Current discussions of ‘mental health’ obscure the fact that there are many different recognised different disorders, not all preventable, and not all responsive to the same approaches. This chapter provides an overview of the nature of mental illness, signposting readers for information on specific conditions to chapters elsewhere in the book. It is not appropriate for lay people to diagnose, treat or case-manage a student’s or colleague’s mental illness. However, some background awareness of the nature of mental illnesses can inform helpful responses. Mental disorders bring implications for admissions policies, rights and responsibilities, fitness to study and to practice, information-sharing with parents, provision of services and links with NHS and third sector. ‘Disclosing’ a mental health condition to the university provides rights to support, services and finance – the DSA (disabled students allowance). The key to accessing all NHS treatment is to be signed on with a local GP, but currently General Practices are financed better for elderly caseloads. Networking with university in-house mental health services is essential . Arrangements to hold GP and Psychiatric clinics on University premises are particularly welcome.

Students and staff are provided with a range of mental health supports, many of them boasting excellent outcomes, but not always adequately connected up. Counsellors, Mental Health Advisors and Mental Health Mentors are available without fee to most university students. These are well researched and evidenced in the treatment of mild to moderate mental illnesses and in the support of people with longer term disorders. Chaplaincy takes many forms and is also a widely available but less well evidenced. There is still much work to do in terms of integrating different services around a vulnerable student. The challenge is greatest when NHS as well as in-house university services are needed. Students with severe mental disorders require longer courses of therapy than university Counselling services routinely offer, and arrangements for treatment during vacations are essential. Integrative models such as that piloted in Greater Manchester show promise, but smaller, less urban universities need different solutions. More than half of universities have no GP on campus. Workforce shortages and funding anomalies make it ever more difficult for GPs to co-ordinate the care of their university patients.