How big a problem is mental ill heath on UK campuses?

In the general population, 25% of people are likely to have a mental health problem at some time in their life. But figures from the organisation which represents university counselling services suggest that incidence is higher amongst the student population.

The Association for University and College Counselling (AUCC) (www.aucc.uk.com), which represents 530 counsellors and another 120 higher education institutions, claims 3%-10% of the student population will have contact with its counselling service in a single year.

Additionally, statistics from the British Association for Counselling and Psychotherapy (www.bacp.co.uk) last year revealed that young people were most likely than any other age group to suffer from depression. First episodes of other serious mental health illnesses such as schizophrenia or manic depression often occur in young adulthood.

Do universities have a legal obligation to act if worried about a student?

Yes. Every university has a statutory duty of care, although some institutions might challenge how far that duty applies. Universities could be open to accusations of legal negligence if they did nothing if concerned about the mental health of a student.

Since October 2005 every university has a statutory duty under the Disability Discrimination Act to meet the special educational needs of their students, which would include students with mental ill health.

In practice, according to the AUCC, this has meant that universities have a duty to address the mental health needs of their students and they should have in place a mental health promotion policy. But even without a legal obligation universities have a moral responsibility to do something - pretending nothing is wrong could prolong any problems the student may have or make their illness worse.

How would someone know if a student is mentally ill?

Lancaster University has produced a student mental health manual (www.studentmentalhealth.org.uk), which was funded by the Higher Education Funding Council for England (Hefce) and has been widely adopted by higher education institutions as an example of best practice.

The guide lists eight signs to look out for which might suggest a student is mentally unwell, such as:

• Look for any noticeable changes in the student's appearance such as weight loss or gain, or decline in personal hygiene.
• Listen to how the student speaks - is their voice flat or agitated? Are they speaking too loudly or too quietly?
• Has the student's mood changed or have their housemates noticed a change?
• Look out for any changes in their behaviour such as not attending lectures or doing too much work or being withdrawn.

What should university staff do?

The general advice to lecturers given by the Lancaster University manual suggests approaching the student to talk to them. The manual says it is important to be open and honest with them about your concerns. Be prepared to listen and make time for them, it says. If the student does not acknowledge they have a problem give them an open invitation if they feel the need to talk in future. If the student is prepared to talk to you remember your limits and what you are professionally qualified to offer.

The AUCC's advice is for any lecturer to approach the university's counselling service and discuss their concerns. Most universities have a counselling service which is staffed by specialist professionals trained to cope with students with mental health problems. Contact details of university counselling services can be found at www.student.counselling.co.uk.

The counselling service will have professional links with statutory mental health services outside the campus including a psychiatric crisis intervention team.

The AUCC recommends that ideally that every university should have one full-time counsellor for every 3,000 students.

What if a university doesn't have its own counselling service?

A GP from a campus-based university practice says it would be appropriate to contact the student's GP if you know who they are, to discuss your concerns and suggest they should step in and help. If you do not know who the student's GP is but you are worried that the student may be psychotic then contact any GP and explain the problem. The GP can step in and treat the student as a temporary patient if necessary and, if appropriate, call in the emergency mental health team.

Another option, if you believe the student is potentially a danger to themselves or others, is to contact the police.