Peter QuinnHead of the Disability Advisory ServiceUniversity of Oxford

4 August 2010

“Providing mentoring support for students with mental health conditions”

Disabled Students’ Allowances Training Day

Peter Quinn Head of Disability Advisory Service, University of Oxford

Member of Board of Directors National Association of Disability Practitioners

Steering Group member for Oxford Student Mental Health Network (OSMHN)

Career History

Personal background

Aims of this session

Ground rules

Brief background: Oxford University

No clear date of foundation but teaching existed in 1096

Oxford University has around 20,000 students made up of 11,766 Undergraduate and 8,701 Postgraduate.

Collegiate University made up of 38 independent self governing Colleges and over 100 University Departments and 100 libraries

Academic Year 2008~2009 1273 students had declared a disability

All students are academic high achievers who have been through an intensive selection process.

Brief background: Oxford University (cont)

2009/10 more than 17,000 people applied for 3,200 undergraduate places.

Based on their academic record, their personal statement and references, 10,545 candidates were invited to attend selections interviews and tests and in total 24,000 interviews were conducted.

The majority of Oxford’s UK undergraduates come from state schools. Latest figures (entry 2009) show that, for UK students attending schools or colleges in the UK, 53.9 per cent of places on undergraduate courses went to applicants from the state sector, and 46.1 per cent went to applicants from the independent sector.

Structure of Oxford University / Disability Support

Students join one of the 38 Colleges, study via one or more of the Departments and are examined and awarded a degree by the ‘University’.

In effect there are “38 Universities” which can lead to complexity.

The University disability team advises the 38 colleges and 100+ departments to ensure that reasonable adjustment can be made for students

The small team (4.6fte) works with a network of ‘disability contacts’ in each College & Department

Mentoring Scheme

Increasing numbers of the following types of disability led to the development of a mentoring scheme:

Chronic Fatigue Syndrome (CFS) / Myalgic Encephalomyelitis (ME)

Asperger Syndrome Mental Health Difficulties including Bi-Polar Disorder,

Depression and Anxiety

A joined up approach between the University Disability Advisory Service, Counselling Service and other Departments incl. Department of Psychiatry has proved to be very successful to date.

Who is a mentor for this scheme?

A person associated with / known to the Counselling Service with appropriate qualifications / experience.

A member of the Autism Research Team in the Department of Psychiatry specifically to support students with Asperger Syndrome.

A member of the Department of Psychiatry with appropriate qualifications / experience in supporting students with depression, anxiety disorders, Obsessive Compulsive Disorders (OCD).

A graduate student with knowledge of the institution (for CFS students)

What does a mentor do?

All in relation to study:

Help with time management

Enable “focus”

Work on “motivation”

Help to address “disability related” specific barriers

n.b. Mentoring is not extra tuition nor is it a stand alone support strategy.

Case Study 1.1 3rd year Undergraduate from developing country

Severe Bipolar disorder

Science degree (very structured and demanding)

“Intermitting” from College on disciplinary / academic grounds but College keen to support re-entry to course

College approached Disability Office for advice on procedure (DDA) and support needs

Student returning to catch up and cover new topics which will be a challenge given pace / short terms

Case Study 1.2Issues to consider when selecting mentor:

Cultural: stigma of disability / depression

Lack of family support in the UK

Difficult financial circumstances

Impact of medication on academic ability

Recent history of frequent hospitalisation due to psychotic breakdown

n.b. Student was in regular contact throughout with GP , Psychiatrist as well as usual academic contacts / college pastoral support. Student in long term relationship

Case Study 1.3

Mentor requirement discussed with relevant expert [Head of Counselling Service].

Mentor selected on grounds of:

Relevant experience working in Educational context

Had lived and worked in a developing country

Appropriate Psychological training and experience

Case Study 1.4

Stage 1

Initial meeting facilitated by Disability Office (DO) in confidential meeting space in DO premises.

Mentor covered: Pre-illness History Student experience of hospitalisation Students history of academic excellence

Case Study 1.5Stage 2

Mentor then met with student weekly in Café near to student’s lectures as student under time pressure / needed ‘offset anxiety’ (i.e.smoke!)

Mentor covered following areas: Established student not suicidal then feelings of loss of old self Student’s enjoyment of ‘manic phases’ of illness but which each time

culminated in “debt, failure and hospitalisation”. Strategies of ‘balance’ to address new way of living with condition

At end of this process student felt positive about mentoring process, its usefulness and became pro-active in seeking academic help and support including extensions / extra time for work.

Case Study 1.6Stage 3

Mentor preparing student for exam & project work:

Developed work plan

Established clear picture of demands discussing realistic ‘concentration’ periods [student proposed 5 hours but agreed that 30 min study / 30 min rest was more achievable].

Factored in sleep, leisure times and optimum times to study taking into account medication effects and mood.

Weekly meetings important so student could air any anxiety.

Case Study 1.7Stage 4

Mentor supports student throughout exams:

Student Status: battling depression, medication reduced to enable more effective study more frequent appointments with Psychiatrist arranged anxious about exam concession process (extra time) physically ill for two weeks preceding exams and throughout

Student passed examinations and was ‘jubilant’

Case Study 1.8Stage 5 Student returns for new academic year: Student Status:

anxious at new academic year historically a difficult time of year as affected by winter (lack of

sunshine) depressed and not sleeping (referred to sleep consultant) psychiatrist ill and unavailable

Stage 6 Mentor preparing student for exam & project work:

Student Status: Submits project Persevering but still battling depression Medication difficulties (one effect is weight gain) Challenge to address both illness and academic work

Case Study 1.9Summary Student was on brink of failing academically before mentoring but graduated.

Key factors in success:

Student is Motivated, Positive personality on varied medication

Supportive girlfriend

Key Challenges: Student had unrealistic expectations where he compares his previous “possibilities” (pre-diagnosis) with his current circumstances and “despairs” Ongoing dependence on powerful medication

Case Study 2.1 Graduate student in third year of course with ongoing severe fluctuating physical disability.

Student has had periods of ‘suspension’ due to ill health, hospitalisation and associated depression.

Severe physical disability involving some mobility difficulty, cardiac problems, frequent fainting. Medication for pain and associated depression.

DO proposed mentoring assistance following improvements in physical condition but increase in problems associated with psychological impact

Student also in ongoing contact with Counselling (CBT), GP, several hospitals and Support Groups.

Case Study 2.2 Issues to consider when selecting mentor:

Physical / psychological elements of disability

College less involved as Graduate student but little department input

Impact of medication on academic ability

Recent history of frequent hospitalisation due to physical circumstances and reaction to medication

n.b. For this case the approach was collaborative between DO and Mentor as student had long term relationship with DO

Case Study 2.3Mentor requirement discussed with relevant expert [Head of Counselling Service].

Mentor selected on grounds of:

Relevant experience working in Educational context

Strong character with rigorous boundaries (student had history of manipulation)

Appropriate Psychological training and experience

Flexible approachable demeanour

Case Study 2.4Stage 1

Initial meeting facilitated by DO in Café near to College where confidential discussion possible.

Disability Office / Mentor covered: Health Concerns Students relationship with academic staff Students relationship with classmates / fellow students Student’s complaints about a variety of areas of College /

Department / University Student vividly described physical suffering

Mentor addressed emotional element. DO addressed practical areas

Case Study 2.5Stage 2

Mentor aimed to meet student weekly whilst feeding back to DO. However, due to hospitalisation and bereavement communication mainly via email.

Student had several periods out to catch up on work due to further health related difficulties (new diagnosis, family bereavement and in patient treatment).

Student also accessing CBT support via counselling service.

Case Study 2.6Summary Student’s academic progress hampered by psychological aspect of physical disability. Student alienated previous support workers and allies as a result. Disability Service persisted and continued engagement.

Key factors in success will be:

Student engaging in process and accessing all support available.

Key Challenge:

Student’s fluctuating condition

Facing the challenge

The mentoring scheme to date has proved successful in the main as students likely to fail academically or drop out on health / disability grounds are now able to have mentoring that is flexible and appropriate.

Oxford is not alone in having the necessary elements but the key area is flexibility in combining a multi-disciplinary approach.

Mentoring Asperger’s Syndrome and CFS/ME students is slightly different but equally successful.

Useful links Videos and information including on Depression and Long Term

Health Conditions from http://www.youthhealthtalk.org/

Oxford Student Mental health Network (OSMHN): is a partnership between local education institutions and health service providers, which focuses on student mental health issues in Oxford. Includes http://www.osmhn.org.uk/

MIND: Information, advice and campaigning on mental health http://www.mind.org.uk/

Excellent series of guides from OUP ‘The Facts’ http://ukcatalogue.oup.com/category/academic/series/medicine/facts.do

` Peter Quinn, Head of Disability Advisory Service, University of Oxford August 2010 peter.quinn@admin.ox.ac.uk