Mental illness on campus really is ‘a thing’

Most mental illnesses begin before or during young adulthood, and a quarter of young Canadians have both a mood or anxiety disorder and a substance-abuse problem. (Shutterstock)

Mental illness on campus really is ‘a thing’

Unlike his former classmates, Alex isn’t writing final exams right now, or searching for a summer job, or choosing electives for next year. Alex is no longer a student at all.

As an academic leader responsible for student affairs, I know that Alex (not the student’s real name) was diagnosed with a severe mental health condition soon after graduating high school.

According to a detailed letter from a clinical psychologist, the condition made it hard, if not impossible, for the then-19-year-old to get out of bed some days, to wash, to eat. To succeed in getting a degree and starting a professional career, Alex would need help.

Many people tried to help: Professors, advisers, counsellors and administrators massaged protocols, stretched the envelope of academic policies and accommodated extended absences from class. But time is a finite resource, and when it’s spent on one student, it’s unavailable to another.

In the end, Alex failed a few too many courses a few too many times and is now working a minimum-wage job.

A dreadful transcript and almost a decade of difficult life experience are the return on the time and money that this student invested with us. And, sadly, the story is far from unique.

“Normal” life pathologized?

Well, cry me a river, some older and allegedly wiser fellow citizens seem to say. We remember tough times, and they didn’t come with smartphones, deadline extensions and therapy dogs.

From this point of view, most students who seek mental-health services and accommodations really just need a kick in the pants. As the Globe and Mail ’s resident snowflake-melter, Margaret Wente scoffed: “You’re too depressed because of Grandma, no problem. The disability office will provide you with a private room and extra time to write your final. Your professor never even needs to know.”

Stress is a normal part of human life; under the always-public gaze of social media, it can become debilitating. (Shutterstock)

Even scholarly lips sometimes curl reactively at reports of pressure faced by universities’ mental-health and intellectual-disability services.

In a recent article in The Conversation, Stanley Kutcher, the Sun Life Financial Chair in Adolescent Mental Health at Dalhousie University, noted that reports on student mental health challenges are often based upon students’ descriptions of their own symptoms, and that these reports are routinely followed by calls for “more pills, more therapy, more of everything, including more panic.”

Kutcher alleged that “many” health professionals are “pathologizing normal life” by failing to recognize that it’s healthy for young people to experience and report negative emotions.

He’s right, of course, that self-reported symptoms do not, in themselves, demonstrate the incidence of illness. People sometimes misleadingly (but innocently) use clinical terms to describe negative feelings.

“Students might say they feel ‘depressed,’ when actually, they feel sad,” says Maura O’Keefe, clinical coordinator of Ryerson University’s Student Health and Well-being Services.

A screentime generation

One thing can, however, lead to another. Mental and physical health challenges may be triggered or aggravated by chronic stress, and just being young is stressful.

Stress, of course, is part of a healthy and productive life. However, adolescent stress has rapidly become more traumatic under the always-public gaze of social media. (Facebook was born in 2004, when today’s undergraduate was entering grade school.)

The damage of cyber-shaming is significantly greater and more enduring than the bullying experienced in pre-internet times, according to psychology professor Jean M. Twenge, who has mined huge datasets about the American generation that she calls iGen.

The picture that emerges from her research is of a cohort that grows up slower, socializes less, sleeps less and whose capacity for happiness is inversely proportionate to screentime. (Equivalent Canadian studies are nonexistent but there’s no theoretical reason to hypothesize a stronger and freer northern cohort.)

And then as teens become 20-something and graduation looms, a big new stress emerges: Facing today’s uncertain, demanding and complex job market.

In one or two conversations, a trained counsellor can tease out mental illnesses from everyday emotional challenges. (Shutterstock)

Are all of these worried young people suicidal or psychotic? Of course not; most (significantly more than half) of the people we encounter on any given day are mentally healthy. But many are not.

One in five Canadians will be affected by mental illness during the course of a single year, according to a 2011 report from the Mental Health Commission of Canada, and 70 per cent of mental illnesses have their onset either before or during post-secondary study.

Diagnosed psychiatric conditions were reported by 7.6 per cent of the 25,600 Ontario community college students who participated in the 2016 National College Health Assessment, with demonstrated damage to academic performance.

Of Canadians aged 15-24, about a quarter had both a mood or anxiety disorder and a substance-abuse problem, according to a 2008 study in the Canadian Journal of Psychiatry.

True, diagnostic data fails to match impressions among counsellors in the United States that they are seeing more severe mental-health conditions. But this disparity may be linked to higher demand for services and growing complexity of diagnoses. Either way, no one doubts that university students are at high risk for mental illness.

Today’s students seem more willing than yesteryears’ to talk about distress and mental health in general terms (“I feel sad”) but the stigma attached to scary symptoms (“I hear voices”) has by no means disappeared.

Campus supports

Meanwhile, clinicians have become increasingly aware that symptoms of relatively minor mood issues may mask personality disorders and psychosis, which, again, are most likely to show up by the early 20s, and are often accompanied and complicated by substance abuse.

Identified and treated early, even those scary diagnoses can be followed by years of productive and symptom-free life.

For these reasons and more, mental illness among young people may well be receiving more media attention these days than in past decades, but this doesn’t make it any less “a thing.”

Nor is it a small thing: Thankfully, not all untreated mental illness ends in tragedy, but no parent or educator needs a reminder that accidents and suicide are the two leading killers of young people, and each of these is linked decisively to mental illness, substance abuse or both.

Today’s uncertain job market can be a huge stressor for graduating students. (Shutterstock)

Compared to death, the other potential consequences of mental illness may seem trivial. But a few lost classes can quickly add up to a lost year, a cycle of discouragement and a prematurely ended academic career.

Someone showing symptoms of illness should be able to check in with a professional quickly, which is the beauty of a properly resourced and well-managed counselling centre.

Some students might be treated on campus with psychotherapy, others referred out to community health-care, others taught (individually or in workshops) new tactics for tolerating sadness, fear and the after-effects of trauma.

While many institutions have expanded or overhauled mental health services, demand generally exceeds the supply. As a result, waiting times for on-campus services can be long, and students’ health insurance plans seldom pay enough to cover psychotherapy in the community.

But for those who do get help, the benefits can be dramatic. I have been a professor for 17 years, and long ago lost count of the formerly struggling students who have shaken my hand in hallways, or on graduation stages, to thank me for connecting them to the counselling office.

Turns out it wasn’t a kick in the pants they needed, after all. Just a chance to get acquainted with strengths they didn’t know they had.