Mental health of students in higher education

College Report CR166Psychiatrists who are involved in the treatment of medical and otherhealthcare students may face a potential conflict of interest if there isconcern that the mental disorder that the student is experiencing is one thatcreates a possible risk to patients. The duty to maintain confidentiality maycome into conflict with duties to third parties, such as patients with whomthe student will come into contact. A conflict can also arise if a psychiatrist isasked to assess the suitability of a student to continue with his/her studies.Any psychiatrist taking on this role should not also assume responsibility fortreating the student.A further problem is the risk of a breach of confidentiality. This canarise if the student is treated at a teaching hospital that is used by his/heracademic institution. Some services have been able to set up reciprocalarrangements with neighbouring psychiatric facilities for the treatment ofstudents. Where this is not possible, every effort should be made to protectthe student’s confidentiality.RecommendationsFor psychiatrists and the NHS1 National Health Service providers of mental healthcare are urged torecognise and respond to the particular mental health needs of thestudent population and the difficulties that many experience in gainingequal access to services. Specific difficulties can arise for this groupas many students live away from home during term time but thenreturn home (or go elsewhere) during vacations. Policies that payconsideration to the following should therefore be put into place:a. if significant disruption to academic progress is to be avoided,it is very important that students are seen quickly for initialassessment;b. if a student is then referred on for treatment such as psychotherapy,the waiting list needs to be managed so that appointments are sentat a time when the student is able to attend, paying due regard toterm and vacation dates;c. therapy needs to commence at a time that will allow this to becompleted without the disruption of examinations and the summervacation, and before the student graduates.2 Clinicians are strongly urged to give due regard to the needs andvulnerabilities of patients with mental disorders who are embarking onhigher education for the first time. Arrangements are needed to ensurecontinuity of care between home and university and back again.3 Students often benefit significantly by being able to gain access todedicated student health services. General practitioners who workin these services acquire considerable experience and knowledgeof mental health problems in students. These practices can offer arange of additional services, such as practice-based counsellors andpsychologists. These services have come under threat with changesin the ways in which general practice is funded. This has led tosubstantially lower remuneration for GPs who work in settings such asthese. In the longer term this will create problems with recruitment12 http://www.rcpsych.ac.uk