Ahead Conference 2019 What impact do mental health difficulties have on the student journey and what can HEIs do about it? Declan Reilly & James Brady, Disability Service, Trinity College Dublin

Overview Increase in students with Mental Health difficulties Impact on student progression Highest risk of withdrawal Repeat year on medical grounds Co-ordinating existing mental health student supports

DARE applicants nationally, Mental health difficulties & ASD, 2010 to 2016 DARE/HEAR Facts and Figures 2017

https://www.tcd.ie/disability/policies/annual-report-stats.php

https://www.tcd.ie/disability/policies/annual-report-stats.php

Numbers & % of students (DS reg) withdrawing and graduating by disability type (2,427 students entering between 2005 to 2014) Withdrawn (WD) Graduate (GRD) Total WD & GRD % WD of WD & GRD ADD 15 95 110 14% ASD 18 58 76 24% Blind/VI 7 40 47 15% Deaf/HI 28 81 109 26% Dyspraxia 5 49 54 9% Mental Health 141 365 506 28% Neurological 4 56 60 7% Physical 27 159 186 14.5% SOI 39 242 281 SPLD 131 867 998 13% Other (6) (3) (9) Total 415 2012 2427 17.09%

Numbers of students withdrawing and graduating by disability type (2,427) 2005 to 2014

% of students withdrawing by disability type

Repeat year on medical grounds 2013/14

Outcomes in January 2019 of medical repeats in 2013/14

Additional years to completion

The Role of the Case Coordinator In Trinity In December 2017 Trinity College Dublin (Trinity) became the first third level institute in the Republic of Ireland to employ a Mental Health Case Coordinator to specifically work with students with complex mental health difficulties. As already mentioned - Trinity has noted the year-on-year increase in students registering with the Disability Service with a mental health diagnosis. In 2017/18 and in 2018/19 mental health was the single largest disability category registering for Disability supports in Trinity.  

An Evolving Role The Trinity Case Coordinator travelled to the UMHAN (University Mental Health Advisers Network) annual conference in London and to Edinburgh to meet University staff working in a similar role While their roles varied, they all had five key areas in common: Internal liaison External liaison Policy development - 'Fitness to Study' policy Policy implementation - “International Students in Crisis Policy” & the “Mental Health Policy’’ Crisis management

Internal Liaison Findings from ‘Mapping best Practice in Higher Education’ found some University’s Student Services seemed to operate within “silos”. The role of Case Coordinator in Trinity spans all of Trinity’s Student Services. It is important that students are receiving coordinated care to ensure they have the best chances of succeeding, to ensure roles are clearly defined and to know that we are not duplicating each others work.

External Liaison Community mental health services are often firefighting and trying to only see those most in need. We too are trying to prioritize our own referrals. Generally, students who are ordinarily resident in Dublin can avail of their catchment mental health services – the Case Coordinator can liaise with these services if needed. Accessing services for international students and students from counties other than Dublin is particularly difficult – the Case Coordinator’s job is to try and make this process more more effective.

External Liaison Many students availing of the DARE scheme will have had a history of regular interactions with CAMHS. Research by McNamara et al (2014) highlighted the difficulties in planning transitioning from CAMHS to adult services in the Republic of Ireland. Trinity are liaising with the Irish University Association to try and improve this transition from CAMHS into adult services so students are already engaging in adult services before commencing University.

Policy Development One of the main tasks when commencing the post of case coordinator was to work with the Dean of Students on a 'Fitness to Study' policy. The philosophy of the policy is to support students with fitness to study difficulties in as positive manner as possible. The role will also involve supporting all stakeholders in any fitness cases, reviewing & updating existing policies.

Policy implementation Policy implementation & the promotion of same is a key area. In Trinity this means implementing current policies such as the “International Students in Crisis Policy” & the “Mental Health Policy”. As well promoting and implementing new policies such as the Fitness to Study policy.

Crisis Management There are many times when students present to services in crisis. This can be in any area of college such as to academic staff, admin staff or Student Services. The role of the Case Coordinator is to assist in these crisis’s and to manage, coordinate and follow-up on these cases.

Other Elements to the Case Coordinator Role Each Case Coordinator will have other elements of their role which is particular to their university. Such as: Working with students on the Learning Educational Needs Summary (LENS) in Trinity Placement Learning Educational Needs Summary (PLENS) in Trinity Sitting on University Committees Working on a one-to-one basis with students

Conclusions If HEIs are to respond appropriately to the growing number of students with mental health difficulties, they should understand not only how mental health difficulties impact on students but also how they impact on HEI’s as a whole Simply increasing resources in response is not sufficient. Instead a change in approach is needed to seek out students who might otherwise not engage with supports; chasing up students who fall between supports and co-ordinating resources across and between services. Students with mental health difficulties are at increased risk of facing financial difficulties because financial student supports are not aligned. There are inconsistencies in how students are funded across ESF, HEA and SUSI.