Appendix 4I have also been <strong>in</strong>volved <strong>in</strong> assess<strong>in</strong>g a student with particularproblems and a disability who had made a number <strong>of</strong> compla<strong>in</strong>ts about theuniversity, and prepared a report, attended court, and then provided a needsassessment based on the student’s diagnosis.I have seen a wide variety <strong>of</strong> <strong>students</strong>, many <strong>of</strong> them present<strong>in</strong>g withfrank psychiatric pathologies. As can be seen by the breakdown <strong>in</strong> Table 1,the wide distribution <strong>of</strong> diagnostic categories, even <strong>in</strong> a small sample such asthis, is probably <strong>in</strong>dicative <strong>of</strong> the variety and degree <strong>of</strong> pathology prevalent<strong>in</strong> the student body <strong>of</strong> London Metropolitan University, and confirms theassumptions made by the university about the need for adequate andprompt psychiatric assessments and referrals to appropriate services whenrequired. I have been impressed, however, by the amount <strong>of</strong> experiencepossessed by the small number <strong>of</strong> staff <strong>in</strong> the counsell<strong>in</strong>g service andelsewhere <strong>in</strong> the university that can <strong>of</strong>fer help to these <strong>students</strong>, but believethat this matter needs further research and development.I have also had the opportunity <strong>of</strong> hav<strong>in</strong>g very helpful regular meet<strong>in</strong>gswith the manager <strong>of</strong> the counsell<strong>in</strong>g service regard<strong>in</strong>g many issues relat<strong>in</strong>gto the service as a whole. I have also met with the disability advisor, theact<strong>in</strong>g head for disabilities and dyslexia, and the lead university chapla<strong>in</strong>, todiscuss liaison opportunities.S<strong>in</strong>ce jo<strong>in</strong><strong>in</strong>g the university I have made efforts to raise the pr<strong>of</strong>ile <strong>of</strong>student mental <strong>health</strong> <strong>in</strong> a number <strong>of</strong> contexts outside the university. I haveorganised and now chair the London Network <strong>of</strong> Psychiatrists <strong>in</strong>volved <strong>in</strong> theLondon Student <strong>Mental</strong> Health Psychiatric Network. I sit on a work<strong>in</strong>g party<strong>of</strong> the Royal College <strong>of</strong> Psychiatrists who reviewed the current report. I amalso the College representative on the Universities UK/GuildHE Committeeon the Promotion <strong>of</strong> <strong>Mental</strong> Well-Be<strong>in</strong>g <strong>in</strong> Higher Education Institutions(MWBHE). The Committee has organised a conference on fitness to practisewhere I facilitated one <strong>of</strong> their workshops. At another conference organisedby the Committee <strong>in</strong> April 2009 I gave a keynote address on facts aboutstudent mental <strong>health</strong> <strong>in</strong> the UK.I am enjoy<strong>in</strong>g my work with the student counsell<strong>in</strong>g service andbelieve that there are a number <strong>of</strong> developments which promise to improveaccess to mental <strong>health</strong>care and support for those <strong>students</strong> that require it,especially work<strong>in</strong>g jo<strong>in</strong>tly with the newly appo<strong>in</strong>ted mental <strong>health</strong> advisor,whom I also supervise.The breakdown accord<strong>in</strong>g to gender <strong>in</strong>dicates a similar ratio tothat observed for mental <strong>health</strong> disorders <strong>in</strong> the general population, thatis roughly 2:1 female to male ratio. Male <strong>students</strong> with mental <strong>health</strong>problems tend to be younger than female <strong>students</strong>, and this would have tobe compared with the age ratios across all <strong>students</strong> <strong>in</strong> London MetropolitanUniversity to see whether this is <strong>of</strong> significance.I have used the ICD-10 as this is the classification system currentlymost used <strong>in</strong> the UK. The most frequent categories <strong>of</strong> mental disorder areaffective disorders, represent<strong>in</strong>g one <strong>in</strong> five <strong>of</strong> all diagnoses (many <strong>of</strong> whichare accompanied by anxiety disorders); some <strong>of</strong> these conditions are severeenough to warrant active treatment under supervision. These are followed bya variety <strong>of</strong> personality disorders, the most frequent <strong>of</strong> which is emotionallyunstable personality, borderl<strong>in</strong>e type – about one <strong>in</strong> six <strong>of</strong> all diagnoses.Both these disorders are likely to affect the academic performance <strong>of</strong><strong>students</strong> but those with personality disorders may also affect other <strong>students</strong>or academic staff. A variety <strong>of</strong> anxiety disorders, approximately 10% <strong>of</strong>all disorders, were also present. I have been struck by the numbers <strong>of</strong><strong>students</strong> with frank psychotic symptoms, all <strong>of</strong> them requir<strong>in</strong>g <strong>in</strong>terventionRoyal College <strong>of</strong> Psychiatrists81
College Report CR166Table 1 Analysis <strong>of</strong> results (up to June 2008)Students seen s<strong>in</strong>ce 9 Oct 2006, a n 55Men, n (%) 16 (29)Women, n (%) 39 (71)Average age, yearsMen 25Women 29Diagnostic breakdown, n (%)Psychotic disorders 6 (9)Affective disorders 13 (19)Anxiety disorders 9 (12)Mixed anxiety–depressive disorders 3 (4)Phobic disorders 2 (3)Obsessive–compulsive disorders 2 (3)Somatisation disorder 2 (3)Autism-spectrum disorder 6 (9)Gender identity disorder 1 (1)Substance use disorders 5 (7)Personality disorders 11 (16)Post-traumatic stress disorders 1 (1)Attention-deficit hyperactivity disorder 1 (1)Eat<strong>in</strong>g disorders 4 (6)No diagnosis 4 (6)Total number <strong>of</strong> diagnoses 70 (100)a. Female:male ratio 2.2:1.from psychiatric services, although at least four <strong>of</strong> these were not knownto local psychiatric services. Also strik<strong>in</strong>g was the number <strong>of</strong> those withautism-spectrum disorders, exclusively Asperger syndrome, who, despitetheir disability, were enrolled <strong>in</strong> courses <strong>of</strong>ten requir<strong>in</strong>g <strong>in</strong>teraction with other<strong>students</strong> and whose disability may have gone unrecognised by previous<strong>education</strong>al establishments. The other area <strong>of</strong> concern is the number <strong>of</strong><strong>students</strong> present<strong>in</strong>g with a variety <strong>of</strong> substance use disorders, approximatelyone <strong>in</strong> ten.Many <strong>students</strong> were either not registered with a local GP or were veryunclear about their registration with GP or mental <strong>health</strong> services. Hav<strong>in</strong>gsaid that, most <strong>of</strong> these <strong>students</strong> also cont<strong>in</strong>ued, and wished to cont<strong>in</strong>ue, tosee a counsellor from our own student counsell<strong>in</strong>g service <strong>in</strong> order to provideliaison and support, as well as psychological <strong>in</strong>terventions.82 http://www.rcpsych.ac.uk
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