Against a background of huge changes in the world of university and college students since the turn of the millennium, together with a multitude of reports on student mental health/wellbeing, this article argues that the field of student mental health is hampered by the imprecise use of terms, a rush to action by universities in the absence of a robust evidence-base, and a lack of overall coordination and collaboration in the collection and use of data. In response, we argue for clearer and more consistent use of definitions of, as well as differentiations between, student wellbeing and mental health, for a longitudinal approach to the student body that captures their developmental transitions to and through university, and a strategic and systematic approach to the use of bona fide measures in the collection of data on wellbeing and on the process of outcomes in embedded university counselling services. Such a coordinated approach will provide the necessary evidence-base upon which to develop and deliver appropriate support and interventions to underpin and enhance the quality of students' lives and learning while at university or college. K E Y W O R D S student mental health, wellbeing, university embedded counselling services, transitions, outcome measures | 357 BARKHAM et Al.

BackgroundADHD is a common childhood onset mental health disorder that persists into adulthood in two-thirds of cases. One of the most prevalent and impairing comorbidities of ADHD in adults are substance use disorders. We estimate rates of ADHD in patients with substance abuse disorders and delineate impairment in the co-morbid group.MethodScreening for ADHD followed by a research diagnostic interview in people attending in-patient drug and alcohol detoxification units.ResultsWe estimated prevalence of undiagnosed ADHD within substance use disorder in-patients in South London around 12%. Those individuals with substance use disorders and ADHD had significantly higher self-rated impairments across several domains of daily life; and higher rates of substance abuse and alcohol consumption, suicide attempts, and depression recorded in their case records.ConclusionsThis study demonstrates the high rates of untreated ADHD within substance use disorder populations and the association of ADHD in such patients with greater levels of impairment. These are likely to be a source of additional impairment to patients and represent an increased burden on clinical services.

Introduction Social anxiety disorder is a prevalent mental illness with a young onset age. Preliminary evidence suggested that low self-compassion may contribute to adult social anxiety, but research with youth has lagged far behind. This study investigated the relationship between self-compassion and social anxiety in adolescents. It also examined the mediating role of three cognitive mechanisms: fear of negative evaluation, self-focused attention, and cognitive avoidance. Methods A total of 316 adolescents (age 14-18, 54% male) recruited in Scotland, UK, completed 7 questionnaires. Results Self-compassion was inversely correlated with social anxiety with a large effect size (r =-.551). This was partially mediated by fear of negative evaluation and cognitive avoidance, but not self-focused attention. Self-compassion also predicted social anxiety above depression and anxiety symptoms. Conclusions Our findings suggested that self-compassion could be an important factor in the development of social anxiety, and hence therapeutic techniques targeting self-compassion could potentially be beneficial in preventing or treating adolescent social anxiety.

There remain barriers to securing robust and complete datasets from counselling embedded in Higher Education (HE). This study aimed to provide the first step towards developing a national dataset of student counselling outcomes drawn from differing outcome measures, platforms and reporting on all clients. Data from four counselling services using two clinical outcome measures and two platforms were pooled and analysed. Students presented to counselling with low levels of wellbeing and functioning, and high levels of depression, anxiety, academic distress and trauma. Counselling was particularly effective for improving depression, anxiety, wellbeing, hostility, social anxiety and academic distress. Results demonstrate value in pooling complete data from HE counselling services and we argue for developing a national dataset of university counselling data.

Metacognition may have a key role in postnatal psychological distress. Where postnatal depression or traumatic birth experiences are identified, screening for posttraumatic stress is strongly indicated.