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Impact of students with emotional dysregulation on mental health services

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As student nurses, it’s easy to be paralysed by the belief that as we’re still training; it’s too soon for us to make a difference, says student nurse Peta Temple. 

But inexperience actually liberates us from the weight of reasons an idea may not work - we have a freedom to explore and develop that is perhaps not afforded trained staff.

I am nearly at the end of a placement with home treatment (HTT) a regional crisis team with a university in its locale. We act as a central point between hospital admission, community and specialist services. The number of students on caseload who struggle with emotional regulation is disproportionate to the general population. And staff from all departments expressed concern about how to manage the influx.

My optimism led me to believe that if we found a way to develop students’ resilience, we would also lessen their impact on local services. I found evidence that suggested outcomes were significantly improved when emotional coping skills (ECS) groups were offered by universities. I set out to investigate just how big the problem was and found:

● In a two month period, 23% of iCMHT referrals were university students fitting criteria for a diagnosis of EUPD or eating disorder.

● I conducted interviews with a group of six similar HTT patients (8% of our caseload) who said they cumulatively made: 28 GP appointments, 18 calls to 999 and attended A&E 26 times over a three month period.

● I collected clinical evidence: this group were the subject of 18 psychiatric liaison reports, eight episodes of HTT care, six iCMHT assessments and two inpatient stays during the timeframe.

● The same six disclosed taking 44 overdoses over the period, which they neither reported nor sought medical intervention for.

Help-seeking has an obvious economic impact. But when people don’t ask for help, even without intent, their high-risk coping-mechanisms can become deadly. In the last academic year at Bristol University, five students took their own lives, with two subsequent student deaths expected to be ruled as such. Some surveys claim that one in five students are self-harming.

With a relatively small student number placing large demands on services, staff struggled to remain optimistic. Yet when I discussed my interest in launching ECS groups as a specific intervention for students, they were unanimously positive, saying: “about time,” “thank god!” and “brilliant”.

I was amazed. As a student, I had suggested something that was immediately taken seriously by such revered groups as the personality disorder team, Trust psychiatrists and the research and development clinical lead.

They asked if I could put a business case together to support delivery of ECS, which I have now done. I don’t know that my idea will come to fruition, but people in the highest echelons of the service listened and encouraged me.

They treated me like a nurse and, for the first time, I actually felt like one. So yes, I might be ‘just’ a student. But I can already make a difference to procedure, to policy and - most importantly - to my patients.



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Readers' comments (1)

  • Congratulations
    Just think of how many lives you have saved.

    PDave Angel

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