University years are often heralded as among the happiest of a person’s life, but post-secondary studies have always come with inherent stresses. The exhilaration of learning from world-class educators and experiencing the cornucopia of campus life is balanced with academic and often financial pressures. Added to those demands is the challenge many students face of living independently for the first time.
While university students have always had stress, recent data and demand for campus counselling services indicate this generation of learners is experiencing a mental health crisis.
About 64% of Canadian post-secondary students reported feeling overwhelming anxiety over the past 12 months, and 12% had seriously considered suicide over the same period, according to results from an online survey released last fall.
The National College Health Assessment (NCHA) findings represent the responses of 43,000 students from 41 Canadian post-secondary institutions, including about 5,000 from the University of Toronto.
Among U of T respondents, 45% reported feeling so depressed over the past year they found it difficult to function.
The data also indicates more post-secondary students are experiencing mental-health challenges than in 2013 when the NCHA survey was first conducted in Canada. Compared to the first survey, suicide ideation is up by 26 %.
“It’s speaking to the fact that students are reporting considerable distress in terms of mental health,” says Dr. Andrea Levinson, Psychiatrist-in-Chief at U of T’s Health & Wellness Centre. “But it’s self-reported data by students, so it has to be interpreted in that manner.”
The mental health issues indicated in both surveys mirror the problems U of T students are seeking help for on campus.
Dr. Levinson, who is also an Assistant Professor in the University’s Department of Psychiatry, estimates the number of students seeking mental health assistance at Health & Wellness is increasing by 10% yearly.
“It’s about figuring out which concerns need a clinical approach; it could be an academic issue, and they need a learning strategist,” says Dr. Levinson. “It’s about not trying to over-pathologize the concern.”
As for the most common psychological issues reported at U of T, Dr. Levinson advises that “anxiety trumps depression.” She shares that some of the severe worries U of T students seek help for have to do with academics, finances, and the ability to connect. Depressive symptoms presented include low mood, sleep issues, fluctuating energy, and appetite changes.
Dr. Judith Laposa (BSc 1999 UC), a psychologist in the Mood and Anxiety Service at Toronto’s Centre for Addiction and Mental Health (CAMH), clarifies the difference between the anxious feelings and down moods we all experience, and the level at which they become a disorder.
“It’s actually interfering in life functioning,” says Dr. Laposa, also an Assistant Professor in the Department of Psychiatry at U of T. “When someone has an anxiety disorder or has major depressive disorder, it could look like it’s interfering in their ability to socialize, have meaningful relationships, or engage in school-related activities.”
While there is an absence of data to explain why this student cohort is struggling, there are theories about multiple contributing factors.
One constant is that early adulthood is the period when symptoms of mental illness emerge. Statistics from the Mood Disorders Society of Canada indicate that the age with the highest rate of depression symptoms is under 20, and the age range with the highest rate of anxiety symptoms is 20 to 29.
But Dr. Levinson believes there are stresses specific to 2017 that are increasing the demand for support. She cites factors including the transition from education to a career being more difficult, the digital culture of 24/7 availability creating an inability to shut off, and the reduction of stigma, so students feel more comfortable seeking support.
But students’ openness to help is challenged by an access issue for mental health assistance in Ontario and beyond.
“The highest proportion of people trying to access emergency departments because of lack of service for mental health are youth,” says Dr. Levinson.
Another theory mentioned by both Dr. Laposa and Dr. Levinson is the decreased differentiation around academic achievement in secondary schools, which may be making students less prepared for university.
Added to this is the changed family culture in which helicopter parents are overly involved in their kids school life, leading students to feel at a loss when that support is removed at university.
On an individual level, beyond an appropriate antidepressant, the best help for anxiety disorders may be Cognitive Behavioural Therapy (CBT), a short-term method that looks at thoughts and behaviours and how they contribute to a difficulty. “What has the strongest research support for mood and all the anxiety disorders from a psychotherapy perspective is CBT,” says Dr. Laposa.
To improve the well-being of an institution is a more mammoth undertaking, and in response, in 2014 U of T released the Student Mental Health Strategy and Framework, which was updated in 2016.
The Framework focuses on a systems approach looking at the role the entire University plays in creating a healthy environment.
Among its 22 recommendations were calls for increased mental-health communication; preventive, educational, resiliency, and anti-stigma programming; supporting the mental health needs of diverse communities, such as LGBTQ and graduate students; expanding partnerships with off-campus health resources and increased peer mentorship offerings.
In January, Daphne Wang, along with Tisha Hasan and Lynn Ly, cofounded Peer2Peer at University College, which holds anonymous weekly drop-in talks led by trained peer facilitators on topics like stigma, homesickness, and post-grad angst.
“We were seeing a lot of need on campus for more relatable mental health services,” says Wang, a fourth-year student doing a double-major in Peace, Conflict and Justice, and Global Health. “A need for safe spaces, a chance to talk with like-minded students about their challenges, as a kind of community-building, which is sometimes hard to find at U of T, where there’s so many students.”
Other examples of how recommendations from the Mental Health Framework have come to life on campus are wellness-focused websites, such as healthyuoft.ca, which links to campus resources supporting physical and mental health, and at the Scarborough campus, the Flourish website, utsc.utoronto.ca/flourish, where students can assess their mental health.
At University College, “we have focused on an integrative approach that includes offering urgent support for students in distress, embedded counselling services in the College, preventative programming to promote mental wellness, and coordinated student communications to offer information on resources and mental health strategies,” says UC’s Dean of Students, Melinda Scott. “Student leaders also play a key role in creating a supportive community that encourages physical and mental well-being, fosters resiliency, and decreases stigma,” says Scott.
Students can also take advantage of stress-reduction offerings you may associate more with a spa than university, such as mindfulness and yoga. In addition, numerous workshops are held on lifestyle management, such as how to improve breathing, sleep, and study habits.
A key success so far from the Framework, according to Dr. Levinson, is providing greater access to mental health supports. In 2015, Counselling and Psychological Services and Health Services merged at Health & Wellness to enhance the delivery of coordinated physical and mental health care. Access has also been improved through embedded counselling and learning assistance services in 21 faculties, departments, colleges, and residences on the St. George campus, including University College’s Success Centre. Created in 2012, it is a one-stop shop where students can go for personal counselling, career advising, learning skills development, and international student support.
While the institutional changes around mental health are vital, Daphne Wang’s perspective is the outlook would improve more rapidly if everyone took responsibility for a healthier university. “Whether as student or faculty, it’s about becoming better listeners and better at recognizing students in distress.”