Mental Health Policy
King’s College London
Draft
Definition of Mental Health Problems
i.
The term ‘mental health’ describes a sense of well-being; the
capacity to live in a resourceful and fulfilling manner and having
the resilience to deal with the obstacles that life presents.
ii.
A mental health difficulty may be defined as one in which an
individual is distracted from ordinary daily living by disturbing and
upsetting thoughts and/or feelings. A mental health difficulty may
disorientate an individual’s view of the world and produce a variety
of symptoms of behaviour likely to cause distress and concern.
Background and Introduction
1.
For a number of years there has been an increasing awareness in the UK of
mental health issues. In 1996, The Green Paper ‘Our Healthier Nation’
defined mental health as one of four priority areas in the Government’s
Health Strategy. Following this, the CVCP issued guidelines on ‘Student
Mental Health Policies and Procedures for Higher Education’ (April
2000). The following is the response of King’s College London.
2.
Most people experience some of the symptoms associated with mental
health difficulties at some point in their life. For some, their difficulties
would be a typical reaction to common life events such as bereavement.
The degree of severity of a problem will be reflected in the intensity of the
symptoms of the individual’s capacity to function. For one individual, for
example, depression may mean feeling temporarily low in mood, whereas
another may feel so debilitated that they are unable to take care of their
basic needs.
3.
King’s College London is concerned about the needs of any student whose
mental health difficulties inhibit their ability to fulfil their potential
whether this is due to a long-term mental illness, an emerging mental
health problem or a temporary debilitating condition or reaction. The
College aims to ensure that appropriate support is offered to any student
experiencing mental health difficulties.
4.
King’s College London is very concerned that no student should be
discriminated against because of their mental health problems. It is
therefore committed to a non-discriminatory and supportive environment
for all students. This includes making reasonable adjustments to enable
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students with mental health problems to engage and participate fully in
University activity.
5.
Students are therefore encouraged to disclose any disability to the College
either pre or post-admission in order to facilitate the necessary adjustments
to meet their needs and enhance their learning experience. Disclosure can
be to a personal tutor, disability advisor, a member of the welfare or
counselling staff or medical practitioner or nurse.
6.
The College has a duty of care not only towards those experiencing mental
health difficulties but to the wider student and staff community.
Therefore, confidential advice can be given by the welfare, counselling,
medical services or chaplaincy staff if a student or member of staff knows
or suspects that a student may have mental health difficulties.
7.
The interest of individual students has to be considered in the context of
the interest of the community as a whole, so that if the behaviour of any
student threatens to disrupt the activities of other students and staff this
will be taken very seriously and treated in accordance with the College’s
disciplinary procedures. However no student, who has made their
disability known to the College, would be disciplined without this being
taken into consideration.
Duty of Care
2.
As a result of the ‘proximate relationship’ resulting from the contract
between the College and its students, there are a number of areas in which
Universities may owe a duty of care to its students. King’s College
London as an institution has a duty of care towards its students and staff
which includes all employees of the college both academic and support
staff.
3.
The term duty of care is used very broadly to cover an Institution’s
responsibilities in contract law, the law of Tort and under specific
legislation such as the Health and Safety of Work Act 1974, SENDA and
the Occupiers Liability Act 1957. In addition, the Supply of Goods and
Services Act 1982 Section 13 requires that the supplier of services will
exercise care and skill when providing that service. Therefore, any service
which the College provides should be delivered with reasonable care and
skill. (Reference AMOSSHE 2001, ‘Responsibility to Student Mental
Health Issues, Duty of Care, Responsibilities to Students in Higher
Education’).
4.
It is impossible to absolutely define the term taking ‘reasonable care’ of
students and staff and each situation has to be considered on its own
merits. This will mean that staff will have a duty to take reasonable care
of a student whom they know has or may have a mental health problem but
they are not expected to be experts in the field of mental health. They are
simply required to meet the ‘standard of an ordinary person exercising and
professing to have the skill in question’. For example if a student tells a
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personal tutor they have a mental health problem, the tutor can only be
expected to ensure that the student is directed to the professional health
and counselling services available in the College. If a tutor suspects that
one of their students or tutees may be mentally ill, they should encourage
that student to attend the counselling service or their own GP perhaps by
suggesting that they seem under stress and that this may impair their
performance.
5.
If a student becomes disruptive or dangerous to themselves or others,
becomes unable to fulfil their studies competently or causes damage to
property on the University or College premises, staff have a duty to speak
to that person and act upon their concerns.
6.
All staff should, therefore, be adequately trained to respond to students
with mental health difficulties.
7.
Services to students should be adequately resourced and supported.
8.
There should be wide publication of services for students particularly those
relating to mental health.
9.
There should be effective record keeping to ensure the monitoring of
students.
10.
If a staff member feels out of their depth when providing support or
pastoral care for a student they should seek advice of the College
Counselling Service or refer the student directly to the service.
11.
If a student with a disclosed mental health problem applies for a place on a
course offered by the College, admission staff and tutors must be very
clear about the level of support available. If they indicate that the student
will receive more support than the College can offer, it is possible that the
student could sue the College for breach of contract.
12.
It is therefore important that staff do not make promises of health and
support in excess of College policy on support and guidance for students
with mental health problems.
Categories of Mental Health Problems
Psychological or Emotional Problems
These are most common amongst students. They can range from mild anxiety and
depression (the two most common presenting problems for individuals consulting
their GP or counselling service), inability to concentrate or produce work, acute
examination anxiety, severe panic attacks, alcohol and drug problems, psychosomatic
symptoms, suicidal thoughts, eating disorders, the effects of separation and reactions
to external situations.
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Evidence of psychological and emotional problems can include the symptoms just
described but also absenteeism, lateness, self-neglect, poor concentration and
performance, changed behaviour, difficulty in sleeping, repeated nightmares,
difficulty with eating or over-eating, over-use of alcohol or drugs, lack of motivation,
feelings of isolation, withdrawal from peer group, obsessive attitude towards work, a
desire to be perfect or an unrealistic occupation with failure.
Suicide/Self Harm
This ranges from severe depression for example which can range from a broken
relationship, bereavement or other loss, to students who feel they cannot make
relationships, study effectively or ever get paid employment. It includes students who
see no point in living as their daily existence is too unbearable. All students with
suicidal thoughts are at risk of acting these out so we take them seriously. Those who
self-harm are not always suicidal but they may well be.
Signs that a student may have suicidal thoughts include any of the above symptoms
and can include manifestations of hopelessness, despair, lack of interest or motivation,
very low self-esteem and extreme self-denigration (with a sense of underlying anger).
Psychiatric illness
This includes psychosis, schizophrenia, manic depressive illness, severe personality
disorder, bipolar affective disorder (manic depression) and severe depression.
Students who manifest worrying symptoms are assessed by the College’s consultant
psychiatrist who will assess, provide diagnosis and treatment as appropriate as well as
liaise with the relevant mental health institutions in case referrals are necessary.
It must be remembered that there is considerable variety in the signs of mental illness.
The individual may be unaware that they are ill and unaware of the effect of their
illness on other people.
Within this category, there are two groups of student:
a)
Those who have already had a formal diagnosis when they come to
University and are under the care of a psychiatrist at the time of
their starting their course. Long-term mental health difficulties are
formally considered a disability.
b)
Those whose mental health difficulties emerge during their time at
University. A wide variety of pressures may contribute to the
emergence of mental illness during late adolescence and beyond.
Signs and indications of psychiatric illness may include:
Unkempt or altered appearance, confusion, a disturbed sense of time and place,
inappropriate or bizarre behaviour, severely paranoid thoughts, significant change
from the perceived norm, a sense of being out of touch with reality.
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Personality problems
These are more difficult to define but can involve strange, threatening, obsessional or
anti-social behaviour which disturbs or disrupts students or staff. Often they are the
most difficult to handle and the most difficult to get help for.
Signs of personality problems may include:
Some of the above for psychiatric illness, students may sometimes ignore usual
procedures, seem unduly paranoid, lack boundaries, have relationship difficulties,
poor concentration and performance, display obsessional and anti-social or aggressive
behaviour.
When a student is a cause for concern
1.
Any member of staff – academic, hall managers, secretaries may develop a
concern about a student and it is vital when this happens that it is directly
addressed. Typical indications that a student is in difficulty and may need
help include the following:
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2.
The student telling you or someone else that they have a
problem.
Significant changes in appearance such as loss or gain of
weight, deterioration of personal hygiene or signs of
sleeplessness.
A notable change of smell which may result from increased use
of alcohol or non-prescription drugs or the individual
neglecting their personal hygiene.
Changes in the way they sound (for example, flat- toned, very
quiet, loud, agitated).
Change of mood, previous experience of the individual for
example, very up and down, miserable, tired.
Other people such as friends, housemates or relatives
expressing concern to you.
Changes in their pattern or standard of academic work.
Talk or evidence of self-harming behaviour such as arm cutting
or of suicidal ideation or plans.
If it is apparent that there is a problem and the student is willing to accept
help, they should be encouraged to contact the counselling service or the
member of staff should offer to do so on their behalf. If the student is
willing to seek help themselves, it is good practice for them to be asked to
let you know how they got on and to follow this up with the student in
order to be satisfied that they are receiving help.
Making a referral to the Counselling Service or Student Health Centre
If a student has difficulty, they may talk to a member of staff with whom they feel
comfortable. However, some students may need more specialist help so that if a
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member of staff feels that they may benefit from speaking with a counsellor they
should encourage a student to contact the student counselling service directly,
emphasising that the service is entirely confidential.
For some students a referral to the counselling service will come as a relief – an
indication that their problem is being taken seriously, but for others who have become
quite involved in talking about their problems, it could be seen as a rejection by the
referrer. This is worth bearing in mind if it has become apparent that a student has
complex issues to deal with.
Members of the counselling team are always happy to discuss a problematic student,
if necessary anonymously, with members of staff.
Members of the counselling team, who include experienced psychotherapists,
cognitive behavioural and cognitive analytical therapists, group analysts and a
consultant psychiatrist, are available on all sites.
Strand
The counselling service is located on the 3rd Floor of the Macadam Building.
Waterloo
The counselling service is located in Franklin Wilkins Building, Room 1.19.
Guy’s
The counselling service is located on the 4th Floor of Henrietta Raphael Building.
Denmark Hill
The counselling service is located in Room 2.48, Weston Education Centre.
The main telephone for all enquiries is 020 7848 2613/1731.
The fax number is 020 7848 2754.
The e-mail addresses are: ann.conlon@kcl.ac.uk; counselling@kcl.ac.uk.
Accessing the counselling service is very straight forward. A student can either go to
the health centre in the Strand where they can fill in a form or download it from
www.kcl.ac.uk/depsta/admsup/stuser and return it by e-mail. They will be contacted,
(outside of peak times, usually within 24 hours) and given the earliest possible
appointment.
If a student, however, is very distressed and/or indicates that they need to see a
counsellor urgently, they can be offered a short emergency appointment that day in
order to assess the urgency of their situation.
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Depending on the nature of their problem, the length of time a student will be seen
can vary widely. They may be offered individual or group therapy. The counselling
service also runs workshops on how to cope with examination anxiety, depending on
the demand. In addition, the service has contacts with other counselling and
psychotherapy units around London and refer accordingly.
Counsellors adhere to the British Association for Counselling and Psychotherapy
Guidelines on confidentiality and data protection.
The counselling and welfare service is open when the College is open throughout the
year.
The Health Centre
The NHS Health Centre on the Third Floor of Macadam Building at the Strand is
open during term time between 9.00am and 6.30pm (5.30pm during holidays). When
the Health Centre is closed, telephone calls will be diverted to a local answering
service. The individual ringing the service should be ready to give their name,
address and telephone number and state whether they are a student or a member of
staff at King’s College Health Centre. After the problem has been explained, the
doctor may give advice, arrange for a prescription or ask the individual to attend an
emergency centre or, if appropriate, do a home visit. Students need to be registered to
use the health centre. If registered with another GP Practice, they can also call their
own GP’s no.
Advice and information can also be obtained from NHS Direct which can be
contacted on 0845 4647 or www.nhsdirect.nhs.uk.
Emergency procedures/dealing with a crisis (see Appendix 1)
-
An emergency or crisis situation is one in which the usual
methods of dealing with a situation break down and one in
which professional help is urgently needed.
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If there is a serious concern that a student is at risk of harming
themselves or others or if their behaviour or state of mind is
causing undue concern, the following procedures should be
followed:
1. Contact the Counselling Service at the Strand on extension 1731 and ask to
speak to either one of the Counsellors or the College Psychiatrist. If none are
immediately available, either leave an urgent message (and one will call back
as soon as they are free) or ask to speak to one of the GPs or a nurse.
2. If it is a medical emergency, there are First Aiders on each of the sites who
can be contacted on extension 2222 or dial 999.
3. In the case of a dangerous or potentially dangerous situation (including a
violent or potentially violent situation), security should be contacted. There
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may be a need to call the Police. The numbers for campus security are as
follows:
Strand
Waterloo
Guy’s
Denmark Hill
0207 848 2874
0207 848 3806
0207 848 6666
0207 848 5555
4. In the case of out of hours emergency, telephone the emergency number 999.
5. Useful numbers are:
London Nightline (the student helpline) 0207 631 0101
The Samaritans 0845 7909090
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When a student refuses help
1.
It may be that the student recognises that he/she has a problem but does
not want help or denies that they have a problem. In either case, it is
important that the member of staff gently but firmly reiterates their
concern and repeats their offer to obtain help. If this is again refused, the
member of staff should then contact the counselling service (or health
centre depending on the nature of the problem) about the situation without
necessarily disclosing the identity of the student. However, the student
may need to be identified so it is important not to give undertakings of
absolute confidentiality. It would also be advisable to discuss the situation
with a line manager or head of department - as well as making a written
note of what has transpired.
2.
If a student in crisis is refusing to help and a member of staff has informed
their line manager, they should contact the student again, preferably the
next day when things have calmed down, the student may be in a more
receptive mood.
3.
In extreme circumstances, i.e. if a member of staff considers a student to
be at risk to themselves or others, or if they have said that they have taken
an overdose or that they intend to kill themselves in the immediate future;
harm somebody else and they are refusing help, the student should be
informed of the consequences of refusing help. The individual dealing
with the situation may then have to call an ambulance or contact the Strand
Counselling, Welfare and Medical Centres to start the procedure for
having the student admitted to hospital. It is important to keep the student
informed of what you intend doing and if possible contact your line
manager and the counselling service for advice and support or dial 999.
4.
If someone refuses to leave the University premises, for example at the
end of the day, when a student who has refused to receive help, then
refuses to leave the building, they should be informed that they no longer
have the right to remain on College premises and have become a
trespasser. It is important to contact campus security staff in order to help
deal with this situation. It may be necessary, for example, to contact the
Police to remove the individual from the premises.
5.
Record keeping: it is good practice to keep a record of discussions with
students and any action taken. This should be filed appropriately in order
to keep personal and sensitive information secure and should always be
written with the awareness that a student has the right to seek access to any
records kept about them.
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Risk Assessment
Risk assessment of a student with a serious mental health problem is a complex matter
and should be undertaken by a psychiatrist. Generally, two issues have to be
addressed:
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Will this person pose a significant risk of harm to themselves or
others if they are admitted to the College?
Will this person be at increased risk of harm to themselves or
others if they engage in or continue a programme of academic
activity?
The nature of mental health difficulties is such that an assessment can only be made at
a certain point in time and will need to be reviewed as the individual’s circumstances
changes.
At pre-admission stage
If there is evidence during the application process that a prospective student may pose
a risk to themselves or others, the case should be referred to the College consultant
psychiatrist who will undertake a psychiatric assessment or who will arrange to obtain
information from the individual’s existing psychiatrist. The exceptions to this are
applications from students who require medical clearance to gain entry onto their
programmes. These applications are to be passed to Occupational Health.
At post-admission stage
If serious concern arises about a student that they may pose a threat to themselves or
others, then a psychiatric assessment may be necessary. This should usually be
initiated with the full knowledge and consent of the student. If the situation is acute,
an assessment is likely to be undertaken as part of a medical assessment as to what
needs to be done in the short term to make the person safe and provide suitable care or
treatment.
Fitness to Practice
Mental health problems may interfere with a student’s ability to cope with their
chosen course of study. This is particularly so on vocational courses where
qualification is subject to a fitness to practice or termination of training procedure.
Any serious mental health concerns should be reported by members of staff as set out
in that procedure so that reference to the counselling service and the College
psychiatrist for a mental health assessment may be carried out.
Admissions Policy for Students with a Mental Health Disability
Under the Disability Discrimination Act (1995), King’s College London has a specific
educational responsibility to all students whose mental condition falls within the
definition of a ‘disability’. The Special Needs and Disability Act (SENDA) extended
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the provisions of the Disability Act with effect from 2002. Institutions are required to
treat people with disabilities no less favourably than others and where necessary, give
reasonable adjustments to policies, practices and procedures in order to achieve this.
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Disability is defined as a physical and mental impairment
which has ‘a substantial and long-term effect on the person’s
ability to carry out normal day to day activities’. It will thus
include students with long-term mental illnesses such as
schizophrenia or manic depression. Other mental illnesses such
as severe depression may also be covered although each case
will need to be reviewed individually.
Prospective students are assessed for admission to King’s
College London according to the admissions regulations for
taught courses. Whilst the College has a duty of care to
students and staff, it cannot always provide for the needs of
every student.
The College Disability Advisers in consultation with the
department concerned are responsible for arranging any study
needs support for students who declare a mental illness prior to
admission, after admission, or who require support or readmission.
The counselling team including the College psychiatrist, may
be required to offer long-term support throughout the duration
of the individual’s course.
Mitigating Circumstances and Special Examination Arrangements
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Any student who has suffered circumstances which were
unavoidable and who believe that these may have significantly
affected their performance may be able to make a claim of
mitigating circumstances. This should be made through the
respective School Office.
One of the results of assessment of need will be the
identification of any alternative arrangements for examinations
or assessments, stemming from the individual’s disability.
A student with mental health difficulties may be vulnerable to
being affected to the stresses of assessment. Therefore,
alternative arrangements may need to be made to minimize this
stress. For examinations, this may mean use of a scribe,
perhaps with additional time to allow for breaks.
For non-examination assessment, the flexibility of deadline
dates is likely to be the most important way of enabling the
student to present their work for academic assessment without
being unduly hampered by their difficulties.
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Interruption of Studies - Withdrawal Procedures
This procedure applies to all students within the College who may wish to withdraw
or suspend their studies. It is also designed to enable students to suspend their studies
if it is clear that their mental health difficulties are affecting their ability to take full
advantage of the educational opportunities being offered.
The College (ie the individual department) will respond with flexibility to any request
to suspend studies on the grounds of mental health and it is usual for students to
suspend their course of study to facilitate a period of recovery. An appropriate period
of recovery can be negotiated after which the College (individual department) may
require medical evidence to confirm that the student is fit and able to cope with the
academic demands that will be placed on them.
A student will not be disadvantaged on the resumption of his or her studies by reason
of the agreed suspension due to mental health difficulties.
In some circumstances, if a student refuses to accept a recommendation that they
suspend their studies or refuses offers of support, there may be implications for that
student’s progress. Where the student’s behaviour is having an adverse effect on
others, there may be disciplinary implications.
Disciplinary Procedures
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A small number of students with mental health disabilities can
cause disruption which may require formal action to be
considered.
It is important to consider the support needs of an individual
who has a mental health difficulty. The student should be
given the opportunity to discuss their worries with a member of
the College staff such as his or her personal tutor or a member
of the student counselling service.
The student should be made aware of how their behaviour is
affecting others and agreement sought with the student to
change this.
In the case of a student whose behaviour appears to indicate a
mental health problem, the disciplinary procedure should be
adjourned in order to inform the panel of any psychological
circumstances that may have affected or currently may be
affecting the student.
The student should then be advised to seek an assessment from
the Counselling Service which might include a consultation
with the College Psychiatrist. A confidential report (copy to
the student) could then be submitted to the Academic Registrar.
If the student does not agree to such a referral, the disciplinary
process would continue.
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Confidentiality/Disclosure
Data Protection Act and disability-related information
The Data Protection Act 1989 requires organisations to process personal data fairly
and lawfully and in accordance with the principles contained within the Act.
Sensitive personal data is a specific category of data consisting of information as to
racial or ethnic origin, religious beliefs and physical or mental health or condition. It
is a legal requirement that when collecting sensitive personal data the individual must
be aware of the agreement into which they are entering. Schedule 3 states the
condition that an individual must give ‘explicit consent’ to the processing of their
sensitive personal data.
This requirement is further endorsed by the Disability Discrimination Act Part IV.
Section 6.18 in the Disability Rights Commission Code of Practice for providers of
post-16 education states:
6.18
‘A disabled person has a right to request that the existence or nature of his or
her disability be treated as confidential. In determining whether it is
reasonable to make an adjustment the responsible body must have regard to
the extent that making an adjustment is consistent with a disabled person’s
request for confidentiality.’
The Disability Discrimination Act 1995 does not override the College’s
responsibilities under the Data Protection Act 1998. The individual’s right to request
confidentiality upholds the requirement for ‘explicit consent’ to be given. The Data
Protection Act does indicate personal circumstances in which the confidentiality
agreement entered into may be broken, such as the individual being perceived as a
risk to themselves or others.
Disclosure of a disability
In order to avoid discriminating against a disabled person or student by treating them
less favourably because of a disability, the College must make substantial attempts to
find out about the existence and nature of a disability. Currently, a student may
disclose a disability at the enquiry, application, enrolment stage, or during their time
at the College. It is also important to remember that Parts II and III of the Disability
Discrimination Act have the same implications for staff and visitors with disabilities
respectively.
It is essential to remember, however, that if one person has been told about a
disability within the College, the institution as a whole is deemed to know. It is not a
sufficient defence to say that the institution could not have reasonably known about
the individual’s disability if the student has disclosed on their application form, for
example. This applies to all staff within the College as well as contract staff and
visiting lectures.
Also important is that a core objective of the Disability Strategy is to foster a
supportive environment within which individuals feel comfortable disclosing a
disability. So there may be occasions when a student will disclose a disability but
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then request that the matter be kept confidential and not disclosed to others. Requests
for confidentiality are often made by students who are unsure of the College’s
approach to disability and the attitudes that they may encounter. By aiming to
promote a positive attitude to fair and equal access for students, staff and visitors
uncertainty surrounding disclosure can in many situations be avoided. Whilst bearing
this objective in mind, the right remains with the individual to request confidentiality
regarding their own information.
It must be made clear to staff, students and visitors at all stages that the disclosure of a
disability is desired in order to provide reasonable adjustments and support.
Individuals must be aware that failure to disclose a disability (provided the College
has made reasonable steps to find out about a disability) or keeping certain
information confidential may affect the level of support they receive. The College
must ensure in these instances that reasonable steps were taken to provide adjustments
whilst maintaining confidentiality.
International Students
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International students are no different from any other group of
students in that some may experience mental health difficulties
whilst at University. There are some aspects of studying a long
way from home however which deserve particular
consideration.
International students sometimes experience loneliness and
disorientation when arriving in a new country for the first time.
Sometimes the pressure of being away from home can stir up
psychological problems that otherwise may have lain dormant.
Many are under enormous pressure to succeed and may come
from a culture where the needs of the individual are considered
less important than those of the family or their immediate
society. They, therefore, might be resistant to seeking help.
The student advisers within student services organize an orientation programme
which goes someway to enabling international students to settle in and adjust.
It is, therefore, important that those dealing with international students are careful to
find out as much as possible before reaching a view as to what is happening when the
international student is exhibiting behaviour or describing feelings or thoughts which
may suggest that they are experiencing mental health difficulties. An understanding
of the individual, their current circumstances, their mental health history and their
cultural beliefs will all be important when determining how to act.
Training
Staff from the Counselling Service currently participate in training programmes for
academic staff and personal tutors. These are designed to raise awareness amongst
staff as to the kind of problems experienced by students, why these problems may
arise and their role in dealing with students who may approach them for help.
Relatively few staff participate in these programmes, however, and a phased training
programme involving staff at all levels is required.
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The need for other support staff including hall staff, departmental secretaries and
senior students to receive similar training has been recognised by the Director of
Student Services who has organized appropriate seminars. Whilst, Health Centre staff
also participate in seminars for hall managers, there is a need for a rolling programme
of training for all relevant staff at all levels including admission tutors, heads of
departments and porters to ensure that all staff are aware of the following:
a.
b.
c.
d.
All staff as possible are familiar with the signs of mental illness.
All staff are aware of the support systems available for students
experiencing mental health problems and know how to refer
students to the health or counselling service.
All staff know what emergency procedures to follow if a student
with a mental health problem is going through a crisis.
All staff feel confident that they have coping strategies for dealing
with students whose mental health problems are interfering with
their academic performance or whose behaviour is interfering with
the wider institution.
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Appendix 1
It is important to recognise that the majority of students with mental health difficulties
are unlikely to present disruption to others. In many cases the College will remain
unaware of students who have mental health difficulties. However, there are a few
incidences in the College each year when students’ disruptive behaviour may impact
on the functioning of other students and on the well-being of others around them.
Guidance notes in dealing with emergency situations:
2.
It is helpful when dealing with a mental health emergency to try to
remember the following:
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Do not panic unduly and try to remain as calm as possible.
Try to be as honest and open with the student as possible. This
may entail being gently firm and showing that you are not
afraid of their state of mind. It is important to reassure the
student that there are people available who can help.
An emergency situation always arouses strong feelings in
everyone. It is quite normal to feel impatient with the time it
seems to take to summon appropriate help.
It is also normal to be worried that you are not handling the
situation as well as you would like to be.
It is important that you let the student know whom you are
about to speak to about the situation and obtain the student’s
permission for this. In cases of serious psychical risk or acute
mental illness, this may not be possible and help should be
summoned if necessary without the student’s permission.
As students are normally aged over 18, the College is not in
loco parentis. Parents, therefore, cannot be informed about a
situation however worrying without the student’s permission.
However, students should be encouraged to give their
permission to contact their family or next of kin if this is
considered appropriate.
In extremely serious circumstances, i.e. if you consider a
student to be at risk to themselves or others or they have told
you that they have taken an overdose or that they intend to kill
themselves in the immediate future or to kill anybody else and
they refuse help, the student should be informed of the
consequences of refusing help. The member of staff may then
have to ring the Health Centre on extension 2613 or call an
ambulance depending on the urgency of the situation. The
student should be kept informed of what you are doing and if
possible the Health Centre and the Student Counselling Service
should be informed. It is also advisable to contact your line
manager.
In the case of a violent or potentially violent situation, security
should be contacted and asked for immediate help. The Police
may also need to be called. It is important to remember that it
is rare for someone with mental health problems to be violent
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towards others but if they are this will often leave people with
them feeling agitated and anxious in turn. It is important not to
exacerbate the situation by reacting to the aggression and it is,
therefore, important not to appear frightened or intimidated.
People who behave aggressively believe that no-one can stand
up to their aggression. It should be remembered that
aggression is normally the result of a number of serious
frustrations which cannot be expressed verbally. Sometimes a
violent situation can be prevented by trying to understand what
a potentially violent person is trying to communicate behind the
aggression. Helping a person articulate this can sometimes
help.
Anyone trying to help an individual in a potentially violent
state should take precautions against putting themselves in a
potentially dangerous situation by ensuring that, whenever
possible, someone knows where you are. Your door should be
left open or you should have a colleague with you if you fear
you may be facing a potentially volatile situation. In the case
of a direct physical assault, try to extricate yourself from the
situation – do not exacerbate it by retaliating.
If it is possible to gain some basic information, the following
would be helpful:
The person’s name and, if possible, address or a subject area.
If they are willing and able to give the name of their General
Practitioner and whether the individual has taken any
medication and what they have taken, how much and when.
Try to establish whether the person has had any such
difficulties before and who or what had been helpful.
Remember the Student Counselling Service is always happy to
discuss a crisis situation, before, during or after the incident.
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