Stress, stigma and solutions

“No one around me knew,” said Jonathon MacIntyre, a recent graduate from the faculty of applied science. “Most of my friends don’t know and there isn’t a way that I can bring it up with them without the concerns of being a buzzkill, feeling attention-seeking or even just [because] I forget about it when I hang out with them.”

MacIntyre, who suffers from depression, is not alone in feeling as though he cannot talk about problems he faced while studying at UBC. Stigma attached with mental health issues along with the academic and financial stressors that come with attending a top school like UBC have lead to many students feeling isolated and like failures.

“University is hard, with lots of stress and I didn’t always cope with it super well,” said Laura How, a recently graduated student from arts. “This year – it being my last year of university – I wanted to do everything and I needed to get good grades to get into grad programs.”

According to a national survey, nearly 70 per cent of students battle with loneliness during the school year.

“I deal with a lot of anxiety, I was really stressed, I was mildly depressed for sure, and I reached a point where I was like, ‘maybe I should not be crying all the time’ and go talk to someone [to] see what is going on,” she said.

Canadian student health data from this year reported that 42.2 per cent of the more than 43,000 students from over 41 Canadian Institutions who responded to their survey had stress impact their academic performance.

All the students who were interviewed for the piece had experienced mental health issues before coming to UBC. However, most students reported that the environment around campus was one of the main reasons problems were exacerbated.

Financial stress can also play a large role in students’ mental health. The latest academic experience survey said that 17 per cent of UBC students feel has though they might need to abandon their studies at UBC for financial reasons — a stat five points higher than last year. Canadian student health data reported that 10.3 per cent of students’ academic performance was affected by finances and 17.1 per cent of students by work.

Sarah, a student in the faculty of science, is in a program that requires a higher course load to qualify for student loans. After facing a multitude of personal and family issues within the span of a few months, she ended up not being able to take more than three courses per term — the amount that would have qualified her for full-time student loans. While living on an average of $20 of groceries per week, she tried to get help.

According to Janet Mee, director of UBC Access and Diversity, this situation is not unusual.

“Often when students come forward with mental health concerns, finances are a big part of that,” she said. “It can be one or the other – whether they are the trigger or whether the mental health concerns then exacerbate their ability to work or study.”

UBC is developing a new model for their approach to mental health on campus. As a part of this, they hope to offer workshops centered around financial wellness and financial literacy.

“There are different levels of approach that meets students where they are and provide the least invasive kind of support that will help them address the concern that they raised,” said Mee.

UBC’s counselling services are located in Brock Hall and at the Lower Mall Research Station. To make an appointment, students must visit in-person for a 30 minute initial consultation, when they are either paired with a counsellor for future visits or transferred elsewhere, if this is deemed what would best fit their needs. On the counselling services website, areas such as stress, depression and relationship difficulties are those which they recommend meeting with a counsellor for. Counselling services provides access to registered clinical counsellors, registered social workers, psychologists and supervised master’s practicum trainees as well as pre-doctoral and post-doctoral interns. However, waitlist times can increase to around three weeks during particularly busy times, according to Cheryl Washman, director of UBC counselling services.

“It depends on the time of year,” she said. “If it’s a particularly busy time, there may be two to three weeks before they can actually begin working with a counsellor, but we may offer them the option – if it’s appropriate – to work with someone off-campus depending on the nature of the concern.”

Justin, an arts student majoring in psychology, was referred to an off-campus counsellor when he tried to access UBC’s services. He had been looking to see a counsellor to deal with stress before he came to UBC and was pleased with the outcome of his interactions with the service.

“I was looking for someone to fill in the holes so I could get back to 100 per cent,” he said “We talked for about 30 minutes just going over my application, to see specifically what I wanted.”

He was assigned a counsellor in downtown Vancouver. As an international student, Justin’s temporary insurance covered his sessions as a student for the year. Of course, the most ideal situation for anyone seeking mental wellness services is that they’d be able to see someone whenever they needed to, it was free and the services were local.

“The most ideal situation would have been if there was someone on campus and I didn’t have to pay for it,” confirmed Justin. “I wanted somebody on campus who could just listen to my current problems and instead of using harmful coping mechanisms from the past, I could use healthier ones.”

One of the main reasons Justin chose UBC was because he felt that, in terms of mental health and wellness, UBC had the best and most accessible services.

“I literally picked UBC over their website,” he said, “They cared more about me as a person than what I gave. That takes the tabooness out of it — it takes away the awkwardness of bringing it up [therefore] making it acceptable. You have to find the people who aren’t wanting to get help but need it. Obviously, that’s a lot easier to say than do.”

On the contrary, Michelle Huang, an unclassified science major, feels that she hasn't been taken seriously by UBC’s services. After speaking directly to a professor about her disability and how the room her class was in affected it, she was told by a counsellor, “Your disability is confidential information.”

“I’m basically black labelled in Access and Diversity – at least, that’s how I feel,” she said. “I’m hoping other students who have similar back situations have had the chance to see a psychotherapist. Even though it’s in my rights to self-advocate, either way you’re going to get labelled.”

She also reported concern about mixed messages on when she should see a counsellor. Huang has been seeking help off-campus for more than a year, but reports confusion over whether she should be visiting her UBC counsellor, her off-campus counsellor – who she only sees once a week – or in the case of an emergency, the hospital. She didn’t feel comfortable or like she was connected to her assigned counsellor.

“They do try to help, but with more severe mental health issues, it takes a long time,” said Huang. “I had a very bad experience with them. My counsellor seemed like she was more concerned about her professionalism over my well-being.”

At one point, according to Huang, she was told to choose between her and her other psychologist. “Every time I went to see her, I’d walk out more agitated than when I walked in.

“There was no patient choice there,” she continued. “If student health wasn’t going to refer me to a different psychiatrist, then the choice to me was very obvious. I couldn’t go to see her for a year.”

Huang’s counsellor told her to come back in emergencies only.

“When I’m in an emergency, I need medication to calm me down — not a counsellor to talk to,” she said. “I got so frustrated last year that I wrote an email to the head of UBC counselling services, explaining what my experience was. I know when I’m not doing well, so I said, even if I had self-harm urges, you can’t see me because I have an outside psychotherapist or you’ll tell me to go to the hospital – you can’t help me.”

A new model for the Wellness Centre is being rolled out – hopefully in January – to help combat some of the problems students have been having with UBC’s services. Four units of UBC’s wellness programs are coming together to form a holistic, collaborative care model.

“I think there’s a strong commitment on campus to really look at a holistic systems approach,” said Washman. “A program where the mental health promotions are as important as resource provision, and the more that we address either the full continuum of resources and intervention and change, all the way up to deep culture change, I think the better chance we have about really improving student mental health on campus.”

One aspect that was particularly highlighted both by the academic experience survey and discussions with students currently engaged in UBC’s services is the large number of gaps between care.

“One of the key elements of the collaborative model is it really does create a circle of care where units function collaboratively so that we really do address and eliminate those gaps between various types of services,” said Washman.

This involves sharing relevant information that supports students’ care – with consent – particularly where the care is provided by more than one unit or resource. The new Wellness Centre model is aiming to be a lot more responsive.

“We’re really trying to create multiple entries or low-barrier entries for students who wouldn’t otherwise try to approach the university for support,” said Mee. “Although we’re trying to reduce stigma, of course there’s still some stigma associated with mental health, particularly in some communities of students that may be more or less willing to come forward and seek help.”

The new Wellness Centre will be a first point of contact for students who aren’t currently connected to supports around campus, as a low-barrier entry into the system. The idea is that students will be able to access multiple services throughout that Wellness Centre, whether they are simply looking for resources, finding out about self-help methods or wanting a referral to one or more of UBC’s offices. Wellness advisors will work on that intake and referral process, freeing up counsellors who are currently administering this role to focus their efforts more on one-on-one and group counselling.

Services and all aside, all the students consulted emphasized the importance of a culture that is more accepting of talking about mental health and wellness.

“Maybe this is a bigger societal thing, but it would nice to be able to talk to people about going to counseling and not feel weird about it,” said How.

“Getting people to talk about it can really help. That’s why I was so disappointed when I was in a position to talk to a lot of people, but I just couldn’t get myself to bring up my depression,” said MacIntyre.

“It’s really detrimental because people will probably react better than I’m ever going to imagine they will.”