At the next Student Life Committee meeting, the Trinity College Dublin Students’ Union (TCDSU) will present a document entitled ‘State of College Counselling and Health Service’. The document, which was seen by The University Times, contains “never-before-seen” statistics regarding College Health and the College Counselling Service. TCDSU President László Molnárfi that the aim of the document is to “encourage more investment into these services”.
The document sets out that, while TCDSU acknowledges that “these vital supports have consistently proven their excellence in assisting our students’ mental and physical well-being”, challenges such as “chronic underfunding” have led to “excessively long waiting lists”. In order to “advocate for the resources necessary” the TCDSU sees this report as “the first step” and makes “a firm commitment” to securing the necessary funding “to enhance the effectiveness” of staffing, waiting times and service usage.
The data within the report comes from three Freedom of Information requests, six reports presented to the Student Life Committee from 2016-17 and a 2014-15 Board report on Student Counselling. Data from the October 12th, 2023 Mental Health Event held by the Risk Office revealed that 20 per cent of non-EU/EEA postgraduate students and 17 per cent of all non-EU/EEA students use Student Counselling.
Students wishing to access regular counselling services must first attend an assessment appointment, and wait times for these initial assessments have grown from a little over one week in 2017/18 to just over two weeks in 2021/22. Wait times for these assessment appointments peaked during the first year of pandemic, when they were marginally higher than they are now.
If the initial assessment appointment qualifies the student for regular counselling, the incurred wait time has almost doubled from three weeks in 2017/18 to five and a half weeks in 2021/22. This figure peaked in the 2020/21 academic year, at close to two months. An external review of College Counselling from earlier this year noted that now, “many students are seen every two to three weeks instead of weekly”.
A detailed breakdown of waitlists in 2022/23 showed reductions in waiting times from the first to the second semester as well as a reduction from the 2021/22 times. It also revealed that the maximum wait time for a counselling appointment (wait time for initial assessment included) was 54 days in the first semester, and then 49 days in the second semester. Wait times in the year 2021/22 were found to form their peak around exam time.
TCDSU noted in the document that emergency appointments are not included in the above calculations, as they are processed and attended on the day they are requested.
A demographic breakdown revealed that 1,990 undergraduate students, roughly 13 per cent of the cohort, accessed the services in 2021/22, compared to 650, or 10.1 per cent of, postgraduates. TCDSU found that EU and non-EU students accessed the services at roughly equal rates, at 12.2 per cent and 13 per cent respectively.
The number of full-time counsellors has increased by 50 per cent from 2018/19 to 2022/23 with the number of full-time administrative staff increasing by 22 per cent. In the year 2021/22, Trinity counsellors saw more clients than 99 per cent of the 626 student counselling services included in the relevant dataset. During the same year, emergency appointment clinics saw a “sharp”’ 86 per cent increase in appointments from the year 2020/21. Also, on average, 25-30 per cent emergency appointment attendees had a repeat emergency appointment, except in the year 2021/22, when this figure was close to 60 per cent.
The document made reference to the results of a survey conducted by Students4Change (S4C) last year. Several students reported waiting four to six weeks, even up to over two months, for an appointment, and S4C later protested for more funding to the College Counselling Services.
At the recommendation of the BAME (Black, Asian and Minority Ethnic) advisory group, the report explored the ethnic breakdown of the College Counselling staff and found that “all College Counselling staff members are white”. Trinity was named as the 16th most international university in the world by Times Higher Education in 2023.
The report also states the need for a “dedicated off-campus student counsellor” of which there currently are none.
The report found that in the last ten years, although the ratio of counsellors to students has increased from 1:2300 to 1:5500, it still falls short of the “recommended safe ratio” of 1:1000 to 1:1500. TCDSU attributed this to “various administrative, staffing or logistical challenges”.
Despite improvements in the staff-to-student ratio, the waitlists show a “steady, and then a significant increase” since 2015. According to TCDSU, this suggests that the service “is not resourced to handle the influx of student demand”, which has increased due to the pandemic and “will keep being high due to external socioeconomic factors” such as the worsening cost-of-living crisis. The report confirmed that demand for counselling services peaked during “high-pressure” assessment periods, described as “pinch points”. It also laments that “staffing numbers have not increased adequately as student numbers increased”, expressing particular concern over the aforementioned 54 and 49 day maximum wait times through the first and second semesters of 2022/23, describing the service as “not equipped to handle all student needs”.
The report states that “the College Counselling service exists on the assumptions that it is not there for significant long-term support”, as a student’s time in college is finite. However, “there would be an expectation that support is given quickly within these constraints”, and in this light, “the waiting lists are too long”. The report further pointed out that the HSE waiting lists of over one million people contribute to a higher use of College services.
The report recognises College’s attempts to “alleviate” some of the issues surrounding understaffing and waitlists with its Stepped-Care Model, which relies on, amongst other therapeutic techniques, Online Resources, the S2S Mentor and Peer Support Programmes, Workshops and Group Therapy. However, due to the continued concerns with staffing and waitlists, it does not see such a model as “a substitute for a well-resourced counselling service”. The report referred to the wait times for the service “cruel” and the external review from earlier this year expressed a similar concern about the length of these wait lists.
The report also requested data for the College Health Services, but found their reporting to be “sorely lacking” in comparison to the College Counselling Services. In response to a Freedom of Information request concerning a demographic breakdown of Health Service visitors College Health Services attributed their lacklustre reporting to a lack of IT infrastructure, “We are currently trying to build this data into our software systems and it is currently being developed by our software provider.”
The TCDSU, however, “understands from approximations” that College Health is used 3.5-4.5 times more by international students.
The report reveals 5,462 students and 216 staff were seen by the College Health Service in 2022/23, and out of 8,637 total appointments, just under 35 per cent were emergency and seen on the same day, and the remaining had an average wait time of almost two weeks, with a maximum wait time of three weeks.
Also included are some student testimonials concerning their interactions with both College Health and College Counselling Services. Some note how they had to try for numerous days to have someone pick up their phone call or keep calling for “three hours” to get through on one day. Others noted lengthy waits to get prescriptions or be seen for gaining access to antidepressants, apparently as long as three months for the latter.
A key issue the report highlights is how, despite an increase in Government student mental health funding from €3 million to €5 million per year since the COVID-19 pandemic, funding is only allocated on a yearly basis which leaves “these services unable to plan for the future”. The TCDSU joins the USI in calling for “multi-annual funding of €6 million a year” which they argue will “maintain core counselling services” and help “to implement” the National Student Mental Health and Suicide Prevention Framework.
The report concludes on the point that there is a mental health “crisis” affecting students which is shown by the alarming number of students who had tried to take their own life (10 per cent of 8,290 respondents, as seen in the Jigsaw My World 2 survey), 54 per cent of whom tried to access help afterwards, and of those, 48 per cent found it ‘difficult/very difficult’ to access said help.
