By Sabina Franklyn, Department of Psychology
Since a few catchy news articles in the popular media back in 2012 pointing to a mental health crisis at universities in Canada, the seriousness of mental health issues on our campuses has been increasingly recognized (Lunau, 2012). A survey conducted at McMaster University in Ontario triggered attention to the issue, finding that a staggering 88.8% of students felt overwhelmed, 50.2% reported being overwhelmed with anxiety, and 34.2% felt depressed (Craggs, 2012).
How is this possible you may ask? I present to you the hypothetical case of an 18-year-old 
first-year undergraduate student and her transition to university. Meet Sally; she has recently left home for the first time to start her freshman year at a university that is six hours from her hometown. She’s living in a single room in an on-campus residence, and is feeling lucky to have been one of the few students to score a room by herself. Nervous but excited, the semester starts full-force and Sally is determined to maintain her admission scholarship and receive medical school calibre grades, just as she has throughout high school. Sally struggles to adjust to the large class sizes, increased workload and the lack of structure to her days. But she makes it through her first midterm, only to find out that she got a D. This is the lowest grade that she has ever received in her life! And this isn’t even her only midterm; she has four others to write this week. Feeling sick with a sense of failure and anxiety, Sally is finding it hard to cope in the absence of the supports that she was accustomed to when she was living at home. As a result, she becomes discouraged and overwhelmed.
Due to a combination of the poor quality of food offered in the cafeteria and a loss of appetite, Sally’s diet also changed considerably. Sally begins to have difficulty sleeping, and has an even harder time getting out of bed in the morning. She starts skipping classes to catch up on sleep, which is putting her even further behind in her coursework. Sally has found herself stuck in a cyclical pattern of underperformance in relation to the physical and psychological impact of the stress that she is experiencing. Sally is made aware of the counselling services on campus by her residence advisor, and she decides to set up an appointment. When she calls, she is told that there is a 4-6-week wait for an initial appointment. When she finally has her initial appointment, Sally feels a bit better and hopeful that she can turn things around. She attempts to book a follow-up appointment but is told the wait time would be another 6-8 weeks. Sally never follows up with her appointment due to the long wait, and also because she believes that she should be able to manage her stress on her own. She finishes her first year on academic probation, wondering if she should reduce her course load, change programs, or possibly even take some time off from school.
Roughly 50% of college and university students experience high levels of stress that result in symptoms of anxiety and depression, with anxiety symptoms being the most common (Bayram & Bilgel, 2008; Storrie et al., 2010). Approximately one in five students has a diagnosed mental health disorder (Auerbach, 2016). Sally’s story paints a picture of how stress-induced behavioural changes and mental health symptoms can impact academic achievement. Students suffering from stress-related mental health issues report having poorer relationships, lower grade point averages and lower graduation rates compared to those not presenting with mental illness (Storrie et al., 2010). In addition, Sally’s story does not take into consideration other complex issues on college and university campuses such as sexual harassment, discrimination and substance use, all of which impact mental and physical health outcomes. In addition, studies on campuses in North America have found that 10% of female students and 13% of male students have experienced thoughts of suicide (Mackenzie et al., 2011).
All of this being said, what practices have universities put in place to combat student mental health challenges? One widespread response has been to expand individual counselling services. This approach does not come without flaws: it is reported that less than a quarter of students who need such services are actually using them (Rosenthal, 2008). This is likely due to a number of barriers including the stigma associated with mental illness and seeking help, the perception that one can manage their own stress and the wait times associated with such services (Pin et al., 2012; Rosenthal, 2008; Talebi et al., 2016). Given this, it is hard to imagine that universities would be able to support a higher volume of students choosing to seek counselling.
Similar to other areas of medicine, preventative mental health interventions are often more economical than treatment after the fact. As assessment of the effectiveness of various interventions from 24 different studies demonstrated that cognitive, behavioural, and/or mindfulness-based techniques were the most effective in reducing symptoms of anxiety in university students. Cognitive-behavioural therapy focuses on identifying and modifying dysfunctional thoughts related to stress. Mindfulness-based techniques incorporate a combination of focusing on and being aware of one’s body, breathing, and thoughts. 
Some aspects of these interventions can be carried out at home (i.e. through audio-recorded guided mindfulness coaching) (Regehr et al., 2013). To the extent that such strategies are effective, campus workshops that encourage their uptake may help reduce wait times for other services so that those who need them the most get help in a timely manner. Some other evidence-based recommendations that universities can consider to help reduce student stress and improve mental health outcomes include initiatives to reduce the stigma associated with student help-seeking, and implementing peer-support programs and animal-therapy programs (Binfet et al., 2018; Felton et al., 2019; Pin et al., 2012).
Would things have turned out differently for Sally had these initiatives been in place at her institution? It’s possible. But, in fact, there isn’t a single, one-size-fits-all answer to the prevalence of mental health challenges being experienced on college and university campuses. However, one thing is clear: colleges and universities should be making the mental health of their students a priority. They need to dedicate more funds to trying new interventions and providing better support for methods that have been shown to work. After all, high drop-out rates, fewer students pursuing additional degrees, lost productivity, etc., reflect on universities’ success. Along with the students, the schools themselves will eventually suffer the consequences if this problem persists.
If you are concerned about the mental health and safety of yourself or someone you know, below is a list of available resources that can help:
Carleton University Health and Counseling Services: (613) 520-6674
Distress Centre Ottawa and Region: (613) 238-3311, Web Site: www.dcottawa.on.ca/
Mental Health Crisis Line: within Ottawa (613) 722-6914, Web Site: http://www.crisisline.ca/
Mental Health Helpline: within Ontario (866) 531-2600, Web Site: https://www.connexontario.ca/
Canada Suicide Prevention Service: within Canada: (833) 456-456, Web Site: https://www.crisisservicescanada.ca/
References:
Auerbach, R. P., Alonso, J., Axinn, W. G., Cuijpers, P., Ebert, D. D., Green, J. G., … & Nock, M. K. (2016). Mental disorders among college students in the World Health Organization world mental health surveys. Psychological medicine.
Bayram, N., & Bilgel, N. (2008). The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Social Psychiatry and Psychiatric Epidemiology.
Binfet, J., Passmore, H., Cebry, A., Struik, K., & McKay, C. (2018). Reducing university students’ stress through a drop-in canine-therapy program. Journal of Mental Health.
Craggs, S. (2012). One-third of McMaster students battle depression: survey.
Felton, A., Lambert, M. (2019), “Student mental health in the healthcare professions: exploring the benefits of peer support through the Bridge Network”, The Journal of Mental Health Training, Education and Practice.
Lunau, K. (2012). Mental health crisis on campus: Canadian students feel hopeless, depressed, even suicidal. Macleans.
Mackenzie, S., Wiegel, J. R., Mundt, M., Brown, D., Saewyc, E., Heiligenstein, E., … Fleming, M. (2011). Depression and Suicide Ideation Among Students Accessing Campus Health Care. American Journal of Orthopsychiatry.
Pin, L., Martin, C. (2012). Student Health: Bringing Healthy Change to Ontario’s Universities. Toronto: Ontario Undergraduate Student Alliance.
Regehr, C., Glancy, D., & Pitts, A. (2013). Interventions to reduce stress in university students: A review and meta-analysis. Journal of Affective Disorders.
Rosenthal, B., Wilson, C. (2008). Mental health services: Use and disparity among diverse college students. Journal of American College Health.
Storrie, K., Ahern, K., & Tuckett, A. (2010). A systematic review: Students with mental health problems-A growing problem. International Journal of Nursing Practice.
Talibi, M., Matheson, K., & Anisman, H. (2016). The stigma of seeking help for mental health Issues: Mediating roles of support and coping and the moderating role of symptom profile. Journal of Applied Social Psychology.