When a student presents in distress
Research has shown that when students experience problems with their mental health, they may choose to disclose this to an academic first (1). When people are distressed, they will often turn to someone they know, like and trust – for students this can be their tutor or lecturer. For this reason, students disclosing mental health problems and presenting in distress is now a common feature of the academic role. Despite this, many academics do not feel equipped to respond effectively (2-3).
Education for Mental Health
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This does not mean that academics can, or should, become mental health professionals. Maintaining the boundaries of the academic role remains important – even when academics are mental health professionals, they are usually not best placed to support students experiencing mental illness (4). The following guidance has been developed to support academic staff to respond effectively when students present to them in distress.
- Acknowledge and accept your own emotional response.
It is ok to feel worried, anxious or sad about being in this situation. It is also ok if your thoughts aren’t all concerned for the student (“I don’t have time right now. I don’t want to know about this. I’m scared of saying the wrong thing”). These are normal human responses and don’t make you an uncaring person. Fighting these thoughts and emotions can get you tangled up in an internal argument that makes it more difficult to identify what you need to do. The thoughts may actually be helpful – you may not have the time right now and that is a practical fact that needs to be part of what happens next. Remember, you are not solely responsible for what happens to this student – you are just one part of a response.
- Assess whether the conversation can and should happen here and now.
If a student begins to disclose, you must be sure that you are in an appropriate place and have the required time. If they’ve just stopped you in a busy corridor, it probably isn’t right to discuss what is happening in any detail. Instead, (if appropriate) you might gently explain this and suggest they see you at a more appropriate time and place or refer them to Student Services.
- Be clear about your boundaries.
Be honest with the student about what you can and cannot do - they can then make informed choices about what they tell you. It may help them to know that you don’t need to know all of the details about what is happening. You only need to know enough to connect them to the support, resources and interventions that will help. Stating your boundaries is not a rejection of the student, it can be part of you honestly helping them: E.g. “I’m concerned about you and I want to make sure we get you the help you need. I’m not going to be the right person to help with everything that’s happening, so I’m going to suggest we include some of my colleagues who I’m sure can help.”
- Give the conversation a structure.
If a student is in distress or in mental health crisis, it can feel like a situation that is in freefall. A deliberate, transparent and structured response will help the student and you. Explaining how you are going to structure the conversation can also help to give the student clarity and support them to organise their thoughts, which in turn can increase their sense of control.
- What is happening?
Be clear that you only need to know enough to work out what will help the student. Listen to their story and empathise with what they are experiencing. Repeating back what they have told you can help them to feel heard and may calm them down. E.g. “So, let me just check I’ve understood. X has happened to you, and it is having Y impact. I can see that must be hard.”
- What might help?
Students often have the resources to resolve their own problems, but because they are upset or distressed haven’t identified this. You can ask:
- Has anything helped when you’ve felt like this before?
- Is there anyone else around who might help?
- What do you think might help?
These questions help the student to stay and feel in control. You can also suggest other options, such as accessing student services, their GP, Chaplaincy etc. You can find more on this in Effective Signposting.
- How can you work together to get the student to what might help?
Together you can build an action plan. Where appropriate, this may include things you can do (e.g., extending a deadline). As much as possible, give the student autonomy over the plan and what they will do next. You can facilitate them to access support if that helps.
- Close down safely.
Reiterate the plan and who is doing what, remind them of your role and, if necessary, your obligation to tell others.
If there is risk
It is not your role to accurately assess risk, beyond what would be expected of any responsible adult. If you believe the student may be at risk, you must inform an appropriate person, by appropriate means. This may include contacting Student Services or calling 999, if the student appears to be at immediate risk. Remember, while you should treat conversations with students with respect, you are not so bound by confidentiality that you cannot tell someone else if you are concerned.
All of this is much easier if you have prepared the student by setting out your role and boundaries in advance.
Key lessons
- It is inevitable that students will disclose mental health problems and present in distress to academics.
- Being prepared can help academics respond effectively, within the boundaries of their role.
- Academics are not responsible for providing qualified mental health support – a helpful structured conversation can help students access appropriate support.
- Where there is potential risk, academics must tell an appropriate person by appropriate means. Confidentiality does not prevent this.
Top tips
- Explain your role and boundaries to students when you first meet, so they are not surprised when you suggest they access support from colleagues in Student Services.
- Be honest about what you can and cannot do.
- Give your conversation a structure and, as much as possible, let students take responsibility and control of the situation.
- Know who you can contact if you are concerned about a student and how you can contact them.
References
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Hughes G, Panjwani M, Tulcidas P, Byrom N. Student mental health: The role and responsibilities of academics. Oxford: Student Minds; 2018. Available from: http://www.studentminds.org.uk/uploads/3/7/8/4/3784584/180129_student_mental_health__the_role_and_experience_of_academics__student_minds_pdf.pdf
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Walker, BW. Tackling the personal tutoring conundrum: A qualitative study on the impact of developmental support for tutors. Active Learning in Higher Education 2020 June:1-13. Available from: doi: doi.org/10.1177/1469787420926007
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Lochtie D, McIntosh E, Stork A, Walker BW. Effective Personal Tutoring in Higher Education. St Albans: Critical Publishing; 2018.
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Hughes GJ, Byrom NC. Managing student mental health: The challenges faced by academics on professional healthcare courses. Journal of advanced nursing. 2019 Jul;75(7):1539-48. Available from: doi: https://doi.org/10.1111/jan.13989