While the past decade has brought a great deal of discussion about mental health in Canadian higher education, these issues are usually framed and discussed as individual rather than systemic, and as problems that PSE institutions should be able to resolve with more supports. But universities and colleges can only do so much, and when services and supports are radically under-funded in the broader health system, we are failing not just students but everyone else who relies on the public system for care. Here is a link to the original post published on January 14, 2014 at University Affairs: Beyond puppies and yoga.

Last October was Mental Health Awareness Month in Ontario (October 10 is World Mental Health Day), and as part of the province’s mental health and addictions strategy, there was much fanfare over the launch of new initiatives for postsecondary students bolstered by $27 million in funding. This is an important and positive step, because there’s been an increasing demand for the limited support services available on campuses, and the problem has been worsening for at least a decade.

Unfortunately, what students experience is part of a much bigger problem. Universities and colleges, as much as they may try, cannot plug the yawning gap in our system that is an issue far beyond the campus. There are many people in Ontario who need help with mental health issues and may be seeking it actively – but can’t get it. Why? Because the system is reactive. It’s designed to deal with short-term problems and with extremes and crises, rather than to help us prevent them, or help us to live with long-term conditions. This matters because ultimately, the services on campuses have to mesh with off-campus services in or connected to the healthcare system.

This is a system in which, without a formal diagnosis, you cannot gain access to accommodations in postsecondary institutions (or elsewhere). Yet to obtain this diagnosis, you have to find the right way in to the system and obtain the right help once you get there. The process can take anywhere from a few months to a year (or longer), depending on how much you know and whether you have an advocate.

For example, an assessment for learning disabilities costs $1,500 to $3,500. Some universities have assessment services, but these refer students to external testing (some of which may be covered, depending on circumstances). You still have to be a registered student to access these, or to have costs partially covered through student loan eligibility; otherwise, you or your parents will be paying. If you’ve had to de-register because of your problems, then you’re out of luck. The same goes for therapy; talk clearly isn’t cheap, in fact it costs $80 or more per hour unless you can use university counselling services – where there is a limit on the number of sessions each student can access. All this is based on the assumption that problems will be short-term and can be “fixed”; wait times for long-term services are often very lengthy.

Of course if you have the resources available, you can simply buy what you need. You can see a therapist of your choice, without waiting months to be told whether you are eligible. You, or your family, can pay for expensive assessments so that problems can be uncovered and named, and help can be obtained. The more fortunate students don’t need most of the university’s services and also don’t have to rely on the government, because they have other forms of support.

Clearly it’s still the disadvantaged students – and less-privileged people in general – who are falling through the cracks in this system. We need to ask, who receives the necessary supports and who does not? Who can step forward and say “I think I have a problem”, without fear of repercussions? Who has the resilience and stamina to pursue a solution that can take so long, and can be so draining, both to discover and to put into practice?

The current system continues to privilege not just people with existing resources but also those who are secure enough to speak about the unmentionable, in spite of the lack of awareness that even those who suffer from such problems may experience themselves. For example, the Council of Ontario Universities held a competition to encourage students to come up with the best mental health “social media strategy”. But the best strategy would be a collective one, informed by (and actively soliciting) the input of those who cannot or will not speak in the public eye. The best process would actively seek out criticism from those most affected, not just the more easily marketable solutions.

University initiatives that gain the most positive media attention often conflate short-term, seasonal stress relating to events like exams, with long-term problems like clinical depression and anxiety disorders (as well as focusing on undergraduate students). Yet it’s the exam period “puppy rooms” that make the news, not the underlying issues that are so much harder to address and resolve, like wait times for “assessments” at university counselling clinics, the lack of privacy many students feel when they go there, the difficulty of having to describe one’s situation repeatedly in the process of trying to find help, and the exhaustion produced by having to negotiate (with) a bureaucracy while simultaneously dealing with the effects of one’s condition.

Giving attention to answers that work well in a PR pitch means depoliticizing our context, and this is a serious mistake. It makes it too easy to forget about all those gaps in the system, and also about factors like poverty, abuse, and discrimination based on race, gender, disability, sexuality, and nationality; it makes it easier to individualize both the problems and the solutions, reducing the answers to “lifestyle choices”. It means we downplay the context in which students are living their lives, and how they bring this to the university when they step onto the campus. That context is part of what enriches teaching and learning, but it also has to be addressed in terms of the problems students experience both on- and off-campus, and how we can help them. Universities alone can’t fix these systemic problems, but perhaps they can bring attention to them, and that would be a great start.