Calendar 2011/12

J - Guidance on Supporting Students Experiencing Mental Health Difficulties

1.	Introduction
	These Guidelines have been prepared by the Mental Health Focus Group. Students or staff with mental health difficulties may come to the attention of any member of the University. We all share a common responsibility to provide an appropriate and realistic level of support to ensure that practices do not discriminate.
	These Guidelines are particularly aimed at College Deans/Service, College Managers, academic staff working with students (eg lecturers, Teaching Fellows, personal tutors, student mentors and resident tutors), Personnel Managers and any staff with line management responsibilities.
2.	Purpose
	The purpose of this guidance document is to ensure that: The University does not discriminate academically or socially against any student or member of staff because of his or her mental health difficulties All students and staff are positively encouraged to declare mental health difficulties or concerns Students with mental health difficulties are given the appropriate support to enable them to complete their studies successfully Staff with mental health difficulties are given the appropriate support to enable them to commence in post or to continue performing/working effectively The interests of individual students and staff will always be considered in the context of the interests of the community as a whole.
3.	Background
	There are a number of reasons why the institution has a responsibility to provide appropriate support to students and staff with mental health difficulties: Students are of a typical age for the onset of some forms of mental illness and thus a significant proportion of them will develop serious mental health problems while at university. Others will arrive at university with pre-existing conditions. Going to university is a major life transition that can at times bring a great deal of personal change and stress. Thus students may be particularly vulnerable to experiencing mental health difficulties, whether transient in nature or more persistent and troubling. There is increasing diversity among the student population. Many students have raised expectations as to what should be provided in terms of support due to the introduction of fees and a more clearly defined legal framework of rights and responsibilities. Students experience increasing financial, employment and other pressures. There are greater numbers of international students who may be coping with a new culture while living apart from established support networks. Legislation such as Disability Discrimination Act and the Human Rights Act defines the responsibilities of Higher Education Institutions with regard to discrimination or disabilities issues. The University has a duty of care for staff under the Health and Safety at Work Regulations 1999. These guidelines are intended to set out a framework of policy, procedure and practice and also to provide information about the sources of help available to students and members of staff with a mental health difficulty and to those supporting them.
4.	Promotion of Mental Well-being
4.1	In general, the University of Exeter 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 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.
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 Awareness of activities which may heighten anxiety for a particular student or member of staff Trying to create a climate of acceptance among fellow students or colleagues without compromising confidentiality
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.
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).
	(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.
	(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.
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.
7.	Confidentiality
	This section is intended to provide guidance to staff and students regarding what information about mental health difficulties will be disclosed, to whom, and in what circumstances.
	The aim is to respect the rights of the individual, to take into account relevant legislation (Disabilities Discrimination Act, Human Rights Act, and the Data Protection Act) and also to balance the interests of the individual against the best interest of the wider community.
	For ease of reference, some key points are listed below:
	(a) Data Protection Acts
	All staff within the University are governed by the requirements of the Data Protection Acts. Under these Acts, all data relating to a person’s physical or mental health is regarded as sensitive personal data. Further information is available from the Data Protection Office website at http://www.ex.ac.uk/admin/academic/datapro/
	(b) Codes of Confidentiality
	There are different codes of confidentiality across the University. Professional Codes of Confidentiality apply to staff in the Student Health Centres, the Student Counselling Service, and the Chaplaincy team. Other support services such as the Careers Advisory Service, the Disability Resource Centre, personal tutors, harassment advisors etc may have their own codes of confidentiality in addition to the overall institutional policy.
	(c) Obtaining Consent
	The student should always be asked to give consent before information is shared.
	It is important that, where consent is given by the student, it is informed consent. Therefore it is necessary to tell the individual concerned why there is a need to disclose information, who will have access to that information and the likely consequences of giving or withholding consent, e.g. if staff know about particular difficulties, specific arrangements might be made for assessment and examinations. Once consent has been obtained, it is the responsibility of the person passing on the information to ensure that it is done on the terms agreed with the student (See also: Mitigation Committees: Procedures).
	(d) Sharing Information when Consent is Given
	When consent is given, information about students or staff with mental health difficulties should be obtained and shared for the purposes of providing support in the context of meeting academic targets and/or care or for the protection of the individual or others on a ‘need to know basis’ only. The Data Protection Act also states that steps must be taken to keep sensitive personal data secure, which means that the routine use of email to convey confidential information about individuals with mental health difficulties should not be encouraged. Where appropriate, it may be preferable to telephone or meet with relevant staff. In cases where email use is necessary, appropriate measures should be taken to preserve an individual’s confidentiality. This may mean that an individual is only referred to by using his/her initials, or that care be taken not to include direct reference to a particular individual student in the subject headings.
	(e) Consent not Given
	When consent is not given to disclose sensitive personal data, this should be respected and information should not be disclosed. However, the individual should be made aware of the consequences of not giving consent (e.g. lack of appropriate financial and other support for which they may be eligible). The rare exceptions to this are when: The member of staff would be liable to civil or criminal procedure if the information was not disclosed; The individual’s mental health has deteriorated to the extent that it is causing a serious and imminent threat to their own health and safety and/or the health and safety of others (see related procedures: Fitness to Study: Procedures; Fitness to Practise: Procedures).
	(f) Request for Information from Relatives
	It is not uncommon for staff to be contacted by concerned parents or relatives. The overall policy remains that personal information cannot be disclosed without the consent of the individual. However, it may be important that staff handle the situation sensitively, provide a sympathetic ear, and give general information about student support services and occupational health to the concerned parents/relatives where appropriate.
	(g) Means of Disclosure and Security of Information
	Disclosure of information can take place not only verbally or in writing, but also accidentally, e.g. as a result of papers left on a desk or through a computer screen being left on in a public area.
	The use of email to convey sensitive personal data is not encouraged as it is very difficult to ensure confidentiality and security. If it is used, it is important to avoid the use of personal names in subject headings.
	Implementation of appropriate measures to keep information secure is a requirement of data protection legislation and the institutional policy on confidentiality.
8.	Application and Admission of Students/Appointment of Staff
	(a) Students
	All applicants are encouraged to disclose any disability at the application stage. Application forms have a section marked ‘special needs and/or additional support required’. If this box is ticked or filled in, then a Pink Form will be stapled to the form and sent to the Disability Resource Centre. This tracking and monitoring ensures that an information pack will be sent out to all declared students pre-entry. The UCAS disability codes are used on all application forms.
	(b) Staff
	All appointments are offered subject to satisfactory completion of a Pre-employment Medical Questionnaire. Before their appointment can be confirmed, successful candidates are required to complete and submit this Questionnaire. This information is held confidentially by the Occupational Health service. Occupational Health staff work with successful applicants to ensure any necessary adjustments to enable the individual to carry out their duties are made where possible.
9.	University Accommodation
	Students who have disabilities that mean that they have specific requirements in accommodation are recognised as a priority group when University accommodation is allocated to first year and continuing students. The Accommodation Office works closely with the Disability Resource Centre to identify the needs of students who fall within this group and see that those needs are met, within reason.
	It is important that the accommodation needs of students with mental health difficulties are identified as early as possible so that the Accommodation Office can allocate appropriate places.
	For students with mental health difficulties accommodation requirements can fall within a number of categories, for example: A continuing student who wishes to stay in a hall of residence beyond his or her first year, in order to benefit from the security of the pastoral system provided within the hall Allocating accommodation close to campus to a student who needs to have easy access to support facilities Allocating accommodation with good access to the University computer facilities so that a student can study in his/her room when he / she does not feel able to come onto campus Assisting a student to share accommodation with one or more friends who provide valuable informal support
	The accommodation application form includes a space for disability information. If relevant, this will be passed to the Disability Resource Centre, but only if the student ticks the box indicating that he/she gives permission for this information to be passed on.
	Accommodation needs are addressed by the Disability Resource Centre when they undertake assessment of needs. The Disability Resource Centre encourages students to give their permission for relevant information to be passed on to the Resident Tutor about their support needs. Where permission is not forthcoming, information will not be forwarded, except when the student is deemed to present a significant risk to themselves or others.
10.	Student Assessment and Examination
	Students can request specific academic assessment and examination arrangements supported by appropriate medical evidence. In many cases, the assessment of need carried out by the Disability Resource Centre will, among others, identify the requirements for alternative arrangements for examinations or assessments, stemming from the individual’s disability. In general, a student with mental health difficulties can be expected to be vulnerable to being affected by the stresses of assessment. Therefore alternative arrangements may be implemented to minimise this stress. More detailed information on the examination of students with all forms of disability can be found at http://admin.exeter.ac.uk/academic/tls/tqa/Part%208/8Aspecass.pdf.
11.	Risk Assessment
11.1	Risk assessment of a student / prospective student or employee / prospective employee with a mental health problem is a complex matter and has to be undertaken by someone with access to appropriate medical evidence or opinion (see also: Fitness to Study: Procedures; Fitness to Practise: Procedures).
	The purpose of conducting a risk assessment is to enable the individual to carry out their studies / duties effectively.
11.2	At pre-admission / pre-employment stage If there is evidence during the application process that a prospective student may pose a risk to themselves or others, the Disability Resource Centre will contact the student to carry out a pre-entry interview. In some cases, it may be necessary to carry out a risk assessment. In this case, the Disability Resource Centre will commission an Independent Psychiatrist to make this assessment. For programmes where professional standards are in place (e.g. PGCE or Medicine), the case is referred to the University’s Occupational Health Physician in liaison with the Disability Resource Centre, who will undertake a medical assessment.
	If there is evidence during the application process that a prospective employee may pose a risk to themselves or others, an interview and risk assessment will be carried out by the Occupational Health Advisors. The University’s Occupational Health Physician will also undertake a medical assessment at the request of the Occupational Health Advisors. As a result, a recommendation, based on health and safety considerations, will be made as to whether this person should be offered a position at the University at this stage. There may be an occasion where, for medical and health and safety reasons, the prospective employee will be declared unfit for the job applied for. This would be in consultation with medical professionals, and personnel and managed in accordance with the Disability Discrimination Act guidelines.
11.3	When someone is a student / employee
	If serious concern arises that a student / employee may pose a threat to themselves or others then an assessment needs to be undertaken (see: Fitness to Study: Procedures; Fitness to Practise: Procedures). This should usually be initiated with the full knowledge, and if possible agreement, of the individual. If the situation is acute, assessment is likely to be undertaken as part of a medical assessment, as to what needs to be done in the short term to make the individual safe and provide suitable care or treatment. This is usually initiated through the individual’s GP.
	The University’s responsibility is to make an assessment as to whether continued study / employment may put the individual or others at increased risk.
	(a) Students
	In general what has to be considered is whether the isolation or intensity of academic study is likely to exacerbate their difficulties. If it is determined that it is unsafe for the student to continue the procedure for required suspension can be initiated.
	(b) Staff
	If the intensity and type of work is likely to exacerbate their difficulties, under the Disability Discrimination Act, and with the guidance and support of Occupational Health, Personnel Manager and line manager, reasonable adjustment to their work practice may be advocated as a temporary measure or redeployment considered in the long term. Continued support from Occupational Health, with or without external agency support, will be offered.
12.	When There is Cause for Concern
12.1	In the course of your everyday activities you may develop concern about a student or member of staff, and it is important that when this happens you address this directly. Typical signs that someone may be in difficulty include: The individual telling you or someone else that he/she has a problem. Changes in the pattern or standard of work. Significant changes in appearance such as loss or gain of weight, deterioration of personal hygiene or signs of sleeplessness. A noticeable change of smell, which may result from increased use of alcohol or non-prescription drugs. Change in the way he or she sounds (for example flat tone, very quiet, loud, agitated). Change of mood from previous experience of him or her (for example very up and down, miserable, tired). Other people, such as friends, housemates, relatives or other colleagues, expressing concern to you. Talk or evidence of self-harming behaviour such as arm cutting.
12.2	In such circumstances the first thing to do is to express your concern to the individual and give him / her the opportunity to tell you how he / she is. This is not always easy as such personal approaches are usually reserved for those with whom we have a close relationship, but often the individual will appreciate you making this effort.
	If you decide to approach an individual you are concerned about, or if a troubled individual asks for help, the following guidelines might be useful: Talk to the individual in private, when both of you have the time and are not rushed or preoccupied with other matters. Be specific about your reasons for concern. Being vague or indirect is unlikely to be helpful. Listen carefully. The aim is not to solve the problem, but to understand the situation or dilemma from the individual’s perspective. Avoid criticisms, simplistic solutions or moral judgements. Refer to the relevant support agency (see section 16 below) if appropriate (but not when the individual is so upset or confused that he / she cannot understand or listen to you). Follow up if needed. Arranging another time to meet communicates a commitment to help and an provide an opportunity to review the situation.
12.3	Out of an initial discussion a number of possibilities may result:
	(a) You may be convinced that your concerns are unfounded, in which case no further action is necessary.
	(b) Through this discussion the individual may confirm the existence of a problem and be willing to accept help. If this happens you should encourage the individual to seek assistance the mselves. Staff should facilitate ‘sign-posting’ to one of the appropriate support services as listed in section 17. If an individual is going to seek help themselves, it is good practice to ask them to let you know how they got on and follow this up with the individual in order to satisfy yourself that he / she is receiving assistance.
	(c) It may be that the individual recognises that he/she has a problem but does not want assistance, or denies that he/she has a problem but you remain unconvinced. In either case you are advised to discuss this with a member of Student Support Services (for students) / your Personnel Manager and Occupational Health (for staff). Discussion should initially be anonymous, but you need to recognise that you may have to identify the individual and it is therefore important not to give any undertakings of absolute confidentiality to the individual.
	(d) If you remain significantly concerned about the mental health or well-being of the individual, a decision has to be made as to whether any action will be taken, and if so, what action. Such a decision may have serious and far-reaching consequences, so must never be taken lightly. Equally, to shy away from taking decisive action could, in some instances, lead to someone suffering serious harm. (see: Fitness to Study; Fitness to Study: Procedures)
13.	Record Keeping
	(a) Students
	It is good practice for all to keep a record of initial contact and all discussions of any staff member with the students and any action taken. This should be filed appropriately, in order to keep personal sensitive information secure, and should always be written with the awareness that the student has the right to seek access to any records kept about him or her.
	(b) Staff
	All Occupational Health documentation about staff is written in accordance with the Access to Medical Records Guidelines and kept confidentially and securely within the Occupational Health Service.
14.	Dealing with a Crisis
14.1	From time to time a student / employee may go into what appears to be a state of crisis, when she/he is difficult to engage in discussion and may be very agitated and volatile. This will often leave other people around them feeling agitated and anxious in turn. It should be noted that it is rare for someone with a mental health problem to be violent towards others.
14.2	The first priority when someone is in crisis is to create as calm and safe a situation as possible. Often it is best for one person to sit with the individual and talk gently to them, or simply sit quietly. Sensible precautions include: ensuring that someone else is within earshot, that the door is left partially open, that there is a clear exit from the room for all present (so that people can leave if they feel that they need to) and that others do not hover or keep going in and out of the room. If the person of concern decides to leave, then no-one should attempt to stop them, but it is preferable that someone accompany them and try to keep them safe, whilst not putting themselves at risk in doing so.
14.3	Emergency Assistance
	If someone is hurt, there is evidence of an overdose having been taken or if someone appears to pose a significant threat of violence emergency assistance should be called.
	On campus
	Estate Patrol should be contacted (ext.3999) and asked to attend and send a First Aider if necessary.
	If emergency services, paramedic or police, are required, contact the emergency services from any telephone on the University campus, outside phone or mobile (dial 999 or 112).
	In all cases, Estate Patrol (3999 from internal phone or 01392 263999 should be contacted to ensure that they can direct emergency services personnel when they arrive.
	Off campus
	Those on the scene should call the emergency services direct (dial 999 or 112) from any University, public or mobile phone.
15.	International Students
15.1	International students are no different from any other group in that some may experience mental health difficulties whilst at university. However, there are some aspects of studying a long way from home that need to be given particular consideration.
15.2	At application stage, it is particularly important that all international students are asked about disabilities and that appropriate non-discriminatory consideration is given to this in offering places. This includes the provision of assistance such as note-taking, personal care or additional tuition. There will be no external financial assistance for this, as there is through Disabled Student Allowance or its equivalent for most Home students, and so could result in significant costs to the University.
15.3	It should be noted, however, that in current experience it appears to be rare for international applicants to declare any mental health difficulties, irrespective of the reassurance the University might provide, because of cultural differences regarding health issues and confidentiality.
15.4	On arrival, many international students experience a period of cultural disorientation, which can be quite alarming. For some there is a parallel period of disorientation as they prepare to return to the home country towards the end of their period of studies. These vulnerable periods can mimic, trigger or mask mental health difficulties.
15.5	It is therefore important that those involved with international students are careful to find out as much as possible before reaching a view as to what is happening, when an international student is exhibiting behaviours or describing feelings or thoughts which may suggest that they are experiencing mental health difficulties. An understanding of the student, their current circumstances and mental health history will all be important when determining how to act.
15.6	It is also important to recognise that an international student who is experiencing a mental health problem may need additional help to understand the UK health service systems and how to make best use of what is available. The terminology used and structure of facilities is quite variable across the world. This can be also the case for the names and descriptions of University and Students’ Union support facilities, which may not be understood by students from some cultural backgrounds. If an international student is very reluctant to use the services available, such as the Disability Resource Centre, the Student Advice Centre, the Student Counselling Service or Nightline, it is often best to refer them to the International Student Exchange and Support Office (ISES), where staff may be better able to offer explanations to encourage the use of appropriate services.
16.	Sources of support
	The stigma attached to mental ill health may prevent people from accessing or seeking help.
16.1	Support for Students
	The student’s GP practice should be contacted with urgent referrals or to gain medical advice and support in a crisis situation. The campus-based Reed Mews Student Health Centre run by the St Thomas Practice, and the Heavitree Health Centre for St Luke’s students provide a full GP service under the NHS and contact details are as follows:
	Student Health Centre Reed Mews (telephone: 01392 676606 or ext 4414)
	The Heavitree Medical Practice South Lawn Terrace (telephone: 08444 77 3486)
	In addition, the University of Exeter has a range of services offering support to students with mental health difficulties or concerns;
	(a) Mental Health Advisor
	Disability Resource Centre (telephone: 01392 263880)
	The Mental Health Advisor has a background of working in psychiatric settings. The Disability Resource Centre writes to any students declaring a mental health issue on their application form. In this letter, the student is asked to contact the DRC if they want to request or access support and information around their mental health needs from the Mental Health Advisor. The Mental Health Advisor also sees students that self refer or who are encouraged to come by University staff. Please note that it is usually left to students to make the initial contact following a referral from a member of staff. The Mental Health Advisor will assess the student’s needs in relation to their mental health and academic progression. This may result in a number of different outcomes including a one-off meeting for advice or practical help: ongoing regular support around coping strategies to monitor progression or referral on to other services such as counselling, student advisers, the Student Health Centre, or to outside agencies.
	In addition, the Mental Health Advisor will liaise with other University staff over specific issues, access to University resources (e.g. library) or examination arrangements that are required. The Mental Health Advisor can help the student to access Disabled Student Allowance.
	(b) Student Counselling Service Reed Hall, Hailey Wing, Streatham Drive (telephone: 01392 264381)
	The Student Counselling Service is available to all students. Because student life can be stressful, the Student Counselling Service aims to help students cope more effectively with any personal problems or emotional difficulties that may arise during their time at University.
	(c) Study Skills Service Disability Resource Centre (telephone: 01392 263880)
	The Study Skills Service aims to help students develop the skills required for successful study in HE. This includes help with both specific skills (such as study techniques) and less specific skills such as motivation, confidence and building effective relationships with students and staff. Students may refer to the service independently, or, alternatively, can be referred by a tutor. The service offered is confidential, though essential information may be shared between advisers when students have appointments with more than one adviser. On these occasions, the student’s permission to share information with the other adviser would be obtained before any further action. Students are encouraged to use their first names when booking appointments. Where a student has been referred to the service by a tutor, advisers will only liaise with the tutor if the student agrees.
	(d) Chaplaincy Roborough Building near the Mary Harris Memorial Chapel (telephone: 01392 263649 or 07739 232455)
	Students, staff and faculty use the Chaplaincy for a wide range of welfare issues, the majority of which are not related to religion, but have to do instead with the complexities of the human condition. Often they do so because they know they will be given both sympathetic as well as professional attention; but sometimes because a Chaplain can usually be seen with a minimum of delay.
	(e) Students’ Guild – Student Advice Unit 1st floor, Devonshire House (telephone: 01392 263520)
	The Student Advice Centre provides information and advice on a range of practical problems, using Citizens Advice Bureau trained advisors. Information and advice can be on such matters as finance, student loans, hardship funds, debt, childcare, housing, legal matters, insurance and accommodation.
	(f) Harassment Advisors Network (list of Advisors available at www.admin.ex.ac.uk/misc/harassment/)
	The University’s network of Harassment Advisors and policy on the Protection of Dignity at Work and Study provides support and advice for students and staff on bullying and harassment.
	(g) International Student Exchange and Support Office (ISES) Room 250, Northcote House (telephone: 01392 263041)
	Provides links for other religions and faiths, as well as a wealth of resource literature and advice on other cultures.
	(h) Nightline (telephone: 01392 674000/1)
	Nightline is a telephone listening service run by students.
16.2	The University of Exeter has a range of services offering support to staff with mental health difficulties or concerns;
	(a) Occupational Health Service Room 9, Northcote House (telephone: 01392 263136)
	The University’s Occupational Health Advisers offer support for any employee with mental health difficulties - proactively, prior to appointment, and reactively, when employees develop a problem whilst at work.
	(b) Staff Counselling Service Referrals to the service are made through an Occupational Health Adviser.
	A confidential staff counselling service is provided independently of the University through TLC which is part of the Devon Counselling Service.
	(c) Personnel and Staff Development (list of Personnel Managers/Officers available at www.admin.ex.ac.uk/personnel/contact_us.shtml#personnel_managers_officers)
	Staff can speak to their Personnel Manager / Officer for support or advice regarding any personal mental health difficulties or if concerned about a colleague.
	(b) Chaplaincy Roborough Building near the Mary Harris Memorial Chapel (telephone: 01392 263649 or 07739 232455)
	Students, staff and faculty use the Chaplaincy for a wide range of welfare issues, the majority of which are not related to religion, but have to do instead with the complexities of the human condition. Often they do so because they know they will be given both sympathetic as well as professional attention; but sometimes because a Chaplain can usually be seen with a minimum of delay.
	(c) Harassment Advisors Network (list of Advisors available at www.admin.ex.ac.uk/misc/harassment/)
	The University’s network of Harassment Advisors and policy on the Protection of Dignity at Work and Study can provide support and advice for students and staff on bullying and harassment.
	(d) Stress Management (www.admin.ex.ac.uk/personnel/~docs/stress.htm)
	The above link provides guidelines for staff explaining what stress is and how to cope with it.
16.3	Further Support for both Staff and Students
	(a) Out of Hours Services
	Devon Doctors 01392 824600 On-call out of working hours GP service
	NHS Direct 0845 4647 Nurse-led telephone help line offering a confidential service with information and advice in relation to physical and mental health. Advisory staff have training in mental health issues and evaluating risk. Available 24/7
	Social Services Emergency Duty Team 0845 6000 388 Operates 5pm to 9am Monday to Thursday; Fridays from 4pm throughout the weekend and bank holidays.
	Chaplaincy 01392 263131 (office) 07739 232455 (mobile) Reverend Charles Hadley is available to offer support during the day, out of hours and in the event of a critical incident. C.A.Hadley@exeter.ac.uk Streatham Campus: Room 217, Amory Building St Luke’s Campus: Room 109, Holnicote Building
	Estate Patrol 01392 263999 First port of call for any campus-based incident. Will contact emergency services (paramedic, police) and also hold emergency contact numbers for the Academic Office and the Chaplains.
	Samaritans 08457 90 90 90 10 Richmond Road, Exeter 01392 411711
	To search for other telephone helplines visit www.helplines.org.uk
	(b) Local Organisations
	There are a number of voluntary organisations and other useful links that offer specific support and advice. Visit Exeter University Student Counselling Service website www.exeter.ac.uk/counselling/resources.html
	Depression & Anxiety Support Service 01392 259993
	EDP Drug & Alcohol Services 01392 666711
	Hearing Voices Network 01392 204495
	MIND Exeter & East Devon 01392 204499
	WorkWAYS provides information, advice, guidance and practical support relating to learning and work for people with mental health problems. Visit www.workways.org.uk or telephone 01392 208833
	Eating Disorders (contact Mental Health Adviser based at Disability Resource Centre for contact details)
17	Acknowledgements: This document has been based on CVCP (2000): Guidelines on student mental health policies and procedures for higher education AMOSSHE (2001): Responding to student mental health issues: ‘Duty of Care’ responsibilities for student services in higher education. Good Practice Guide. This document also includes material previously published by the Universities of Hull, Loughborough, Sussex and Oxford.