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Student mental health: appendix 1

Suicides

This is an appendix to the Student mental health policy.

UCL has produced the following guidance in response to the UUK (formerly CVCP) papers:

  • CVCP/SCOP Guidelines on Student Mental Health Policies and Procedures for Higher Education, 2000
  • CVCP/SCOP Student Suicide Project, 15 November 2000
  • UUK/SCOP Reducing the risk of student suicide, 10 December 2002)

There are difficulties in collecting and interpreting such statistics for the following reasons:

Death by suicide is a formal verdict reached by one of HM Coroners. Coroners will only reach such a verdict by applying the test of evidence: 'beyond reasonable doubt'. This means that in addition to the evidence of the circumstances relating to the cause of death, the Coroner will seek evidence of the mental intent of the deceased person; for example in the form of a 'suicide note'. In practice, this means that some deaths that are in reality suicides will be recorded as misadventure, or an open verdict will be delivered. Strictly, statistics should only be collected from Coroners' verdicts but in practice those cases not attracting the formal verdict, but for which the circumstances indicate suicide, will be included.

Unless a death occurs on UCL premises, UCL may not have access to the cause of death, making it difficult to obtain complete statistics.

The death rate from suicide is low and it would take a long time to generate statistics that might be used as 'management information'.

All student deaths are reported to the Registrar at UCL. The Registrar and Deputy Registrar (Operations and Planning) will examine student deaths in each academic year and report annually on the number known or suspected to be suicides. An annual report of these figures will be prepared for the relevant UCL committees.

The avergae suicide rate for the student age-group is 7.88 per 100,000. Projection of this figure onto the UCL student population gives an estimated annual number of suicides at UCL of 3.

Risk factors

  • gender: much more common in men, whereas parasuicide (attempted suicide or self-harm) is more common in women
  • age: Main peak in incidence is in males 15-24
  • previous history of substance abuse
  • feelings of deprivation relative to the community in which the person at risk is located
  • homelessness
  • financial problems
  • family problems: divorce, sexual abuse
  • previous history of mental ill-health, including parasuicide
  • social isolation arising from ethnicity, sexuality, low self-esteem or dislocation
  • risk assessments based on the co-incidence of a number of these factors may be useful but issues of confidentiality and inability to elicit a full history may impair full risk assessment

Protective factors

  • increasing 'coping skills'
  • developing problem-solving skills
  • social support by encouraging integration and reducing social isolation and reducing other risk factors
  • getting individuals to reflect on and value their social 'capital'
  • encouraging those with care responsibility to work effectively in partnership
  • raising awareness of mental health issues and de-stigmatising suicidal thoughts
  • providing information on sources of support
  • encouraging those with responsibility for care to engage with potential suicide victims and eliminating any blame culture if things go wrong

Dealing with a suicide threat

If a student makes a statement that they intend to take their own life, the primary aim is to get them to see a counsellor or doctor. They should be settled in a comfortable and private environment and given opportunity and encouragement to talk. The idea of their seeking help from a counsellor or doctor should be introduced gently and without haste. If they agree to seek professional assistance try to arrange an immediate appointment at

Student Psychological Services or the student health centre at the Ridgmount Practice, or, out of hours, suggest that they go to UCH Accident and Emergency Department where the duty psychiatrist can be called. Stay with the student, ask if they would like a friend or family called, but do not insist. Discretely try to summon support and assistance from a colleague. Accompany them to the source of professional advice and stay with them until they are seen. If the student refuses professional help after patient attempts to encourage this, then there is little more that can be done. Ask again if they would like friend or family alerted. If they refuse, provide them with the telephone number for 'Samaritans' and 'Nightline'. Remember that you can discuss the matter, even without revealing identities or asking for intervention, by talking to a counsellor by telephone.

For students actually engaged in an attempt on their lives, the following steps may be helpful:

  • speak to them calmly, quietly and without a sense of urgency, encourage them to talk - start with introducing yourself and ask their name, address them by their first name.
  • encourage them to go with you to a comfortable and private environment to talk things over
  • try discretely to alert a colleague whom you can call upon if assistance is needed
  • suggest that the student should seek advice from a doctor and explain why you think this is important, try to obtain their agreement to seek professional help
  • in office hours, call the student health service at the Ridgmount Practice on 020 7387 6306
  • out of hours, or if the condition of the student gives cause for serious concern, get the student to UCH Accident and Emergency department, calling an ambulance  if necessary.
  • accompany the student to either the Ridgmount Practice or to the hospital until they are seen by a doctor
  • in the case of a student who appears unmanageable or if their life appears to be at risk summon an ambulance and the police on 999, the police have powers to remove people who are a danger to themselves to a place of safety

Dealing with an actual suicide

Upon discovering or being called to a student who is, or may be dead, an ambulance and the police should be summoned on a 999 call. If there is doubt about whether or not a person is alive, appropriate first aid should be given by a trained person.

The person discovering the event or being called to the scene, should, as soon as is practicable, record the events in writing after the ambulance and police have completed their work. The record must include the names and addresses of any witnesses.
The record of the events should be transmitted immediately to the Deputy Registrar (Operations and Planning).

The Deputy Registrar (Operations and Planning) will inform the Registrar, the Provost and the UCL Press Office. The Registrar will, in the event of a death, follow the UCL Procedure with respect to the death of a student. 

The Deputy Registrar (Operarions and Planning) will advise any witnesses of a death of a student of the availability of staff counselling. The same advice will be given to friends of the deceased.

Where there is suspicion that the death may have been a suicide, the Deputy Registrar (Operations and Planning) will ask for reports from: the Department, Student and Registry Services, student residences staff, the Student Psychological Services, the Student Health Physician and any other relevant sources.

The Deputy Registrar (Operations and Planning) will liaise with the Coroner's Officer, and with the Registrar, in the case that UCL may wish to be represented by its solicitors at the inquest. The Coroner may, of course, make requests directly to UCL staff and students for evidence relating to a death.

Following the inquest, the Deputy Registrar (Operations and Planning) will convene a panel comprising the Deputy Registrar (Operations and Planning), the Education and Campaigns Officer of UCL Union, a member of staff of Student Psychological Services, a student counsellor and the Student Health Physician to consider the information relating to the death and to prepare a report which will be sent to the Provost. That report will be confidential but the Deputy Registrar (Operations and Planning) will provide a summary of relevant issues to the relevant UCL committees.

Help at UCL

Emotional and pyschological support
Student Health, Ridgmount Practice

Help from other organisations

Samaritans
Nightline
Survivors of Bereavement by Suicide
Maytree