This policy supports students who may experience emotional or psychological difficulties are persistent and affect their ability to participate fully in higher education.
This policy covers:
- providing support
- respecting confidentiality
- helping students in crisis
- local mental health services
- raising awareness
- supporting those involved in student welfare
- meeting commitments to students with disabilities
- taking time out and discipline
Students arriving at university for the first time need to adapt to significant changes, such as moving to a new area, separation from family and friends, establishing a new social network, managing a tight budget, combining academic study with family commitments, coping with a disability in a new environment and, for international students, living in a new country and adjusting to a different culture. For many, these changes are exciting and challenging and an intrinsic part of the attraction of going to university. However, they can also give rise to anxiety and stress.
Most personal problems experienced at university can be resolved quickly by talking to a family member or a friend or by seeking help from tutors or other advisors. It is important not to label as "mental health" problems what are in reality normal emotional reactions to new experiences. However, a number of students may experience emotional or psychological difficulties that without appropriate professional support are more persistent and inhibit their ability to participate fully in higher education. These difficulties may take the form of a long-term mental illness or a temporary, but debilitating, psychological condition or reaction. In addition, some students may arrive at university with a pre-existing psychological problem, either declared or undeclared.
Mental health problems can seriously impair academic performance and may lead to confused or disturbed behaviour. Minor difficulties that interfere with a student's capacity to work May also result in distress and wasted effort and undermine academic progress. A more seriously disturbed student, as well as needing appropriate professional support, may cause anxiety and concern to fellow students, tutors and UCL staff. The suicide or attempted suicide of a student is an extreme, but fortunately rare, response to mental distress and a very disturbing event for all, especially for those close to the individual concerned.
It is important that students who are aware that they have, or have had mental health problems be encouraged to share this information with an appropriate member of UCL staff. The reason for this is that certain people at UCL need to know of their circumstances in order to ensure that reasonable adjustments can be made to enable them to study effectively. The student should share their relevant health information and how it affects their academic performance and/or day-to-day life with their departmental tutor with an understanding that confidentiality will be maintained: only those who need to know being informed. The student should always be made aware of to whom the information is passed and why. Some students may be reluctant to share such information with members of staff in their department, in which case, they should be encouraged to talk to an appropriate member of staff outside their department: the Head of Student Psychological Services, a member of the Student Psychological Services team, or the Student Disability Advisor (Mental Health) in the Student Disability service. If the student does not want to disclose their circumstances to a UCL staff member, they should be informed of the consequences for them of not doing so.
UCL aims to provide a supportive environment that will help students with mental health difficulties to realise their academic potential and more specifically, to meet course requirements. By providing the opportunity to pursue social, cultural and sporting fulfilment, in addition to academic excellence, it also aims to facilitate and promote positive mental health and well-being.
UCL seeks to implement these aims by:
- encouraging students with mental health difficulties to seek help
- supporting a culture in which mental health problems are accepted, not stigmatised
- liaising with appropriate services to ensure that students with serious mental health problems receive appropriate treatment
- meeting the support and study needs of students with mental health disabilities
- making reasonable adjustments to policies and procedures which might otherwise unlawfully discriminate against students with mental health difficulties
- ensuring that the availability of support is accurately and widely publicised to both prospective and current students
- establishing consistent procedures across the University for helping students with mental health difficulties
- providing guidance and awareness training to those UCL academic staff involved in the support and care of students; and
- respecting the confidentiality of personal information provided by students with mental health difficulties
UCL has an extensive network for student support comprising pastoral care by tutors, the Ridgmount NHS Practice, Student Psychological Services, Student Disability Services, the UCL Union Rights and Advice Centre, UCL Union Sabbatical Officers, as well as student self-help. Responsibility for helping students with problems rests, in the first instance, with the departmental tutor, the Programme Tutor or Graduate Tutor, or, in the case of research graduates post-graduates, the main supervisor. Tutors should make reasonable adjustments to coursework and examinations for students with mental health difficulties. Any member of staff should therefore liaise with the relevant individual if they have concerns about a student, subject to the requirements of confidentiality. Good communication between staff is particularly important for graduates, as their contact with academic staff may be less frequent than that of undergraduates and any problems less easily identified.
Both the formal and informal systems of non-medical pastoral care are usually sufficient to address those academic problems that give rise to anxiety or stress. However, more serious emotional and psychological problems require professional intervention by the Ridgmount Practice or Student Psychological Services.
The general practitioners in the Ridgmount Practice are particularly experienced in the care of university students. They know the university system well and are integrated into university life. They treat students with mental health problems and liaise with UCL staff over mental and physical health issues. They and other local general practitioners can refer students to other agencies within the local Mental Health Services; provide medical certificates at the time of examinations for those who are ill; negotiate "an interruption of study”, should this be necessary; and provide medical certificates for local education authorities if an interruption of study is taken.
The Ridgmount Practice on the UCL campus employs nurses experienced in dealing with students' problems, including mental health problems. Students can visit the surgery twice a day during the morning and afternoon drop in sessions, or make an appointment to discuss these with the nurses or with GPs in the Practice. The nurses are sometimes responsible for long-term drug treatment for students with psychiatric disorders. The nurses are willing to act as the first port of call for students with mental health problems before referring them on for counselling or medical help.
Student Psychological Services provides the following support to both under-graduate and post-graduate students:
- psychological assessments
- psychiatric assessments
- time-limited psycho-dynamic counselling
- time-limited cognitive behavioural therapy
- personal development groups
- referrals to external psychological services.
- self-help library
Students are encouraged to refer themselves. The Service aims to see a student as soon as possible. Waiting times vary according to demand and information about the likely delay is regularly updated on the website.
Students with mental health difficulties of a more than temporary nature may benefit from the non-therapeutic support that can be arranged by Student Disability Services. Staff in Student Disability Services can also advise on, and liaise with other staff in the implementation of, appropriate reasonable adjustments to teaching and learning in individual cases.
UK home students with mental health difficulties may be entitled to the Disabled Students Allowances (DSAs). These allowances can enable a student to purchase computing equipment and to have study-related mentoring. Student Disability Services plays an important role in the application process for DSAs and in the implementation of the recommended support. UCL also endeavours to provide similar support for disabled international students.
Students with mental health difficulties may also be entitled to special arrangements for examinations.
A student with mental health difficulties is extremely unlikely to seek help unless he or she knows the information they provide will be treated as confidential and that it will not harm their academic standing. Doctors, nurses, counsellors and chaplains are all required to observe confidentiality in accordance with strict ethical codes.
On the issue of confidentiality in matters relating to student health and welfare. Whilst emphasising the responsibility to respect privacy, it also advises on those extremely rare circumstances when it would be appropriate to share information with third parties who have a clear need to know that there are specific concerns about a student e.g. where there is a significant danger of a student harming themselves or others.
The best way to manage a crisis is to avoid it developing. This means recognising the early manifestations of mental illness and encouraging the student to seek help. However, even the most experienced professionals can be caught unawares, and it would be both wrong and impractical to treat every example of unusual behaviour as if it might be a manifestation of mental illness.
Either the student will be known to have a mental illness or there will be a history of gradually changing behaviour that has caused concern. The most common manifestations are increased self-neglect, deteriorating coursework, disruptive behaviour and isolation. Occasionally, however, abnormal behaviour can develop suddenly.
UCL is not able to provide support outside normal office hours, with the exception of students living in UCL Residences where an on-call warden is available.
Students can call UCL’s free out of hours telephone support line, Care first, by calling 0800 197 4510. The advisers at Care First are all BACP accredited counsellors and students can access counselling via telephone from Monday to Friday from 5pm to 9am, at weekends and during Bank Holidays and College closure periods. Further information can be found here.
UCL subscribes to London Nightline who are available to talk between 6pm and 8am.
Although rare, the most serious risk associated with a developing mental illness is that the student might seriously harm themselves or others. This constitutes a medical emergency and requires immediate attention. The main objective will be to obtain a medical assessment, preferably in what is technically called ‘a place of safety', which is the local NHS Accident & Emergency (A&E) department or psychiatric unit. This will require the presence of the duty general practitioner and sometimes the support of a Security Officer or even the Police, although often the individual will cooperate and allow themselves to be escorted to the designated place of safety where a formal assessment of their mental state can be undertaken. An independent account of the student's behaviour will help the examining psychiatrist form a view of the diagnosis and the most appropriate management, which may include medication and admission to hospital.
Another example of an emergency is when a student suffers a severe panic attack just before, or during, an examination. This can be extremely frightening for those who observe it as well as for the student, who will behave completely irrationally and be obviously terrified. When it is sufficiently severe the only way to manage the immediate situation is to allow the student to leave and to arrange for them to receive specialist help in order to prevent a recurrence.
Much more common than either of the above examples is the gradual onset of abnormal behaviour that is, particularly in the early stages, very easy to misinterpret. Descriptions of these and the possible ways of helping are outlined in “The Recognition and Management of Emotional Problems in Students.”
Mental health problems are increasingly managed in the local community. Mental health services are provided by a combined psychiatric and social service Trusts predominantly organised around local, community mental health teams (CMHT). The local trust for UCL is Camden & Islington Mental Health & Social Care Trust (CANDI). Although this structure benefits a local population it is less effective for a peripatetic population, such as UCL students, since many of them live outside the local catchment area. It is therefore important to know how these services can be accessed should they be required.
Students who live in the local catchment area will be treated like all other patients. Their general practitioners, who work closely with CMHTs, will make most routine referrals. Some students will also be referred via Student Psychological Services. Such referrals will only take place with the student's agreement.
In an emergency a student will be seen in the A&E department at UCLH, the Whittington Hospital or the Royal Free Hospital by the Liaison team and their Psychiatrist for an assessment. There is also a crisis team that supports individuals at home who might otherwise have needed to be admitted.
The psychiatrist who has assessed the student will provide a report to their general practitioner. This will include their opinion regarding diagnosis and further management, including who will be responsible for supervising this. If UCL staff has concerns regarding the student's fitness to return to UCL, or whether the student requires special support, this should be provided by the psychiatrist.
Information about the support available to students with mental health difficulties is provided in UCL's prospectuses and as part of the induction process, both electronically and in paper form. Publicity material emphasises the importance of seeking help at the earliest possible opportunity and of the confidentiality of personal information. Information is regularly reviewed to ensure that it remains accurate and appropriate.
Student Psychological Services provides detailed information on-line and in print about the services it offers students. They also provide a student self-help library and self-help web-pages, both of which provides practical advice on how to cope with problems such as anxiety, depression, bereavement, insomnia and exam stress.
To promote consistency in the way individual cases are handled, guidelines are available for use by staff on how to identify and respond to students with mental health difficulties, including procedures for dealing with those at risk of harming themselves or others.
The objective is to ensure that tutors and others are better able to recognise the warning signs of a mental health problem and to know when it is sufficiently serious to require referral to a professional. It is important that those involved in student welfare do not try to deal with problems that require expert assessment and management, although they may still have an important role to play in supporting the student in their studies or living arrangements. Early recognition and intervention will help to prevent problems escalating. Training in skills relevant to mental health is also on offer throughout the year.
UCL has specific legal responsibilities towards students whose mental condition falls within the definition of 'disability' under the Equalities Act. The Special Educational Needs and Disability Act (SENDA) extended the provisions of the Disability Discrimination Act to education with effect from September 2002. Institutions are required to treat people with disabilities no less favourably than others, and, where necessary, to make reasonable adjustments to policies, practices, and procedures in order to achieve this.
Disability is defined as a physical or mental impairment that has a 'substantial and long-term adverse effect on a person's ability to carry out normal day-to-day activities'. Thus, it is likely to include students with a long-term mental illness such as schizophrenia. Other mental conditions may also be covered, although each case will need to be examined individually.
The management of potential disciplinary matters in a student with mental health problems always requires balancing 2 underpinning principles. The need to understand the relevance of all the factors involved, including those directly related to illness, and respect for an individual's autonomy. Each case will therefore depend on individual circumstances.
While every effort is made to help students in need, the duty of care owed by UCL to the wider student body and to staff takes priority where the behaviour of a student with mental health difficulties causes significant disturbance or distress to others. The Director of Student Support and Wellbeing and the Head of Student Psychological Services will make efforts to resolve such problems through discussion with the individual concerned and in particular to point out the effect that his or her behaviour is having on others. However, if these efforts are unsuccessful, alternative strategies will be considered, including, if necessary, requesting the student to withdraw from the University for a suitable period. If a student is suffering from a serious mental health problem, withdrawing from the University may offer them the best chance of making a full recovery, particularly if they receive support from their family, and because of this some students may decide to withdraw on their initiative. Withdrawal will also be necessary if the student's mental condition is such that they are unable to meet course requirements, notwithstanding the support of UCL and local medical services.
However, if the student does not agree to withdraw voluntarily it will be necessary to consider other measures. Procedures exist for the suspension of students on the grounds of academic insufficiency, whatever the cause. Suspensions for academic insufficiency are recommended to a Faculty by the student's Department. Upon the recommendation of the Faculty, the Dean of Students (Academic) makes the suspension under the UCL Regulations for Management. Where a student with mental health problems is suspended for academic insufficiency they will be advised to seek appropriate treatment of their problems in order that they may return to UCL being fit to study. In the case of behaviour that is causing significant disturbance or distress to others and where it has not been possible to resolve the matter informally with the student concerned, the matter will be referred to the Discipline Committee. In referring a case to the Discipline Committee, where the Registrar believes that mental ill-health is a contributing factor, the Registrar will make the Discipline Committee aware if this.
Students withdrawing from, or excluded from the UCL for mental health reasons will be allowed to resume their studies once UCL is satisfied that they are medically fit to do so, as certified by an appropriate, qualified medical practitioner or mental health practitioner, and that there is appropriate educational and pastoral provision to support them.