Mental health
This guidance is designed to help identify, and respond appropriately to, students with mental health difficulties to ensure that support and treatment is received as early as possible.
- What is mental ill-health?
- Possible signs of mental ill-health
- What should you do if you are worried about a student?
- What should you do if the student refuses help?
- What should you do if you think the problem might be urgent?
- Resources
- Further information on the web
What is mental ill-health?
Mental ill-health takes many different forms and varies greatly in severity, from short-term depression or anxiety triggered by some personal setback, to self-harm, to long term psychiatric illness. Students suffer the same types of problems as the rest of the population, although research suggests they are more prone to anxiety and depression than similar age groups in the general population. Some students arrive at university with a pre-existing condition but will not necessarily have fully recognised or disclosed their difficulties. There is an increasing amount of information available on student mental health and those wishing to explore this further should refer to the websites listed at the end of this page.
The aim here is not to define the nature of different types of mental ill-health. What is important is to be able to recognise a problem, to know what options are available for help, and to recognise when to refer to an appropriate professional.
Possible signs of mental ill-health
Mental ill-health can reveal itself indirectly, through changes in a student's work, behaviour or appearance. The possible warning signs to be alert to include:
- a sudden deterioration in academic performance or motivation
- persistent lateness for, or absence from, tutorials
- an obsessional attitude to work and/or an unrealistic preoccupation with failure
- withdrawal from social, cultural or sporting activities once considered important
- mood swings and irritability
- difficulty in sleeping
- misuse of alcohol or drugs
- changes in appearance: unkempt, weight change, decline in personal hygiene.
What should you do if you are worried about a student?
It is important to let the student know that you are concerned. You might wish to gather more information first by talking discreetly to a colleague to see if your concern is shared, but you should not come to any conclusions until you have heard what the student has to say. Express your concerns in private to the student and, most importantly of all, be prepared to listen. Any information provided by the student must be treated as confidential unless the student gives explicit consent for it to be shared with others. It can be extremely time-consuming and stressful helping a distressed student.
- Think carefully beforehand about what you can and cannot do.
- Ask yourself whether you have the time and skills to support them.
- Consider whether there might be a conflict with any of your other responsibilities e.g. of a disciplinary nature. It may be necessary for a different person to approach the student (bearing in mind issues of confidentiality).
- Explain clearly to the student the limits of your role.
- Be prepared to take a firm line about the extent of your involvement e.g. I can help you with the academic side but you need to seek expert advice from your doctor/the Counselling Service on other matters
You may find that all the student needs is a sympathetic ear or some extra help with work. However, if you have any suspicion at all that the problem goes deeper than this, or if there is no improvement in the student, despite your intervention, encourage them to seek help from the college doctor, the college nurse or the Student Counselling Service. (College chaplains are another possible source of help.) It is important that you should err on the side of caution and not get drawn into situations which you may not be able to manage and which may cause you a great deal of stress. If in doubt always refer the student on; don't try to be an amateur psychotherapist.
What should you do if the student refuses help?
If the student is not ready to talk about their problem or to admit that they have one, it could be counter-productive to try to force the issue, particularly if they become agitated or defensive. It might be better to back off but to extend an open invitation to come back and talk to you in the future. At the same time suggest again that they might like to consider consulting the college doctor, nurse, chaplain or a counsellor, as it is often easier to talk about personal problems to a complete stranger than someone the student knows and sees regularly.
The student might admit that they have a problem but be reluctant to seek professional help. This could be for a number of reasons. They might feel that their problem is not serious enough; that they should be able to cope on their own; that they would have to reveal information about themselves or their families which they would prefer to keep private; or they might have concerns about confidentiality. These feelings reflect widely held misconceptions about how mental health problems are treated as well as concerns about the stigma that still attaches to mental ill-health. Alternatively, the student might have more mundane concerns, for example, about how to access counselling or how long they would have to wait for an appointment. (The student rumour mill can exaggerate waiting times for the Student Counselling Service.)
You can help the student to overcome their fears about seeking professional help. You could:
- reassure them that anything said to a doctor, nurse, chaplain or counsellor will remain confidential;
- inform them that the waiting time for counselling is usually less than 10 days;
- point out the consequences of not seeking help; that the problem will not go away by itself and that academic performance could continue to suffer;
- refer them to the information available on the web (see the list of websites at the end of this page).
If you remain anxious about a student or have doubts about whether you have given the correct advice you can discuss your concerns with the college doctor or a member of the Student Counselling Service. The Service operates a college liaison scheme with most colleges which enables you to speak to a counsellor who will be familiar with your college and who will be your usual point of contact.
What should you do if you think the problem might be urgent?
There are varying levels of risk, and how you respond will depend on your personal judgement as to the seriousness and urgency of the situation. The safety of the student and of those around them has to be the prime consideration, and it is important (again) to err on the side of caution.
If a student threatens to harm themselves or others, and their behaviour suggests they will carry this out, you should call the college doctor and/or the emergency services. (The Student Counselling Service is not an emergency service for this purpose.) The college doctor has the expertise and knowledge of specialist help that is required in the management of any major crisis. If there is a risk of physical harm, it is acceptable to breach confidentiality (although, depending on the circumstances, it may be helpful to tell the student what you have decided to do).
Not all situations will be so clear-cut. A student may talk about wanting to be dead without showing any obvious signs of suicidal intent. A student may be out of touch with reality and not functioning normally but not necessarily threatening any physical harm to themselves or others. One of the difficulties of managing such a situation is the fear that it could develop into an emergency at any moment. If in doubt it is always better to seek the advice of the college doctor or a member of the Student Counselling Service who will be more expert in risk assessment. Whatever the circumstances, whether obvious emergency or something less clear, it is important to listen carefully to the student, to take their feelings seriously, to show concern, and to remain calm.
Resources
College Doctors
College doctors deal with mental health as well as physical health, and are the gateway to NHS psychological and psychiatric services.
College Nurses
College nurses are involved in supporting students with mental health problems and are familiar with mental health specialist services.
Other college staff
Students with personal problems can, in the first instance, seek help from those with pastoral responsibilities such as Chaplains and Welfare Advisors. However, as indicated above, where a problem appears to be serious, the student should be referred to the college doctor or other professional.
Contact information for doctors, nurses and pastoral staff is in college handbooks, and usually available at the lodge.
The Student Counselling Service
The Service is used to dealing with a wide range of problems, including stress arising from academic work and examinations. Students can approach the Service direct. Advice is available to those who support students (although it should be noted that the Service is not an emergency service). Tel: (2)70300, or email: reception @counserv.ox.ac.uk.
Further information on the web
How to make an appointment, nature of counselling, "self-help" pages on a variety of topics such as depression and exam stress. | |
HEFCE project comprising the University, Brookes and CFE. Comprehensive information about local and national resources. | |
The mental health of students in higher education: comprehensive survey of student mental health problems and policies and procedures. |
Documents
- Mental health policy
(50kb)