Supporting students in crisis: developing a common strategy across a multi-campus institution

The University of the Highlands and Islands explains how it has developed a single policy framework to support students who are at risk of suicide across its wide geographical area which includes multiple institutions, with many in rural settings.

The University of the Highlands and Islands (UHI) has created a Suicide Intervention Policy to provide a single framework for supporting students and staff in crisis across its many sites.

The policy is part of the overall university mental health strategy and aims to ensure that students who are experiencing thoughts of suicide, or those at risk of harm are provided with support wherever they are studying.

It has been devised to enable the university to create suicide safer communities in line with government and sector guidance.   

This case study explores how UHI developed and implemented the policy.

UHI is a partnership of 12 separate institutions, as well as an executive office. This includes nine colleges, plus three specialist institutions. 

The geographical area covered by the university is roughly equivalent to the size of Belgium and represents approximately one sixth of the land mass of the UK. There are a number of challenges related to this:

• Although it contains two cities, Inverness and Perth, most of the geography is both rural and isolated – including the Outer Hebrides to the West and Shetland to the North.
• The area covers seven regional health boards, all differently resourced, from larger areas such as Highland to smaller ones such as Argyll and Bute, or Shetland.
• There is a range and disparity of third sector and external providers throughout the region. Some island locations do not have direct access to services, and mainland rural locations may be up to 100 miles away from ‘local’ provision.
• The student profile is extremely wide, from school pupils through to postgraduate researchers. In 2020 UHI had over 10,000 higher education students and 25,000 further education students across more than 70 learning centres and campuses.
• The university is rooted in the local communities, and the impact of any death by suicide is wide and deep.

There are additional challenges with:

• the distance and time from statutory services in some areas (a ferry ride or a drive on single track roads of 50 miles or more)
• access to high-risk locations
• a community culture where people are known, meaning there can be a lack of privacy regarding one’s personal situation – neighbours and friends work in the local services
• the greater number of students studying totally online making it harder to pick up behavioural clues.

The university therefore needed to develop a mental health strategy and a suicide intervention and risk management policy that was appropriate and accessible for the whole institution, accommodating the needs of its many campuses, students and staff.

UHI wanted to ensure that despite the differences in size and resource between academic partners, processes and support were recognisably the same for the students, wherever they are based. Students do move from one partner to another for different courses and levels, and they need to know they have a baseline of suicide intervention and support which is comparable at any given location.

A whole institution approach was therefore required from the outset.

In 2018 the university conducted a mental health service review, led by the UHI senior leadership team. A key outcome was the creation of a Mental Health and Counselling Manager post.

The Mental Health and Counselling Manager led the work to create a university wide mental health strategy, setting up a steering group of mental health practitioners and student services managers from each academic partner, and representation from the Students’ Association.

The mental health strategy identified six key aims, one of which was the creation of a Suicide Intervention and Risk Management Policy. The aims were:

1. To develop a mental health framework.
2. To create an inclusive culture promoting mental health and wellbeing.
3. To engage stakeholders and improve links with external agencies.
4. To purchase a data management system to allow for cross partnership data collection.
5. To provide opportunities for staff development.
6. To develop suicide prevention activities.

Developing the policy

UHI has a single policy framework to ensure equivalent provision to all students wherever they are based.

The Suicide Intervention Policy was designed to allow for local contextualisation relating to management structures and job titles, and the differing sizes and resources base of academic partners. It also takes into account local partnerships with statutory and third sector organisations and reflects the challenges presented by the geography of the available support.

The policy highlights certain key principles that each academic partner needs to consider:

1. Minimise risk wherever possible, through prevention work such as awareness raising, signposting and offering early interventions when students are in distress. This can include support through a PLSP (personalised learning support plan), ongoing one-to-one support, referral to external agencies or attendance at workshops/group sessions.
2. Aim to make suicide preventable, wherever possible.
3. Ensure wellbeing and mental health support is available and known to the student population. Support is outlined at induction to all students, and repeated at key points throughout the year using student representatives, personal tutors and online platforms.
4. Support those bereaved or affected by suicide – this is long term and can be far-reaching.
5. Create a culture of openness and compassion and reducing stigma – this can be quite a challenge in rural areas but is vital nonetheless so that students feel able to ask for support.
6. Develop the capacity in everyone for self-care.
7. Create or strengthen local links - many of our communities have a local charity working in the area of suicide prevention, often in response to the death by suicide of a local young person e.g. mikeysline in Inverness or Ewen’s Room in Lochaber. There may be local groups for those bereaved by suicide.

Implementing the policy

Providing online support

At UHI many students only study online and many are based in smaller, sometimes rural communities. The suicide intervention policy therefore emphasises the importance of providing confidential online support.

Some examples of the online support that has been put in place include:

• Partnerships with two external support providers – Togetherall and Student Assistance Programme - Spectrum.Life to provide online support 24/7, 365 days of the year to all students. This offers different support options for students including monitored peer support, a telephone line, wellbeing self-help information and wider mental health tools.
• Counselling is provided online and is tailored to each institution. A large proportion of counsellors have completed additional Online Counselling Diploma qualifications.
• The university promotes a student app which allows students to create a safety plan and also provides signposting to support options.

Staff training and support

UHI also recognised the need for clear guidance to support all staff, particularly those less experienced in dealing with students in crisis, to ensure everyone feels comfortable dealing with a student who may be experiencing suicidal thoughts.

A guidance document was therefore developed to accompany the policy. This document allows for local contextualisation, and it covers a multitude of potential scenarios aiming to help and support staff across all the institutions.

Mental health practitioners have undertaken bespoke training on assessing risk and safety planning, and are involved in regular continuing professional development. All staff across the university have had some level of training and awareness building through various inhouse and online training platforms, together with some staff being ASIST and SafeTALK trained. Effective practice is shared through the university’s mental health practitioner group.

The Mental Health and Counselling Manager has undertaken Applied Suicide Intervention Skills Training (ASIST training) and provides that training to other staff across the university. This role offers support and supervision across the partnership to any member of staff.

Every member of staff has access to a trained and qualified person to talk to about suicide and risk.

The policy ensures that every partner institution is informed and able to provide the same level of support to students. The policy gives a structure to the work around supporting students in crisis, and provides a framework in which all staff can feel enabled to support students.

Feedback from Highlands and Islands Students' Association (HISA) President Flo Jansen:

‘HISA has seen major improvement on the mental health provision and suicide intervention support over the last years, in particular that all services across the Highlands and Islands, no matter how remote the area, are being made available and accessible to all students across all colleges at UHI.’ 

Feedback from Polly Crooks, Academic Registry Officer at The Scottish Association for Marine Science, a partner of UHI:

‘As Lead Student Support at SAMS UHI I really appreciated being involved in the development of our suicide intervention policy and guidance. As a small academic partner within the UHI network it was great to be able to offer my views and experiences when supporting students in crisis.’ 

Review discussions with practitioner network groups have indicated that the work has resulted in increased awareness around suicide intervention among all staff across the institutions.

UHI’s partnership network continue to disseminate the work across each campus, ensuring local ownership and contextualisation.