<p>Mental Health Wellbeing plan for students</p><p>Full Name Date of Birth Student Number</p><p>Course student currently studying / planning to study</p><p>Behaviour / episodes I may develop / exhibit if unwell </p><p>Warning signs / changes in my behaviour that I may be becoming unwell that I may not be able to recognise in myself at that time</p><p>Triggers / factors which may increase my potential to become unwell.</p><p>I would like one or more of the following people to be contacted if I exhibit or I declare any of the warning signs / episodes / behaviours described above or the University legitimately considers that my health or condition has deteriorated in other ways in order that they can support me and potentially prevent me becoming more unwell</p><p>Person to be contacted Telephone Email My named disability adviser</p><p>Other named University contact</p><p>Out of Hours contact</p><p>My informal support</p><p>Relationship to me GP</p><p>CPN</p><p>Social worker</p><p>Other external service</p><p>I understand that this consent applies to the duration of my course unless I withdraw consent in writing</p><p>Student signature ______</p><p>Date ______Procedure for Mental Health Wellbeing intervention plan</p><p>Preparation</p><p> Disability adviser (DA) has an appointment with a student who is likely to need the plan</p><p> They would discuss the plan together and the student would complete and sign the document</p><p> Students should be given the assurance that all information contained in the plan will be dealt with confidentially and will only be shared with the members of staff who need to know eg personal tutor.</p><p> Assure the student the information contained in it will only be used when they exhibit / declare signs of a relapse</p><p> The document will be kept securely on file until it is needed</p><p>Using the wellbeing plan</p><p> Written notes should be kept by all staff involved at every stage</p><p> Members of staff notice signs of relapse themselves or shows signs to others then this is highlighted to the Academic Group Leader (AGL) or Named DA depending on who has reported it</p><p> Named DA together with AGL would gather relevant evidence of the signs</p><p> The named DA would arrange an initial appointment with the student to inform them of what is going to happen </p><p> The DA would then inform the heads of service / AGL after seeing the student</p><p> A meeting must then be convened with all relevant staff or their nominee (DA, counsellor, AGL, personal tutor), the notes of the meeting would be recorded on the attached form (appendix 1)</p><p> The reasons as to how any decisions were made at the meeting, must be fully evidenced on the form eg the signs the student exhibited or declared and how this informed the decision made, including the factors taken into account</p><p> The form must be signed by the relevant people</p><p> A nominated person to contact the relevant named people named in the Mental Health Wellbeing plan Appendix 1 </p><p>Meeting notes for meeting held on ______</p><p>Student Full Name Date of Birth Student Number</p><p>Course student currently studying / planning to study</p><p>Staff attending meeting and their role</p><p>Signs / behaviour student exhibiting</p><p>Decision made by meeting</p><p>Reasons why decision above has been made</p><p>Nominated person to contact relevant named people</p><p>Chair of meeting</p><p>Name ______Signature ______Date ______</p><p>Pro Vice Chancellor Name ______Signature ______Date ______</p>