Mental Health Difficulties
- Introduction
- Behaviour and Mental Health
- Supporting the student
- Responding to Crisis
- Action to be taken following a crisis
- Further Help
Introduction
Most students will experience some degree of stress during their time at university. In most instances, students will be able to cope without outside help. Here, we will consider those students who experience mental health problems that are outside their own coping skills. These difficulties may be present before the student starts university or they may develop later.
Because of the regular contact they have with students, lecturing staff can play an important role in identifying mental health problems and so help to promote good mental health. It is worth noting, however, that serious mental health problems are sometimes difficult to distinguish from the more common symptoms of stress.
There is a tendency for students with mental health problems to avoid disclosing these problems. In any case, procedures for helping students in these situations tend to be ad hoc in nature since mental illness can take so many forms. A pre-admission interview with an Enabling Support Adviser is always recommended for those students who do disclose a mental health problem.
We shall consider briefly some of the more prominent types of disorder that may be encountered, and suggest some options for supporting the affected students.
Behaviour and Mental Health
By no means all mental health disorders will lead to visible disruption: some may not even be noticeable to lecturing staff. Some of the main types of disorder encountered are the following:
- Depression, anxiety and stress : depression and anxiety are the most common forms of mental illness likely to be present in the student population. Many people experience both depression and anxiety from time to time, often as a result of stress. Those suffering from clinical depression will require intervention and treatment. Sufferers from depression are rarely disruptive: rather, they tend to show a flattening of mood and a withdrawal from social and study activity. Sometimes, sufferers will be unaware that they are depressed, and may seek help only when prompted by others. Staff at all levels who have regular contact with students may be able to play a vital role in the early detection of depression or attacks of panic or anxiety.
- Eating disorders : problems such as anorexia and bulimia have achieved some media prominence in recent years. The disorders are usually noticed by someone close to the sufferer, or who sees them frequently. Where a student is identified as suffering from either problem, it is advisable to recommend appropriate counselling or perhaps medical attention.
- Manic-depressive behaviour : manic-depressive illness is also known as bipolar disorder and is characterised by severe mood swings from ecstatic highs to severe depressive lows. Particularly during the high periods, sufferers can behave out of character, perhaps being very talkative, energetic and disruptive. Students with the disorder may make unhelpful lifestyle choices and prompt medical referral is necessary. All types of disorder mentioned so far can be treated successfully, allowing students to continue their university careers.
- Schizophrenic behaviour : schizophrenia is a more serious condition, which is characterised by disordered thinking of one kind or another. Schizophrenic behaviour can be irrational, difficult for others to understand and disruptive. The symptoms of schizophrenia can often be treated with some success, especially if the condition is identified in the early stages. However, the presence of even mild symptoms can make it difficult for students to continue on campus.
- Personality disorder : students may sometimes exhibit changes in their behaviour or personality as the result of a head injury or neurological disorder. However, the term ‘personality’ disorder is usually used to refer to unexplained changes in personality or behaviour, which are not caused by, for example, illness or drugs.
Supporting the student
Where you suspect that a student may be suffering from a mental health problem, it is advisable, first to assess the situation carefully. For example, the same signs and symptoms may indicate alcohol or substance abuse rather than mental illness. In most instances, it will be helpful to raise your concern initially with the student him or herself. You may also find it helpful to discuss your concerns with the Student Counsellor in the Student Advisory Service, respecting the student’s confidentiality.
Where mental health problems do seem to be indicated, you may wish to consider referring the student to:
- the Student Counsellor,
- the Enabling Support Advisor,
- his or her own GP,
- his or her personal tutor,
- an appropriate counsellor,
- the University Occupational Health Nurse.
Responding to crisis
The most difficult aspect of support for students with mental health problems is the immediate handling of disruptive behaviour or other serious incidents. The principle of careful assessment remains central to situations of this type. An impulsive, panic reaction by staff may increase the anxiety of the disturbed student and can cause the disruption to escalate. If you remain calm you are more likely to be able to deliver the appropriate response. Try to achieve and maintain some form of co-operation with the student, if possible. If the student believes that you are against him or her then it will be more difficult to find a positive way forward.
The first priority is to ensure the safety of everyone involved. Where there is an immediate safety threat, for example, a student becoming violent towards someone, you should do whatever you can to protect whoever is at risk - but only if it is possible to do so without endangering yourself and others.
Usually, it is wise to seek assistance from another member of staff. As soon as possible, you should seek the assistance from the police, informing the Health and Safety Officer when you have done so.
Some situations may arise where there are genuine threats to safety but which may not merit intervention by the police. For example, a student may be speaking or acting in an aggressive way, or may be voicing an intent to self-harm or to harm others. In other cases, the student’s behaviour may simply be bizarre or unreasonable. ;In such cases, you may form the opinion that the student is mentally unwell and may cause some risk to others. Here it will again be helpful to seek support from another member of staff right away.
Talking to the student and listening to his or her concerns may allow you to defuse the situation and make it safe, especially if you can do so in a setting that ensures both privacy and safety. You will also have the opportunity to calmly reflect on your next step and be able to discuss with the students ways of helping with the illness or stress. However, the student should not be left alone and should not leave the university’s premises until it is safe to do so.
Referral to professionals may well be appropriate, either for further assessment or to provide specialised support. The Student Counsellor is always willing to arrange a meeting with a lecturer or student at short notice where the need is urgent. Also, where you feel it likely that a student is suffering from mental illness, you should strongly encourage him or her to make an appointment with a doctor. You may offer to help them to make the appointment.
Action to be taken following a crisis
Where emergency action has been taken in the case of a student with mental health problems, the student’s course leader or personal tutor should be notified as appropriate, since special arrangements may be necessary to remove the student temporarily from the course. The course leader, in turn, must consult widely, particularly with the student’s medical adviser, in order to establish the student’s future participation in study and the support necessary. Consideration must also be given to the issue of confidentiality: exactly who in the university should be made aware of the nature of the student’s illness?
In the longer term, arrangements will have to be made about the student’s return to university. If the student’s condition led to violent or disruptive behaviour, for example, it may be necessary to impose certain conditions on his or her future study. The student could be required to seek appropriate medical advice, move to alternative accommodation or have certain standards of behaviour imposed. Such conditions should only be imposed in very exceptional circumstances as a last resort and with the backing of a medical practitioner.
Further Help
The Renfrewshire Association for Mental Health offers a number of support, counselling and advice services for sufferers from a wide variety of mental health problems. They can be contacted as follows:
Renfrewshire Association for Mental Health
41 Blackstoun Road
Paisley
PA3 1LU
Tel: 0141 847 8900
Web link: www.ramh.org
Glasgow Association for Mental Health
33 Turnbull Street
Glasgow
G1 5PR
Tel: 0141 552 5592
