Helping Distressed Students

Helping distressed students

A guide for university staff

Helping distressed students: A guide for University staff

University is often a very positive experience for students, but mental health difficulties among young people are on the rise. In a 2022 survey by the mental health charity Student Minds, 57% of respondents self-reported a mental health issue, and 27% said they had a diagnosed mental health condition*. Experiencing poor mental health as a student will have a significant impact on a student’s ability to fully engage with their course and enjoy the university experience. Students may need to manage a range of mental health challenges including suicidal thoughts and behaviour.

The University of Exeter is committed to a community approach to mental health and suicide awareness, recognising that we can all make a difference to the wellbeing of others. Working together as colleagues is an essential part of supporting students experiencing mental health difficulties and distress. This guide provides Information

for University of Exeter Colleagues about how to provide initial support for students with mental health difficulties who may or may not be in crisis. Whilst it is important to know what to do if a student experiences a crisis, please remember these are not a regular occurrence.

This guide will offer guidance to help assess the urgency of a situation, and outlines referral routes for a student. If you find yourself in a situation where you need to give a student support, it is important to help within the boundaries of your role, and to access support for yourself. We have a whole University approach to mental health and wellbeing, and no one person is solely responsible for another’s emotional wellbeing.

Staff are also encouraged to attend the mental health awareness and suicide safety training exeter.ac.uk/staff/wellbeing/ suicide/training

Written by Jo Blakely and Rachel Bragg, Wellbeing

Consultants (Mental health pathway/Occupational Therapists) 2008, revised 2016 and September 2023.

For further copies and feedback on the usefulness of this document, contact: wellbeing@exeter.ac.uk

Available in alternative formats on request from accessability@exeter.ac.uk

* Student mental health in England: Statistics, policy, and guidance - House of Commons Library (parliament.uk)

THIS GUIDE HAS BEEN PRODUCED TO:

Help colleagues to recognise when a student may be in difficulty or in crisis

Help colleagues feel more confident to have conversations about mental health and suicide

Provide guidance on when and where to refer a student for support

Provide contact details of relevant sources of support

Raise awareness of issues relating to student mental health and suicide risk

To enable colleagues to feel supported within the University’s community approach to mental health

WHAT TO DO:

Notice when a student is having difficulties and start a conversation

Ask the student how they are feeling

Gather information about their current situation

In cases of urgency take relevant immediate action

Signpost and encourage student to access appropriate sources of support

Link with the relevant sources of support for staff

WHAT NOT TO DO:

Take sole responsibility for the student’s wellbeing

Ignore the situation – it is important to ensure the student is informed about support available

Solve all the student’s problems

Guarantee the student will engage with follow up support

Work in isolation - remember the university’s community approach to supporting students

Roles and responsibilities

Responsibility of colleagues/staff members

We can all make a difference in helping each other, staff and students, to feel more supported and able to access support when things are difficlult.

We would encourage all staff to embrace the ‘See, Say, and Signpost’ method for supporting students. (see exeter.ac.uk/ staff/wellbeing/suicide/training colleague training in mental health and suicide awareness – supporting students).

SEE involves noticing signs that may indicate a student is experiencing difficulties with their mental health.

SAY involves starting a conversation and asking how a student is.

SIGNPOST involves either signposting the student to support, or in case of urgency being proactive and referring for support.

We also need to look after ourselves. If you feel uncomfortable carrying out the above please discuss with your line manager.

If you offer support to students you must ensure that:

n You have sufficient time within your role, the support offered remains in the boundaries of your role and personal competencies.

n You have access to support, advice and/ or supervision eg line manager, wellbeing services, MHFAider communities of practice.

n You protect yourself and don’t take on too much.

Confidentiality and safeguarding

Confidentiality and safeguarding are important factors to consider when helping students in difficulty. There will be further information on the next pages in this guide.

Do not promise absolute confidentiality. Explain to the student that confidentiality may be breached in ‘exceptional circumstances’ ie if the student is at risk of harm to themselves or others.

Information can be shared with a line manager/superviser without consent.

Health is sensitive data under the General Data Protection Regulation. You can listen and take information from third party/next of kin. It is recommended that if parents are requesting information this request is passed to colleagues in Wellbeing Services.

It is recommended that colleagues are aware of and follow any Faculty guidance on student support procedures.

Wellbeing Services are available to offer support and consultation to colleagues across the university. If you do have consent from the student to talk to Wellbeing Services please do not share the students name, unless there are risk issues. Talking through their situation can still be an effective way to consider the student’s needs and to plan next steps.

Further advice and guidelines on disclosure and confidentiality are available at: exeter.ac.uk/dataprotection/release

It is important to remember as a staff member you are not solely responsible for a student’s welfare. The university has a whole community approach to supporting students.

How do you know there is a cause for concern

IS THE STUDENT’S BEHAVIOUR CAUSING CONCERN?

• Is the student telling you they are having difficulties?

• Is there anything unusual or unpredictable about the student’s behaviour that makes you feel uneasy?

• Is the student having difficulties with their academic work?

• Is the student requiring a lot of your time?

• Is the student absent from seminars, lectures or supervisory meetings?

• Is the student isolating themselves, withdrawing, or avoiding situations?

HOW DOES THE STUDENT SEEM?

• Tense/irritable/agitated

• Sad/distressed/tearful

• Feeling hopeless, miserable and self critical

• Panicky, feeling overwhelmed

• Withdrawn or very quiet

• Distracted/difficulties concentrating

• Smelling of alcohol, cannabis

• Talking loudly and incoherently

• Disinhibited behaviour

• Fatigued, tired

• Physically unwell

IS THIS DIFFERENT FROM YOUR PREVIOUS EXPERIENCE OF THIS STUDENT?

IS THERE OTHER INFORMATION?

• Does the student have an ILP stating they experience mental health difficulties?

• Is there concerning language in academic work?

• Have friends/housemates told you concerning information?

• Have family/next of kin told you concerning information?

• Have colleagues expressed concern about this student

• You might see a significant change in appearance (e.g. weight change, decline in personal hygiene)

• Behaviours may have changed (e.g. staying in bed all day, work handed in late, not attending lecturers, classes, supervisory meetings or avoiding going out)

• Changes in a student presentation and behaviour may be difficult to establish if you havent known the student for long

DO YOU NEED MORE INFORMATION FROM THE STUDENT?

• Arrange to speak to the student

• Meet in a private space

• Hold a supportive conversation

• Consider how the student feels, do they perceive there is an issue?

• Is there anything going on for them that is contributing to this behaviour?

• If you are concerned about suicide – ASK them about this

DO YOU NEED MORE INFORMATION FROM OTHER STAFF?

• Has anyone else expressed concerns about the student?

• How is the student functioning academically?

• Does the student have an ILP?

• Has the student had contact with the Education Welfare Adviser?

WOULD IT BE HELPFUL TO CONSULT WITH SOMEONE ELSE?

• Your line manager, senior colleague or MHFAider

• Your Education Welfare Adviser EWA. It is good practice to get the student’s consent for this. Otherwise please follow your department/Faculty policy

• Consider contacting Wellbeing Services for a conversation without giving the student’s name

If you remain concerned about a student assess the urgency of the siltation and use the referral route identified on the next few pages.

What to do if the situation is URGENT and requires an immediate response

The situation is URGENT and requires an immediate response if:

n You believe the student is at risk of ending their life or harming others now

n The student has taken steps to end their own life, ie tells you they have taken an overdose

n The student has a serious medical emergency

n The student is imminently at risk from others

n The student seems significantly disorientated and out of touch with reality

n The student is violent or threatening violence to people or property

IF THE STUDENT WILL ACCEPT HELP

Agree with the student the course of action

In office hours

• Call 999

And inform either

• Exeter: estate patrol 01392 722222

• Penryn campus security 01326 253503

• Exeter Medical school based at Penryn Glasney Lodge 01326 253503

• Give the student the leaflet for managing suicidal thoughts and distressing feelings and encourage them to call First Response Service 0808 196 8708

• Seek support from a MHFAider (Mental Health First Aider)

• Recommend the student accesses Wellbeing Services as soon as possible

• Seek advice and support for yourself from your MHFAider, line manager, supervisor, Wellbeing Services, staff wellbeing pages, communities of practice

• Inform your line manager

Out of hours

Please follow the steps above plus:

Next day inform your line manager and Wellbeing Services

• Look up urgent support numbers and out of hours support on the Wellbeing Service’s urgent support page: exeter.ac.uk/students/wellbeing/support/ urgentsupport

IF THE STUDENT WILL NOT ACCEPT HELP

If at all possible let the student know that you will need to break confidentiality and inform relevant others about your concerns about their wellbeing

In office hours

• Call 999 And inform either

• Exeter: estate patrol 01392 722222

• Penryn campus security 01326 253503

• Exeter Medical school based at Penryn Glasney Lodge 01326 253503

• Give the student the leaflet for managing suicidal thoughts and distressing feelings and encourage them to call First Response Service 0808 196 8708

• Recommend the student accesses Wellbeing Services as soon as possible

• Seek advice and support for yourself from your MHFAider, line manager, supervisor, Wellbeing Services, staff wellbeing pages, communities of practice

• Inform your line manager

Out of hours

Please follow the steps above plus:

Next day inform your line manager and Wellbeing Services

• Look up urgent support numbers and out of hours support Wellbeing Service’s urgent support page: exeter.ac.uk/students/wellbeing/support/ urgentsupport

CONFIDENTIALITY ISSUES TO CONSIDER

• Do not promise absolute confidentiality. Explain to the student that confidentiality may be breached if there are very serious concerns. If you think a situation is urgent, confidentiality can be breached.

• It is best practice to try to get the student’s agreement to call emergency services and estate patrol. If a student is reticent then persist gently, express your concern for the student and explain why its important to get them to A&E.

•

• In some circumstances you may need to call 999 and estate patrol without consent. In this situation explain the reason for doing this by expressing your concern and need for the student to be safe, with professional help to support them.

• It is not recommended that you take a student to A&E yourself.

• If a student walks away from you and will not stay to wait for the ambulance, do not follow them but let estate patrol and Wellbeing Services know.

IN ALL SITUATIONS

• Try to engage the student and actively encourage them to agree to accept help and support

• Try to stay calm

• Wherever possible try to inform a colleague about the situation to get back up support for yourself

• Make sure that you debrief by talking the situation through with a line manager, Wellbeing Services, communities of practice meeting

• Look after your own wellbeing, access support through staff wellbeing pages, occupational health

What to do if the situation is URGENT and doesn’t require an immediate response

The situation is URGENT not requiring an immediate response if:

n The student is at risk of harm to self or others/expressing suicidal thoughts but has NO intent to act on the thoughts now

n The students is exhibiting extreme behaviour ie elated, withdrawn

n There has been significant concern from others (friends/family)

n There has been very concerning language in discussions/academic work/mitigation requests

n The student is homeless or at risk of becoming homeless imminently

n Student has disengaged from contact and you’ve had previous concerns about their welfare

n A student has lost significant weight/is not eating

IF THE STUDENT WILL ACCEPT HELP

In office hours

• Complete the student concern referral form and inform the student about this tinyurl.com/3tz5xtuz

• Support and encourage the student to see their GP

• Give the student the leaflet for managing suicidal thoughts and distressing feelings and encourage them to call First Response Service 0808 196 8708

• Ask the student if they have any additional support that they can access

• Encourage them to make a plan for the next few hours eg contact a friend, go for a walk, listen to music

• Ask about any immediate academic issues causing concern that you may be able to help with. refer to EWA if needed.

• Discuss the situation with a MHAider student support

Out of hours

• Complete the student concern referral form but it will not be looked at until the next office hours

• Inform either Exeter estate patrol 01392 722222, Penryn campus security 01326 253503, Glasney Lodge 01326 253503

IF THE STUDENT WILL NOT ACCEPT HELP

In office hours

• Discuss the student concern referral form and explain that you want them to have some support from Wellbeing Services

• Gently persist to try to engage the student in accepting support

• Complete the student concern referral form ideally with student consent but can be without consent tinyurl.com/3tz5xtuz

• Inform the student that you have referred them to Wellbeing Services unless you feel it would be detrimental to their mental health and wellbeing to do so.

• Discuss the situation with a MHFAider student support

• Give the student the leaflet for managing suicidal thoughts and distressing feelings and encourage them to call First Response Service 0808 196 8708

• Ask the student if they have any additional support that they can access.

• Encourage them to make a plan for the next few hours eg contact a friend, go for a walk, listen to music.

• Ask about any immediate academic issues causing concern that you may be able to help with. Refer to EWA if needed

Out of hours

As above plus:

• Inform either Exeter estate patrol 01392 722222, Penryn campus security 01326 253503, Glasney Lodge 01326 253503

CONFIDENTIALITY ISSUES TO CONSIDER

• Do not promise absolute confidentiality. Explain to the student that confidentiality may be breached if there are very serious concerns ie if the student is at risk of harm to themselves or others. If you think a situation is urgent, confidentiality can be breached.

• It is best practice to try to get a student’s agreement to complete the student concern referral form. If a student is reticent then persist gently, express your concern for the student and explain why its important to get them support and help.

• In some cases you may need to fill in the student

referral form without consent. In these situations inform the student that you have complete the form and referred them to Wellbeing Services for support.

• In a small number of cases you may believe that it would be detrimental to the students wellbeing to tell them about the referral. In these situations state that the student is unaware of the referral on the form

• Wellbeing Services offer a confidential service to students, however confidentiality may need to be breached in exceptional circumstances exeter.ac.uk/students/wellbeing/policies/service/#a1

IN ALL SITUATIONS

• Try to engage the student and actively encourage them to agree to accept help and support

• Try to stay calm

• Wherever possible try to inform a MHFAider student support about the situation to get back up support for yourself

• Make sure that you de brief by talking the situation through with a MHFAider, line manager, Wellbeing Services, communities of practice meeting

• Look after your own wellbeing, access support through staff wellbeing pages, occupational health

What you should do if the situation does NOT require immediate action?

The situation is NOT urgent if:

There is no immediate risk to the student, or others, although the student may be:

n Depressed, anxious, generally stressed

n Homesick, lonely and isolated

n Physically or mentally unwell

n Having difficulty with relationships (family, friends, flatmates, etc.)

n Suffering from low self-esteem

n Bereaved

n Having problems studying and/or managing finances

n Recovering from a traumatic event

IF THE STUDENT WILL ACCEPT HELP

Agree with the student the course of action

HAVE A SUPPORTIVE CONVERSATION WITH THE STUDENT

IF YOU FEEL SOMEONE ELSE IS BEST PLACED TO HAVE THE SUPPORTIVE CONVERSATION

IF THE STUDENT WILL NOT ACCEPT HELP

• Explain that you will help if the student changes their mind

• Find a private and confidential space

• During the conversation:

– listen to the student’s concerns

– provide reassurance

– acknowledge their challenges/ experiences

– ask how you can help – offer practical support eg helping with mitigation – signpost to University support services (see page 10 and 11 for online version)

– signpost to University Wellbeing Services for emotional and mental health support

– signpost to their GP

– follow up your conversation at another time

• Make sure it does not conflict with your role

• Make sure you are clear about your personal and professional boundaries

• Make sure you have access to support and advice

• Discuss with a MHFAider student support and agree who will hold the supportive conversation Offer meeting to hold the conversation. Signpost the student to support services (see back pages of the guide)

• Identified colleagues to inform the student about support services available (see page 10 and 11 for on line version)

• If you are unsure then seek further advice (without giving the students name) from Wellbeing Services and/ or the MHFAider, Education Welfare Adviser, your line manager, etc. by having a what if conversation with the Education Welfare Adviser, your line manager, or other appropriate service

• Ensure the student understands the implications of not accessing help i.e. not having access to reasonable adjustments such as exam arrangements

• Explain issues of confidentiality especially in relation to passing on information in exceptional circumstances

• Seek advice from your MHFAider, line manager, supervisor, Wellbeing Services, Education Welfare Adviser

• Monitor the situation if it’s within your role

• If the concerns become more serious refer to the urgent support sections in this guide

CONFIDENTIALITY ISSUES TO CONSIDER

• Health is sensitive data under GDPR and University data protection and GDPR principles need to be followed.

• Non urgent situations are not exceptional circumstances. Therefore you must not pass on information without the students express consent. Best practice would involve supporting the student to access the support themselves.

IN ALL SITUATIONS

• If needed, talk the situation through with a line manager or supervisor, MHFAider, Education Welfare Adviser, Wellbeing Services

• Keep a note of your discussion with the student, outlining agreed actions/recommendations and store them confidentially

• Follow up on the meeting by emailing a brief note of your conversation, the services you have discussed and any actions agreed

Who can support the student?

Is the student experiencing difficulties with their mental health?

Is there a physical health problem?

Is the student a care leaver, carer, or estranged?

Do you need help and advice about next steps for supporting a student

Is the student struggling with their studies?

Is the student neurodiverse eg SpLD, ADHD, Autistic

Does the student have a disability or long term health issue?

Is the student isolated and wanting social events?

Is there a problem of discrimination, harassment or complaint?

Is there a visa issue or is the issue related to the student being from overseas?

Does the student need some advice on safety and security

Wellbeing Services exeter.ac.uk/students/wellbeing

Student Health Centre/GP exeterstudenthealthcentre.co.uk

Education Welfare Adviser

exeter.ac.uk/students/wellbeing/talk/welfare

Mental Health First Aider

Relevant member of academic staff

Relevant member of academic staff

Hub Information Point exeter.ac.uk/students/infopoints

AccessAbility

exeter.ac.uk/students/wellbeing/support

Student Guild Advice Unit advice@exeterguild.com exeterguild.org/advice

Residence Life Team

exeter.ac.uk/study/accommodation/currentresidents/wellbeing-reslife

Dignity and Respect Advisors

exeter.ac.uk/about/speakout/support/ dignityandrespectadvisors

Chaplaincy exeter.ac.uk/students/chaplaincy

International Student Support exeter.ac.uk/students/international/ accessourservice

Estate Patrol exeter.ac.uk/departments/campusservices/ campussecurity

Is the student experiencing emotional or personal difficulties?

Is the student experiencing suicidal thoughts and/or self harm thoughts?

Are there academic issues arising from a mental health or welfare issue?

Does the student need support under HWSS?

Does the student have ILP queries, program queries, need mitigation?

Does the student need to have, or update their ILP?

Does the student have financial concerns?

Is the student having difficulties in their accommodation?

Does the student want to talk things through with someone who can provide a listening ear?

Does the student need to report an incident

Useful contacts:

Wellbeing Services

Reed Mews Wellbeing Centre

Tel: 01392 724381

Email: wellbeing@exeter.ac.uk exeter.ac.uk/wellbeing

AccessAbility

The Forum

Tel: 01392 723880

Email: accessability@exeter.ac.uk

Chaplaincy – Exeter exeter.ac.uk/students/chaplaincy

Estate Patrol

Ext: 3999 (2222 in an emergency) exeter.ac.uk/departments/campusservices/ campussecurity

The Moorings@devon

Mental health support in Devon

Tel: 07990790920

Email: devonexeter.mhm@nhs.net mhm.org.uk/the-moorings-devon

Residence Life Team

Email: residencelife@exeter.ac.uk exeter.ac.uk/study/accommodation/currentresidents/wellbeing-reslife

Students’ Guild Advice Unit

The Forum

Email: advice@exeterguild.com exeterguild.org/advice

Education Welfare Advisers

Email: welfare.peterchalk@exeter.ac.uk welfare.queens@exeter.ac.uk welfare.buildingone@exeter.ac.uk welfare.stlukes@exeter.ac.uk welfare.harrison@exeter.ac.uk welfare.PGR@exeter.ac.uk welfare.amory@exeter.ac.uk

International Student Support exeter.ac.uk/students/international/ accessourservice

Student Health Centre

Reed Mews, Streatham Drive EX4 4QP

Tel: 01392 676606 exeterstudenthealthcentre.co.uk

Dignity and respect adviser exeter.ac.uk/about/speakout/support/ dignityandrespectadvisors

Accident and Emergency Department

RD&E Hospital, Barrack Road, Exeter

Tel: 01392 411611

First Response service

(Devon NHS mental health crisis line)

Tel: 0808 196 8708

dpt.nhs.uk/our-services/first-responseservice

Papyrus Hopeline papyrus-uk.org

Samaritans

10 Richmond Road, Exeter EX4 4JA

Tel: 116 123

Email: jo@samaritans.org samaritans.org/branches/exeter

For a list of other local and national support: exeter.ac.uk/students/wellbeing/index

Useful University Documents:

• Health, Wellbeing and Support to Study

• Fitness to Practice Policy

• Teaching Quality Assurance Handbook

Mental Health First Aiders student support exeter.ac.uk/staff/wellbeing/suicide/training/ mental-health