Some days I feel overwhelmed

By Kimberly Ellis-Hale , Sociology.

Some days I feel overwhelmed. Between students asking for support and understanding, Accessible Learning’s term-long student accommodation updates, Dean of Student’s requests for additional student-related consideration, and URGENT-student-related-notices, I very rarely feel that I have a handle on this side of teaching.

Maybe I am feeling this way because of my course load or student numbers or the tragedies at the Universities of Guelph and Waterloo, or the increase in the percentage of students, who require, ask or need more than just a review of their latest assessment. Whatever the reason, I am not alone in feeling the increased pressure that mounting student mental health concerns has created across the post-secondary sector.

Results of the 2016 National College Health Assessment (NCHA II) Ontario Canada Reference Group’s survey of more than 25,000 Ontario post-secondary students indicate that rates of anxiety, depression, suicidal thoughts and suicide attempts have increased since 2013.

According to Meg Houghton, president of the Ontario University and College Health Association (OUCHA), campus mental health care providers are not only seeing increased severity and complexity of student mental health care needs, but also a broadening of the demands for their services which now often include supporting “significant diagnoses, trauma counselling and crises (Ontario campus counsellors say they’re drowning in mental health needs http://www.cbc.ca/news/canada/ottawa/mental-health-ontario-campus-crisis-1.3771682).”

With words like ‘increasing’, ‘crisis’ and ‘overwhelming’ liberally interspersed in conversations and news reports on the situation faced by Ontario colleges and universities, it is not surprising that the mental health care needs of students has outstripped the post-secondary sector’s capacity to meet the increasing demand. Perhaps that’s why the Ministry of Advanced Education and Skills Development (MAESD) has recently announced that it will provide additional funding starting in 2017-18 to assist with the costs of hiring added mental health service providers at all publicly funded colleges and universities.

Laurier is not immune. Between 2014/15 and 2016/17, the Waterloo campus’ Wellness Centre experienced an almost 20 percent increase in student mental health care visits and, according to the centre’s Director, Karen Ostrander, the numbers continue to climb. When combined with the peak demand periods of end of October to mid- November and end of February until the end of March, students often have to wait several weeks just for an initial appointment. That is not to say that the Centre won’t see students in crisis, but rather that their same-day appointment slots are limited.

While the Wellness Centre’s approach to student health is multidisciplinary — providing access to family physicians, one consulting psychiatrist, registered nurses, Master’s level trained counsellors, a dedicated mental health nurse, a case management and outreach counsellor and a gendered violence advocate (through the Diversity and Equity Office) — there are many things it is not.

The Laurier Wellness Centre is not an emergency service. It is not equipped to provide long term counselling support. It does not provide specialized mental health services. More egregiously, however, is that it is not available to support students outside of ‘regular working hours’. If only mental health issues were compliant!

Outside of ‘regular working hours’, the Blue Folder (see article by Leanne Holland Brown this issue) recommends that faculty contact Special Constable Services (SCS) if they are concerned about a student’s safety or the safety of others. According to Karen Sider, SCS’ Administrative Assistant, members receive initial specialized training on the Ontario Mental Health Act (1990) (which they have the authority to enforce), participate in Laurier’s Mental Health and First Aid training, and have access to online de-escalation, suicide awareness and prevention, drugs and psychosis, etc. training through the Canadian Police Knowledge Network. Important training, indeed, given that the SCS not only appears frequently as the first point of contact in the Blue Folder but also because it has expanded its mandate.

In partnership with others on campus—some more easily identifiable than others—the SCS is a member of two specialized teams mobilized when either a student is said to be in extreme distress or it has been determined that the student’s behaviour is disruptive or threatening. The first of these is the Behavioral Intervention Team (BIT) which is described as a ‘student support team’ providing “early intervention and elevated levels of support for students exhibiting disruptive or concerning behaviour” and “aim[s] to foster conditions for student support, success and safety through assessment, intervention and coordination” (see the Blue Folder). The second is the Threat Assessment and Prevention Team (TAPT) whose role, as described in the HR & Compensation Meeting minutes of Tuesday January 24, 2017, is to “triage, assess and report on violent behaviour by employees or students.” Under the direction of Safety, Health, Environment & Risk Management (SHERM), its advantage is in cost savings and outcome control accrued by keeping it in-house rather than hiring external professionals.

The difficulty with these ‘Teams’ as they are currently configured, and with online form-based programs like the At Risk Student Reporting, is that there is very little clarity regarding the processes that faculty may have initiated. Given the lack of available information about such approaches and the termination of the faculty member’s involvement, many faculty either hesitate to initiate or, for those who do, are left wondering just what they have given license to.

Let’s hope that at a minimum there is greater transparency in all aspects of SHERM’s proposed changes to the way Laurier students, staff and faculty are handled under its Violent Risk Assessment and Management. But given that the proposed changes, found on page 175 of the 176 page April 10th, 2017 Senate Agenda Package, provide little in the way of detail, it may be unlikely. Of equal, if not greater, concern in the proposed amalgamation of BIT and TAPT is the apparent loss of BIT’s said focus on providing a safe and supportive environment for students.

So, what are faculty to do in the face of increasing mental health concerns among students? If there was a clear, easy answer to that you would be reading something else.

Faculty can take advantage of the various training opportunities (see Leanne Holland Brown’s article this issue). Though having completed the Mental Health First Aid training, I was astonished at the expectation that we know all our students well enough to discern slight shifts in their behaviours. (This feat is unimaginable for growing class sizes, let alone the ‘do more with less’ environment faculty face.) And I was frankly horrified by the depiction of those with major mood disorders as threats. There are the pathways laid out in the Blue Folder, extensions to dial and forms to submit but know that while these steps are easy, they are all missing their disclaimers: our Wellness Centre is stretched, on-campus counselling is restricted to working hours, off-campus resources may provide little comfort (especially for first-year students living away from home for the first time), online form-filling is some-what suspect, training often confers a false sense of security and unclear lines of responsibility, SCS may seem too much while BIT, and especially TAPT (and who knows about the new Teams), appear to be downright heavy-handed. Until there is greater clarity around intent, opportunities for involvement, information regarding process and clear statements about responsibly and student-desirable mental health outcomes rather than University cost savings and risk reduction, caution is needed–at least for our students’ sakes.

What am I going to do? I will continue to show genuine interest in and concern for as many of my hundreds of students each term as I can. I will demand more information before I submit a form or call in the troops. I will advocate for the spending of Laurier’s annual $100,000 MAESD money to be directed towards the hiring of after-hours and weekends mental health service providers. I will hold my university responsible for the mental health needs of our students–after all, they are part of our Laurier family now right? And I will continue to seek out and talk with people who are also genuinely concerned about students to buoy myself when I am feeling overwhelmed.