Mental health of students in higher education

What to do if a psychiatric patientis moving to universityIn many cases young people with serious mental health problems are ableto enter higher education. This may involve a move to a new location. Insuch circumstances, there is obviously a need to ensure continuity of care.If the student is on long-term maintenance medication, it is essential thatarrangements are made for continued prescription of this. The ‘home’ mentalhealth team should make every effort to ascertain the service or servicesthat would be appropriate for the patient and to make a referral before thestudent starts at university. Most CMHTs serve defined populations whichmay be based on primary care lists or on geographical location. If theuniversity or college has a mental health or disability advisor, he or she maybe able to advise on how to do this. Mental health advisors can also help inother ways. They may be able to arrange a visit to the university so that theycan meet the student before the start of the academic year, and ensure thatthey receive appropriate services and preparation for study. They would alsobe able to advise on the student’s eligibility for DSA. Referral to a mentalhealth advisor will obviously require the consent of the student. NationalHealth Service personnel can play a very important role by encouragingprospective students to make early contact with their chosen universityor college, and agreeing to allow them to provide relevant backgroundinformation to the key higher education support staff.A successful application to university or college by a young person witha history of mental illness will usually be viewed in a spirit of optimism andhope. It may be seen as the opening of a new chapter in life and a breakwith a recent past dominated by illness and disability. A student may decidenot to disclose a history of mental disorder because of a wish to move onand leave the past behind. In many cases, optimism and hope will be fullyjustified. In others, it is important that these feelings are tempered byrealism about the young person’s capacities to adjust to a new life and tocope with the demands of higher education. This is especially the case withillnesses such as schizophrenia, in which there may be enduring disabilitiesin areas such as motivation, emotional expression and ability to relate toothers. This applies even more so if there are residual positive symptoms,such as delusional thinking. In cases such as these, university may not bea happy experience for the young person. He or she may struggle to formrelationships with peers and as a result become socially isolated. He orshe may find it difficult to cope with the kinds of interactions that arise inthe context of small-group teaching, such as giving presentations to fellowstudents. Concentration may be impaired as a result of medication and thiscan combine with diminished motivation to make it difficult to meet theacademic demands of the course. A person who is studying far from homeRoyal College of Psychiatrists57