Presentation on theme: "Mentoring for Students with Mental Health Difficulties Sue Meads Head of Mentor Service, University of Southampton Friday 28th July 2006 AMOSSHE Conference."— Presentation transcript:
Mentoring for Students with Mental Health Difficulties Sue Meads Head of Mentor Service, University of Southampton Friday 28th July 2006 AMOSSHE Conference 2006: Enhancing the Student Experience
Rationale for mentor support In general terms Studying while attempting to manage the impact of a disability, chronic medical condition, or severe crisis places severe strain on the student’s organisational and study strategies and their emotional and physical resources Students with hidden disabilities often have, for much, or part of the time, emotional, psychological and physical symptoms or states which restrict their capacity to study to their full potential
Rationale continued This affects performance, achievement, self esteem, physical and mental health, social integration, financial resources whilst studying and future earnings New fee structure may increase negative effects because the opportunity cost of ‘failures’ will increase
Rationale continued Support from specialist services benefits transition to HE, retention, achievement, development of transferable coping strategies, self esteem, self awareness and health Mentoring offers effective and appropriate specialist help
For whom? Students who are more vulnerable to the effects of stress because of disability or health condition. Or the effects of a traumatic event. Any student with mental health issues, disability or chronic medical condition which affects their ability to study to their full capacity
Including Depression Anxiety PTSD Schizophrenia Eating disorders Self harm Social phobia Bi-polar affective disorder General anxiety disorder Cerebral palsy Epilepsy Brittle diabetes Lupus ME Heart conditions ADD Aspergers syndrome Bereavement Hearing impairment Partial sight
Wide range of hidden effects Greatly raised anxiety levels Being in a state of fear Extreme fatigue Self criticism and hostility Elation, grandiosity and a tenuous relationship with practical reality Hyper vigilance Acute self consciousness
Hidden effects continued Panic attacks and fear of panic attacks Sleep deprivation Obsessive behaviour Intrusive thoughts Unable to stay, or function, in certain environments Problems with processing information, memory, concentration etc
Mentoring can provide Support for motivation and morale Help with organisation and planning, solving problems, developing and tailoring life and study skills and strategies to individual needs Advocacy for student Liaison with tutors, academic and other departments in the institution
And … Liaison with other services including medical and social services teams Access to reasonable adjustments and examination arrangements Help with DSAs and/or other funding Access to ancillary learning support e.g. note-takers, library support
Mentor Service at Southampton Started 1999 with 4 students Numbers approx 360 in 2005-6 Nearly half have regular mentoring Weekly meetings with mentor Supportive relationship to help manage course, University life and condition/s 75-89% mental health issues, 10-24% chronic medical, 1-5% temporary
Extent of demand GPs on campus estimate approx one third consultations involve mental health issues Estimates vary but 6-10% UK students experience a significant mental health difficulty during period of study At Southampton that would be 1440-2400 students Minority of students disclose
Funding Most frequently from Disabled Students’ Allowances (DSAs): maximum non medical helper allowance for UG approx £12000 Possibly from Access to learning Funds (ALF) Other University or Departmental Hardship Funds Charitable Foundations?
Mentors need Ability to respond to student – student centredness Excellent interpersonal skills, ability to establish rapport Ability to hear distressing experiences and feelings without judging, panicking, ceasing to think, overstepping boundaries or becoming ill
And… Ability to identify strategies and help adapt them to the individual Enjoy working at several levels at the same time Observe and think about student’s manner and disclosures Communicate empathy and understanding Monitor own emotional responses Assess student’s situation Choose how to respond Identify and facilitate useful strategies
Counselling and Mentoring: the differences Complementary forms of help, different with some overlap, not mutually exclusive Mentoring is an active, practical role, very ‘hands on’ when the student is in crisis Confidentiality is treated slightly differently, mentors will contact GPs routinely if the student is at risk, and the academic school if the student is a risk to others Counselling is a very private relationship with little or no communication with others outside of it, the emphasis on facilitating the student’s self understanding and own resourcefulness Mentors will contact doctors, academic schools, tutors, other services, DSA providers to arrange support and adjustments, for and with the student Mentors will help identify skills gaps and useful strategies, then teach and facilitate them
Differences continued Counsellors will communicate outside the relationship in extreme circumstances Mentors will do so as routine part of the role for reasonable adjustments, and will be more or less active in response to student’s current state and needs. Counsellors will offer supportive counselling, emotional ‘holding’ or interpretation which helps extend, or challenges, the student’s self understanding, according to the student’s needs. Mentors offer emotional support and ‘holding’ as part of a wide range of skills. They do not offer interpretation or ‘treatment’. They help students manage their courses and study whilst managing a condition, or whilst having treatment. A student who wants to explore their emotional difficulties, will be referred on by Mentors, mentoring will not be continued if that is everything they want to do.
Differences continued Counselling is a generic service, open to all students with emotional issues Funding for Counselling is for a generic service Mentoring is restricted to those who are eligible on, essentially, disability grounds Funding for Mentoring from the Disabled Students‘ Allowances (DSAs) is for non medical helpers. It is for the individual and cannot be used for generic services e.g. counselling or generic study skills, or for anything which should come from the NHS.
Differences continued Because the funding is a grant to the individual, mentor support can be long term, for the whole length of student’s course, weekly even twice weekly if needed. Mentoring is an effective way to support students who are waiting for, or receiving NHS treatment, or managing a serious long term condition without treatment HE Counselling Services often need to manage carefully the amount of counselling available to an individual HE Counselling Services have increasingly been responding to the needs of students with more serious mh conditions to compensate for shortage of NHS provision, often referred by the NHS Long term support for students with serious mental health issues is not usually available in HE Counselling Services, since it would duplicate NHS responsibility. If it were, there would also be a risk that they would need so much resource that others would have less access to counselling.
Choosing mentors: Criteria for selection Relevant qualifications and experience Academic level, graduate a minimum with teaching qualifications and experience if study skills involved Experience of working in FE or HE Appropriate professional qualifications and experience in counselling, mental health social work, mental health nursing, occupational therapy, counselling or health psychology
Why set criteria for selecting mentors? Why not just nice people? Working regularly and closely with people with mental health difficulties, even depression and anxiety, is a powerful experience, risks include taking on the feelings, even symptoms of the client inability to manage feelings inability to manage boundaries breaking professional boundaries illness how can we be so sure they are nice?
Why set criteria for selection? Many people are attracted to this role, with a genuine desire to help but … Desire to help doesn’t equal ability, being nice isn’t enough How do you screen out people who are attracted because of their own issues? Is always a bad thing for the mentor to have their own issues? This involves questions of degree, training and clinical supervision. Even people with relevant professional training should have clinical supervision Intuition and insight need the discipline of theory, experience and training
Why set criteria for selection? continued The professional trainings listed all involve learning advanced counselling and communication skills to manage boundaries to monitor own responses and behaviour to work with clinical supervision how to recognise the emergence of serious mental illness and the qualification includes an element of being fit to practice
What about peer mentoring? Usually cost effective Attractive because it offers development opportunities for the ‘mentors’ - something for their cv Fraught with the difficulties listed earlier in relation to selecting mentors Impossible to supervise properly
The issue of responsibility Vital issues arise in this work at whatever level Duty of care and duty of confidentiality Making appropriate referrals to other services Fitness to study and fitness to practice Professional boundaries of all kinds, including academic
Feedback Consistently emphasises that mentoring enables the student to stay at University complete course achieve grades in line with potential overcome difficulties recover from setbacks
Feedback example : Charlie, 3 rd year humanities student with General Anxiety Disorder/Depersonalisation, returned to University after a breakdown in year 1, achieved 1 st class honours What have you found particularly helpful? Accessibility (openness to discuss any problem) Dynamism (always find a solution) Non-judgemental accepting environment Open meetings – student brings in issues to discuss The whole package – logistical, emotional, financial support – this made it possible for me to come back to Uni.. And stay!
Charlie’s feedback continued What difference has mentoring made to you? Taken the pressure off Made me feel it is ok to be ill Made me feel less isolated – did not feel I was coping alone Took pressure off logistical problems Helped fulfil academic potential Eased relations with academic staff Takes away stigma One very important leg of 3 leg support system – GP, therapist, Mentor Service
Other Examples Amy – bi polar affective disorder Jenny – Post Traumatic Stress Disorder Tom – anxiety and depression, non traditional background Zoe – bi polar affective disorder(?) frequent suicide attempts Jo – borderline personality disorder Helen – suicide attempt, anger, depression and anxiety Sally – 5 children, husband with serious mental health issues, poverty, condition of hand affecting writing, low mood and exhaustion Henry – Aspergers, dyspraxia and mental health issues (with low frustration tolerance) Frank – paranoid schizophrenia, studying part-time