Studying with mental health issues A guide for higher education supervisors and academic counsellors 1 Studying with mental health issues A guide for higher education supervisors and academic counsellors handicap + studie expert centre Publication details Translation Studying with mental health issues A guide for higher education supervisors and academic counsellors Author Handicap + studie expert centre This translation was made possible by EPALE Netherlands, subsidised by the Acknowledgements This guide was partially funded by Fonds Psychische Gezondheid European Commission. (Mental Health Fund) in Amersfoort. This publication reflects the views Focus group members: only of the author. The Commission André Rozendaal, Fontys University of Applied Sciences cannot be held responsible for any use Anniko Kiss, VU University Amsterdam which may be made of the information Dia Ronner, Amsterdam University of Applied Sciences contained therein. Elwin Goedgedrag, student Egbert Hulshof, HAN University of Applied Sciences Els van Lith, Avans University of Applied Sciences Geertje Grooten, Windesheim Joost Dierckx, Reinier van Arkel group Kee Lengkeek, Amsterdam University of Applied Sciences The layout of the English version Leonie Lubbersen, student was made possible by the handicap Lily van Rosmalen, Inholland University of Applied Sciences + studie expert centre. This centre Mandy Verleijsdonk, student supports higher education institutions Regien Blom-de Poel, Avans University of Applied Sciences in the Netherlands in their efforts Yvonne van den Berg, De Jutters to make education accessible for University of Twente students with disabilities. The handicap + studie centre of expertise Lies Korevaar, Hanze University of Applied Sciences Groningen/ is part of CINOP. Rehabilitation Professorship Publication Handicap + studie expert centre Visiting address Stationsplein 14 5211 AP ’s-Hertogenbosch The CINOP Foundation creates well- The Netherlands founded, integrated and practical Postal address PO Box 1585 solutions for complex education 5200 BP ’s-Hertogenbosch and job market issues. As leading The Netherlands strategic partner in learning, CINOP is dedicated to fostering participation in Telephone +31 (0)73 6800783 society on the part of all citizens, now Email [email protected] and in the future. Website www.handicap-studie.nl Design Evert van de Biezen © Handicap + studie expert centre 2015 Reproduction of text, ideas and results included in this publication is permitted providing that the source is acknowledged. 4 Foreword As a student with a personality disorder, I encountered a lack of understanding and received lots of well-meaning, generic advice that wasn’t very helpful. I didn’t want to seem as though I was complaining, so I had a hard time making that clear. I had regular meetings with the student counsellor in order to make certain arrangements. For example, they let me do my exams on a computer in a separate room during the final year. That really gave me peace of mind. I’d also make planning schedules and assess my study methods with the study adviser from time to time. However, I had to face a lot of red tape in my interactions with both of them. Although they wanted to help, they had to deal with a lot of regulations. For example, an extra examination opportunity or reduced tuition fees wasn’t an option. Setting up a meeting also took up a lot of time. In some cases, I’d have to wait over a month, which could be a real drag. The above is just one of many experiences recounted by a student with mental health issues. An experience that clearly highlights the difficulties of studying with mental health issues from the perspective of both the student and the educational institution. The handicap + studie expert centre is receiving a growing number of questions on the issue of studying with mental health issues. These questions extend to the role and responsibility of educational institutions, the possibilities and limitations, the perceived inability to respond, the disparity (in terms of knowledge, attitude and skills) among student counsellors, the collaboration between educational institutions and mental health-care institutions, and the need for inspiring examples (which do exist). Consultations and collaboration with a focus group resulted in the following digital guide: ‘Studying with mental health issues. A guide for higher education supervisors and academic counsellors’. We hope that this guide will help to improve the quality of supervision for students with mental health issues, enabling them to graduate more successfully. Sietske Sportel Studying with mental health issues project leader Handicap + studie expert centre ’s-Hertogenbosch, November 2015 5 6 Contents 1 Background 9 2 Introduction 11 2.1 Why focus on studying with mental health issues? 11 2.2 What is this guide about and for whom is it intended? 11 2.3 How is the guide structured? 11 2.4 What is this guide for and what not? 12 3 Studying with mental health issues 13 3.1 Studying with a disability 13 3.2 Studying and mental health issues 13 3.3 The role of the educational institution 14 4 Supervising students with mental health issues 15 4.1 Identifying issues 15 4.2 Basic supervision principles 15 4.3 Conducting a supervision interview 16 4.4 Recommending a course of action/dealing with the problem 19 4.5 Referrals 20 4.6 Assignments 21 5 Literature 35 Overview of appendices 36 Bijlage 1 Practical guidelines from the Supported education expert centre 37 Bijlage 2 Dealing with the issue of privacy 38 Bijlage 3 Age group peers as the social reference framework 39 Bijlage 4 The diagnostic interview 40 Bijlage 5 Self-monitoring guide 41 Bijlage 6 Self-monitoring form for students 44 Bijlage 7 Elwin, Rotterdam University of Applied Sciences PowerPlatform 45 Bijlage 8 Courses and e-help 46 Bijlage 9 Understanding fear of failure 47 Bijlage 10 Contract/work plan 48 Bijlage 11 Avans University of Applied Sciences intake and matching procedure 55 Bijlage 12 Fontys University of Applied Sciences protocol for acute mental health crises 57 7 8 1 Background In 2013, The Dutch Student Union conducted a study The handicap + studie expert centre conducted an on mental health problems among higher education exploratory survey of its contacts in the higher education students.1 According to the outcomes, 49 per cent of sector. According to the outcome, student counsellors, all Dutch students are suffering from – or have suffered study advisers and student psychologists are all coping from – some form of mental health problem. The most with a growing number of students who suffer from frequently mentioned issue was depression, followed by mental health issues. As a result, there is a need for more fatigue and stress. Concentration problems and fear of expertise on the supervision of students with mental failure were also common. Academic pressure and result- health issues. driven thinking are the most frequently mentioned causes, A more in-depth exploration was conducted in 2014, in followed by family issues and an excess of extracurricular collaboration with a focus group made up of students, activities. student counsellors, student psychologists and mental According to the report by ResearchNed and ITS health-care professionals. This exploration ultimately Nijmegen (2012),2 four per cent of students suffer from resulted in a grant application to Fonds Psychische mental health problems, not counting ADHD and autism Gezondheid. The resulting grant and basic subsidy from spectrum disorder. However, this figure becomes far the Ministry of Education, Culture and Science were higher if we expand our definition from mental disorders used to create the following digital guide for higher to include general mental health issues such as stress, fear education supervisors and academic counsellors working of failure and fatigue. with students who suffer from mental health issues, in collaboration with the focus group. 1 Schmidt, E. & Simons, M. (2013). Psychische klachten onder studenten. Utrecht: Dutch Student Union (LSVb). 2 Broek, A. van den, et al. (2012). Studeren met een functiebeperking. Nijmegen: ResearchNed/ITS. Also see: Factsheet Cijfers + studeren met een functiebeperking (2013). ’s-Hertogenbosch: handicap + studie expert centre. 9 10 2 2.1 Why focus on studying with mental health since 2008, conclude that early-stage treatment of mental issues? health issues has a preventive effect. ‘Nearly half (42.7%) of all Dutch citizens will encounter As a result, this group does not stagnate socially or require a mental health issue at some point in their lives. long-term treatment. <Read on2> In order to ensure that Nevertheless, mental disorders such as borderline, issues can be identified effectively and treated early on, depression, anxiety and autism are still a major taboo. educational institutions will have to develop expertise and There are also many widely held misconceptions cooperate effectively with mental health-care services. about people with mental health disorders. In fact, the stigmatisation facing so many is even more destructive than the mental health issues themselves.’ <Read on1> 2.2 What is this guide about and for whom is it intended? Many mental health problems emerge for the first time during our student days. Higher education institutions This guide is intended for higher education professionals may be the first to notice that ‘something is wrong’. who play a key role in supervising students with mental Students who previously experienced mental health issues health issues. Although we will use the term ‘student often fail to mention this fact, or only do so when it is too counsellor’, it can also be substituted by academic career late. Among other reasons, they may be afraid to open up counsellor, study adviser, tutor, thesis supervisor or course about their problems for fear of being stigmatised. Many supervisor. Naturally, any use of the word ‘he’ can also students are also unaware of the available treatment and be taken to mean ‘she’. The emphasis is on supporting support options.