Sask. universities face rise in mental health problems among students

Mark Everett attempted suicide the winter after his first year at the University of Saskatchewan.

He had been diagnosed with anxiety and depression after a particularly rough term in 2015. He was working on prerequisites he needed to get into the University of Regina's Bachelor of Social Work program. 

"I'd been having problems prior to that, but kind of always had the mentality of like, 'Oh, I'll fix this myself. I can do it myself.'"

The suicide attempt was a turning point.

"It was at that point I realized this was not something I could work out for myself," said Everett, who at 26 is now set to graduate in spring 2020.

Everett is one of a growing number of post-secondary students who wrestle with mental illness. 

Research published in 2005 using data collected from 2001 to 2003 found more than 75 per cent of first-time mental health diagnoses happen between the ages of 16 and 25, a time when many young adults are attending post-secondary schooling. 

In a 2019 survey conducted by the American College Health Association, nearly half of Canadian students (45.6 per cent) reported experiencing above-average stress and 15.3 per cent reported tremendous stress levels. Only 35 per cent said that experiencing stress had not negatively impacted their academic performance. The survey included responses from more than 43,000 post-secondary students attending 41 schools across Canada.

According to Peter Hedley, director of student affairs and services with the University of Saskatchewan, more students are seeking help on a regular basis. Historically, he said, schools saw more pronounced peaks and troughs, with larger numbers of students seeking support for mental health concerns during crunch times in the academic year: start of term, midterms, and finals. 

"Now the troughs aren't so significant and the peaks continue to rise."

Enrolment is growing at the Universities of Saskatchewan and Regina. Rates of student distress are outpacing that growth. 

The universities are feeling this pressure most acutely in increased demand for counselling services and for academic accommodations  — things like deferred due dates on assignments, or private rooms and additional time for exams — to help students cope. 

Thomas Chase, provost and vice-president (academic) at the U of R, said this taxes university budgets, faculty and staff workloads, and physical space.

Chase said governments from coast-to-coast have cut back university funding increases, making the schools more reliant on student tuition to balance the budget. 

"Universities across the country are having to invest fairly scarce operating funds in things like counseling positions and psychologist positions," he said. 

Counselling visits up

Depending on the severity of their distress, students can access services ranging from one-on-one visits with a psychologist -- the most resource intensive -- to peer counselling, wellness seminars and online modules. 

Scheduled appointments for counselling at the University of Regina (not including drop-ins or crisis response services) climbed 25 per cent from 2017 to 2018.

Jenny Keller, the U of R's manager of counselling services, said this figure is similar to annual growth seen in other Canadian and American universities and illustrates increased demand for mental health services, not an increase in mental illness among students. 

The U of R has also seen a 120 per cent increase in drop-in visits compared to the same time last year. Another marker of increased demand is the growth in the size of Keller's team. It now has the equivalent of five full-time psychologists on staff, up from two therapists five years ago. 

We have to recognize that university students are doing exactly what we've been telling them to do since high school: If you notice problems or issues or concerns, then go and talk to someone.- Jenny Keller, U of R manager of counselling services

At the Student Wellness Centre on the U of S campus, students wrestling with mental illness can see family doctors and members of the centre's therapy team, which includes social workers, psychologists and a marriage/family therapist.

Jocelyn Orb, who manages the centre, says appointments to see the therapy team has jumped 67 per cent since 2017, a reflection of both increased demand and changes to team function and structure. The team has grown by two in that time, to a total of 8.8 full-time equivalent positions. 

There's also been a marked increase in mental health diagnoses by the centre's family doctors. Orb says that since 2018, they've seen a 45 per cent increase in appointments related to anxiety and depression, which are now their two most common diagnoses (in 2015, the top reason for visits was contraception). 

Fifty per cent of the appointments with the centre's doctors now are for mental health concerns.

More requests for academic accommodations

Over the last 10 years, Access and Equity Services at the U of S has seen a nearly-500 per cent increase in applications for accommodations from students diagnosed with attention deficit disorder, major depressive disorder and generalized anxiety disorder. These top-three "invisible disabilities" account for around 75 per cent of such requests. 

In the 2018-19 academic year, special arrangements were made for nearly 9,000 exams, which represents a 120 per cent increase over the past five years.  

About 1,300, or roughly 8 per cent, of the U of R's 16,500 students applied for accommodations, an increase of 116 per cent over the past six years. While these special arrangements are for both physical and mental health conditions, the increase is a result of growth in the latter. 

Why the rise?

Peter Hedley said the increase in demand is partially good news, because it signals the university has reduced stigma around mental health issues. 

Keller agreed. 

"We have to recognize that university students are doing exactly what we've been telling them to do since high school: If you notice problems or issues or concerns, then go and talk to someone," Keller said. 

She also said students who previously accessed provincial mental health services as children are looking for the same level of support now that they're more than 18. 

The university is a more challenging environment for students now than it was 20 or 30 year ago, according to the U of R's Thomas Chase. On top of the pressures of taking four or five classes, many students are also working up to 30 hours a week. 

World events such as climate change, political upheaval in the U.S. and U.K., talk of separation closer to home and 24/7 access to social media can all also weigh heavy on students.

"The stresses and strains in the world that we see playing out certainly are going to impact a portion of the student population, causing increased worry and even fear of the future," Chase said. 

New national standards coming for all Canadian post-secondary institutions

Chase said post secondary institutions' role has changed substantially.

"Universities are expected more and more to be sort of like city states, mini governments, providing health care and security services and so on. Thirty years ago or 40 years ago, those things were rudimentary, if they were present at all on campus."

The Mental Health Commission of Canada, in partnership with the CSA group, is scheduled to release a new Pan-Canadian Standard on Psychological Health and Safety for Post-Secondary Students in early 2020. It will encourage more consistent application of evidence-based best practices by all universities and technical schools in this country. 

Ed Mantler, with the Mental Health Council of Canada, said the new voluntary guidelines are a response to the increase in students with mental health concerns and gaps in the availability of supports.  

The road to 'steady'

University has been a roller-coaster for Mark Everett.

"It always seems to go in waves," he said.

In his second year, he went from taking a full course load of five classes to dropping all but one.

There are still times when he struggles with the lows, but he said he's feeling "steady" now.

While he did use accommodations while he was at the U of S — writing exams in a private room, with extra time on the clock — he's opted not to access any accommodations in his final year of studies. He credits the smaller classes and more close-knit community in his social work program, which is housed at Saskatoon's Innovation Place. 

"It's nice that because it's such a small campus I'm able to work, really, one-on-one with the professors, to work around my needs and what needs to be done for the class."