Around 1 in 4 people will suffer from a mental health problem at some point, so it's not surprising that many students experience this whilst at university.

Not only is it a period of significant workload and exam stress, but there's also the upheaval of moving away from family and friends, or living with (initially) unknown people.

It can be difficult to recognise when tiredness or other problems are an appropriate response to your current demands, or a mental health problem that requires to be addressed.

Student of Staff in Mental Distress (Flowchart)


Student or Staff in Mental Distress Incident Recording Guidance Notes


Student or Staff in Mental Distress Incident Recording Form 1


 

Student or Staff in Mental Distress Recording Form 2

Common signs and symptoms

  • Poor appetite, or compensatory over-eating
  • Excessive tiredness
  • Poor concentration
  • Deterioration in self-care skills e.g. personal hygiene
  • Impaired motivation
  • Difficulty in remembering things
  • Problems in making decisions
  • Loss of drive, energy and interest
  • Disturbed sleep pattern
  • Feeling low or miserable much of the time, even despairing at times
  • Thoughts of suicide
  • Withdrawal from social events/contacts
  • Fears about attending lectures and/or tutorials
  • Hearing or seeing things that others seem not to
  • Increased irritability
  • Odd thinking

If you are experiencing a number of these symptoms then it is a good idea to seek a professional opinion and support. If you are experiencing thoughts of suicide, get help quickly.

Getting Help

There are various options both within and outwith the University, for you to choose from.

  1. Your own doctor has access to your medical history and therefore is able to contextualize your experiences to some extent, which can be very useful. They are also the gateway for referral onto other specialist services, should they feel that this is indicated.
  2. The University Health Service consists of a medical adviser (doctor), who is available for two short clinics each week, and a mental health nurse. We link in with the statutory NHS wherever appropriate and you would be advised of this on attending.
  3. The University Counselling Service If you are feeling distressed, unhappy or confused, counselling may be able to help you. If they feel that your mental health is seriously impaired or at risk, they will advise you to contact your own doctor.
  4. Outwith office hours, you may 'phone NHS 24 who will assess whether or not your presentation is considered an emergency or urgent enough to warrant immediate medical assessment. Either way, they will advise you of what to do next.
  5. The Samaritans are a confidential, free helpline, where there is always someone available to talk and listen
  6. Breathing Space is a confidential, free helpline, funded by the Scottish Executive
  7. Choose Life help and advice for those with suicidal thoughts and their family & friends
  8. Living Life Guided Self Help a confidential telephone service based on a Cognitive Behavioural Therapy (CBT) approach for people suffering low mood, mild to moderate depression and/or anxiety
  9. Touched by Suicide Scotland run support groups for people who have suffered a bereavement through suicide. For more information contact them on 0141 584 3211

It is important to talk to someone and to do something, rather than ignore the situation and hope that it will go away. Getting help earlier means you will feel better sooner, with less disruption to your studies and your life.

Suicide Prevention

Thoughts about suicide can be very distressing and isolating. These can occur without any real warning and lead to feelings of panic and being out of control of oneself. If this happens to you or to someone you know, it is essential that professional help is sought. Although many people experience such thoughts without ever then acting upon them, it is a dangerous position to be in and specialist assessment and input is required.

For many people, just knowing that outside help is coming can be a source of great relief e.g. an appointment is organized, even if it is not immediate, and can really ease their sense of despair. Support from a friend or relative is also very valuable, but you should not expect to substitute this for professional help if you are desperate.

If you feel that such suicidal thoughts are very immediate and persistent, i.e. you feel that you are in danger of acting on these imminently, you should contact your own doctor, indicating that you need an urgent appointment or, outwith office hours, contact NHS 24, again highlighting the urgency of the situation. Alternatively, you can present to 'Accident and Emergency' at Ninewells hospital, where your mental state will be assessed by a trained health professional.

Remember that whilst university is an intense and, at times, all consuming period in your life, your health is more important. It is surprising how effectively people begin to effect positive change with the right support in place, and how what seemed like insurmountable problems quite recently, can be put into realistic perspective and therefore back within your control.

Referral to Mental Health Service

The University of Dundee provides a mental health nursing service.

This confidential service is for students and staff who are either:

  1. experiencing a mental health problem,

    or

  2. felt to be in danger of developing a mental health problem. Clients' own GP's will be informed of the referral and the outcomes of this, as will psychiatric medical staff where they are also involved. Where the referrer is someone other than the afore mentioned, no information will be disclosed without the client's permission (the referrer will be notified of the first appointment date on receipt of the initial referral).

Means of referral

Referrals can be made by anyone who is concerned about the mental health of a student or member of staff. All referrals must be supported by a letter outlining:

  1. The client's details including name, address, date of birth, GP and psychiatrist (where applicable)
  2. The reason for referral
  3. The nature of the difficulties giving rise for concerns
  4. Summary of past mental health problems
  5. Category of referral

On receipt of the referral, the client will initially be given an appointment to see the doctor. The purpose of this is to medically review the client to rule out any other reasons for their difficulties and to ensure that mental health nursing referral is appropriate. If the referrer is the client's own GP or Psychiatrist, screening by the University Doctor will not be carried out.

Verbal referral may be made in cases or urgent need but these must then be followed up with a written referral.

Mental health nurse

Fiona Grant, Health Service, Support Hub, Old Technical Institute, University of Dundee

Telephone number: 01382 384168 (Internal Ext: 84168)

Fiona works part time, and so you might not always be able to contact her immediately. If you leave a message, your call will be returned as soon as possible.

Indicators for referral

Examples of specific disorders/mental health problems which would indicate referral to this service, and their referral priority rating are listed below:

Priority 1* referral

  • Risk to own safety
  • Safety of others may be at risk
  • Unintentional self harm e.g. self neglect
  • Abuse by others in the context of a mental health problem e.g. physical, sexual, emotional, financial

Priority 2* referral

Concerns regarding:

  • Undiagnosed/unmanaged psychotic illness
  • Functional disorders, for example:
    • Anxiety disorders
    • Depression
    • Phobic or obsessional disorders
    • Undiagnosed/unmanaged eating disorders

OR

A mental illness or condition which has not been given a specific label but has been significantly affecting the client's ability in the following areas for periods which may vary between months and years:

  • maintaining their employment/academic performance
  • maintaining their appearance and personal hygiene
  • performing necessary domestic chores
  • participating in recreational activities
  • sustaining social relationships

OR

People who are experiencing symptoms which are not severe but which cause significant and persistent psychological distress and, if not assessed and treated, may lead to severe and/or enduring problems, for example:

Examples:

  • generalised anxiety/stress disorders
  • abnormal bereavement reactions
  • abnormal adjustment reactions e.g.
    • following significant life events
    • post traumatic stress

* In summary, clients thought to be at risk of harming themselves or others, or being harmed, within the context of a mental health problem, should be regarded as a priority 1 referral and all others will be priority 2. Priority 1 referrals will be seen within one week of the referral being received. Priority 2 referrals, we would hope to see within 6 weeks, however, at busier times, this may be longer. If this is not possible for any reason, the referrer will be advised of this by the University Health Service on receipt of the referral. 

Nature of intervention

On first contact with the client, the following will be discussed:

  • information regarding the process and potential outcomes
  • boundaries of the therapeutic relationship
  • confidentiality and what this actually means
  • the means of assessment used
  • the existence of a care plan

The assessment process may last between one and three sessions after which the outcomes are discussed. This includes the findings of the assessment and what happens thereafter. There are a number of possible outcomes:

  • recommendations for self help resources
  • referral to the statutory psychiatric services, via your own GP
  • referral to other services where indicated
  • negotiation of a structured, time focused care programme with specific goals and actions

Other roles

As well as actual clinical work with clients, this service hopes to provide educational and advisory roles. This may include the following activities:

  • being a contact point for people seeking advice on whether referral is necessary/appropriate
  • regular networking meetings with groups of staff/students to answer any questions.
  • collecting feedback and suggestions on the service provision, access etc.
  • providing guidance/information on the recognition of potential mental health problems and possible actions.