Transcript mentoring060626

The Iceberg Factor
Mentoring for students with hidden primary and
secondary mental health issues in higher education
Sue Meads
Head of Mentor Service, University of Southampton
Monday 26th June 2006
Rationale
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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
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Rationale continued
Support from specialist services
benefits transition to HE, retention,
achievement, development of
transferable coping strategies, self
esteem, self awareness and health
 Mentoring is most appropriate
specialist help
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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 (this
would not be DSA)
 Any student with mental health issues,
disability or chronic medical condition
which affects their ability to study to
their full capacity
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Including
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Depression
Anxiety
PTSD
Schizophrenia
Eating disorders
Self harm
Social phobia
Bi-polar affective
disorder
General anxiety
disorder
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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 practical with reality
 Hyper vigilance
 Acute self consciousness
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Hidden effects continued
Panic attacks and fear of panic attacks
 Sleep deprivation
 Obsessive behaviour
 Intrusive thoughts
 Unable to stay in, or function in, certain
environments
 Problems with processing information,
memory, concentration etc
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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
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And …
Liaison with others services including
medical
 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
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Mentor Service at
Southampton
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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
75-90% mental health issues, 10-25%
chronic medical, 1-5% temporary
Extent of demand
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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
Factors which influence
individual need
Nature of difficulty, especially if
condition or medication is changing
 Willingness to believe help is possible
 Multiple disabilities
 Social factors affecting potential
academic success
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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
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And…
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Ability to identify strategies and help adapt
them to the individual
Enjoy working at several levels at the same
time
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Observe and think about student’s manner
and disclosures
Monitor own emotional responses
Assess student’s situation
Choose how to respond
Identify useful strategies
Choosing mentors
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Relevant qualifications and experience
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Academic level, graduate a minimum
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?
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Why not just nice people?
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Working regularly and closely with people
with mental health difficulties, even
depression and anxiety, is a powerful
experience, risks include
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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 continued
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Many people are attracted to this role, with a
genuine desire to help but …
• Desire to help doesn’t equal ability
• How do you screen out people who are attracted
because of their own issues?
• Is having your own issues always bad?
• Being nice isn’t enough
• Even people with relevant professional training
should have clinical supervision
• Intuition and insight need the discipline of theory,
experience and training
Why continued
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The professional trainings listed all involve
learning
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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?
Often popular
 Usually cost effective
 Fraught with the difficulties listed
earlier
 Impossible to supervise properly
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The issue of responsibility
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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
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Examples
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Amy – bi polar affective disorder
Charlie – General Anxiety disorder
Tom – anxiety and depression, non traditional
background
Helen – 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
Feedback
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Consistently emphasises that
mentoring enabled the student to
stay at University
 complete course
 achieve grades
 overcome difficulties
 recover from setbacks
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Charlie’s feedback - 3rd year humanities student,
General Anxiety Disorder/Depersonalisation
1st class honours
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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
Charlie’s feedback continued
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What have you found particularly helpful?
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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!