Helping distressed students: A guide for University staff
University is often a very positive experience for students, but mental health difficulties among young people are on the rise. In a 2022 survey by the mental health charity Student Minds, 57% of respondents self-reported a mental health issue, and 27% said they had a diagnosed mental health condition*. Experiencing poor mental health as a student will have a significant impact on a student’s ability to fully engage with their course and enjoy the university experience. Students may need to manage a range of mental health challenges including suicidal thoughts and behaviour.
The University of Exeter is committed to a community approach to mental health and suicide awareness, recognising that we can all make a difference to the wellbeing of others. Working together as colleagues is an essential part of supporting students experiencing mental health difficulties and distress. This guide provides Information
* Student mental health in England: Statistics, policy, and guidance - House of Commons Library (parliament.uk)
for University of Exeter Colleagues about how to provide initial support for students with mental health difficulties who may or may not be in crisis. Whilst it is important to know what to do if a student experiences a crisis, please remember these are not a regular occurrence.
This guide will offer guidance to help assess the urgency of a situation, and outlines referral routes for a student. If you find yourself in a situation where you need to give a student support, it is important to help within the boundaries of your role, and to access support for yourself. We have a whole University approach to mental health and wellbeing, and no one person is solely responsible for another’s emotional wellbeing.
Staff are also encouraged to attend the mental health awareness and suicide safety training exeter.ac.uk/staff/wellbeing/ suicide/training
Written by Jo Blakely and Rachel Bragg, Wellbeing
Consultants (Mental health pathway/Occupational Therapists) 2008, revised 2016 and September 2023. For further copies and feedback on the usefulness of this document, contact: wellbeing@exeter.ac.uk
THIS GUIDE HAS BEEN PRODUCED TO: WHAT TO DO: WHAT NOT TO DO:
Help colleagues to recognise when a student may be in difficulty or in crisis
Help colleagues feel more confident to have conversations about mental health and suicide
Provide guidance on when and where to refer a student for support
Provide contact details of relevant sources of support
Raise awareness of issues relating to student mental health and suicide risk
To enable colleagues to feel supported within the University’s community approach to mental health
Notice when a student is having difficulties and start a conversation
Ask the student how they are feeling
Gather information about their current situation
In cases of urgency take relevant immediate action
Signpost and encourage student to access appropriate sources of support
Link with the relevant sources of support for staff
Take sole responsibility for the student’s wellbeing
Ignore the situation – it is important to ensure the student is informed about support available
Solve all the student’s problems
Guarantee the student will engage with follow up support
Work in isolation - remember the university’s community approach to supporting students
Roles and responsibilities
Responsibility of colleagues/staff members
We can all make a difference in helping each other, staff and students, to feel more supported and able to access support when things are difficlult.
We would encourage all staff to embrace the ‘See, Say, and Signpost’ method for supporting students. (see exeter.ac.uk/ staff/wellbeing/suicide/training colleague training in mental health and suicide awareness – supporting students).
SEE involves noticing signs that may indicate a student is experiencing difficulties with their mental health.
SAY involves starting a conversation and asking how a student is.
SIGNPOST involves either signposting the student to support, or in case of urgency being proactive and referring for support.
We also need to look after ourselves. If you feel uncomfortable carrying out the above please discuss with your line manager.
If you offer support to students you must ensure that:
n You have sufficient time within your role, the support offered remains in the boundaries of your role and personal competencies.
n You have access to support, advice and/ or supervision eg line manager, wellbeing services, MHFAider, pastoral mentor/academic tutor.
n You protect yourself and don’t take on too much.
Confidentiality and safeguarding
Confidentiality and safeguarding are important factors to consider when helping students in difficulty. There will be further information on the next pages in this guide.
Do not promise absolute confidentiality. Explain to the student that confidentiality may be breached in ‘exceptional circumstances’ ie if the student is at risk of harm to themselves or others.
Information can be shared with a line manager/superviser without consent.
Health is sensitive data under the General Data Protection Regulation. You can listen and take information from third party/next of kin. It is recommended that if parents are requesting information this request is passed to colleagues in Wellbeing Services.
It is recommended that colleagues are aware of and follow any Faculty guidance on student support procedures.
Wellbeing Services are available to offer support and consultation to colleagues across the university. If you do have consent from the student to talk to Wellbeing Services please do not share the students name, unless there are risk issues. Talking through their situation can still be an effective way to consider the student’s needs and to plan next steps.
Further advice and guidelines on disclosure and confidentiality are available at: exeter.ac.uk/dataprotection/release
It is important to remember as a staff member you are not solely responsible for a student’s welfare. The university has a whole community approach to supporting students.
How do you know there is a cause for concern
IS THE STUDENT’S BEHAVIOUR CAUSING CONCERN?
• Is the student telling you they are having difficulties?
• Is there anything unusual or unpredictable about the student’s behaviour that makes you feel uneasy?
• Is the student having difficulties with their academic work?
• Is the student requiring a lot of your time?
• Is the student absent from seminars, lectures or supervisory meetings?
• Is the student isolating themselves, withdrawing, or avoiding situations?
HOW DOES THE STUDENT SEEM?
• Tense/irritable/agitated
• Sad/distressed/tearful
• Feeling hopeless, miserable and self critical
• Panicky, feeling overwhelmed
• Withdrawn or very quiet
• Distracted/difficulties concentrating
• Smelling of alcohol, cannabis
• Talking loudly and incoherently
• Disinhibited behaviour
• Fatigued, tired
• Physically unwell
IS THIS DIFFERENT FROM YOUR PREVIOUS EXPERIENCE OF THIS STUDENT?
IS THERE OTHER INFORMATION?
• Does the student have an ILP stating they experience mental health difficulties?
• Is there concerning language in academic work?
• Have friends/housemates told you concerning information?
• Have family/trusted contact told you concerning information?
• Have colleagues expressed concern about this student
• You might see a significant change in appearance (e.g. weight change, decline in personal hygiene)
• Behaviours may have changed (e.g. staying in bed all day, work handed in late, not attending lecturers, classes, supervisory meetings or avoiding going out)
• Changes in a student presentation and behaviour may be difficult to establish if you havent known the student for long
• Arrange to speak to the student
• Meet in a private space
• Hold a supportive conversation
• Consider how the student feels, do they perceive there is an issue?
• Is there anything going on for them that is contributing to this behaviour?
• If you are concerned about suicide – ASK them about this
DO YOU NEED MORE INFORMATION FROM
• Has anyone else expressed concerns about the student?
• How is the student functioning academically?
• Does the student have an ILP?
• Has the student had contact with the Education Welfare Team?
• Your line manager, senior colleague or MHFAider
• Your Education Welfare Team EWT. It is good practice to get the student’s consent for this. Otherwise please follow your department/Faculty policy
• Consider contacting Wellbeing Services for a conversation without giving the student’s name
If you remain concerned about a student assess the urgency of the siltation and use the referral route identified on the next few pages.
What to do
if the situation is URGENT and requires an immediate response
The situation is URGENT and requires an immediate response if:
n You believe the student is at risk of ending their life or harming others now
n The student has taken steps to end their own life, ie tells you they have taken an overdose
n The student has a serious medical emergency
n The student is imminently at risk from others
n The student seems significantly disorientated and out of touch with reality
n The student is violent or threatening violence to people or property
IF THE STUDENT WILL ACCEPT HELP
Agree with the student the course of action
In office hours
• Call 999 And inform either
• Exeter: estate patrol 01392 722222
• Penryn campus security 01326 253503
• Exeter Medical school based at Penryn Glasney Lodge 01326 253503
• Give the student the ‘You Are Not Alone’ leaflet and encourage them to call First Response Service NHS 111
• Recommend the student accesses Wellbeing Services as soon as possible
Seek advice and support from your MHFAider, line manager, supervisor, Wellbeing Services, staff wellbeing pages, communities of practice
• Inform your line manager
Out of hours
Please follow the steps above plus:
Next day inform your line manager and Wellbeing Services
• Look up urgent support numbers and out of hours support on the Wellbeing Service’s urgent support page: exeter.ac.uk/students/wellbeing/support/ urgentsupport
IF THE STUDENT WILL NOT ACCEPT HELP
If at all possible let the student know that you will need to break confidentiality and inform relevant others about your concerns about their wellbeing
In office
hours
• Call 999 And inform either
• Exeter: estate patrol 01392 722222
• Penryn campus security 01326 253503
• Exeter Medical school based at Penryn Glasney Lodge 01326 253503
• Give the student the leaflet for managing suicidal thoughts and distressing feelings and encourage them to call First Response Service NHS 111
• Recommend the student accesses Wellbeing Services as soon as possible
• Seek advice and support from your MHFAider, line manager, supervisor, Wellbeing Services, staff wellbeing pages, communities of practice
• Inform your line manager
Out of hours
Please follow the steps above plus: Next day inform your line manager and Wellbeing Services
• Look up urgent support numbers and out of hours support Wellbeing Service’s urgent support page: exeter.ac.uk/students/wellbeing/support/ urgentsupport
CONFIDENTIALITY ISSUES TO CONSIDER
• Do not promise absolute confidentiality. Explain to the student that confidentiality may be breached if there are very serious concerns. If you think a situation is urgent, confidentiality can be breached.
• It is best practice to try to get the student’s agreement to call emergency services and estate patrol. If a student is reticent then persist gently, express your concern for the student and explain why its important to get them to A&E.
• Try to engage the student and actively encourage them to agree to accept help and support
• Try to stay calm
• Wherever possible try to inform a colleague about the situation to get back up support for yourself
• In some circumstances you may need to call 999 and estate patrol without consent. In this situation explain the reason for doing this by expressing your concern and need for the student to be safe, with professional help to support them.
• It is not recommended that you take a student to A&E yourself.
• If a student walks away from you and will not stay to wait for the ambulance, do not follow them but let estate patrol and Wellbeing Services know.
• Make sure that you debrief by talking the situation through with a line manager, Wellbeing Services, Employee Assistance Programme, a MHFAider
• Look after your own wellbeing, access support through staff wellbeing pages, occupational health
What to do
if the situation is URGENT and doesn’t require an immediate response
The situation is URGENT not requiring an immediate response if:
n The student is at risk of harm to self or others/expressing suicidal thoughts but has NO intent to act on the thoughts now
n The students is exhibiting extreme behaviour ie elated, withdrawn
n There has been significant concern from others (friends/family)
n There has been very concerning language in discussions/academic work/mitigation requests
n The student is homeless or at risk of becoming homeless imminently
n Student has disengaged from contact and you’ve had previous concerns about their welfare
n A student has lost significant weight/is not eating
IF THE STUDENT WILL ACCEPT HELP
In office hours
• Exeter Campuses: Complete the student concern referral form and inform the student about this tinyurl.com/3tz5xtuz
• Cornwall campuses: Call student support 01326 253503, email studentsupportadmin@fxplus.ac.uk
• Support and encourage the student to see their GP
• Give the student the ‘You Are Not Alone’ leaflet and encourage them to call First Response Service NHS 111
• Ask the student if they have any additional support that they can access Encourage them to make a plan for the next few hours eg contact a friend, go for a walk, listen to music
Ask about any immediate academic issues causing concern that you may be able to help with. Refer to Education Welfare Team if needed.
• Discuss the situation with a MHAider student support, this includes pastoral mentors
Out of hours
• Complete the student concern referral form but it will not be looked at until the next office hours
• Inform either Exeter estate patrol 01392 722222, Penryn campus security 01326 253503, Glasney Lodge 01326 253503
IF THE STUDENT WILL NOT ACCEPT HELP
In office hours
• Have a conversation explaining that you would like them to get support via the student concern referral form for Exeter or contacting student support in Cornwall
• Gently persist to try to engage the student in accepting support
• Exeter Campuses: Complete the student concern referral form ideally with student consent but can be without consent tinyurl.com/3tz5xtuz
• Cornwall campus: Call student support 01326 253503, email studentsupport@fxplus.ac.uk
• Inform the student that you have referred them to Wellbeing Services unless you feel it would be detrimental to their mental health and wellbeing to do so
• Discuss the situation with a MHFAider student support, this includes pastoral mentors
• Give the student the ‘You Are Not Alone’ leaflet and encourage them to call First Response Service NHS 111
• Ask the student if they have any additional support that they can access
• Encourage them to make a plan for the next few hours eg contact a friend, go for a walk, listen to music
• Ask about any immediate academic issues causing concern that you may be able to help with. Refer to Education Welfare Team if needed
Out of hours
• As above plus:
• Inform either Exeter estate patrol 01392 722222, Penryn campus security 01326 253503, Glasney Lodge 01326 253503
CONFIDENTIALITY ISSUES TO CONSIDER
• Do not promise absolute confidentiality. Explain to the student that confidentiality may be breached if there are very serious concerns ie if the student is at risk of harm to themselves or others. If you think a situation is urgent, confidentiality can be breached.
• It is best practice to try to get a student’s agreement to complete the student concern referral form. If a student is reticent then persist gently, express your concern for the student and explain why its important to get them support and help.
• In some cases you may need to fill in the student referral form or contact student support Cornwall
without consent. In these situations inform the student that you have complete the form and referred them to Wellbeing Services for support.
• In a small number of cases you may believe that it would be detrimental to the students wellbeing to tell them about the referral. In these situations state that the student is unaware of the referral on the form
• Wellbeing Services offer a confidential service to students, however confidentiality may need to be breached in exceptional circumstances exeter.ac.uk/students/wellbeing/policies/service/#a1
IN ALL SITUATIONS
• Try to engage the student and actively encourage them to agree to accept help and support
• Try to stay calm
• Wherever possible try to inform a relevant colleague eg MHFAider student support about the situation to get support for yourself
• Make sure that you de brief by talking the situation through with a MHFAider, line manager, Wellbeing Services, communities of practice meeting
• Look after your own wellbeing, access support through staff wellbeing pages, occupational health
What you should do if the situation does NOT require immediate action?
The situation is NOT urgent if:
There is no risk to the students, or others. However, the student may be experiencing some emotional distress and/or personal difficulties and may need signposting to additional support.
The student may be:
n Depressed, anxious, generally stressed
n Homesick, lonely and isolated
n Physically or mentally unwell
n Having difficulty with relationships (family, friends, flatmates, etc.)
n Overwhelmed or struggling with academic work
n Bereaved
n Having problems studying and/or managing finances
n Recovering from a traumatic event
IF THE STUDENT WILL ACCEPT HELP Agree
HAVE A SUPPORTIVE CONVERSATION WITH THE STUDENT
• Find a private and confidential space
• During the conversation:
– listen to the student’s concerns
– provide reassurance
– acknowledge their challenges/ experiences
– ask how you can help – offer practical support eg helping with mitigation – signpost to University support services (see page 10 and 11 for online version)
– signpost to University Wellbeing Services for emotional and mental health support
– signpost to their GP
– follow up your conversation at another time
• Make sure it does not conflict with your role
• Make sure you are clear about your personal and professional boundaries
• Make sure you have access to support and advice
IF YOU FEEL SOMEONE ELSE IS BEST PLACED TO HAVE THE SUPPORTIVE CONVERSATION
• Discuss with a MHFAider student support and agree who will hold the supportive conversation, this includes pastoral mentors
• Offer meeting to hold the conversation. Signpost the student to support services (see back pages of the guide)
• Identified colleagues to inform the student about support services available (see page 10 and 11 for on line version)
• If you are unsure then seek further advice (without giving the students name) from Wellbeing Services and/or the MHFAider, Education Welfare Team, your line manager, pastoral mentor/ academic tutor by having a what if conversation
IF THE STUDENT WILL NOT ACCEPT HELP
• Explain that you will help if the student changes their mind
• Ensure the student understands the implications of not accessing help i.e. not having access to reasonable adjustments such as exam arrangements
• Explain issues of confidentiality especially in relation to passing on information in exceptional circumstances
• Seek advice from your MHFAider, line manager, supervisor, Wellbeing Services, Education Welfare Team
• Monitor the situation if it’s within your role
• If the concerns become more serious refer to the urgent support sections in this guide
CONFIDENTIALITY ISSUES TO CONSIDER
• Health is sensitive data under GDPR and University data protection and GDPR principles need to be followed
• Non urgent situations are not exceptional circumstances. Therefore you must not pass on information without the students express consent. Best practice would involve supporting the student to access the support themselves
IN ALL SITUATIONS
• If needed, talk the situation through with a line manager or supervisor, MHFAider including pastotal mentors, Education Welfare Team, Wellbeing Services
• Keep a note of your discussion with the student, outlining agreed actions/recommendations and store them confidentially
• Follow up on the meeting by emailing a brief note of your conversation, the services you have discussed and any actions agreed
Who can support the student?
Is the student experiencing difficulties with their mental health?
Is there a physical health problem?
Is the student a care leaver, carer, or estranged?
Do you need help and advice about next steps for supporting a student
Is the student struggling with their studies?
Is the student neurodiverse eg SpLD, ADHD, Autistic
Does the student have a disability or long term health issue?
Is the student isolated and wanting social events?
Is there a problem of discrimination, harassment or complaint?
Is there a visa issue or is the issue related to the student being from overseas?
exeterguild.org/advice
Does the student need some advice on safety and security
Is the student experiencing emotional or personal difficulties?
Is the student experiencing suicidal thoughts and/or self harm thoughts?
Are there academic issues arising from a mental health or welfare issue?
Does the student need support under HWSS?
Does the student have ILP queries, program queries, need mitigation?
Does the student need to have, or update their ILP?
Does the student have financial concerns?
Is the student having difficulties in their accommodation?
Does the student want to talk things through with someone who can provide a listening ear?
Does the student need to report an incident
Useful contacts:
Wellbeing Services
exeter.ac.uk/wellbeing
Reed Mews Wellbeing Centre
Tel: 01392 724381
Email: wellbeing@exeter.ac.uk
Cornwall exeter.ac.uk/students/wellbeing/cornwall
Phone: 01326 370460
Email: studentservices@fxplus.ac.uk
Devon exeter.ac.uk/students/wellbeing/devon
Phone: 01392 724381
Email: wellbeing@exeter.ac.uk
Chaplaincy – Exeter exeter.ac.uk/students/chaplaincy
Estate Patrol
Ext: 3999 (2222 in an emergency) exeter.ac.uk/departments/campusservices/ campussecurity
Pastoral mentors exeter.ac.uk/students/pastoral-mentors
The Moorings@devon
Mental health support in Devon
Tel: 07990790920
Email: devonexeter.mhm@nhs.net mhm.org.uk/the-moorings-devon
Residence Life Team
Email: residencelife@exeter.ac.uk exeter.ac.uk/study/accommodation/currentresidents/wellbeing-reslife
Students’ Guild Advice Unit
The Forum
Email: advice@exeterguild.com exeterguild.org/advice
Education Welfare Team
Cornwall exeter.ac.uk/students/wellbeing/cornwall/ education
Devon exeter.ac.uk/students/wellbeing/devon/ education
International Student Support exeter.ac.uk/students/international/ accessourservice
Student Health Centre
Reed Mews, Streatham Drive EX4 4QP Tel: 01392 676606 exeterstudenthealthcentre.co.uk
Dignity and respect adviser exeter.ac.uk/about/speakout/support/ dignityandrespectadvisors
Accident and Emergency Department
RD&E Hospital, Barrack Road, Exeter Tel: 01392 411611
First Response service (Devon NHS mental health crisis line)
Tel: 111 and select the mental heath option dpt.nhs.uk/our-services/first-responseservice
Papyrus Hopeline papyrus-uk.org
Samaritans
10 Richmond Road, Exeter EX4 4JA
Tel: 116 123
Email: jo@samaritans.org samaritans.org/branches/exeter
For a list of other local and national support: exeter.ac.uk/students/wellbeing/devon/ atozindex
Useful University Documents:
• Health, Wellbeing and Support to Study
• Fitness to Practice Policy
• Teaching Quality Assurance Handbook
Mental Health First Aiders student support exeter.ac.uk/staff/wellbeing/suicide/training/ mental-health