A Holistic Systems Approach To Mental Health On Campus

A Holistic Approach To Mental Health On Campus
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With commencement season upon us, post-secondary graduates around the world are getting some wonderful advice before they sail off into the “real world.” But even before they graduate, students are struggling to navigate the open waters of their lives.

And by the numbers, many of them are sinking fast.

Since 2010, even as average institutional enrollment has increased by 5 percent, the average level of counseling center use has grown by 30 percent. Among students attending counseling, the prevalence rates of “threat-to-self” characteristics have increased every year for the last six years. In 2016, a survey of 25,000 students across Ontario found that 65 percent reported experiencing overwhelming anxiety in the previous year; 46 percent felt so depressed that it was difficult to function; and 13 percent had seriously considered suicide.

At McGill University, where I taught last fall, about 3 in 5 students report feeling overwhelmed on a weekly or daily basis. Even as a professor, I was struck by how hard students have to work just to stay afloat. Their personal needs compete with their social obligations, their classes conflict with their jobs, they’re going through profound developmental changes, money is tight, they don’t sleep enough, established career paths are disappearing at every turn—and in the meantime, somehow, they’re expected to “find themselves.”

Combine this with the sense of anonymity that a large campus environment can create, and it’s no wonder so many students feel invisible, adrift, and alone.

As McGill graduate Maria Leis powerfully observed in her 2017 Arts convocation address, earning a post-secondary degree can come “with a price.” Leis said, “I have witnessed friends and fellow peers crushed by the pressures … I have seen healthy individuals come into this school, full of optimism and vigor, only to leave here four years later with anxiety, depression, and eating disorders.” No doubt, reports on other campuses might sound the same.

Clearly, students need help. In March, a group of McGill students petitioned the administration to expand mental health services in order to keep up with increasing demand. Similar petitions have recently circulated at the University of Waterloo, the University of Guelph, and more than twenty universities in the U.S., including Harvard, Princeton, Yale, MIT, and Columbia.

But, just as clearly, administrators, faculty, and other university personnel need help in addressing this fast-growing crisis. Indeed, when I raised the subject with a top administrator at McGill last month, she was emphatic: “This is the most serious issue we are dealing with now.” Last month in Toronto, mental health professionals and university staff held their own National Conference on Campus Mental Health for Higher Education Administrators, to share best practices and ensure they have “the most up-to-date information, tools, and strategies to respond.” When it comes to mental health, university students are underserved, but they are not undervalued.

It is heartening to see so many students and university staff working in their own circles to set collective priorities. Among their many excellent initiatives are more inclusive decision-making about funding allocation, evaluation metrics, and even job descriptions for university clinicians; extensive faculty training in confidentiality, privacy issues, and legal liabilities; and administrators’ sharing best practices for crisis management, sexual assault, and addictions on campus.

These kinds of discussions lead to more understanding and sensitivity, and hopefully less blame and alienation. After all, what makes community mental health especially difficult to confront is that the issue isn’t reducible to a simple explanation or remedy. Challenges are ambient and ever-shifting. Between the private self and the public system, there are complex dynamics and unpredictable triggers. And from a top-down policy perspective, the relationship between inputs—like more funding and better job descriptions—and outputs—like recovery and resilience—is nonlinear at best.

But in order for the campus mental health crisis to subside, we need to bring these various circles together as one whole community, so that everyone is pulling together in pursuit of their common goal. Students, professors, administrators, and other members of the human-centered environment are all part of the “university system”—and a system must function holistically in order to function well.

That doesn’t just mean the people on campus. It means social workers and lawyers who are focused on how the university community functions; scientists who study the neuroscientific and social bases of mental illness; therapists who help individuals gain insight into their own psychology; and community leaders, who inspire us to replace labels and stigma with acceptance and empowerment.

Naturally we all have different ways of seeing the problem. And while each perspective is valid and important, a systemic approach to campus mental health—what I call a “caring campus”—is only possible if we work together to make every person feel heard, honored, and cared for, even as we continue to push for the practical levers of greater funding, transparency, and education.

On May 30, 2017, the surgeon and writer Atul Gawande delivered a beautiful commencement address at McGill’s health sciences convocation. The biggest challenge across all of medicine, he said, is “just getting people to come together and devote effort to functioning as a system.”

That challenge is also our biggest opportunity, and I do not think it is a coincidence that the values Dr. Gawande sees as core to the mission of public health—physical and mental—are also antidotes to the pernicious problem of social isolation.

What are those values? As Dr. Gawande put it, “reason, human decency, community, and a foundational belief that all lives have equal worth.” Words to live by, on university campuses, and in the so-called “real world” beyond.

If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HELLO to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.

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