there who are on placement, who are having to spend money on transport and so on? Again, our hardship funds can help there, but we suspect that there will be more of an ask. So, we're prepared to look at this, we're prepared to top it up. We've got plans for term 1, we'll have plans for term 2 when we see how those things are going. But ultimately there's only so much cash in the bank to do that, whilst we're also trying to do all of the other things that, as universities, we're required to do. I'm not aware of a vice-chancellor in the country that I have spoken to that isn't focused on this issue and isn't prepared to do what they can to help. It will be different across different universities, because our populations are different and the needs of our students are different. 

Thanks, Ben. Tom, do you have anything to add?  

Yes. Thank you. Only something very specific towards colleges again. Taking on board everything Ben said, I think we're all doing as much we can and realise that the cost of living is problematic, and more so within the adult sector. Sorry, not more so, but we're finding it within the adult learners. For our FE learners, we actually get a financial contingency fund for 16 to 18-year-olds. We don't get a similar funding pot for HE learners. That is something we would like to suggest. It may be a way that would be able to help HE learners. 

Thanks, Tom. Ceri. 

Thanks, Jayne. Financial pressures and the link between that and mental health is well known. It's something that many, many of our students are reporting to us. As Ben said, the funding available during COVID was incredibly helpful. We distributed something like £600,000 worth of funding, and I think this crisis is another area where we'd be really keen to work together with the sector and Welsh Government to look at what options we might be able to offer students for support. 

Thank you, Ceri. Sioned. 

Diolch, Sioned. I'll pick this up. I think, just on a point of clarification, the intention behind that recommendation in the policy work that we've done is more around how students should be treated on a par with the wider population, so that, regardless of where they're living or studying, they are part of the population there, hence the recommendation around population health assessments.

As you say, universities are autonomous institutions and we're not suggesting any kind of specific uniformity. Because they all have diverse populations and so on, that wouldn't necessarily be appropriate. So, that's not necessarily what we're advocating, more that students are treated as part of the wider population regardless of where they live and where they study. Essentially, it's that the support to which they are entitled with the NHS is the equivalent to everybody else and that they are aware of that.

So, if you live in Wrexham during the holidays at home but you study in Cardiff, or you're from Portsmouth and you study in Aberystwyth, the question is: how are we ensuring that students are able to access mental health support throughout the year? There's not necessarily an easy fix on this. We've talked a lot this morning about transitions. GP passports are something that could be piloted and could be explored further. I think there's probably a whole piece of work around data sharing, which is something that, generally, we would recommend that the Welsh Government could look into further. 

Thank you, that's really helpful. Just before we go on to other questions, I'm wondering whether the panel would be happy if we did extend the session for about five or 10 minutes, just because there's so much to get through, if you're happy. Would you be okay to do that? Yes, I can see nodding; lovely, thank you. Sioned, was that the final part of the question? Lovely; diolch, Sioned. Questions now from James Evans.

Thank you, Chair. On a lot of my questions, I think elements of them have already been answered. If you just want to say that you refer to an answer that you gave earlier, that's absolutely fine, so that we're not repeating what was said earlier. To what extent do students and staff in higher education providers understand where their responsibilities for mental health support lie? What are the respective roles of NHS care versus university-based services? How could these roles be better clarified? Would a national set of guidelines be easier or do you think this should be done on local levels and universities set their own course? I'll probably come to Elizabeth, if that's all right.

Thanks, James—a really good question. This is one of the challenges we face, isn't it? What are the expectations of students when they come to universities? What are the expectations of their parents? Do staff know where to direct students who are struggling? We are committed to adopting a whole-institution approach, as advocated for in the Stepchange framework, ensuring that staff understand when and how to signpost students for further support.

I think there is some misunderstanding around some parts of the student population. I think I discussed before the fact that we're not NHS services and that there is only so much that it's appropriate and safe for us to do within universities. So, we do provide counselling and well-being support, but if a student is experiencing mental health problems, it is our responsibility to signpost them to the NHS.

I think there is a role for local and national guidance to make it clear for as many people as possible what routes we can follow. As was alluded to, we are autonomous institutions, but we work very collaboratively together, and we demonstrated that very effectively during the pandemic. Ben has said how we worked very closely with the Welsh Government and with the funding council, and I think there's a lot of lessons to learn from that in how we do the same over mental health problems.

I see Sophie nodding away, so I think she probably agrees with what you've said.

Tom, did you want to come in? No. Ceri, anything to add?

I wanted to say that, obviously, being a pan-Wales institution working across seven health boards, it’s particularly challenging for us, but I agree with Elizabeth’s comments about national and local approaches being required.

That’s fine. One thing we are finding, though, is when a young person transfers between child and adolescent mental health and adult services—. Is that a problem for universities, do you think, the challenge of transition? I don’t know who wants to comment on this one.

I’m more than happy to. Yes, it is. The transition from CAMHS to adult mental health services around the same time as students are starting, effectively, a new life at a university can have the effect of removing a safety net they’ve had for a period of time, where you’re used to a certain mode of support and then you’re having to find another one. I guess it is normal for any student who’s coming to university to experience a level of transition anxiety anyway about starting a new life. If they’re used to and have had access to sources of support that they’re then having to re-establish when they go to university, one can see how that would compound, I guess, that academic stretch, being in a new social environment, and so on. I guess there’s a higher risk there of exacerbating mental health problems. I think there is a question about whether or not some kind of bespoke 16 to 25 mental health transition service could be explored further as a way to make sure that cliff edge for people starting university isn’t there. What we’re confident about is that if they declare to us, we’re really good at getting around to them; if we know, we’re really good at getting around them and providing them with support.

In terms of geography, there are also challenges. A good number of our students are not Welsh domiciled, or they’re coming from England, so they aren’t even a patient of the NHS in Wales. There are data-sharing issues between the English NHS and the Welsh NHS before registering. They don’t share the same patient data. So, I think there are challenges there. They might find themselves therefore at the start again of a diagnostic journey when they come to Wales, when they register with a GP and they’re having to go through the same rigmarole again. Even, I think, if people are moving from one part of Wales to another, and registering with a new GP, these things can take some time. I’ve even experienced this myself, in my own family, where you’ve got your child registered with a GP in Wales, and then they come home, back across the border. At Christmas or the summer, when they’ve got any health challenges, how do they manage that effectively? It’s difficult. So, I don’t have a solution for you, but I think there’s an issue here that requires some joint exploration around whether or not we can advocate for data sharing, GP passports, ways of mitigating those challenges, because I think those challenges are there.

I’ll jump back in, Chair. I think you’ve almost answered my next question, because I was going to ask you how you think data sharing problems could be addressed. I know HEFCW have talked about having that NHS student passport that moves around with that individual. You’ve got NHS Wales, NHS England, data sharing between those is different, but people move now, don’t they, they aren’t as static as they were before. So, do any of you have any suggestions as to how we could address this? I know you said about the student passport. Is there anything else you could think of? If you haven’t, or you want to write to us, that’s absolutely fine, with just some ideas and suggestions.

Just a very quick one, James. I think there are things that we’ve done that we could build on here. There was work that was funded in south Wales in partnership with the University of South Wales, Cardiff Met and Cardiff University, looking at how we can join up better, particularly how we can join up better with NHS services, and make sure that some of the things that Sophie described earlier on, where students are maybe attending acute services on the NHS, are being reported back into the institutions. I think there are things where that kind of mental health university liaison service that’s part of that piece of work can be scaled up. What could that mean across the piece? Is that something that could become a kind of Welsh approach to liaison between services and data sharing? So, I think there are things that we can build on that are already working. Indeed, the initial feedback that we’ve had from students who’ve accessed that model has been very positive, about the sense of it being joined up. So, I think there are things to build on, James, is what I'm saying. 

Okay, thank you. 

Thank you, James, as well. And just to say that, as James has said, if there are any suggestions that you do have or you think of things, please get back in touch with us, or write to us. That would be great. Our final set of questions now from Ken Skates. 

Thanks, Chair, and apologies, I joined you late; I was being quizzed myself in another committee this morning. You've already touched on quite a number of issues that I was going to raise, but just first of all in regard to the cost-of-living crisis and the impact that that's going to have on learners, are education providers increasing the support and resources available to learners in a consistent way across all institutions and settings? 

I think we have, Ken, a mixed student body, so we need to do different things for different types of students. What we're doing at the moment—and Ben covered this in some detail—is looking at our student body and putting as much help as we can in for those students. For me, the group who are possibly most at risk are non-traditional students living in private accommodation, followed by maybe traditional students living in private accommodation, where it is much harder to—. And I'm drawing on learning from the pandemic here. Those were the groups who maybe didn't get rent rebates and things. So, we can make sure that we don't pass on, for example, energy cost increases to students who are living in halls of residence. 

So, I think we have to work through, in a very dynamic way, what the problems are that our students are encountering, and using the hardship funds that we have available to us to plug those holes. I think we are all looking at ways in which we can provide hot food as close to cost as we can, or at cost, for example, so that we are making nutritious food available. But, as we all know, it's moving very fast, and any extra money for hardship would always, always be appreciated, because I know that we can distribute that to those most in need. And as we've said, those non-traditional students with caring responsibilities, with other pressures, are the ones we really do have to look at. 

Absolutely. Tom or Ceri, did you want to come in? Tom. 

I'd just back Elizabeth up there on those non-traditional students with caring responsibilities, who may be doing part-time work as well, as well as looking after children and managing households. We need to be thinking about how we can support them with hardship loans, like I mentioned briefly in the last set of questions. Typically within FE colleges, we get a financial contingency fund for learners 16 to 18; we're not in receipt of that for learners in the university setting.  

Okay, thanks. Ceri.

Thank you. Yes, I echo all of that and just emphasise that we know that, for our students, maintenance support is not just supplementing their income, it is the difference between eating and heating, and it's certainly a very, very difficult situation that all providers are facing with finite budgets. The will is there and we'd be very happy to work collaboratively and with Welsh Government on some solutions. 

Ken.

Thanks. Just two more questions from me, Chair; I'm conscious of time. Turning to CTER, it's going to be empowered to prioritise the oversight of vitally important matters such as student welfare. How would you like to see the new regulatory arrangements developed, particularly regarding the condition of registration relating to well-being? 

We're particularly keen to ensure that regulatory framework arrangements recognise the roles and responsibilities of health and education providers, and that they provide a clear understanding of what interventions, monitoring and support are suitable for HE providers. We all adhere—all universities in Wales—to the whole-university approach set out in the Stepchange framework, and that could be expanded upon to a whole post-16 approach to mental health and well-being overseen by the new commission. I would also really encourage the new commission to help develop these links that we've been talking about between health and education, to ensure that we join up at a national and regional level.  

Okay, thank you. Anyone else? Ceri. 

Thank you. Just to add that, as a four-nations university, we're mindful that the regulation will affect us in a slightly different way, but very much welcome and recognise the importance of well-being, and agree that the Stepchange framework provides a useful steer for that.

Ken.

Great. Thank you. Finally, are there any other recommendations that you'd like to suggest to Welsh Government that could lead to an improvement in mental health support for learners in higher education?

There's a lot of work that can be done to explore developing NHS higher education partnerships, like the excellent model that we're seeing in south-east Wales and the data-sharing opportunities to ease the transitions. We may also want to consider suggesting that Welsh Government should consider a specialist policy adviser post on student mental health and well-being to explore this area. Any work that Welsh Government can do on developing a shared understanding across students, parents, staff and services of the roles and remits of the institutions' support services and the NHS would be helpful to clear up the confusion that we've been talking about this morning, and ensure that students know where and how to access support.

Okay, thank you. Tom.

The only thing I'd like to add is that, when new funding does become available, if thought and consideration could be given to it being longer than on a one-year basis; if it could be on a longer basis so that we could have longer to embed, measure the impact and fully evaluate if there has been impact with that. I appreciate that funding is tight at the minute, but a slightly longer period of time would help us evaluate the impact of what we're doing.

Thanks, Tom. Ceri.

Nothing to add. I would agree with that point about sustainable funding, yes.

Lovely. Brilliant. That's it. Thank you, Ken. Thank you to everybody on the panel—we really appreciate you taking the time to come in this morning, and thank you for extending your time here with us as well. I realise that you have a few papers that you can send in to us as well, so if you've given some more thought to some of the evidence you've given, we'd appreciate that. And if there are any other questions, we will write to you as well. You will, of course, also receive a transcript of this meeting in due course to check over. But, diolch yn fawr, and thank you for coming in to us to give this evidence today. 

Diolch.

Diolch yn fawr i chi.

Brilliant. Thank you.

We'll move on to the next item on the agenda, and the next item is papers to note. We have 14 papers to note. Are Members content to note all those papers together? They are set out in the agenda and in the paper pack. Yes, I can see that all Members are content. That's great.

We'll now move on to item 5, which is the motion under Standing Order 17.42 to resolve to exclude the public from the remainder of the meeting and the meeting on 13 October. So I propose, in accordance with Standing Order 17.42, that the committee resolves to meet in private for the remainder of the meeting and the meeting on 13 October. Are Members content? I see that Members are content, so we will now proceed in private.