Campus mental health has been an ongoing issue for most of my nearly two decades in higher education in Canada. In recent years, various groups, echoed by the media, have framed this issue as a crisis. And, indeed, I can confirm from my vantage point that mental health and wellness is a top concern on our campus, as the needs of students continue to increase and the demand for services outstrips resources.
That being said, there are a few facts that are often not discussed as part of the debate. It is important to highlight these facts so that we can properly assess the situation and place it within the broader context of mental health supports in our provinces and the nation as a whole.
Students on many campuses (although not all, I might add) often have more effective access to mental health supports than those who are not in university, where waitlists for care can often be longer. While the demand for care on campus continues to climb, so too does the demand for care for those not in postsecondary education. Many institutions have moved to walk-in models, increased the number of counsellors on staff to keep up with demand and added additional mental health resources across campus. Meanwhile, in Ontario as a whole, the average wait for psychiatric care was 45 days, according to research by Rachel Loebach and Sasha Ayoubzadeh published in the University of Western Ontario Medical Journal in 2017.
Young people in general, and not just those in college or university, are at higher risk of suicide. Indeed, the issue of suicide is not just confined to campus. Data from the Canadian Mental Health Association shows that suicide is the second leading cause of death for young people in Canada. However, young people have very uneven access to care, especially those in rural or remote areas. According to Children’s Mental Health Ontario, over 28,000 Ontario children and youth are waiting for mental health services, and for some the wait for services is up to two and a half years.
Shifting the burden
One of the ways universities along with their partners in student government have coped is to significantly invest in mental health services on campus. In effect, this helps to alleviate to some extent the burden on our already overburdened hospitals and community-based services. Think what this crisis might have looked like if universities or colleges had neglected to invest in services to support students on campus? Regardless, it was the right thing to do, especially if universities are admitting students from across the country or increasingly from outside Canada. Simply put, mental health services are critical on campus. However, I worry as a citizen about those who are not in school and are outside a system that cannot provide them or their families with accessible mental health support.
The media have portrayed this as a “crisis on campus,” but often without digging deeper into the facts about the investments that have been. It is incumbent on the media to look at this issue in the broader systems context. I think about the various efforts that many institutions across Canada have made, in good faith, to develop strong mental-health strategies. In fact, the issue is not one of crisis related to mental health on campus, but should be framed more broadly as a lack of mental health treatment and support in our society in general.
A broader societal issue
So where do we go from here? What are some of the priority items that need to examined? First, we need to acknowledge the reality that mental health and access to care is a broader societal issue. On a basic level this is about funding, but it is also a question of balancing priorities in the country. The enormous impact that poor mental health outcomes have on our workplaces, in our criminal justice system and, yes, in our schools is apparent, so we must collectively address the issue and not work in silos. This is a public health issue, not just a postsecondary education issue.
Universities and colleges in partnership with students should continue to invest in services and resources. As more data becomes available, we need to pursue evidenced-based strategies that have the greatest impact. Talk to students about barriers that prevent them from seeking care, and continually examine policies and procedures that can have an impact on the mental health and wellness of the students we serve. A healthy and vibrant campus includes strong mental health supports.
Finally, we need to talk to the media and those who are framing this issue as a crisis uniquely affecting colleges and universities. Yes, we need to do better, but we also need to advocate for adequate resources for our mental health partners in the community. The crisis will not be solved if we cannot have a balanced conversation, acknowledge the facts and work together to achieve better outcomes for all.
Joe Henry is the dean of students at King’s University College at Western University.
A really strong policy analysis. You are right. It is a crisis in healthcare as services are not meeting the needs of students where and when they need them. Investment in hiring front line mental health professionals in communities at or near colleges, universities….and schools has an incredibly strong ROI for the province. By investing in community care, students will have access to full inter-professional teams and therefore if there needs become more intensive, severe, crisis and acute then there can be a seamless integration of services. In addition, the dream of shared EMR’s can mean that youth don’t have to share their story over and over.
This ignores the fact that a good number of people in mental health crisis on campus are faculty. There has been no study in Canada that I’m aware of, but anecdotal evidence tells me it is hitting crisis levels as faculty are increasingly pressured to perform to unworkable standards. In the UK, the only country I’m familiar with who have conducted a study, found mental health among faculty to be at “epidemic levels”, where “Freedom of information requests revealed that at one university, staff referrals to counselling services went up more than 300% over a six-year period up to 2015 while, at another, referrals to occupational health soared by more than 400%”.
I would not be surprised if the mental health crisis experienced by faculty is subsequently impacting student mental health.
Let’s fix the entire system, not just one part, eh?
Indeed mental health issues affect emerging adults whether or not they are on campuses. However, there are some distinctions about the experience of young adults on campuses, relative to those in the community, which must be acknowledged, and which underscore media and student representations of an emerging crisis on campus.
For one, campuses expose students to various stresses and risks that are higher than for those on campus. For instance, a young female as a higher risk of sexual assault while on campus than a young female who is in the workforce. Very high rates of sexual violence on Canadian campuses have been confirmed in a recent 2018 study of 160,000 students, and with sexual assault being the leading cause of PTSD in women, the long term consequences of an assault on campuses can not be discounted.
Additionally, university environments and processes themselves can contribute to mental distress and poor functioning as has been outlined in Anderson;s (2015) guide for higher education professionals; intense competition, abusive or exploitative supervisor-research assistant dynamics, transient social networks, inflexible deadlines and processes etc. So many lawsuits have been brought by Canadian students relating to severe mental health problems stemming from their time on campus–and to inaction on the part of the university–that a legal non profit group has been formed just to track this legal trend against universities.
Perhaps most importantly, is that young adults pay tuition while on campus; Universities market to them directly and sell them on the positive features of investing their tuition dollars there…unlike in one’s home community. Thus, there is an implied contract for a certain service as well as respect for their rights, whether those be safety from abuse, harassment, violence, or any injustice based on their human rights..as has been recognized in some courts. International students in particular have paid exorbitant fees to universities only to face incredible pressures and cultural adjustment issues on campus, leading to a true mental health crisis on campus.
The onus for student wellbeing can not fall solely on the shoulders of universities–as such a large multitude of factors impact this current generation which are beyond the universities’ control…however, for those factors within their control, such as abusive or low functioning staff or faculty, overly demanding schedules and policies, unsafe campus environments..universities are responsible to address those areas just as any other business or organization would for those who choose–with their dollars–to sign up for their service.
It is true that young adulthood is marked by many life transitions and challenges which contributue to low mental health in many, but to frame the issue as such without calling attention to the unique stressors of campus life, belies the unique responsible universities have to protect students and to ever improve their policies and campus environments. This article somehow frames the issue as a larger mental health problem, where universities as doing better than the norm. In reality, university life poses its own mental health risks to youth who choose to attend, and universities must work hard to prevent and mitigate those risks. As a product they sell, they are accountable for those side effects…and yes, certainly, broader mental health supports and initiatives are also needed in the wider community.
As a university counsellor myself, I have found myself questioning whether I would want my family members to attend university, given the risks I see on a regular basis.