Clinical placements enable students to develop knowledge, skills and attitudes for future practice as well as providing opportunities for students to learn how to build professional relationships, manage stress, and develop self-confidence and self-awareness. Students respond to these opportunities in different ways; some thrive but others experience difficulties (Allied Health Professions’ Office of Queensland, 2017).
In the video below, Michael and Jodie, Clinical Education Liaison Mangers at the University of Queensland, discuss strategies supervisors can use when a student reports or is experiencing anxiety while on placement:
Students, universities, and service settings all have a role to play in supporting student mental health and wellbeing. Placements can be challenging for students. Students may be away from their usual environment and supports and may be confronted by strong emotional reactions when exposed to sensitive situations or workplace organisational demands. Student supervisors must be cognisant of the prevalence of mental ill health and the likelihood that they may supervise students with mental health conditions.
Inadequate understanding of the impact of psychological distress, burn-out, conflict and physical and mental health by both the student and/or their supervisor can be a barrier to learning, and the health care provided to a client.
To support students to navigate the placement experience and support maintenance of self-care, it is important the student supervisor:
- Initiates early conversations about mental health and wellbeing to normalise and demonstrate the importance of establishing good self-care strategies. This might include a daily routine discussion about how the student is managing their health and wellbeing and the supports that they may need. Alternatively, supervisors can create a ‘safe space’ for sharing of concerns.
- Supports students to be open, honest, and professional about emotional reactions experienced during the placement, whether they are in response to a client interaction or supervision feedback. This is achieved by normalising and actively acknowledging the reaction and providing additional support / strategies as required.
- Supports students to identify their own strategies and supports to maintain their mental health and wellbeing.
- Recognises the signs of poor mental health and the behaviours that may indicate health and wellbeing concerns.
- Identifies processes to maintain the safety of the student and the client and provide immediate support for the student. Consider strategies that can be employed before, during and after a triggering event.
- Prior to the commencement of student placement, identifies support services offered by both the university and the service, so that they are ‘on hand’ should the student wish to seek further support.
- Recognises their own mental health and wellbeing.
Resources to support student mental health and wellbeing
- The Allied health students health and wellbeing - guide for Hospital and Health Services (Queensland Health) guides the development of safe and supportive learning environments, and provides strategies and resources for supervisors, to promote and support student health and wellbeing.
- Heads Up, an initiative of Beyond Blue, provides resources that support better mental health in the workforce.
- The Student Health and Wellbeing Resources handout (Queensland Health) can be provided by student supervisors to students to assist them in maintaining attention to their own health and wellbeing.
- The Emotional Wellbeing – resources for the student supervisor section of this website has additional resources and tools.
- When the Cowpat hits the Windmill: A guide to staying mentally fit
- The Adult Learning and Teaching Council commissioned a guide to supervision in social work field education outlining comprehensive tools for student placements. Page 61-65 provides an evidence-based explanation and strategies for building personal and student resilience. This section could be provided to the student prior to placement also so they can consider options for building resilience and self-awareness in readiness for their placement.
Working with student who have a mental health condition
Student supervisors should ensure they are able to recognise the common physical and behavioural signs associated with anxiety and depression and identify organisations, resources and processes to support student’s health and wellbeing. Useful resources include:
It is also important that student supervisors consider how the presence of these physical and behavioural signs may translate and impact the student’s performance during the placement. This might include:
- Changes in performance – needing excessive time, avoidance, over preparation
- Arriving very early or staying very late
- Difficulty concentrating, making decisions or remembering things
- Withdrawing from or conflict/irritability with peers
- Mistakes or accidents
- Fatigue, lack of energy, restlessness
- Frequent statements about performance, seeking excessive reassurance
- Unexplained illnesses
- Absenteeism
- Appearing disengaged or disinterested
- Fear of failing
The Mental Health First Aid website contains guidelines on providing mental health first aid in the workplace and tertiary education settings, that may provide guidance for student supervisors. This website has a number of culturally and linguistically diverse resources.
Prior to placement, it is important that the student supervisor confirm the university processes for planning and negotiating reasonable adjustments to a placement for a student with a disclosed mental health condition. It is also important to establish the service’s capacity to accommodate university requests for reasonable adjustment to placement structure (for example, how to manage a part time placement with concurrent student placements and workload demands). The Australian Human Rights Commission provides information relating to reasonable adjustment to support people to complete their duties effectively.
It is important that if you consider that a student’s mental health is at risk or the client’s care is compromised as a result of the student’s emotional wellbeing, contact the university placement coordinators as early as possible to discuss a co-ordinated approach to manage the student placement. Due to privacy legislation, universities cannot generally disclose student issues. However, they may be aware of a particular student’s specific needs and be able to work with student supervisors to support the student.
There may also be reporting requirements if the student's capacity to practice is in question. Please refer to the webpage on Mandatory Reporting for more information.
References:
Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.
- Centre for Addiction and Mental Health (2008). Clinical Supervision Handbook: A guide for clinical supervisors for addiction and Mental Health. The Office of Nursing Practice and Professional Services and the Faculty of Social Work (University of Toronto), Canada.
- Litvack, A., Mishna, F., & Bogo, M. (2010). Emotional reactions of students in field education: An exploratory study. Journal of Social Work Education, 46(2), 227-243.
- Litvack, A., Mishna, F., & Bogo, M. (2012). Emotional reactions of students in field education: An exploratory study. Retrieved from University of Toronto Research Institute for Evidence-Based Social Work: http://www.socialwork.utoronto.ca/Assets/Social+Work+Digital+Assets/Research/Emotional_field.pdf
- Maidment, J. (2013). Getting Ready for Placement. In K. Stagnitti, A. Schoo & D. Welch (Eds.), Clinical and Fieldwork Placement in the Health Professions (2nd ed.). South Melbourne: Oxford University Press.
- National Association of Social Workers Association of Social Work Boards. (2013). Best Practice Standards in Social Work Supervision. Washington DC.
- Pearson, Q. (2004). Getting the most out of clinical supervision: strategies for mental health counselling students. Journal of Mental Health Counseling, 26(4), 361-373.
- Queensland Health (2017) Allied Health Students Health and Wellbeing – a guide for Hospital and Health Services. Accessed February 2021 from: Allied Health clinical placements | Queensland Health
- Australian Health Practitioners Regulation Agency (2013). Mandatory Reporting. Retrieved from https://www.ahpra.gov.au/Notifications/Raise-a-concern/Mandatory-notifications.aspx
- Holley, S and Pittard J (June 2019) Supporting Student Health and Wellbeing on Placement: Top tips for clinical educators (presentation), Queensland Health
- Orygen, The National Centre of Excellence in Youth Mental Health. Under the radar. The mental health of Australian university students. Melbourne: Orygen, The National Centre of Excellence in Youth Mental Health, 2017.
