University faces mental health ‘crisis’

Keeping ahead of the surging tide of students with mental health issues is an ongoing struggle, and one counselors and support services employees at The University of Western Ontario do not see quelling anytime soon.

Western has two locations on campus for students seeking support for mental health concerns. The Student Development Centre hosts the Psychological Services department, which offers confidential psychological services including individual and crisis counseling, group programs and workshops. Students requiring medication, a psychiatric assessment or long-term therapy are referred to the counseling and psychiatry services within Student Health Services.

There are about 75-100 names on the waiting list for Psychological Services at the Student Development Centre and another 30 in line at Student Health Services. While Western is doing everything it can to reduce its waitlists, the demand continues to grow.

“What we noticed in the last couple of years is a dramatic change – it was an exponential growth in the demand and type of concerns,” says Gail Hutchinson, director of Psychological Services at Western. “What university counseling centres are dealing with is very different than what they were initially set up to deal with.

“It’s really like you have a mental health crisis.”

Symptoms of mental illness are often first identified in the late-teens and early-adult years – the same age demographics enrolling in university. The Mood Disorders Society of Canada reports 18 per cent of adolescents (aged 15-24) have a mental illness or substance-abuse problems.

Even before they set foot on campus grounds, students are under pressure to perform, says Peggy Wakabayashi, director of residences. The high entering grade averages, not to mention many students with pre-existing mental health conditions, sets expectations high early on. The competitiveness continues to mount once they make it through the university gates with financial concerns, academic performance challenges, social issues and family pressures that often become the catalysts of mental health issues, she says.

International students sometimes come with their own unique settlement issues; face challenges due to cultural differences; and depending on the stability in their home country, some face more serious mental health concerns, such as post-traumatic stress disorder and depression, Hutchison adds. As Western prepares to increase its international student enrolments, these cases are expected to rise.

“We are just seeing students having a great deal of difficulty coping,” Hutchinson says. “We’ll hear students say ‘I’m not getting the grades I want’ and they honestly say, ‘I don’t want to live. I want to kill myself.’ We just hear that in a way we never heard that to that level before.”

The number of cases involving police has increased as well, notes Hutchinson. “Everybody noticed it. Everybody said, ‘What the heck happened?’ We just can’t keep up with the demand.”

This year, there were about 75-100 people on the waiting list for Psychological Services. Prior to the hiring of a new psychologist, the waiting list was around 200 students.

There has been about a 20 per cent rise in counseling appointments at Student Health Services in the last year and a half. While the staff has worked hard to reduce the waitlist number, there are still about 30 students in line to see a counselor. At the same time last year, the number was 200.

Director Shelagh Hodson notes anxiety and depression are the most common issues.

Psychiatrists, psychotherapists who are general practitioner physicians, family physicians, nurses and social workers are available to see students through Student Health Services.

“We are slowly breaking down the stigma. I think people are reaching out more. They are realizing there is help out there,” Hodson says.

Christine Mellon, residence counselor and organizational effectiveness consultant with Western’s Housing & Ancillary Services, saw her number of files more than double in the 2010-11 academic year compared to four years ago.

“Some of that is awareness of the availability of my services and this goes hand-in-hand with an increased need,” she says, noting the severity of the mental health concerns has also increased.

INVESTING IN MENTAL HEALTH

In the 2011-12 operating budget for support units, Western earmarked $300,000 in support of mental health-related initiatives. These funds are allocated toward implementing the recommendations resulting from former Ontario Provincial Police commissioner and lawyer Gwen Boniface’s review.

Boniface was brought in to conduct an independent review following an incident involving a 22-year old student in the Social Sciences Centre on Oct. 14, 2009. Among its eight recommendations, the review called for services and supports for individuals with mental health problems.

“We know that the incidence of mental illness is indeed increasing,” says Gitta Kulczycki, vice-president (resources and operations). “Part of it is greater awareness, which is a good thing. The more we can learn to be able to identify the clues that someone may be dealing with mental health issues, the earlier it can be identified, the earlier intervention we are able to provide and the higher probability therefore of the success of the individual in the long run.

“We want our students to be successful. The more we are able to talk openly about mental health, the more people do become aware of it and perhaps be more forthcoming that they themselves or someone that they know, needs help,” she adds.

As part of the operating budget allocation, $104,000 will be used to support training related to harassment and concerns about personal safety, which is provided through initiatives such as the Bill 168 Occupational Health and Safety training, and Mental Health First Aid Canada training.

As well, $196,000 will support staffing positions, including the Safe Campus co-ordinator for Western’s Campus Community Police Service and the recruitment of a case manager who will work with students who face interruptions in their academic studies because of mental health issues.

Western students, through the student services committee, have made additional investments in mental health initiatives for 2011-12 through student fees totaling $150,000.

Mental health remains a priority for the University Students’ Council (USC) and students are funding the recruitment of an additional social worker within Student Health Services, adding to the one recruited in 2010-11. Beginning in July, a full-time psychiatrist will be joining Student Health Services. Students are also adding funding to support a full-time outreach psychologist in the Student Development Centre.

IT TAKES A COMMUNITY

Psychological Services offers group sessions on emotion regulation, behaviour therapy and anxiety management as a proactive approach to helping students build up resources on how to manage life.

Anyone who visits Psychological Services will be seen for a thorough assessment and those who can be triaged out to other services either at Western or in the community will be placed if possible. However, as the demand continues, some may be placed on a waiting list.

“It does mean some students don’t get what they need,” Hutchinson explains. “They have real needs, but you know, you are taking the crises first.”

The goal is to have all the services available on campus so students don’t have to go out in the community to seek help, Hodson says. Not only would they have to pay for it, there is also a saturation of need in the community and not enough resources to service them, she explains.

Across the institution, Western has taken great strides to de-stigmatize mental illness and increase education and awareness about behaviour issues, how to respond, and resources available on campus.

In addition to offering a mental health first-aid course and adding more professionals with expertise in mental health to a number of service units, the university has worked to strengthen the network, collaboration and communication amongst the units dealing with student behavioural issues to facilitate interventional at the earliest opportunity.

The USC has appointed a Mental Health Issues Commissioner and developed the “Holding on to Hope” campaign to end stigma of mental illness, spearheaded by a former student living with mental health issues.

“An awareness and understanding and openness to discussing mental health and mental health issues have definitely increased and that is a good thing,” Mellon says.

As housing staff live and work alongside students, they can often be the first ones to notice a change in a student.

In residence, the staff (including student volunteers) is trained to look for symptoms of mental illness and awareness of available resources. They are also trained how to have an effective dialogue with students and help them get appropriate care, and a senior staff member is always on call 24-7.

“There is a very well-defined protocol that is in place to provide the level of support and referral,” says Wakabayashi.

“We pay attention to the rhythm of the academic year and feel the pressure of the academic workload,” she adds. “We offer a number of intentional programs that are intended to come at the right time in the academic year.”

BEYOND OUR WALLS

The responsibility for addressing mental health issues goes beyond the university walls.

“The university does as well as it can. It is an issue that needs to be addressed outside university,” Hutchinson says. “We have to watch that we don’t push young people too far and that marks are everything. There should be some real thought, early on, in a preventative way. We have to look at a full-rounded individual.”

But there are limitations to what universities can do. Western does not provide hospital-based care, which in a case of acute illness may become necessary. Just as hospitals are pressed for available space for mental health patients and sufficient mental health professionals, equally constrained are outpatient treatment health-care practitioners.

The demand in the community is just as high, revealing the problem “there are simply not enough health-care practitioners that specialize in mental health,” Kulczycki says.

Western is not alone in dealing with these issues. Queen’s University recently announced plans to expand its mental health counseling.

“Clearly Western and all universities are faced with limited financial resources at a time when demands for service are escalating,” Kulczycki notes. “It’s a constant challenge to balance these two perspectives.”

But Western remains committed to supporting students with mental health issues and improving available services on campus, as well as raising awareness across the community to de-stigmatize mental illness.

“It isn’t up to one person or one office; it is a community,” Mellon says.

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If you need help, please contact one of the following services:

Psychological Services, Student Development Centre, Western Student Services Building (4th floor), 519-661-3031, sdc.uwo.ca;

Student Health Services, University Community Centre, Room 11 (lower level), 519-661-3771, healthservices@uwo.ca, shs.uwo.ca/mentalhealth/index.html; or

Canadian Mental Health Association (London-Middlesex Branch), 648 Huron St., London, Ont., 519-434-9191, london.cmha.ca.