STUDENTMENTALHEALTH

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

MENTAL HEALTH“A state of emotional and psychological well-being

in which an individual is able to use his or her cognitive and emotional capabilities, function in

society, and meet the ordinary demands of everyday life.”

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

SIMPLE EXPECTATIONSPREHISTORIC

TIMES

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

THE EVOLUTION OF STRESS:SYMPATHETIC NERVOUS SYSTEM FIGHT OR FLIGHT

Release of adrenalin & noradrenaline

Release of cortisol

Heart rate & blood pressure increase

Pupils dilate

Veins constrict to send blood to muscle groups

Muscles tense up ready for action

Blood glucose level increases

Digestion and immune system shut down

Brainpower is directed toward escaping

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

THE RESOLUTION OF STRESSPARASYMPATHETIC NERVOUS SYSTEM: RELAX & RENEW

Heart rate and blood pressure decrease

Breathing slows down

Endorphin release

Circulation improves

Digestion restored

Immune system restoration

Able to rest & recuperate

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

MUST get a 2:1 …

MUST get

a FIRST!

GREAT EXPECTATIONS

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

SHIPSTON-ON-STOUR

THE EVOLUTION OF STRESS

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

SHIPSTON-ON-STOUR

THE EVOLUTION OF STRESS:SYMPATHETIC NERVOUS SYSTEM FIGHT OR FLIGHT

+NO ESCAPE !

MUST get

a FIRST!

Release of adrenalin & noradrenaline

Release of cortisol

Heart rate & blood pressure increase

Pupils dilate

Veins constrict to send blood to muscle groups

Muscles tense up ready for action

Blood glucose level increases

Digestion and immune system shut down

Brainpower is directed toward escaping

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

DOOM GLOOM

STUDENTS MENTAL HEALTH RISK

FACTORS Coping with independent living

Cultural issues

Academic year

High parental/self expectations

“I MUST achieve a first/2:1”

Procrastination and perfectionism

Pressure of academic work/assessment

Individual susceptibility

Historical factors

Poor diet/reduced physical activity

Substance misuse

Family/relationship difficulties

Peer pressure

Concerns for the future

Financial issues/student debt

High expectations of the student experience!

INTERNAL

&

EXTERNAL

FACTORS

PERFECTIONISM

&

PROCRASTINATION

TRANSITIONS

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

STUDENT DEBT & MENTAL HEALTH

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

STUDENT DEBT &MENTAL HEALTH

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

STUDENT DEBT &MENTAL HEALTH

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

STUDENT DEBT &MENTAL HEALTH

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

STUDENT DEBT &MENTAL HEALTH

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

STUDENT DEBT & MENTAL HEALTH

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

Remainder after costs of shared rented house and owning a car and mobile phone:

£102 per week

for food, petrol and luxuries.

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

STUDENT DEBT & MENTAL HEALTH• Student debt is having a negative effect on the well-being of students.

(Scott, J. et al, 2001)

• Over a three year course, students with high financial concerns felt more ‘tense, anxious or nervous’, more ‘criticised by other people’ and found it more ‘difficult getting to sleep or staying asleep’ than students with low financial concerns. (Cooke, R. et al, 2004)

• Students' perceptions of their own levels of debt rather than level of debt per se relates to performance. Students who worry about money have higher debts and perform less well than their peers in degree examinations.(Ross, S. et al, 2006)

• Amongst the student population, debt management clients and older adults, there is a significant relationship between debt and mental disorder, depression, suicide completion or attempt, problem drinking, drug dependence, neurotic disorder and psychotic disorders. (Richardson, T., Elliott, P. & Roberts, R. 2013)

• Psychiatric morbidity increases after students start university and does not return to pre-university levels (Cooke et al, 2006)

• 29% of students reported “clinical levels of psychological distress” (Berwick et al, 2008)

• 6% undergraduates and 4% post graduates “significant thoughts of suicide” (Drum et al, 2009)

• Individuals with an excellent school record are 4 times more likely to develop bipolar disorder compared to those with average grades (MacCabe et al, 2010)

• 0.53% UK undergrads declared a “mental health difficulty” in 2009/2010(HESA, 2011)

Over half of students have suffered from at least one mental health problem (anxiety, depression, eating disorders as well as self-injury and suicidal ideation)(Zivin et al, 2009)

STUDENTS AND MENTAL HEALTH

PREVALENCERoyal College of Psychiatrists 2011

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

MENTAL HEALTH “DISORDERS”

• Anxiety disorders

• Mood disorders

• Psychotic disorders

• Eating disorders

• Personality disorders

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

OR “DISTRESS” ?

• Stressed, anxious or worried

• Low, defeated, helpless

• Traumatised

• Breakdown

• Eating distress

• Self harm and self hatred

• Hopelessness

• Suicidal ideation

• Suicidal behaviour

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

MAXIMUMMENTAL

WELL-BEING

Individual with no diagnosis of illness or disorder who is not coping well and has

negative mental health

Individual with no diagnosis of illness or disorder who has a sense of subjective

well-being and positive mental health

Individual with a diagnosis of bipolar

disorder, who copes well and has positive mental

health

Individual with a diagnosis of bipolar

disorder who does not cope well and has negative mental

health

MENTAL WELLBEING CONTINUUM

MINIMALMENTAL

WELL-BEING

MAXIMUMMENTAL

ILLNESS/DISORDER

MINIMUMMENTAL

ILLNESS/DISORDER

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

STUDENTS & MENTAL HEALTH

SPOTTING THE SIGNS

STUDENTS AND MENTAL HEALTH

SIGNS TO LOOK OUT FOR

S t u d y i n g

T e m p e r a m e n t

R e a c t i o n s

E n e r g y

S o c i a l i t y

S u i c i d a l i t y

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

STUDENT MENTAL HEALTH

Studying• Decline in performance and interest in work or study

• Problems with concentration, memory, logical thought or speech

• Reduction in conscientiousness

• Uncaring attitude

• Frequent sickness & absences

• Obsessiveness and over-conscientiousness

• Studying at the expense of everything else

• Perfectionism!

Temperament• Rapid or dramatic shifts in feelings or “mood swings”

• Tearfulness

• Flatness of affect

• Expressing excessive anxieties

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

STUDENT MENTAL HEALTH

Reactions• Avoidance of everyday activity: withdrawal

• Expressions of strange or grandiose ideas

• Reduction in attention to appearance/poor personal hygiene

• Noticeable smell of alcohol, cannabis

• Bizarre, unusual and out of character dress

• Disruptive, confrontational or disturbing behaviour

Energy• Excitability or restlessness

• Excessively drawn or tired

• Difficulty sleeping

• Sleeping too much

• Marked weight loss

• Marked weight gain

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

STUDENT MENTAL HEALTH

Sociality• Avoidance of everyday activity

• Withdrawal from others

• Excessive shyness

• Argumentativeness/agitation/irritation

• Displays of anger or blaming of others

• Socially and/or sexually disinhibited

Suicidality• Signs of self harm

• Hopelessness

• No future plans

• Suicidal statements

• Suicide attempts

“Flatter me, and I may not believeyou. Criticize me, and I may notlike you. Ignore me, and I may notforgive you. Encourage me, and Imay not forget you.”William Arthur

“I always prefer to believe the bestof everybody, it saves so muchtrouble.”Rudyard Kipling

“A kind and compassionate act is often its own reward.”William John Bennett

SUPPORTING

STUDENTS

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

C ALM Focus on your own breathing, posture and thinking; a calm

manner will be more helpful to someone in distress

A PPROACH ASSERTIVELY Talk to the person, outlining concerns

Ask them how they feel they are coping

Try and find somewhere private & quiet for them to talk

L ISTEN Bracket judgements

Empathise

M OTIVATE People can and do recover from mental health difficulties

E NCOURAGE Access to self help and professional support

R EMEMBER Record and review (if appropriate)

Refer: Student Support & Statutory Services, e.g. GP

Boundaries; personal and role limitations & confidentiality

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

SUPPORTING STUDENTS

CONFIDENTIALITY

Clarify confidentiality/Data protection issues at your University.

Information will need to be passed on in circumstances where:

A person discloses information or behaves in a manner which indicates that there is a possible risk of harm to self

A person discloses information or behaves in a manner which indicates that there is a possible risk of harm to others

A person’s behaviour or mental health condition is affecting the health, safety or wellbeing of other students, staff or visitors to the University

A person discloses information pertaining to an offence which has been or is about to be committed which involves a serious breach of the law

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

ASSERTIVENESS

1: EMPATHY/VALIDATIONTry to say something that shows your understanding of the other person's feelings:

“I can see that you are very frustrated about this situation.”

“I have noticed that you are very distressed.”

2: STATEMENT OF PROBLEMA clear statement of the problem from your perspective:

“When you shout and swear at me, it is difficult for me to help you.”

“When I see you crying, I am concerned about your welfare.”

3: STATEMENT OF WHAT YOU WANTA specific request for a specific change in the other person's behaviour:

“I would like to help and cannot do so if you continue to shout; please stop.”

“I would like you to access appropriate support”

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

COMMUNICATION VERBAL & NON-VERBAL

DO• Remain calm

• Keep breathing regular

• Speak evenly and clearly

• Convey interest, concern and alertness through your body posture and facial expression.

• Retain focus on the person visually but avoid direct eye contact which might be threatening

• State that you are here to help and what you intend to do to keep the person/others safe

• Briefly and calmly state concerns about behaviour and safety

COMMUNICATION VERBAL & NON-VERBAL

DON’T

• Stand too close or invade his/her personal space

• Stand over the person if they are sitting down

• Shout

• Make threats

• Block the doorway, but keep yourself between the person and an exit

• Forget that the person may be feeling frightened and confused

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

SUICIDAL IDEATION

It’s OK to ASK!

A S K the question (and listen to the answer)

S E E K more information

KN O W where to find resources

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

SUICIDAL IDEATION

ASK

• Are you thinking of ending your life?

• Are you having thoughts of suicide?

• Listen to what the answers, non-judgmentally

SEEK

• Have you thought about how you would do it?

• Have you made any preparations

• Have you thought about when and where?

• Plans for the future

• Tomorrow

• Next week/month/year?

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

SUICIDAL IDEATION

KNOW

• Samaritans 08457 90 90 90 24 hours, 365 days jo@samaritans.org

• HopeLine UK 0800 068 41 41Practical advice on suicide prevention www.papyrus.org.uk

• CALM 0800 58 58 58(Campaign Against Living Miserably) Resource for young men aged 15-35

• Student’s GP

• A & E department of nearest Hospital

• Local Mental Health Crisis Teams

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

SUPPORTING STUDENTS. . . IN A NUTSHELL

• Stay calm

• Approach, outline concerns, listen

• Outline the help which is available and offer support to the person to access it

• Confidentiality/Data protection issues

• In a crisis situation:

o Assess immediate risk and act accordingly

Get support from colleagues

Crisis Resolution and Home Treatment Team

Institution Security Team

Emergency Services

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

FIVE A DAY FOR

MENTAL WEALTH

1: Connect2: Be Active3: Take Notice4: Keep Learning5: GiveForesight Mental Capital and Wellbeing Project (2008)

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

CONNECT

Colleagues

Friends

Family

Neighbours

Community

Partner

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

BE ACTIVE

Walk

Run

Swim

Dance

Move

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

TAKE NOTICE

Be curious

Savour the moment

Mindful awareness

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

KEEP LEARNING

Skills

Hobbies

Cooking

Languages

Drawing/painting

Musical instrument

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

GIVEDo something nice for:

A friend

A stranger

A colleague

Yourself

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

MEDITATION

Can lead to a myriad of improvements

• Improvement in postgraduate academic performance (Kember, 1985)

• Fewer symptoms of aching muscles or joints and well as less use of drugs and tranquilizers (Monk-Turner, 2003)

• Physical changes in the structure of the brain, including improvement in attention and focus (Lazar et al, 2005)

• Improved academic performance among adolescents with learning disabilities (Beauchemin et al, 2011)

• Relief from depression, anxiety, pain, and psychological distress (Marchand, 2012)

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

STATEMENTS

None

of the

time

Rarely

Some

of the

time

Often

All of

the

time

I’ve been feeling optimistic about the future 1 2 3 4 5

I’ve been feeling useful 1 2 3 4 5

I’ve been feeling relaxed 1 2 3 4 5

I’ve been feeling interested in other people 1 2 3 4 5

I’ve had energy to spare 1 2 3 4 5

I’ve been dealing with problems well 1 2 3 4 5

I’ve been thinking clearly 1 2 3 4 5

I’ve been feeling good about myself 1 2 3 4 5

I’ve been feeling close to other people 1 2 3 4 5

I’ve been feeling confident 1 2 3 4 5

I’ve been able to make up my own mind about

things 1 2 3 4 5

I’ve been feeling loved 1 2 3 4 5

I’ve been interested in new things 1 2 3 4 5

I’ve been feeling cheerful 1 2 3 4 5

The Warwick-Edinburgh Mental Well-being Scale

(WEMWBS)Below are some statements about feelings and thoughts.

Please tick the box that best describes your experience of each over the last 2 weeks

Warwick-Edinburgh Mental Well-Being Scale (WEMWBS)

© NHS Health Scotland, University of Warwick and University of Edinburgh, 2006, all rights reserved.

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r

www.studentsagainstdepression.org/

RESOURCESUseful website & books…for racing minds, stress, anxietyand depression

RESOURCESUseful website & books…for racing minds, stress, anxietyand depression

http://www.getsomeheadspace.com/

S a r a h A s h w o r t h

M e n t a l H e a l t h C o - o r d i n a t o r