During her second year of university, India found herself in over her head. “I was struggling to stay afloat,” she admits, recalling feelings of anxiety and depression all too familiar to many young adults. “I was deteriorating from the inside out.”
Like many university students, India turned to her school, the University of Toronto, for help. She says that at first, the services she was able to access were “less than stellar.” “Although everyone seemed to want to help, I found that most of the mental health professionals I spoke with were burned out,” she explains.
She was diagnosed with generalized anxiety, and given a prescription for Lazarapam, to take along with a routine of regular exercise. But India wasn’t just an anxious student — in the end, she was diagnosed with a chronic illness, fibromyalgia, which symptoms include fatigue and mood issues.
In the end, what helped India most was a more personalized form of care. At U of T, graduate students in the school of social work are paired with students in need of help, in the school’s “Counseline” program. It turned out to be the exactly the kind of support India had been looking for.
“I’d seen psychologists and therapists before, but Jessica was different,” she explains. “She’d say, ‘We don’t need to work on anything in particular, we can just talk.’”
“She helped me to understand that I wasn’t alone,” says India. Ultimately, she was referred to mental health professionals outside of the university, who diagnosed her condition. But it was her experience with her counsellor at U of T that gave her the courage to continue to dedicate herself to her studies, even in the face of her mental health problems. “I didn’t feel like I was a problem that need to be solved, and then got rid of,” she shares. “I felt like I mattered.”
Toronto’s Campus Town
The City of Toronto is made up of a whopping 2.6 million people. When discussing the city’s demographics, neighbourhoods are often used to breakdown statistics into manageable chunks, and to better understand the unique needs of particular areas.
But there is another city we don’t often talk about, one without solid borders, that stretches across North York to downtown Toronto.
That city is Toronto’s student population, which, between its colleges and universities, sits at over 200,000—a number that only grows with each passing year.
It’s a population made up mainly of young people; young people that are increasingly seeking out resources to fill their mental health needs. According to the Centre of Addiction and Mental Health, while 1 in 5 Canadians will experience a mental health or addiction problem this year, up to 70% of mental health problems have their onset during childhood or adolescence. Young people aged 15–24 are more likely to experience mental illness than any other age group.
The Mid-East and Mid-West Sub-Regions of the Toronto Central LHIN are heavily populated by students. And yet, when you look at the data on mental health visits (only available for those above 20 years of age), they are relatively low in the neighbourhoods surrounding Toronto’s post-secondary institutions. For example, mental health visits for those above 20 years of age for the Church-Yonge Corridor and University neighbourhoods are 8.9% and 7.9%, respectively. These rates are relatively low compared to other neighbourhoods; the Toronto Central LHIN average is 9.4%. This might have to do with that fact that numerous mental health visits with on-campus counsellors aren’t pick up by this data, nor are visits by those younger than 20 years of age.
Universities stepping up
“The onus for student mental health care is falling to post-secondary institutions,” says Janine Robb, Executive Director of the Health and Wellness Centre at the University of Toronto. “We are caring for students with increasingly complex and acute need, and we also bridge the care of students until they can be seen in the few mental health resources that are available in Toronto for this age group.”
Robb is quick to point to the thousands of students in downtown Toronto, many of whom will seek out mental health services during their time at university. While U of T does its best to accommodate student demand for counselling or referrals, students say wait times still number in the weeks.
“While there are acute and emergency services available in the city for this age there are few ongoing resources,” explains Robb. “The University provides episodes of short term care; the challenge is the few community resources to support them in their long term care.”
Robb’s concerns are echoed by Allan MacDonald, Director of Student Health & Wellness at Ryerson University. “What I hear from colleagues across the province is that the volume of students coming to seek these services has been going up year-over-year for the last five years,” he shares. MacDonald says that Ryerson is equipped to handled students short-term care, and is acting as a first line responder. “We’re not able to provide the services a primary care giver would,” he admits. “We’re trying to move towards that model, but we’re not there yet.” In the 2015–2016 school year, 1927 students accessed the university’s individual counselling sessions, while an additional 275 attended its group therapy sessions.
MacDonald says that the students who access Ryerson’s services are often transitioning away from both their home support network and their primary care givers. “These are young adults often with pre-existing mental health conditions that they’ve been dealing with their whole lives—but we’re not connected [at Ryerson] to any kind of health system—we’re completely outside of that community. The invitations for events that I get are from the Ministry of Education, not the Ministry of Health,” he explains. “We really have to work to insert ourselves into that equation for our students.” The average number of same day appointments at Ryerson has risen from 30 in September 2015 to 71 in September 2016.
“A couple of years back I had to use U of T’s services, because I needed a psychologist and I definitely couldn’t afford one on my own,” shares Kawmadie, now in her final year of undergraduate study.
Worried about a long waitlist, Kawmadie put off calling the centre for weeks. “I waited until it was intensely imperative that I get some form of psychological aid before I even called,” she admits.
Kawmadie spoke with a counsellor, and was prescribed a medication that she ultimately found unhelpful. While she didn’t continue to use the service, she appreciates that the service was there when she needed it. “It definitely helped to have some professional perspective on my condition, and to motivate me to find more continuous aid,” she shares. “It’s supposed to be for the short term, and I think for its role it works well.”
“My relationship with U of T’s counselling is a complicated one to say the least,” shares Lily, a recent graduate of the university.
Lily had a rough experience with the school’s counselling services, where wait times were long, and counsellors were burnt out. Still, she credits the process with her realization that she needed to commit herself to finding a solution that worked for her. “Being able to admit that I could no longer go through the pain and anxiety alone, even if it was in a system that was unhelpful, made me feel proactive,” she explains.
She eventually found her way to Counseline, the same service India had such a positive experience with. “It was a place where I finally found a good fit,” she explains.
These days, as a university graduate, Lily is struggling to pay for her mental health care. She was recently diagnosed with PTSD, and says the burdens of insurance coverage, waitlists and referrals have been overwhelming.
“I initially called Women’s College Hospital which bounced me around to places with months-long waiting lists,” she shares. “AlI can think about is how all of these logistical issues were at least things I did not have to worry about as an undergraduate. My recent experiences have made me yearn for the days of decent waitlists and on-campus emergency services without the financial strain.”
Where to go from here
MacDonald says that Ryerson is doing what it can to increase access to its services. The wait time for an appointment has gone from 13 days in the 2014-2015 school year to 6 days in the 2015-2016 one. They have more counsellors than ever available to offer same-day support, and have increased online resources and student support groups.
Robb says that U of T has taken steps to combine its services, so that students are seem first by a nurse and a doctor, before speaking with a psychiatrist. It has increased group programming for anxiety and depression to help students who feel overwhelmed and will have to wait weeks to speak with a professional. Robb says that, in order to be effective, the school needs funds: “What we need is additional health care funding. The only funding we receive is through billing OHIP. We need an integrated system of prevention education and intervention to better serve the needs of our students,” she shares.
MacDonald says he would love to sit down and talk to someone from the LHIN about his concerns about a lack of funding; he envisions a collaboration between universities and health care providers. “Because there’s such a high concentration of mental health providers downtown, and because of both U of T and Ryerson’s geographical locations and existing care facilities, I think a system could be created that would go both ways,” he explains.
In MacDonald’s world, what university’s have done to help at risk youth could act as a model of further care: but more funds are needed. “Ideally, students could access care outside of Ryerson and I’m almost certain we could contribute to the mental health care of downtown Toronto,” he says.