As more students seek mental-health care, they face long waits - or pay out of pocket - as universities struggle with demand. Written by: Victoria Gibson
High demand for counselling is changing how Canadian campuses get students the help they need – but many still feel they’re falling through the cracks
Julia Burnham knows the symptoms well: a simple stop in a busy coffee shop or crowded bus ride can prompt the sudden, frantic feeling that she can’t get enough air. For years, she has suffered from full-body anxiety attacks that can leave her sobbing in a workplace bathroom, or urgently seeking the safety of her bedroom. A numbing depression follows, which can keep her housebound for a day or two.
The fourth-year university student may seem like a perfect candidate for school counselling services – the kind that postsecondary institutions have been offering for more than 60 years. But in fact, with her multiple diagnoses of post-traumatic stress disorder, panic disorder, social anxiety disorder and major depressive disorder, Ms. Burnham is exactly the kind of student that many universities now try to refer to resources outside of their counselling centres.
For the past three years, Ms. Burnham has been paying $120 a visit to an external Vancouver psychologist – rather than relying on services University of British Columbia students can access without charge. (Counselling services can be funded in part by annual student fees.)
The number of young people seeking mental-health help, in Canada and worldwide, has been rising for years, and the phenomenon is stretching school resources. Under the strain of appointment gridlock, student criticism and, in some dire cases, suicides on campus, postsecondary institutions are rethinking their strategies to handle the mounting need. At UBC, that has meant a new-found focus on referrals. By taking students with more enduring needs out of internal counselling, the thinking goes, more students can be seen by the school team, and those who require more complex support will get the help they need.
The strategy is getting the university its intended results: Data out of UBC showed a drastic shift last year, bucking upward trends of other large schools such as the University of Toronto and Queen’s University. The number of students in UBC counselling, as well as total appointments, dropped for the first time in at least seven years – by 542 students (or 13 per cent) and 906 sessions (or 7 per cent.) Dr. Cheryl Washburn, who directs UBC’s counselling services, says the drop is “directly tied” to the increase in options outside their centre, including more access points for services, online programs and resources in the wider community.
The numbers at counselling services tell a success story, but the experience of some students show there is a hidden cost. The increased demand on mental-health resources is not contained to just universities. The health-care sector is also feeling the squeeze, meaning public health practitioners are backed up, too. “Demand for care continues to exceed the supply of clinically active psychiatrists,” says Mathieu Dufour, co-chair of the Coalition of Ontario Psychiatrists. Some students seeking help off-campus, including from external psychiatrists, have been referred back to their university campuses for care.
For students who are able to pay out of pocket, options expand to include psychologists or psychotherapists – but with a going rate of more than $100 an hour, and sparse coverage under student health-care plans, these services are only accessible to economically advantaged students.
“I was really fortunate that I was able to afford the luxury,” Ms. Burnham reflected, pointing out that she’d also paid less than most patients, as her psychologist offered students pricing on a sliding scale. All told, offset marginally by a $300 allowance from her student health-insurance plan but mostly shouldered by supportive parents, she’s spent approximately $2,500 seeking help since her first year.
Unlike other students with continuing needs, Ms. Burnham wasn’t referred to her psychologist by UBC counsellors – she sought one out directly, in an effort to avoid long waits and repeated recitations of her history with mental illness, only to be referred to an external resource anyway.
“I don’t have the emotional energy to go through another process and re-explain everything to these people that may or may not actually help me in the end,” she said.
Counselling services in universities originated around the end of the Second World War, when veterans returning to campuses required specific educational and vocational supports. Decades later, the purpose of the centres is to address more broadly students’ mental-health needs. The increased demand for mental-health support on campuses can be attributed to a miscellany of factors, from changes in parenting styles to decreased stigma and increased awareness of students’ mental health. Some experts point out that increased technology use can be tied to changes in brain development and modified sleep patterns; some believe young people today are less adept at emotional self-regulation than past generations, feeling pressure to succeed, but lacking the proper mechanisms to cope with failure.