Disability: Students & Mental Health

So having had the rant about ‘differently abled’ I thought I should articulate some thoughts about what support and ‘allowances’ and ‘due consideration’ can mean.

Firstly I would stress that I believe there is a big difference between making concessions and making adjustments and that confusion between the two often makes people unhappy. There is some feeling that other people are getting an unfair amount of ‘help’ or worse that they are expected to reach lower standards or simply do less because they are ‘unwell’. This can lead to resentment of ‘scroungers.’ Sometimes this is because of a misunderstanding of the amount of effort certain activities require for different people and needs to be dealt with through a better understanding of differences but sometimes this is because of mismanagement of funds and resources. ———I don’t want someone to change the rules just for me because I find some things difficult – I want to earn a living and to deserve my PhD not have someone give me things because they feel sorry for me, but I also want a fair chance.

There is beginning to be some guidance for Higher Education about what Needs might mean and how they can be met, but this is often designed for a specialist audience not the students (or even the staff) themselves.

When I first began to consider the idea of acknowledging not just my situation but my options for continuing in education I looked for guidance about what I could do or someone else could help me do to cope…Apparently the best advice is to get a mentor and/or buddy and some extra time and/or a separate room for exams. That’s fine in its way, I wouldn’t turn them down in retrospect, but what’s missing is guidance on how to make that help. What good is someone shadowing you or extra space to panic in? If there is someone to explain the advantage of having someone who knows the ropes showing you round, or helping you talk to someone for the first time; someone to talk you through taking breaks to relax yourself perhaps you could feel less like a freak who is a complete loser for even asking for help.

So What does my University say?

 Read Example University Policy & My Comments

Sections from the University Guidelines on Support for Mental Health Difficulties

With Italics Added by Me

4. Promotion of Mental Well-being
4.1 In general, the University of XYZ aims to provide a supportive environment that will help students and members of staff with mental health difficulties to realise their full potential and complete their programme / carry out their duties successfully. It also aims to facilitate and promote positive mental health and well-being by:

  • Promoting understanding and recognition of mental health difficulties I think it would definitely help if this was an issue raised at the beginning of each period of study – rather than just a series of posters
  • Providing clear guidance on the confidentiality of personal information provided by students or staff
  • Encouraging students and staff with mental health difficulties to seek support
  • Establishing consistent procedures across the University for helping students and staff with mental health difficulties
  • Providing a range of support services for students and staff, including a mental health adviser for students, student and staff counselling services, a study skills service, services provided through the Students’ Guild, chaplains, Personnel welfare-related support, services provided by union representatives for staff, and personal tutors in Schools
  • Ensuring that the sources of support are clearly communicated to both prospective and current students and staff !!!!!!
  • Ensuring those staff involved in ‘pastoral’ care receive guidance to carry out their duties appropriately
  • Raising mental health awareness throughout the University by improving the quality and accessibility of information available on mental health issues
  • Establishing effective procedures for helping students or staff in crisis
5. Mental Health and Mental Illness
5.1 Throughout this document, the term ‘mental health difficulties’ is used in a broad sense to include two different groupings:
(a) those who experience the onset of emotional or psychological difficulties, which significantly affect their capacity to function. These may result from one of a number of causes, a temporary reaction to a painful or frightening event or experience, being under external pressure of some sort, induced by physiological factors such as use of drugs (for staff, see also: Policy and Guidelines on Substance Abuse), lack of sleep, change in diet or physical illness, or they may signal the onset of a more deep-seated psychological condition.
(b) those with a psychiatric condition (who may or may not have a diagnosis) for which the individual may, or may not, be receiving medical or psychological treatment. For such individuals, the ‘difficulties’ usually arise when their condition becomes unstable in some way and symptoms recur, which may be the result of external factors or changes in response to treatment. The term ‘psychiatric condition’ is being used to mean a set of symptoms that are of sufficient severity to be identified within one of the commonly accepted psychiatric categories (see Appendix).
5.2 It needs to be recognised that many of us experience symptoms of mental health difficulty at some points in our lives and indeed some are typical reactions to particular circumstances. The degree of severity is reflected by the intensity of symptoms and the impact on the individual’s capacity to function. For example for one person ‘being depressed’ may mean feeling temporarily low in mood whereas someone else may use this term when they are completely debilitated and unable to take care of basic personal physical needs. The stage at which a mental health difficulty is sufficiently profound and enduring to be termed ‘mental health illness’ remains open to debate. Note the use of ‘capability to function’ – the trouble with the flexibility of the definitions of impaired mental health is the ability of people to misuse the system by claiming stress simply to get some extra time. Staff need guidance on judging different capabilities of functioning and also they need awareness of how much this can fluctuate in a long-term condition.
5.3 Many individuals with mental health difficulties have effective coping strategies and support already in place; they may not need or wish to seek adjustments or additional support. It may help to be aware that not all individuals experiencing difficulties, even relatively severe, need any action to be taken beyond

  • Understanding and sensitivity
  • Tolerance of difference – obviously specifically tailored tolerance for the mad 😉
  • Awareness of activities which may heighten anxiety for a particular student or member of staff – This is particularly important since it must be remembered that a source of stress can trigger other symptoms
  • Trying to create a climate of acceptance among fellow students or colleagues without compromising confidentiality – I wish they knew how to accept that some people freak out or don’t do their work because things just seem impossible.. that sometimes we didn’t stay in bed because we were lazy but because it was the only way to make it to tomorrow.
5.4 Throughout this document the primary focus is on the needs of individuals with some form of mental health difficulty. The term ‘mental health difficulties’ is used to describe individuals whose mental health may require support to enable them to participate fully in higher education / employment. – How do individuals either those with mental health difficulties or those working with them decide at what point they ‘may require support’
5.5 It should be noted that within the Disability Discrimination Act (1995) enduring mental health difficulties are defined as a disability. Within the context of Higher Education this has a number of implications:
(a) It is unlawful for any University policies, procedures or practices to discriminate against someone because he/she has a mental health problem.
(b) The University is required to make ‘reasonable adjustments’ to enable students and staff experiencing mental health difficulties to undertake their academic studies / duties. Advice on what constitutes a reasonable adjustment can be sought from the Disability Resource Centre for students and from Occupational Health/Personnel Managers for staff (see also: Fitness to Study: Procedures; Fitness to Practise: Procedures). – Note that this document in itself doesn’t have any suggestions for what constitutes a ‘reasonable adjustments’
(c) Students experiencing mental health difficulties are eligible to apply for Disabled Students Allowance (DSA) to provide practical assistance to aid them in their studies. Typically, this may provide money to buy computer equipment to enable them to study from their accommodation when they feel unable to come onto campus. It may also pay for tutorial assistance or mentoring to manage the impact of mental health issues in relation to their academic progress. – Here we see some suggestions as to what financial aid might cover, which may or may not be the same as reasonable adjustments..
(d) Staff experiencing mental health difficulties may be eligible to apply for Access to Work (AtW). This programme offers practical advice and help to employees and employers which may include a grant towards the approved costs that arise because of an individual’s disability. Typically, AtW may help to pay for a support worker, special aids equipment, or adaptation to premises or existing equipment to help a disabled person function in the workplace. – Is it me or is this clearly just adapted from their general disability protocol and not made specific to mental health needs? Now I’m fine with only having a generic guide if you wish but if you are going to have a specific one surely you should take the opportunity to narrow your focus somewhat?
 6. Duty of Care to Students
There are a number of areas in which universities may owe a ‘Duty of Care’ to students as a result of the ‘proximate relationship’ resulting from the contract between the University and its students. The extent of the ‘Duty of Care’ owed to any individual is difficult to determine and may often require a balance of the needs of one student and those of another student or group of students. However, some general principles can be followed:
(a) The University has a duty to take reasonable steps to ensure the health, safety and well-being of all its members and visitors.
(b) The University sets out to provide services within its Student Handbook, which forms part of the contract with students. The services provided should always be of a standard to be expected from a competent practitioner providing a service.
(c) There may be an enhanced standard of care owed to particular groups of students who may be more vulnerable (for example, first years in catered halls or international students).
(d) Where the University does not provide a specific service, this should be made clear to a student and he / she should be encouraged to seek out other services available to them. In the context of mental health, this often means encouraging students to seek out their GP or local mental health services.
(e) No member of the University should go beyond his or her level of competence in trying to support or advise a student, as this may result in harm.
(f) The University has a responsibility to ensure that the requirements it makes of students do not harm and to take all reasonable steps to ensure that this is the case (see also: Fitness to Study: Procedures; Fitness to Practise: Procedures).
Autonomy and Duty of Care
Almost all the people working and studying at the University are 18 or over, and as such are adults. They have the right to make their own decisions, including behaving in ways which others may consider inappropriate or foolish. It can be a considerable challenge to find a way to balance these two apparently opposing principles so that we support personal autonomy whilst exercising duty of care. However, it should be noted that the University does not act in loco parentis. This is an exceedingly difficult area and I applaud their efforts to find a middle ground

Support Page

The Mental Health Team would be happy to meet with you to discuss your situation in more depth and to consider possible options for support if you:

  • have a previously diagnosed mental health difficulty or
  • are experiencing a range of signs of symptoms outlined below which are impacting on your ability to study and cope at university. And calm and hope that talking to your support worker/personal tutor/gp can talk you through it

Students need to contact the Mental Health Team directly and they will be offered an appointment as soon as possible. Referrals are also received from a student’s G.P. or mental health professional.

The most common types of mental health difficulties that students experience are anxiety and phobias, eating difficulties, depression, obsessive compulsive disorder, bi-polar disorder, psychosis and schizophrenia.

However a person’s mental health and well being can also be affected at difficult times of their life, for example moving away from home or experiencing a bereavement. At times like these we can experience changes in the way that we think, feel and behave. For some of us these feelings occur to such an extent or for such a long period of time that they begin to affect our ability to cope with everyday life, and can develop into a more significant mental health difficulty.

Such signs and symptoms can include:

  • Thoughts – e.g. difficulties with concentrating; being distracted; thoughts being disrupted, slower or faster than usual; difficulty in making decisions; persistent negative thinking; lack of self belief. These things are hard to pin down but significantly impact on your ability to study – the trouble is noticing that the cause is anything other than your own crapitude..
  • Feelings – e.g. reduced self worth; prolonged sadness; elation; rapid mood changes; anxiety; panic; fear; increased irritability; feeling overwhelmed and out of control.
  • Behaviour – e.g. poor motivation; increasingly tearful; less active; disorganised; socially withdrawn; difficulty sleeping; poor life /work balance; a change in academic achievement; difficulty with planning and organising; agitation; difficult to relax.
  • Physical – e.g. fatigue; lethargy; nausea; tremor; palpitations; difficulty breathing; losing or putting on weight. This can be a difficult area for students who are trying to negotiate there own life patterns for the same time and trying to maintain a social life under pressure as well as academia

Ongoing Support

Mental health mentoring and ongoing support includes:

  • supporting you to manage your mental health and well being. (unspecified)
  • supporting you to develop coping strategies and skills to maximize your potential and your experience at university. (Still unspecified)
  • exploring and developing  a healthily balance in daily life.
  • establishing an individual learning plan (ILP) and negotiating/advising schools on reasonable adjustments, including exam arrangements.
  • providing support and practical help in enabling you to access and apply for Disabled Students’ Allowance (DSA).
  • ongoing co-ordination and liaison with your University School(s) and outside agencies. This may include formulating joint plans, advocacy, meditation (any liaison would be done with your consent – see xyz)
  • regular and ongoing monitoring and review of your mental health and well being and its impact on their academic progress.

And in Extremis

If you are really struggling with your mental health and feel you need to see someone urgently please contact your GP or the out of hours GP service.  See the Useful contacts and website list

If you are really struggling with your studies the Mental Health Team support can include:

  • exploring the options that may be possible for you (Stil Unspecified)
  • gaining relevant information to help inform your decision e.g. the Schools perspective on your academic situation, the Students Guild for your financial situation
  • coordinating joint meetings with the other university departments. This may be under the Fitness to Study and/or the Fitness to Practice procedures
  • supporting you to decide on the best course of action in relation to your studies and health

Options available may include: deferring some or all exams, renegotiating deadlines, health related breaks such as interruption, repeating a year, part-time study, changing courses, and/or recommendations to access ongoing support from university and /or outside agencies. (aha specified help – except that the phrasing sounds horrendously like you are fucking the whole thing up ….or maybe thats just me)

 

Actually maybe its all just me, but I don’t feel any the wiser or any more comfortable asking for help..

So what do I actually see happening? to be continued..

 

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