Top tips for students starting University with mental or physical health issues

September 10 2018

Dr Alys Cole-King (@AlysColeKing) with input from Dr Dom Thompson, student health expert (@DrDomThompson | buzzconsulting.co.uk), Dr Knut Schroeder (@DrKnut and @expertselfcare) and Mari Evans and Gwenda Evans (University students)

It's normal to feel unsure about what to expect when starting university. It’s also normal to feel nervous at times of change, which is why we've written these top 10 tips to help you steady your nerves:

  1. Prepare: Sit down with someone you trust and write a list of all your worries and concerns, so that you can start to address them together.
  2. Create an action plan: Put all your worries or concerns into different categories, such as making friends, your studies, budgeting, living away from home, and make an action plan for each one, containing solutions for each worry.
  3. Organise your medical care: If you need support for any health condition or disability, plan how you can get the care and support you need. A good starting point is to search your university's website for 'student support' to look for information about available services.
  4. Register with a new GP: Check out your university's website to see if they have a surgery on campus or whether they recommended a particular GP practice. Phone the new GP practice and see if they have anyone who specialises in student health. Try to make the call yourself if you can, but if you find it hard, ask your next of kin to call and sit next to them so you can listen and join in if needed.
  5. Medication: If you take regular medicines or need medical devices or equipment, plan what you need and get an appropriate supply of prescriptions in advance (to be agreed with your GP) so you don't run out! 
    Prescriptions are free in Wales, Scotland and Northern Ireland but not in England.  Check out if you are eligible for a prescription prepayment certificate (PPC) which can save you money https://www.gov.uk/get-a-ppc
  6. Contact Student Support:  Get in touch with Student Support before you go to Uni. They're there to support you and will do what they can to help. Phone or email them for advice and don't be shy in asking for help if you need it.
  7. Sort out ongoing care: If you're under specialist care for conditions like asthma, diabetes or a mental health problem, register with a new GP as soon as possible so that you can discuss ongoing care and possible referral to local services.
  8. Get comfortable: Take a few things with you that remind you of home, like a blanket, dressing gown or your usual duvet and bedsheets instead of buying new ones. You could also make a playlist of your favourite songs for times when you need a boost.
  9. Look after your wellbeing: Make a 'Personal Wellbeing Plan' of 5 things you can do every day, to help build your wellbeing. Include things in your plan like sleep, exercise, activities that you enjoy, something relaxing, socialising with friends, small treats, Uni clubs, support from home, and so on.   
  10. Make a Safety Plan: Sit down with someone you trust and make a plan of things you can do for yourself. Write down how you can get in touch with people you can ask for support if you ever feel low, get stressed or if you are struggling. Check out the leaflet 'Feeling Overwhelmed and Staying Safe' for ideas.

If you're worried or stressed after reading our tips please talk to someone about how you are feeling as you may need extra support.

 

International Award for Connecting with People Clinical Director

Connecting with People
August 23 2017

Connecting with People Clinical Director, Dr Alys Cole-King, has become the first person from the United Kingdom to be awarded the prestigious Ringel Service Award from the International Association for Suicide Prevention (IASP).  Dr Cole-King was recognised for her innovative and tireless support of people at risk of suicide both nationally and internationally at a glittering awards ceremony in Malaysia on Friday 21st July.

Founded by the late Professor Erwin Ringel, the International Association is dedicated to preventing suicide and includes professionals and volunteers from more than fifty countries.

Dr Cole-King said: “I feel very honoured to have received this award.  There are so many people and organisations around the world doing excellent work in suicide prevention.  It’s fantastic to be able to get our work which started here in the UK recognised in this way.”

Earlier this year she was named one of the most influential women in medicine by the respected Medical Women’s Journal in recognition of her pioneering work with policy makers, voluntary bodies and academics to raise awareness of suicide and self-harm. She combines her role as Clinical Director of Connecting with People with her clinical duties as the Consultant Liaison Psychiatrist with Betsi Cadwaladr University Health Board (part of the National Health Service in the UK). Her expertise lies in supporting people with mental health problems as well as carrying out a specialist suicide and self-harm prevention role.  

Through Connecting with People, Dr Cole-King has developed bite-sized training for healthcare professionals and leaflets and online self-help resources to support people at risk of suicide or self-harm.  She has led the development of the Suicide Assessment Framework E-Tool (SAFETool) - a web based app which enables healthcare practitioners to use tablets or smartphones to guide the assessment, documentation and safe response to people at risk of suicide.  She also played a leading role in making the ‘U Can Cope’ film and facilitating the coalition of over a hundred organisations including the Professional Cricketers’ Association and Rugby Players’ Association – which came together to spread the message that it is possible to overcome suicidal thoughts and feelings.

Dr Cole-King has described every suicide as a “tragedy” and says that while suicidal thoughts are common, suicide can be prevented.  She added:  “People attempting suicide usually want their suffering to end, not necessarily their life to end.  It is vital that anyone considering suicide knows that it's never too late to seek help, and there is always hope.  They should have a Safety Plan with details of what they can do to help themselves and who they can contact for support.  We also need to tackle the stigma that still surrounds suicide and self-harm and have a more compassionate approach to people experiencing suicidal thoughts.  I would urge anyone in distress to our self-help resources on: http://connectingwithpeople.org/StayingSafe

Betsi Cadwaladr University Health Board Chairman Peter Higson said:  “I am delighted to see Alys receive the international recognition that she deserves for her pioneering work in support of people at risk of suicide and self-harm.  As a Health Board we are incredibly proud to support Alys’ ground-breaking work and witness the impact it has made here in North Wales and further afield.”

A statement on the Netflix Series ‘13 Reasons Why’

Dr Alys Cole-King and Dr Stanley Kutcher
May 08 2017

Dr. Stan Kutcher, Sun Life Financial Chair in Adolescent Mental Health and the Director World Health Organization Collaborating Centre in Mental Health Policy and Training at Dalhousie University and IWK Health Centre in Canada. He is a renowned expert in adolescent mental health and leader in mental health research, advocacy, training, and policy and has been involved in mental health work in over 20 countries.

Dr Alys Cole-King is Clinical Director, Connecting with People

This blog is in response to the growing media and social media coverage of the Netflix Series ‘13 Reasons Why’. We are keen to ensure that adults are alert to the situation whilst not being unduly anxious. Many international mental health and suicide prevention experts have already published guidance, position statements and blogs on the programme (see below for links).   One theme that is consistently found in these documents is a significant concern that 13 Reason’s Why inaccurately portrays youth suicide and contains many of the elements that research has identified as impacting on increased rates of suicide through the contagion and copycat phenomena that irresponsible media portrayal of suicide can have on vulnerable young people.

We are also dismayed by  ‘13 Reasons Why’ as it either ignores or breaks national and international media guideline on suicide safety and responsible media portrayal of suicide, is overly sensationalist and ignores all the expert advice provided before the show was made. It glamorises suicide, suggests that suicide is a plausible solution to life problems, presents suicide as a means of gaining peer respect and does not accurately portray the common factors that underlie suicide in young people.  Thus it contains the very components that research has identified as contributing to suicide contagion and increasing rates of suicide in young people, particularly those who may be most vulnerable.  However the programme is here and has probably already been ‘binge watched’ by hundreds of thousands of teenagers around the world.

Our aim now, is for damage limitation and for all viewers, especially vulnerable young people to know that suicide is preventable with early identification, intervention, hope and removal of access to means. Young people need to know that others will listen when they share their distress, that it's never to late to seek help, and there is always hope. 

The majority of young people who end their lives by suicide are not in touch with mental health services around the time of their death, even though many are suffering from problems that would benefit from receipt of mental health care or support. However, most are in contact with someone who could provide an opportunity to support them and who can help them access the care that they need.  For those young people at risk of suicide, connecting with an empathic, confident and competent person could be their tipping point back to safety, when they start to receive and accept help to deal with their problems and find a way forward.

Remember suicide is tragic but rare event and we must keep this in perspective. Young people need to know that thousands of people become distressed and have thoughts of suicide but with the right support they can get through tough times. People need to know what they can do to help themselves and others. Dr Cole-King, Clinical Director, Connecting with People states that “We wish we could reach every young person who is thinking that life isn’t worth living and help them to see that their feelings are a sign that they need to change something in their life, not to end their life”. 

Encouraging help-seeking behaviour, rapid access to effective treatments, hopefulness, identifying reasons for living, and removal of access to means can contribute to suicide prevention. It is essential that health care providers be available to give the help and support needed.

Dr Cole-King  said “It’s key that every young person considering suicide needs to know they can be supported through tough times. If they are considering suicide, they should have a Safety Plan with details of what they can do to help themselves and who they can contact for support when they need it. Information about how to make a Safety Plan can be found in the ‘Feeling Overwhelmed and Helping You Stay Safe’ resource. This is an online resource for anyone struggling with suicidal thoughts, designed  to offer hope, compassion and practical ideas on how to find their way forward http://www.connectingwithpeople.org/StayingSafe

Since the program is now widely available and the media attention to it may be having the impact of fuelling viewing rates, it is necessary to share what can be done by those who are concerned. Here are some tips for parents, guardians, teachers, youth workers and concerned adults to help address this issue and how to have a conversation with young people about the series.   

  • Keep calm and do not panic - remember the majority of young people may not be unduly affected
  • Have a conversation with the young person watching the series and to discuss their feelings and thoughts and open up a channel of communication in case they do become affected or concerned, so that they know they can talk to you
  • Let them know they can ask you any question now or in the future if an issue crops up
  • Reinforce the reality that ‘13 Reasons Why’ is a made up story and not based on a real person and that the majority of people who experience bullying, the serious injury or death of a friend, a sexual assault or any other life adversity do not think about suicide nor do they take their lives 
  • Reinforce the message that people think about suicide when they are in a huge amount of emotional pain and they don’t know what else to do - but that actually there are so many things that they could do – if only they knew who to contact for support or what to do
  • The most important thing to do is to speak to someone - and that they can speak to you any time now or in the future
  • Suicide is not a solution to problems and that help is available. This is particularly important for adolescents who are isolated, struggling, or vulnerable to suggestive images and storylines.
  • Thousands of young people experience thoughts of suicide every day, but they find ways to cope with these intense feelings. Like them, your child or the young person you care about, can get the help they need to deal with their feelings

Advice if the young person is actively distressed or talking about suicide:

  • Reassure them that you are taking them seriously and that you will be there for them

  • Reassure them that there is help and they will not feel like this forever

  • Avoid statements that they could perceived as minimising their distress such as “surely it’s not that bad” or “Come on now... you need to get over this.”
  • Provide support and supervision as required
  • Never agree to keep suicidal thoughts a secret and always support them to seek support or seek assistance on their behalf
  • Do not leave the person alone until you think it is safe to do so:
    • You have concrete evidence and reassurance and you are convinced that their distress or intent to self-harm or attempt to take their life has passed 
    • Once they have received additional support or an assessment from a suitably qualified person.  Take them to a health care provider who has the skills needed to help.  In a crisis this may be your closest A and E Department
    • See http://www.connectingwithpeople.org/StayingSafe for specific advice and guidance on who to approach if you are worried about a young person in distress

Self-help resources

Connecting with People have produced a series of leaflets on behalf of the Royal College of Psychiatrists, providing information for both individuals experiencing suicidal thoughts and those who are concerned. These are available through the Royal College of Psychiatrists or the Connecting with People website: http://Connectingwithpeople.org/ucancope

For guidelines on best practice in talking about suicide in the media or social media

Articles outlining concerns about ‘13 Reasons Why’

With thanks to Professor Siobhan O’Neil for reviewing the draft and for her helpful suggestions.

Senior Business Leaders Share Personal Mental Health Experiences and Publicly Challenge Workplace Mental Health Stigma

Claire Metters
December 08 2016

Marketing & Programmes Manager, Connecting with People

For the first time EVER senior business leaders have publicly shared their personal mental health experiences, in an effort to eradicate workplace mental health stigma. The ‘This is my Story’ event took place in London on 7th December 2016 and was organised by Minds@Work, a movement co-founded by Geoff McDonald, former Global VP of Human Resources at Unilever, Executive Director at Open Minds Health and passionate campaigner for breaking mental health stigma within the corporate world.

Research reveals that a staggering 71% of the people would worry about disclosing a mental health problem to their employer, fearful of receiving a negative response. A valid concern given that 1 in 5 people have lost a job at some point in their life following mental health disclosure or inappropriate disclosure on their behalf. 

The implications of non-disclosure of mental health conditions has wide implications for both the employee and employer. Employee’s who feel unable to openly discuss their mental health are highly likely to experience increased professional anxiety, with no line management support, and risk finding themselves in a downward spiral leading to further mental health problems that could otherwise be avoided. For employers, the associated costs in terms of increased absenteeism, presenteeism, staff replacement and reduced productivity are significant; particularly as one in four people experience a mental health problem at any given time. The total cost of staff mental health problems to UK employers is estimated to be around £26 billion each year, the equivalent to £1,035 for every employee across the UK.

Employer’s that lead by example and purposefully create a culture that openly discusses mental health, can and will remove the stigma sting. Stigma relies upon ignorance, prejudice and discrimination for its survival. Introducing a framework that educates, supports and challenges attitudes and behaviour provides confidence to employee’s struggling that disclosure won’t result in negative consequences. 

The ‘This is my Story’ event has gained media attention from BBC Online, BBC Business Daily, BBC Worldwide and The Telegraph, coverage that will no doubt help Minds@Work achieve their aim to normalise workplace mental health discussions and “create mentally and emotionally healthy and human workplaces where individuals can flourish and organisations prosper

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