The transition to adulthood is a challenge for many young people. Throw in the stresses of attending university and living away from home for the first time, and it’s no wonder some find it difficult to cope.
Studies in Canada and the United States, such as those by Richard Kadison of Harvard University, have found that about 30 percent of the postsecondary student population have some kind of mental health or substance abuse issue. That compares with about 18 percent for the general population. What’s more, many universities are reporting that the demand for mental-health counselling is on the rise.
To explore these issues, University Affairs spoke with Pam Whiting, director of health and counselling services at Simon Fraser University, and Cindy Crossman, who coordinates clinical health services and health education at Mount Allison University.
UA: Is the demand for mental health services among students on the rise?
Cindy Crossman: I work collaboratively with the personal development counsellor and our physician services on campus and we have noticed that there is an increase in demand. The transition to university is stressful and there are a lot of things to balance. However, I think there is also more awareness about mental health in the media. There was an article recently in our student newspaper written by a student who had been diagnosed with depression and she was saying, “Here are the symptoms, it’s alright to seek help, and you shouldn’t feel ashamed.” Maybe it’s a little more socially acceptable to seek help now.
UA: Pam, what is your perspective? Is this rise due to increased awareness, or do young people just have more stressful lives now?
Pam Whiting: I think it’s a combination of both. The predominant age group we’re dealing with, 18 to 24 years old, certainly falls within the primary time for the onset of mental illness – things like eating disorders, depression, anxiety, psychosis. It’s not unusual to see those arise in these transition years. Then there’s the increase in the number of international students we’re admitting – all the stress around relocation, different cultural norms, that kind of thing. I think also that students these days are facing a lot of challenges financially. And, overall in the general population, we’re seeing a rise in mental health issues, so it’s not unusual we’d see the same rise in the student population.
UA: What impact does this have on your counselling resources? I’ve heard reports of counselling staff scrambling to keep up.
Pam Whiting: Absolutely the demand has gone up. I was recently doing some measurement of our utilization between 2005 and 2006, and we had a 30 percent increase in physician visits. The top three presenting issues were sexual health, then the large area of physical pain and injuries, followed by mental health. So I think one could fairly assume that a fair bit of that increase was from a mental-health perspective. As well, I was speaking recently with the person that overseas our Centre for Students with Disabilities, and they’ve certainly noticed a strong shift in demand from individuals with physical disabilities to individuals who are coming in with anxiety and depression. This may be something that’s arisen while they’ve been attending university, but we also have quite a number of students who have been previously diagnosed with anxiety or depression and need special accommodation.
UA: Cindy, what about your experience at Mount Allison?
Cindy Crossman: According to our clinical utilization statistics for the past three years, the third most common reason for students to see a physician at our campus clinic was for mental health issues. Mount Allison currently has one full-time personal development counsellor on staff and she reports that some days can be very hectic in the counselling area. There is often a wait list, which tends to get longer as the semester progresses. Referrals are made as appropriate, but if a client needs to be assessed by a psychiatrist, this may mean a 40-minute drive to Moncton.
UA: What are the top mental health issues students are diagnosed with?
Pam Whiting: Anxiety and depression are the most prevalent mental health issues that people face in the broader population, and it’s no different in the student population. Along with that, there are eating disorders, psychosis, bipolar illness.
UA: What about alcohol and drug abuse?
Cindy Crossman: Our student development counsellor is seeing an increasing number of students seeking help for alcohol abuse and the use of drugs like nicotine, cocaine and marijuana.
Pam Whiting: We also are seeing evidence of both at SFU.
UA: Do students complain of sexual assault or relationship issues?
Pam Whiting: Our counselling staff report that a lot of students have relationship issues. There have been some situations of sexual assault. There has been some evidence of the use of the date-rape drug. Certainly it’s of concern.
UA: Are there gender differences?
Cindy Crossman: We find that females usually present more than males with any kind of health concern. But when male students do come for mental health issues, the issues are much the same.
UA: One of you mentioned international students. Do they face particular challenges?
Pam Whiting: If you have an international student that’s diagnosed with a mental illness, the cultural beliefs around mental health issues can certainly be different. There is a huge amount of education that needs to be done with family members, who of course can be living a great distance from us. We work very closely with SFU International to try to support the staff there.
Cindy Crossman: It’s important to have your family involved with the recovery process if you’re diagnosed with a mental illness requiring hospital care, but it’s not always possible to have your family there if you’re an international student. There may also be challenges with the language barrier between the client and the health professional. However, we have a full-time international student adviser who works closely with this group of students to support them.
UA: We hear much about how today’s parents are very involved in their children’s lives, perhaps too involved. Does this manifest itself in any way in terms of students’ coping abilities?
Pam Whiting: There has been the perception that parents here are hovering over their kids too much, perhaps being overprotective. But there is a counterpoint to that, which is that many students want to have their parents more involved, and so what we’re trying to do is to support parents more through orientation. The other thing is educating parents about the sharing of information. Sometimes we’ve had parents contact us just expecting that one area of the organization will know what’s going on in the other and can communicate around that. We also find it important to educate parents about confidentiality. We can’t necessarily share all the details about what’s going on with their family member.
UA: What do you counsel people to do if they suspect a student has a mental health issue?
Pam Whiting: We encourage them to refer people to our services so that we can at least triage the situation and provide counselling or health services or at the very least get them connected in the community with an appropriate service.
Cindy Crossman: We also encourage clients to seek an assessment from counselling or health services.
UA: Any final thoughts?
Cindy Crossman: We hope that students come to our institutions to maximize their university experience, to develop the whole person, and derive some kind of meaning and enjoyment through that experience. But it can be complex at times and there are lots of things to juggle. Are we meeting their health needs? I think ongoing needs assessments are crucial so that we can provide the appropriate health services that our clients require to attain their goals.
A student health snapshot
Many Canadian universities rely on the U.S.-based National College Health Assessment, administered by the American College Health Association, to collect data on students’ health habits and behaviours. The surveys are conducted twice a year, in the spring and fall, and institutions can take part on a one-time basis or participate in multiple surveys to track trends over time.
Here are some of the highlights of the fall 2006 survey of a reference group of 24,000 students from both the U.S. and Canada:
- 35 percent responded that at least one time in the past 12 months they felt so depressed that they found it hard to function; 24 percent said this happened three or more times in the past year.
- 10 percent reported “seriously considering suicide” in the past 12 months.
- Eight percent of males and 15 percent of females reported being in an emotionally abusive relationship in the past 12 months.
- Among the impediments to academic performance, the most commonly cited was stress, by 34 percent. Others included sleep difficulties, 25 percent; relationship difficulties, 16 percent; and depression and anxiety disorder, 15 percent.
- Nearly half of males and 32 percent of females reported drinking at least five alcoholic drinks in a sitting during the previous two weeks; 34 percent of respondents reported “doing something they later regretted” as a result of their alcohol use.