Institutional-level mental health strategies should be made a registration requirement for Australian universities, according to the country¡¯s key advisory agency on regulatory policy.

Universities should also boost online mental health services and team up to secure better health insurance deals for their foreign students. The recommendations are outlined in a 1,350-page Productivity Commission??on the personal and economic toll of mental ill health, which affects some 4.3 million Australians and costs the country at least A$200 billion (?110 billion) a year.

The report says university students are less vulnerable than unemployed people but more prone than paid workers, with?more than 30 per cent suffering moderate to high levels of psychological distress ¨C affecting their academic results as well as their personal well-being. ?

While Australia does not routinely collect national data on the mental health of tertiary students, the report cites evidence that the prevalence of mental problems at university is on the rise ¨C and that sufferers may be hiding their problems.

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Just 6 per cent of students acknowledge having disabilities of either the physical or ¡°psychosocial¡± variety, suggesting that some either conceal their troubles or do not enrol in the first place.

While all Australian universities offer counselling, the report says that some sufferers are unaware of these services. Others resist seeking help, often because of ¡°stigma¡±.

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In doing so they risk ruling themselves ineligible for ¡°supports¡± under the Disability Discrimination Act, which bans institutions from allowing people¡¯s disability ¨C including mental illness ¨C to compromise their access to educational services.

The report says universities should develop institutional-level student mental health and well-being strategies which explain how they meet their obligations under the act. The strategies should also outline early interventions, staff training arrangements and links between onsite counselling services and the ¡°broader health system¡±.

The Tertiary Education Quality and Standards Agency should monitor the strategies¡¯ implementation and ¡°disseminate information on best practice¡±, the report says.

It also advocates more online delivery of counselling for diagnosis and triaging as well as ¡°low-intensity, self-directed mental healthcare¡±. Online services could appeal to students who are reluctant to discuss their problems, while improving data collection and reducing waiting times for therapy.

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The report also says universities should lean on insurers to improve their coverage of international students¡¯ out-of-pocket expenses for mental health services. Institutions could band together to negotiate ¡°group cover¡± for foreign students, the report says.

Another option would be to revise the ¡°deed of agreement¡± governing the level of health cover overseas students must obtain to qualify for visas. While this may lead to better coverage, ¡°it would increase costs for international students and could make Australia a relatively less attractive destination¡±, the report acknowledges.

Prime minister Scott Morrison promised to respond to the report in next May¡¯s budget.

john.ross@timeshighereducation.com