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Student Case Studies: Mental Health

Look at these scenarios illustrating how a student’s needs can be impacted by their university experience.

George

George has a diagnosis of depression and anxiety and has been prescribed with anti-depressants. Other than this George did not receive any specialist support or counselling either before or after they began their studies at University.

Read George’s case study

During induction and transition into Higher Education, George put on a brave face and attempted to attend as many of the academic activities as possible. However, they found the pace of induction fairly overwhelming and George did not take in as much as they would have liked to at this stage. George would have preferred a gentler induction and in particular the opportunity to get to know their tutors more.

As their studies continued, George began to fall behind with some tasks. They struggled to complete work on time or to hand in work of a standard that reflected their abilities. George also feels that they do not contribute much in lectures, seminars and tutorials, largely due to anxiety about getting things wrong in front of others.

There are other factors that impact on George’s academic progress:

When researching and composing academic work, George is easily distracted, particularly by feelings of dissatisfaction with the quality of their work. This places an additional burden on George with knock on impacts on their confidence in their ability to work effectively. This in turn impacts George’s motivation and mood leading to delays in starting their work and avoidance of particularly challenging tasks or areas which George does not fully understand. George’s organisation suffers, the deadlines pile up and George’s feelings of desperation increase accordingly.   

George struggles to make connections confidently and therefore feels incompetent in these situations. In those classes where lecturers ask questions and seek to engage all members of the class in question-and-answer sessions and group activities, George has begun to feel particularly anxious. When anxiety is particularly impacted by this, George avoids or leaves certain classes as a result of these feelings.   

George faces particular anxiety over participation in group activities. They do not feel they work well in these situations or that their participation is valued or of sufficient quality. Rather than express concerns in this area George uses avoidance as a means of coping with their feelings.

Although George has made friends, this does not stop them from feeling alienated from their peers at times and particularly when undertaking academic tasks in class. George feels inadequate academically and doubts that University study is for them. In addition, when socialising George fixates on the fact that they should be working instead, making George feel guilty.   

George has not spoken to anyone about these issues and avoids a booked meeting with their Personal Academic Tutor for fear that they will be in trouble for their poor attendance or lack of progress. They have not disclosed their depression and anxiety prior to arriving at University and as a result have not been contacted by any of the specialist support services.

Though George knows that they are unlikely to be the only person likely facing these challenges, they still feel isolated and that no-one fully understands their problems. George’s issues continue to mount up to the point that they temporarily withdraw from their course of study so that they can recover from the experience and decide whether a return to University is the right thing for them.

Pause for thought

  • How might tutors have supported George differently when they first arrived at University?
  • How might a tutor or lecturer create the environment within which George would feel comfortable disclosing their difficulties?
  • What changes to teaching and learning strategies could a tutor/lecturer introduce to support George in playing a full part in the course?

Reflecting on George’s situation, consider:

  • What emotional impact or stress is George experiencing?
  • How about physical manifestations?
  • Is George accessing all the resources available to them or do they feel conspicuous about doing this?
  • What check points are in place for George to review their learning?
  • How institutional policies and strategies might help to support their induction to their course and to student life?
  • How the academic discipline they have chosen to study might impact on their engagement, for example would their experience be different if they were studying engineering, sciences, languages or humanities subjects?
  • How might a tutor take into account George’s needs and personal differences when thinking how to prepare activities that promote student active engagement in class?
  • What support services and other support might be available to George?

Sam

Sam has a diagnosis of generalised anxiety.

Read Sam’s case study

Sam had not disclosed their anxiety prior to attending University as they were concerned that this might affect their chances of getting on the course. Sam also sees University as a positive step where they will be able to make a new start and hopefully move on from some of the difficulties they faced in school and at college. However, though Sam knows that they are unlikely to be the only person likely to face these challenges, they still initially feel isolated and that no-one fully understands their problems.

During one of the first sessions provided by Sam’s course tutors they run a session with all students mapping the diversity of students as an induction exercise. This anonymous exercise using a phone-based app included questions about where people were from, what they were most excited about and what their concerns were. Sam saw in real time that some people had the same questions as them and so they took part too. This made Sam aware of the diversity of their fellow students and the fact that many of them faced both similar and different challenges and anxieties to Sam about starting at University. Tutors also invited in some of the student support teams who spoke about their work and identified how students could contact them.  

Sam wished that they had disclosed their needs before starting their course as they found out there was an earlier induction day for students who would prefer a less intense induction. As such Sam found some of induction and transition fairly overwhelming resulting in them missing some sessions and not fully engaging in the team building and other activities put on by tutors. However, having disclosed to their tutor after the diversity induction exercise, Sam was offered weekly check ins for the first few weeks and was also given the name of the specialist team who would be able to support them with counselling and other options.

Sam’s Personal Academic Tutor has fixed meetings with Sam but also allows the occasional open-door chat where possible. The tutor proactively ensures that Sam is aware of their deadlines and is clear about what is expected of them.

Although it took a time to put in place, Sam started meeting with a counsellor who helped them to address some of the difficulties their anxiety presented and drew up a plan for supporting Sam during their studies. Through Disabled Students Allowance (DSA), Sam has also been able to access specialist software called “Brain in Hand” which enables them to use a phone app to manage their anxiety and ensure that they have plans in place to refer to should they feel the need. 

Tutors are aware that Sam can feel uncomfortable in group situations and does not like to be directly asked questions in open forum. However, tutors do still offer Sam the opportunity to contribute if they want through subtle eye contact and blanket offers to answer. Tutors also make sure to check in with Sam during sessions.  

When researching and composing academic work, Sam is easily distracted, particularly by feelings of dissatisfaction with the quality of their work and anxiety over what is expected of them and the fact that deadlines are piling up. This places an additional burden on Sam with knock on impacts on their confidence in their ability to work effectively. Sam has begun to check in with tutors at the end of sessions to check their understanding is correct and their Counsellor is working with them to chunk their work tasks, managing each task at a time, and this has helped with reducing anxiety and ensuring Sam feels that they are making progress. 

Tutors have discussed with Sam their anxiety over participation in group activities. Sam understands how their skills will be developed through group work and presentations, but they have been given options to select particular people to work with and to make presentations just to their tutor and this has enabled Sam to manage some of their anxieties in this area. It is early days, but they feel that they are making progress here. 

Pause for thought

  • What else might tutors have done to support Sam differently when they first arrived at University?
  • How might you create the environment within which Sam and other students would feel comfortable disclosing the anxieties and difficulties they face?
  • What changes to your teaching could you introduce to support Sam in playing a full part in your course?

Reflecting on Sam’s situation, consider:

  • How institution-wide policy and procedures might have helped to encourage Sam to disclose their needs at an earlier stage
  • Whether Sam’s degree subject(s) might affect the ways in which they are able to engage with learning opportunities e.g. the number of lectures, seminars, practical activities, online learning and independent directed tasks
  • Whether Sam’s tutors and lecturers might face any challenges in providing appropriate support, and how they might access support and guidance to enhance their own practice
  • Where Sam might be signposted in order to access additional support and guidance on an ongoing basis, as they feel it is needed

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