Openness By Whom And Of What?

In preparation for a talk last week entitled, ‘Mental Health: How Do We Encourage Openness And Meet Higher Demand For Services?’, there were two questions that seemed particularly topical. The first was, should we encourage openness around mental health if services can’t meet demand?

I had put the title of the talk to my Twitter followers, and one student suggested that we shouldn’t encourage openness if services are inadequate because we’ll “just be letting students down”. The assumption seems to be that the only reason for openness is to encourage use of services; this might be one reason, but if we’re talking about openness in a general sense, then there are many more that are just as important — some of which follow.

As another Twitter follower noted, there is a need for more understanding of self-care – something which openness ought to encourage through the sharing of information and resources. Openness can also improve the fit between students and services by educating students about the most appropriate service for their needs. Openness means services get more of those most in need, and less of those that would benefit from other services or that can figure out a solution themselves.

If openness increases demand for services, it also puts more pressure on those in a position to fund services. More shameful than an inability to meet demand is the concealment of insufficiencies, because it lifts pressure from those tasked with allocating resources.

I noted in my talk that the term ‘openness’, as used in the context of student mental health, needs to be unpacked. There are different things we might be open about – namely our mental health, or mental health in general; and there are is openness with different people – our friends & family, or institutions & authority figures. Then there is, of course, the matter of who’s being open. In this case, we’re mostly talking about the need for students to be open, but it’s equally as important that institutions are being open so that students can make informed decisions.

It’s the under-appreciated complexity of openness that leads into the second question: Why should students be open? (I’ve addressed this question before in the context of disclosure rates.)

Since the Royal College of Psychiatrists’ report on student mental health in 2011, there have been calls for institutions to be more honest and open about their support provision and commitment to students’ welfare by publishing a formal and publicly available mental health policy. (Annie Grant of MWBHE is currently surveying universities to find out how many have policies in place, and hopefully the results will be available before the end of the year.) The most important reason for such a document is that, without one, it’s very difficult for institutions to be held to account; not just by those outside of the institution but by themselves.

A mental health policy is also a statement of intent and a commitment to being open and transparent. If institutions are not being open about what they can and cannot do, it’s hardly surprising that their members might also want to withhold information about themselves.

The powerpoint presentation from my talk can be downloaded here, and an action plan for building a ‘whole-institution approach to wellbeing’ is available here.

Education reforms in China set to shift focus to “whole person”

prominent scholar in China has reported that the Chinese Ministry of Education is set to introduce a “major reform” to shift emphasis in education away from academic tests. The announcement, which comes just weeks after concerns were raised about the mental health of students in China, promises to “broaden” evaluation methods to fully recognise the health and wellbeing needs of students and “support development as a whole person”.

In a recent survey of 2,151 students in north-east China, almost 50% reported suffering from mental health problems. Last month, Lin Guiru, a mental health advisor for the Ministry of Education, told the China Daily, “The ultimate goal of education should be the cultivation of personality, ideals, an outlook on life and values, good human relationships and communication skills. Unfortunately, our education system places too much emphasis on the cultivation of skills that concentrate on the trivial and neglect the essentials.”

Guiru also emphasised the impact that global economic issues were having on young people, and spoke about work that was underway in universities to “popularise knowledge of mental health” and train students in psychological skills.

The planned education reforms involve the introduction of an evaluation framework encompassing five areas, which include ‘moral development, academic development, health (psychological and physical), wider interests, and academic burdens’. According to Yong Zhao, the quality of education will also be judged based on levels of student engagement, boredom, anxiety, and happiness.

There have been growing calls for similar reforms in the United Kingdom. Writing for the Independent earlier this year, Anthony Seldon, Master of Wellington College, warned that urgent measures need to be taken to curb the rise in student suicides: “A key job, not only of schools but also universities, is to educate the whole person, to help him or her live an autonomous and meaningful life. It is no longer acceptable in the 21st century for universities or schools to hold up their hands and say, “We do exams only: get the rest elsewhere!”

In 2005, SEAL, a scheme designed to promote social and emotional skills was rolled out in British schools, but last month a professor at the University of Manchesterraised concerns that schools were currently being pressured by the government to drop the programmes.

New mobile app helps young people manage moods

A mobile app designed to help young people manage anxiety levels has been launched in Canada. The Android and iPhone compatible app, called Mindshift, was launched last week to coincide with students’ exam period, CTV News reports.

The app, which is free, aims to help students keep track of their anxiety levels and identify symptoms of anxiety, and contains tips and strategies to hep users “put their negative feelings in perspective”. Strategies featured in the app include breathing exercises and visualisation. According to Anxiety BC, “ Rather than trying to avoid anxiety, you can make an important shift and face it.”

The app was created by Anxiety BC and BC Mental Health & Addiction Services (BCMHAS), organisations both based in the western Canadian province of British Columbia. More than 800 people downloaded the app on its first day of launch,  according to BCMHAS.

Mindshift joins a growing number of ‘happiness apps’ designed to help users track and improve their moods. In 2010, Harvard researchers launched Track Your Happiness, an  app that intermittently notifies users asking them to report how they’re feeling. Last month, the University of Cambridge launched their own mood-tracking app called Emotion Sense which aims to pull together data on emotions and mobile usage.

Optimism about the role that apps can play in promoting emotional wellbeing is far from universal.  Last month, concerns were raised about addictive use of smartphones after research in South Korea linked overuse of smartphones with “psychopathologies in adolescents”.

Is It ‘Wellbeing’ Or ‘Well-being’? (And Why It Matters)

Who cares, right? Quite a few people apparently. According to Google Keywords, 450,000 people a month are unsure whether to go with well-being or wellbeing.

For those working in the area, it’s mostly just a minor niggle. The internet makes it more important, though. Get it wrong, and a particular webpage won’t show up in search results. For those looking for information about support services, it could be crucial.

Some of us – the geeky ones, perhaps – have also thought about why there are two words that seem to describe the same thing, and what it means to use one over the other.

The short answer: Should I use ‘well-being’ or ‘wellbeing’?
It’s up to you – just be consistent. Generally, well-being and wellbeing are used to refer to the same thing. While ‘wellbeing’ is becoming more popular, ‘well-being’ is probably still used more. If that’s all you wanted to check, thanks for reading.

If you want to read the analysis, and to know why I suggest using ‘wellbeing’, read on.

What do the dictionaries tell us?
Oxford and Cambridge dictionaries go with ‘well-being’. accepts them both equally.
Princeton, based in the USA, favours ‘wellbeing’, although Merriam Webster, also USA based, goes with ‘well-being’.

On balance then, ‘well-being’ seems to be the linguist’s favourite.

What about general usage?
The media, as you’ve probably gathered, uses both words. In the realm of politics, we find that the British government is not set on ‘well-being’ either. Actually the government seems a bit confused about which to use. While the Office of National Statistics uses ‘well-being’, the number 10 website and parliamentary reports went with ‘wellbeing’.

In the voluntary sector, there’s also a mix of usages. While the New Economics Foundation opts for ‘well-being’, the Young Foundation has gone with ‘wellbeing’.

So, it seems that there’s no agreement on whether to use ‘well-being’ or ‘wellbeing’. The words are used interchangeably, and it’s a matter of personal preference. But things seem to be changing.

What’s the trend?
Here’s where it gets interesting. (Well, about as interesting as a discussion about hyphens can get.) To date, Google search results indicate that ‘well-being’ is more popular than ‘wellbeing’. However, Google Trends indicates that since 2004, searches for ‘well-being’ have been on decline, while searches for wellbeing have significantly increased.

To understand why this is, it’s useful to know the role of the hyphen.

Oxford Dictionaries says that “the hyphen is used to link words and parts of words”. In our case, the words are (obviously) ‘well’ and ‘being’, which, like ‘well-known’, come together to form what is technically known as a compound adjective.

According to ‘The Grammar Curmudgeon‘, “The trend in English is for frequently used word combinations to “grow together” from two words to one, sometimes passing through a hyphenated stage.” But this “hyphenated stage” is, apparently, becoming less and less used, at least partly because of the internet. (A hyphen is often recognised by computer software as a space, which can make things confusing.)

In this way, ‘well being’ has become ‘well-being’, and is gradually becoming ‘wellbeing’. If we accept this it’s only a matter of time before all dictionaries recognise ‘wellbeing’, after which the continuing survival of the hyphenated ‘well-being’ will probably depend upon people finding some need to regress back from ‘wellbeing’ into the broader notion of ‘being well’.

So is there a difference in meaning between ‘wellbeing’ and ‘well-being’?
Yes, kind of.

Most of the time the two words are used interchangeably, but in removing the hyphen, ‘wellbeing’ implies a standalone meaning beyond merely ‘being well’. So, if we mean ‘being well’ then use of the word ‘well-being’ might be most appropriate. But if we want to express more than this, such as psychological interpretations of the term (which are increasingly common), then ‘wellbeing’ might be better.

As interest in measuring well[-]being continues to grow, independent meanings for the word will continue to develop. There will inevitably be more debate around the meaning of the word, but widespread use of the word ‘welfare’, which is also a coming together of two words (‘faring’ and ‘well’), suggests that the ambiguity of the word will not be enough to stop ‘wellbeing’ from becoming more prominent than ‘well-being’. In short, ‘wellbeing’ is here to stay.

Why might it be better to use ‘wellbeing’?
There are two reasons why I (usually*) use ‘wellbeing’ over ‘well-being’.

  1. When I use the word ‘wellbeing’ I am referring to more than just ‘being well’. Academic accounts of well[-]being (such as this one from Ryff and Keyes) consistently refer to well[-]being as a dynamic and active state of flourishing, which conflicts with the sense of mild satisfaction and inertia implied by the term ‘being well’.
  2. If my earlier analysis is correct then, despite dictionary definitions, the word ‘wellbeing’ will become more widely used than ‘well-being’. By adopting ‘wellbeing’ now, we accelerate the transition and minimise the period in which inconsistency over use of the words causes webpages to be missed by those searching for information about services and resources.

So that’s my analysis of the wellbeing / well-being issue. Dispute anything I’ve said? Got something to add? Let me know!

* The exception would of course be when referring to a specific article that uses ‘well-being’, where the use of ‘wellbeing’ would then cause confusion.

Student suicide data, and what needs to be done

(Note: The issues discussed in this article may be distressing for those affected by suicide. You can find out more information about suicide at the Mental Health Foundation’s website, here. If anyone has been affected by the issues discussed in this post and needs to talk to someone immediately, you can call the Samaritans helpline and speak to someone confidentially, 24 hours a day, on this number: 08457 90 90 90.)

A report published by the Royal College of Psychiatrists last year warned that there was a “pressing need” to do more around student mental health. New figures released last week show what’s at stake. In 2011, 112 students in England and Wales took their own lives. Every suicide is tragic. But what makes this figure particularly concerning is that it is almost a 50% increase on 2007.

I was sent the data on Wednesday by the Office of National Statistics whilst researching for an article to mark the one year anniversary of the Royal College of Psychiatrists’ report (which I reviewed here). Having failed to find any up to date statistics, I contacted the ONS with a freedom of information request on Monday. The figures have been published to the ONS website here*, and are discussed in a Guardian article here.

Although the ONS officer I worked with urged caution about drawing conclusions due to the numbers involved, the increase corresponds with a BMJ study of the wider population that suggests the financial crisis may have caused a significant rise in suicides. It also corresponds with concerns raised in the Royal College of Psychiatrists’ report about the current pressures facing students: “Social changes such as the withdrawal of financial support, higher rates of family breakdown and, more recently, economic recession are all having an impact on the well-being of students and other young people.”

When I received the figures, I was writing an article about the lack of urgency around student mental health. These figures raise further questions about the higher education sector and about what institutions are doing to ensure their students have adequate support. It’s time for the sector to respond.

The Royal College of Psychiatrists’ report provides clear recommendations for institutions and policy-makers. Currently, it is difficult to know which institutions, if any, are making serious efforts to meet these recommendations. This needs to change;

  1. Institutions should guarantee a certain level of support for their students.
  2. Institutions should put in place an institution-wide mental health policy and make it publicly available through their website; the policy should be reviewed and updated regularly by an institution-wide mental health & wellbeing committee that meets several times a year.
  3. The sector should fund a national committee to recognise and promote good practice in student mental health.

It’s up to students, staff, parents, and all those with an interest in the welfare of young people, to demand that institutions and policy-makers prioritise student support.

*The figures are for students aged 18+. ONS data was only available for England and Wales. The number of students in full-time education has increased by 15% during the same period.
Resources:  Universities UK produced a guidance paper on Reducing the Risk of Student Suicide in 2002, available here.

Think Tank Reports Minorities Have Lower Well-being. How valid is the data?

The New Economics Foundation’s Centre for Well-being, a leading think tank for well-being research and policy, expressed concern today about apparent disparities in well-being between ethnic groups. The corresponding report says the following:

“We find that Black, Arab, Bangladeshi, Pakistani, and Indian people experience significantly lower well-being than White people in the UK, even when controlling for individual characteristics”.

The research might have controlled for individual characteristics (I don’t know, I haven’t read through it yet…), but what about cultural characteristics?

The questions that the participants in the study were asked were based on self-perception (i.e. how the participants view themselves and their lives). This raises issues. We know, for instance, that according to the latest research there is good reason to believe that those from North America are more likely to show positivity biases than those from Asia, potentially causing them to inflate their own self-rating for life satisfaction (Kim, Schimmack & Oishi, 2012). Then there are the potential language issues that arise from trying to ask subjective questions of those that don’t necessarily share the same first language (the report doesn’t mention what language(s) the participants speak).

I tweeted the Centre for Wellbeing to ask if they had controlled for cultural interpretation of well-being. They responded: “We didn’t control for cultural interpretation. Could be explanatory factor, needs investigation“.

Maybe it doesn’t matter much at this stage, but due consideration of cultural differences is surely going to be crucial as well-being research becomes increasingly influential in policy-making.

Kim, H.,  Schimmack, U., & Oishi, S. (2012) ‘Cultural Differences in Self- and Other-Evaluations and Well-Being: A Study of European and Asian Canadians’, Journal of Personality and Social Psychology, vol. 102, no. 4, pp. 856–873.