Mental health of students in higher education

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Pathways to psychiatric careand is potentially precarious. There is a risk that the expertise in dealing withmental health difficulties that has been developed in some practices will bediminished or lost.Collaborative working between health and highereducation institution servicesThere is overlap in the problems that people present with to NHS psychiatricteams and higher education institution services (e.g. Connell et al, 2007).It seems self-evident that care could be improved if these two sectorsworked in closer collaboration with each other. For some students, integratedcollaborative working is well established; some examples of these aredescribed in Appendix 1.A possible option would be to create a single pathway of care in whichNHS and the relevant higher education institution staff work together in afully integrated service. This would allow all who are involved to see studentswho are most appropriate to their skills and training. It would also alloweasy referral of students from one professional to another. However, suchintegration may be difficult to achieve when there is separate managementof the different elements of mental health provision. There are often otherbarriers to joint working.One of these is the existing configuration of psychiatric services. Anintegrated service could probably only arise if there was a designated CMHTwhich took all referrals from the student population of each higher educationinstitution. In most psychiatric services, provision of care is sectorised bygeographical location or GP population. The establishment of dedicatedstudent psychiatric services would require considerable reorganisationof services. It might also cut across important working relationships thatpsychiatric services have with GPs and social work departments.A second problem arises from constraints on exchange of clinicalinformation. National Health Service clinical records are created and retainedin well-established organisational and legal frameworks. Administrationand monitoring of case notes is undertaken by trained clinical recordsprofessionals. There are clear standards in relation to retention, storageand disposal of case notes. Case records are covered by data protectionlegislation which sets out criteria and procedures for patient access. Thereare restrictions on the extent to which confidential clinical information canbe disseminated outwith the health service. Any clinician who does conveysuch information to a non-NHS provider of care will remain accountable forany breach of confidentiality that might arise from this. Similarly, counsellorsand mental health advisors maintain case notes and confidentiality in linewith professional guidelines and data protection legislation. Service-levelagreements could be negotiated between services and disclosure formsdesigned and agreed by university/college and NHS staff to enable liaisonand information exchange where appropriate. This would require the explicit,written consent of the student.If higher education institutions had contracts with the NHS for theprovision of counselling and mental health support rather than being directproviders themselves, it might be possible to bring counselling, mentalhealth advisors and NHS services under a single organisational umbrella. Thedownside of this is the risk that the level of understanding of the structuresand cultures of higher education institutions, the context-specific training,Royal College of Psychiatrists55
College Report CR166the understanding of learning processes and ready access to professionalhelp would be lost.If complete integration is an unattainable goal, it is desirable thatrelations between student services and NHS services are formalised in someway. This would be particularly valuable in some of the more extreme casesinvolving, for example, students who experience depression and are at riskof suicide or those with an eating disorder who are becoming dangerouslyunderweight. In such cases, it would be helpful to have procedures to followand for higher education institution staff to know whom to contact in theNHS for advice and assistance. Most higher education services make it clearto their clients that in circumstances where there is a serious risk to self orothers confidentiality may have to be breached.Better networks of communication between higher educationinstitutions and the NHS can ensure that psychiatric services are readilyavailable to those who are in need and can facilitate access to the expertiseof NHS staff for advice, supervision, support and teaching about psychiatricconditions.56 http://www.rcpsych.ac.uk
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Mental healthof studentsin higher e
Page 3 and 4:
DisclaimerThis guidance (as updated
Page 5 and 6: Working groupPrincipal contributors
Page 7 and 8: AcronymsAMOSSHE, Association of Man
Page 9 and 10: College Report CR166Epidemiological
Page 11 and 12: College Report CR166Care pathwayThe
Page 13 and 14: College Report CR166Psychiatrists w
Page 15 and 16: College Report CR166Promotion of Me
Page 17 and 18: IntroductionThe purpose of this doc
Page 19 and 20: College Report CR166managing mental
Page 21 and 22: College Report CR166Students who ex
Page 23 and 24: College Report CR166Students must a
Page 25 and 26: College Report CR166of postgraduate
Page 27 and 28: College Report CR166alcohol use. Fo
Page 29 and 30: College Report CR166driving, unsafe
Page 31 and 32: College Report CR166the first, the
Page 33 and 34: College Report CR166ConclusionsWhen
Page 35 and 36: College Report CR166undergraduates
Page 37 and 38: College Report CR166and the Institu
Page 39 and 40: College Report CR166body. The EHRC
Page 41 and 42: College Report CR166and provision o
Page 43: College Report CR166consultation to
Page 46 and 47: Higher education contextConclusions
Page 48 and 49: Higher education contextMental heal
Page 50 and 51: Higher education contextHealthy Uni
Page 52 and 53: Higher education contextImproving h
Page 54 and 55: Pathways to psychiatric careIn coun
Page 58 and 59: What to do if a psychiatric patient
Page 60 and 61: What to do if a psychiatric patient
Page 62 and 63: Mental health issues facedby intern
Page 64 and 65: Mental health issues faced by inter
Page 66 and 67: Medical and other healthcare studen
Page 68 and 69: ReferencesAdams, T. & Moore, M. (20
Page 70 and 71: ReferencesJumaian, A. (2001) Preval
Page 72 and 73: ReferencesSocial Exclusion Unit (20
Page 74 and 75: Appendix 1understanding of, student
Page 76 and 77: Appendix 2Internal liaison within h
Page 78 and 79: Appendix 3Different models of psych
Page 80 and 81: Appendix 3see this as a step forwar
Page 82 and 83: Appendix 4I have also been involved
Page 84 and 85: Appendix 5University general practi
Page 86 and 87: Appendix 6Initiatives from counsell
Page 88 and 89: Appendix 6The Westminster mentoring
Page 90 and 91: Appendix 6to the volunteer and then
Page 92 and 93: Northampton Assessment CentreUniver
Page 94 and 95: Appendix 8AimsThe aims of the MWBHE
Page 96 and 97: Appendix 8Current projectsThe group
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