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 [email protected]
• 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