Mental health services growing slowly at universities
Self-stigma of depression biggest problem, psychologist says
When Gwen Danson began displaying symptoms of bipolar disorder during her first year of university in 2006, being away from home was difficult enough. The fact that she didn't know who to turn to made matters worse.
"They kept on shuttling me around from doctor to doctor to doctor. I never saw the same doctor twice. It was not helpful to be going to see different people all the time," said Danson, who attended Halifax's University of King's College, which shares services with Dalhousie University.
She said that while their intentions were good, they were unable to identify the problem. "They wanted to get me in to see someone as quickly as possible ... but I was in a lot of pain," she said. "They sent me to counselling services and the person that I saw wasn't the right fit for me."
Already struggling with physical problems and a history with depression, she turned to alcohol. She said living in a brand-new environment meant she didn't have friends who recognized that her behaviour was out of character.
"I used to have a great support system of my mom and my dad," said Danson. "Then you move out, you move into residence, you have meals if you want to, you don't have your mom behind your shoulder telling you to get up and go to class, all you have to rely on is peer pressure and your own drive, and if you lose your drive, all the way down to losing your will to live, there's not a whole lot you can do, academics-wise."
As mental health issues have received more media attention, universities have honed their approach to on-campus services, investing already limited dollars and collaborating with other institutions. Still, progress remains slow.
In a 2009 study by the American College Health Association, one third of university students said they'd felt so depressed in the last 12 months that they found it hard to function; the same study found that seven per cent seriously considered suicide.
Dr. Gordon Flett, a professor at York University's department of Psychology and a Canada Research Chair in Personality and Health, says that while there hasn't been a definitive study yet done in Canada, he is confident that the numbers would be the same, if not higher, if the study was done today.
"We know the levels of maladjustment for students are pretty astronomically high," he said. "It's a pretty big task, and if you acknowledge the complexities and the differences, including cultural, among students, we've got a really complex problem and we'll need complex solutions."
Flett said that, in recent years, research has found solid evidence as to the kinds of programs that work — cognitive behavioural therapy high among them. Schools have expanded counselling services and added peer support groups, too.
Still, he sees schools working primarily on awareness campaigns, to provide students and staff the tools to identify problems before they manifest into something darker.
"What we're seeing now is that universities are trying to be much more preventative to the extent they can — heightening awareness about stigma, heightening awareness of when there's a problem," he said. "The biggest problem besides the actual level of mental health concern out there, is not just stigma but of self-stigma, internalizing beliefs of what it means to be depressed, and that stops them from getting the help that they need."
Still, as budgets shrink and bottom lines tighten, growth in a non-profitable aspect of the university community is hard to provide.
For larger schools like Queen's University, donors have been "very responsive" to helping expand mental health services, says Ann Tierney, vice-provost and dean of student affairs for the school. Over the course of one year, the Kingston, Ont., university endured a spate of six student deaths, including two by suicide, a tragic wave that brought the issue of student mental health to the national level.
In response, a 2011 commission produced a report with 116 recommendations; two years later, the university says approximately half the recommendations have been implemented or are in progress. While the number of students accessing counselling services remains steady at about 10 per cent, Tierney says the biggest change has been faculty and staff recognizing problems and reaching out to resident dons or health advisors.
She added that over the course of those years, she's seen "huge collaboration," from schools around the country, from UBC to McMaster, and with the Association of Universities and Colleges of Canada.
Demand for counselling
"Funding is always an issue ... We all share these kinds of concerns, and we all share our best practices and look to each other. This is a Canadian-wide university and college focus, and our student groups have been really strong advocates, as well," said Tierney.
But for smaller schools, funding and assistance can be hard to come by, says Ron Byrne, the vice-president of international and student affairs for Sackville, N.B.'s Mount Allison University — which has an enrolment of just over 2,000. He says demand for counselling has only increased in recent years.
"But I think in fairness, the nation across the country, people are responding far more assertively and far more publicly on issues of mental health," said Byrne. "So as part of that zeitgeist, so to speak, of people discussing mental health, we've really found ways — within reason — to be proactive."
Mount Allison is proof that necessity is the mother of invention. Byrne says they've hired a mental health outreach co-ordinator; they've developed a program of student volunteers who offer peer support; and recently, they started an online moderated forum where students can share concerns anonymously.
"Scale is always a factor, but I think what we've been able to do is be very, very creative and innovative in terms of using the resources that we have, and tying in with provincial government departments to find pathways that allow us to connect into larger networks," Byrne said. "It's little things like that that we're able to leverage."
He admits the growth has been slow and steady, but Danson's experience shows that at least awareness is growing.
Now 26, Danson is engaged and employed, two things she thought could never happen with her bipolarity diagnosis. "I was pretty sure it was a death sentence, that it meant I wouldn't have any of the things I wanted in life ... Now, things have changed a lot."
Danson says King's — a tiny school itself — has changed over that time too, reaching out to students more with new peer support groups in place. But change, she says, needs to continue to come.
"If you look at it expense-wise, it's not making [universities] any money to offer programs, when they're cutting programs and they're cutting teaching staff. But we can't afford not to.
"How many lives does it cost before people start waking up?"