Failure to provide mental-health support

Understanding what is happening

Being “passed between” university and NHS services usually reflects a genuine and well documented gap rather than deliberate wrongdoing. Universities and the NHS are separate organisations with different remits, thresholds and referral processes, and there is often a lack of clarity about who is responsible when a student has needs beyond what a university wellbeing service can offer but does not meet the NHS threshold for specialist care. Recognising this is important, because it shapes the most effective response: you generally have two distinct organisations to hold to account, each with its own obligations and its own complaint route, plus a possible failure of the two to coordinate.

Before treating this as unlawful conduct, it is worth separating out what may simply be poor coordination or resource-driven thresholds from a genuine breach of a legal duty. Both can be challenged, but they engage different arguments.

The university’s obligations

A university that is aware of a mental health condition amounting to a disability under the Equality Act 2010 owes you the anticipatory and individual duty to make reasonable adjustments, and must not discriminate against you because of the disability. A mental health condition counts as a disability if it has a substantial and long-term adverse effect on your ability to carry out normal day-to-day activities.

The university is not the NHS and generally is not obliged to provide clinical treatment. However, its duties can include making reasonable adjustments to teaching, assessment and deadlines, providing or signposting appropriate wellbeing support, following its own published support and fitness to study policies, and making a proper, individualised assessment of your needs rather than simply directing you elsewhere. A failure to follow its own procedures, or to make reasonable adjustments once it knew or ought to have known about your condition, is challengeable.

If your difficulties have affected your academic performance, you should also engage the extenuating or mitigating circumstances process and the disability support service to put a support plan in place. Keep these separate in your mind from any complaint, because they run on different timescales and one should not wait for the other.

The NHS’s obligations

NHS mental health care is provided according to clinical need and locally set thresholds. If you have been referred, assessed and then discharged or bounced back to the university, you can ask for the reasons and the clinical rationale, and you can request re-referral if your circumstances have changed or worsened. Your GP is a key gateway here and can advocate for onward referral. Where you are in crisis, NHS 111 (select the mental health option) and local crisis teams provide urgent routes that are separate from routine referral thresholds.

Poor transitions and discharge, and services failing to communicate on referral, are recognised problems that the Parliamentary and Health Service Ombudsman has specifically examined, so a discharge or transfer that leaves you without a clear plan is a legitimate subject of complaint.

Gather evidence first

1. Compile a timeline of every contact with each service, with dates, names, what was said, and what was or was not arranged.

2. Collect written records: emails, letters, referral forms, appointment records, any discharge summaries, and your support plan or disability documentation.

3. Ask each service, in writing, three direct questions: what support they will provide, what they say falls outside their remit, and who they say is responsible for the part they will not cover. Getting each side to commit in writing exposes the gap and is powerful evidence.

4. Consider a subject access request under data protection law to each organisation to obtain your full records if they are not forthcoming.

Complaining to the university

Use the university’s formal complaints procedure. Set out the facts, identify where it failed to follow its own policies or to make reasonable adjustments, state the impact on you, and say clearly what you want done, for example a named point of contact, a coordinated support plan, specific reasonable adjustments, or a review of an academic decision.

If you exhaust the internal procedure and remain dissatisfied, ask for a Completion of Procedures Letter. You can then complain to the Office of the Independent Adjudicator for Higher Education, which handles student complaints against most higher education providers in England and Wales. You must submit the OIA complaint form within twelve months of the date of the final decision, and you will normally need to send the Completion of Procedures Letter with the final decision. The OIA can recommend remedies including further action and financial redress but it is not a court.

Complaining about the NHS

Raise a formal complaint under the NHS complaints procedure with the provider concerned, whether that is the mental health trust, the service, or your GP practice, or with the commissioning body. Local NHS complaints must generally be made within twelve months of the event or of when you became aware of it, though this can be extended for good reason. NHS Advocacy services can help you make the complaint.

If the local response does not resolve matters, you can escalate to the Parliamentary and Health Service Ombudsman, which investigates complaints about NHS care in England once the local process has been exhausted. Separately, the Care Quality Commission regulates the quality and safety of services and can be told about concerns, although it does not resolve individual complaints or award redress.

Tackling the gap between the two

The core of your problem is that neither body takes ownership. Practical steps that often break the deadlock:

1. Ask each organisation to name a single point of contact and to attend a joint meeting or make direct contact with the other to agree who does what. Improving coordination between higher education and NHS services on student mental health is a recognised policy priority, and asking explicitly for joined-up working is a reasonable request.

2. Involve your GP as the clinical anchor, since the GP can push for NHS re-referral and can document clinical need for the university.

3. Use the students’ union advice service, which is independent of the university and can help with both academic processes and complaints.

4. If either body has a safeguarding or “students of concern” process, ask for it to be triggered given the risk of you falling through the gap.

Discrimination and legal claims

If the university has treated you less favourably because of a disability, failed to make reasonable adjustments, or subjected you to discrimination arising from disability, you may have a claim under the Equality Act 2010. Such claims against education providers are usually brought in the County Court, and there are strict time limits, generally six months from the act complained of, though the OIA route can run alongside or first. Litigation is costly, slow and stressful, and the OIA and NHS complaints routes are usually the more proportionate first steps, so treat court action as a later option once the informal and ombudsman routes are exhausted or clearly futile.

What the answer depends on

The strongest route depends on facts you have not yet given: whether your condition meets the Equality Act definition of disability and whether the university knew of it, what each service has actually said in writing about its remit, whether you have been formally assessed and discharged by the NHS or simply not referred, whether you are currently in crisis or at risk, and where you are in each organisation’s internal process. If you are in crisis now, prioritise the urgent NHS routes over the complaints process.

Suggested order of action

1. If in crisis, contact NHS 111 mental health option, your GP, or emergency services.

2. Gather your evidence and timeline.

3. Ask each service in writing to define its remit and name a contact.

4. Engage disability support, reasonable adjustments and extenuating circumstances at the university now.

5. Involve your GP and the students’ union.

6. Make formal complaints to the university and to the NHS provider, in parallel.

7. Escalate to the OIA and the PHSO respectively if the internal responses fail.

8. Only then consider a court claim, and take advice on time limits before any deadline passes.