Intersystem Collaboration

What is it? Intersystem collaboration refers to interventions in which multiple organisations or departments work together to improve student mental health. Most commonly, this includes partnerships with the NHS.

Evidence? Despite some promising projects in recent years, there is very limited causal evidence on this intervention from the UK.

What is the intervention?

Intersystem collaboration refers to an intervention which is delivered by multiple organisations or departments working in partnership. This can be for preventative, ongoing or crisis support. Collaboration and communication between services can be internal or external, and is centred upon information sharing through appropriate channels. Internal intersystem collaboration may be between, for example, academic staff and student support services within a singular HE provider. External collaboration may be between a HE provider and a local NHS Trust or a mental health charity. Depending on the organisations involved, this intervention can be targeted or for a universal student population.

Intersystem collaboration initiatives are distinct from Settings-based interventions as they may include collaboration between one university department and another, or an external body, as opposed to providing a provider-wide approach.

How effective is it?

Our evidence review uncovered too few studies on intersystem collaboration to make generalisations about the effectiveness of this approach.

How secure is the evidence?

Our evidence review uncovered very little literature demonstrating the effectiveness of this sort of intervention in HE. We have only identified one study on this topic and it was not strong enough to feature on this page.

It is important to note that this does not mean that this intervention does not work, nor that it is not being implemented. This style of intervention will be harder to evaluate. Furthermore, in being an intervention that affects the whole student experience, it may be more difficult to establish a causal link between the intervention and student mental health.

The lack of evidence is a strong indicator that the current research in student mental health does not map exactly across current practices and rapid developments in student mental health. To develop the evidence base on intersystem collaboration more UK longitudinal research is needed.

How do I evaluate this intervention?

Our evidence review uncovered few studies which evaluate the impact of intersystem collaboration, meaning we cannot highlight any examples of good practice. We also cannot identify common evaluation pitfalls, as we have for other pages in this Toolkit.

Developing better evaluations of intersystem collaboration is a key priority for  the HE sector, and we are keen to hear from anyone conducting research or evaluation on this topic.

General guidance on evaluating interventions to improve mental health apply to this intervention and can be accessed on the evaluation guidance webpage.

Those looking to evaluate this sort of intervention may also find the TASO resources on quasi-experimental designs and evaluating complex interventions using randomised controlled trials (RCTs) particularly useful.

Where can I find more information and guidance?

• The OfS funded Student Mental Health Partnerships project showcased a variety of projects demonstrating collaborative approaches between the NHS and HE providers. The project included interventions in Greater Manchester, Liverpool, Bristol, Sheffield and North London. Please see the Student Services Partnerships Evaluation and Quality Standards (SPEQS) toolkit developed as part of this project.
• The South East Wales Mental Health Partnership involved partners from statutory mental health services with Cardiff University, Cardiff Metropolitan University and the University of South Wales (USW) including the Royal Welsh College of Music and Drama (RWCMD). The project involved the establishment of a pilot Mental Health University Liaison Service (MHULS) and a landmark data sharing agreement. As a result of the project, a Severity Index was developed to standardise the way student mental health is assessed and triaged: Severity Index and reason codes May 2023 V.03.pdf. For a full report, please see SEWMHP Evaluation January 2023.pdf.
• The University of Toronto has developed a suite of mental health support services to widen access to mental health care. The university used a stepped-care model, collaborating with local mental health services so that students with complex and urgent care needs have access to mental-health navigators to guide them through the hospital system. For more on the University of Toronto’s stepped-care approach, please see here. As part of their redesign project, the university has also looked at eliminating waiting times, streamlining care and referrals and renovating wellness spaces across their campuses. For more on the redesign project, please click here.
• For guidance from the Mental Health Charter, please follow the links below:
  • External partnerships and pathways

Where does the evidence come from?

The evidence in the Toolkit was gathered via an evidence review undertaken as part of the Student Mental Health Project. For full details of this review, please see our Methodology document.

It is important to note that our review, and therefore this Toolkit, only relates to student mental health. The review did not cover other populations (e.g. school children, other adult populations) or non-HE settings. The review was also subject to other inclusion/exclusion criteria, outlined in the Methodology document.

Please also note that the Toolkit pages only include Type 3 (causal) studies which have been rated as providing medium/high-quality evidence according to our evidence strength ratings. A full list of studies collated via our evidence review, including Type 1/Type 2 studies, and those rated as providing weak/emerging evidence, can be found in our Evidence Review Spreadsheet. A breakdown of these studies by type and strength of evidence is available to download.