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Queen’s has taken up the challenge of leading the way in the battle against the corrosive and sometimes tragic effects of mental health ailments that affect an estimated one-in-four university-age young people.
On the surface, Josephine Tsang, PhD’06, had it all.
Although in 2004 she was only in her late 20s and still a student, the fledgling academic already had a number of awards, patents, and publications to her credit, was earning her doctorate in physical organic chemistry and in 2008 was named by Chatelaine magazine as one of “80 Amazing Canadian Women to Watch” for her research on the proteins that are thought to play a role in Bovine Spongiform Encephalopathy – Mad Cow Disease. However, under her cheerful exterior, things were far less rosy.
Josephine was wrestling with feelings of chronic inadequacy, doubts about her self-worth and pressure from well-meaning, but traditional, parents who wanted her to excel academically.
Her depression peaked on the day her PhD supervisor remarked that Josephine “wasn’t quite herself” – an observation that caught her by surprise. Josephine sought help at Health, Counselling and Disability Services (HCDS), but because of the high demand for appointments she could only see a counselor infrequently, and so she stopped going.
Having discovered that the man she’d been dating had been unfaithful, Josephine retreated to her apartment and swallowed handfuls of antidepressants and painkillers, knowing full well that she might not wake up.
Fortunately, before taking the pills, Josephine had called a friend and left a message for her to call back. The friend did, several times, but when Josephine didn’t answer, that friend and a couple of others hustled over to her apartment. Reminding herself that she had to finish her doctorate, Josephine admitted what she’d done. Her friends insisted she accompany them to Kingston General Hospital. What happened there remains a blur to Josephine, but she survived.
Eight years later, she is a manager at a Calgary oilfield services company. Her career is flourishing, and she’s president of the local Branch of the Queen’s Alumni Association. Still, she continues to battle depression.
“It just goes to show that someone can look perfectly normal and be successful and all of that,” says Josephine, “but he or she can still be very depressed on the inside. There’s not really a profile for depression.”
The fact that Tsang attempted suicide is bad enough. Even more alarming is the fact that hers is by no means an isolated case. According to mental health experts, one in four young people experience some form of mental disorder – from depression and anxiety, to bipolar disorder and schizophrenia – while attending high school, university or college. Roughly one in 10,000 will attempt suicide, which is the leading non-accidental cause of death in the 14-to-24 age group.
However, suicide prevention is just one aspect of mental health awareness and promotion. As one undergrad student noted in a posting that appears on the web site of the Principal’s Commission on Mental Health, “It’s dangerous to talk about just suicide when you are talking about mental illness and mental health; a huge issue is living with it. The main struggle is not avoiding suicide. It’s important to have students understand what mental illness is. It’s more than the tragedies.”
There is no doubt that university can be a stressful place. For highly motivated students – and that would be the majority of those at Queen’s – readings, essays, studying for and writing exams can consume 100 hours a week. Some students manage this workload on top of a part-time job and volunteer work. As well, for most undergrads at Queen’s, attending university is their first time living away from home, family, and childhood friends. Not having such stabilizing supports close at hand can make tough times seem even tougher.
These stresses aren’t unique to Queen’s, nor are they new. What is different for the current generation of students is a higher level of uncertainty about the future: constant media coverage of the economic recession, shrinking job markets, and worries about career prospects can weigh heavily on already-stressed students.
In adition to HCDS, Queen’s has had a mental health working group in place since 2007 and offers a variety of services for students in distress. An alarming number of student deaths in 2010 and 2011 lent a new sense of urgency to mental-wellness on campus and sparked a push to broaden the existing supports on campus.
One positive by-product of that year was The Jack Project, launched by the parents of Jack Windeler, an 18-year-old first-year Queen’s student who took his own life in March 2010. The project aims to provide mental-health-related information and resources to young people transitioning from high school to postsecondary education or independent living. A year-long pilot outreach project, delivered online and in high schools and universities across Ontario, is now in progress. Queen’s was among the first post-secondary institutions to sign up. Information about its mental health services is being provided for inclusion in a global database.
On campus, Queen’s has hired an extra full-time counselor and a mental health nurse, and has made it easier to get a quick appointment. Students are more aware now that they can help their friends; professors have become more observant, as have staff members whose work involves interacting with students. The department also continues to offer a number of training programs, from one hour to two days in length, to students, staff, and faculty. Each program is designed to equip people with basic skills that will help them recognize, support and refer individuals in crisis.
Dr. Mike Condra, MA’78, PhD’82, an associate professor of psychiatry at Queen’s, is HCDS’s director. He says that since last summer some 3,000 people have taken the one-hour education session, and there is steady demand for all the programs.
The Society of Professional Graduate students has a peer-student advisor program and the Alma Mater Society offers assistance through a Peer Support Centre that is staffed by students who have been trained by HCDS. The Centre, which is open daily, is a place where students can drop in or call to make an appointment to visit. Confidentially is assured. They can share their feelings of worry or distress with a sympathetic, non-judgmental listener. Evette Yassa, Artsci’12, marketing and communications co-director at the centre, says the demand for services has exploded in recent years, from seven visits in 2007-2008 to more than 300 this past academic year.
"We need to create an environment on campus that says to people, ‘If you’re struggling, don’t struggle alone.'"
There’s also been a lot of action at the top. In September 2011, Principal Daniel Woolf established the Principal’s Commission on Mental Health. Chaired by Dr. David Walker, Meds’71, the former Dean of Health Sciences, the Commission includes senior administrators and one student rep. It has been meeting weekly with students, family members of students, faculty and staff, alumni, counselors from HCDS, and representatives from Kingston mental-health organizations. Feedback from their discussions is being combined with findings from the Commission’s survey of best practices at campuses across North America to inform recommendations for a broad-based mental health strategy for the University. The Commission is expected to release a draft report for community feedback soon.
But, as the Commission has heard, offering counseling for those who need it isn’t enough. The services will be of little use if people in distress are reluctant to reach out for help if they fear being labeled as weak, “crazy,” or unbalanced. Depression sometimes paralyzes even the small motion of picking up the phone.
“We need to create an environment on campus that says to people, ‘If you’re struggling, don’t struggle alone,’” says Ann Tierney, Law’89, MPA’04, who is Vice-Provost and Dean of Student Affairs and a member of the Principal’s Commission. “Those who are in difficulty have to be able to know and to feel that there won’t be repercussions in other areas of their life if they seek help.”
Creating that kind of environment on a societal level is what Queen’s professor Heather Stuart has been trying to do for years. Her efforts got a big boost in February, when she was named the Bell Mental Health and Anti-Stigma Research Chair, the first academic position of its kind in the world. The chair provides $1 million in funding that will enable Dr. Stuart, a professor of Community Health & Epidemiology whose work is internationally known, to continue and expand her research on the most effective ways to prevent the stigmatization of people with mental health problems.
Stigma is a serious issue, because those who are labeled “mentally ill” often have a harder time finishing school, finding and keeping a job and establishing new relationships.
“Once people discover that you’ve been diagnosed and treated for a mental illness, the doors slam shut,” says Stuart. “Being stigmatized can be worse than the mental illness itself.”
Queen’s Rector Nicholas Francis, Artsci’13, underscored that point in poignant fashion when he spoke at the event at which Stuart was officially introduced to the Queen’s community in her new role. Francis revealed that he had first-hand knowledge of what it’s like to deal with a mental health issue, having suffered with an anxiety disorder brought on by being an overachiever who didn’t know when or how to slow down. “The stigma of having to deal with a mental health issue was the greatest barrier to recognizing and coping with it,” he said.
“People have to know that it’s okay to have depression . . . and it’s also okay to talk about it.”
Francis and other speakers noted that while the consequences of mental-health stigmatization are well known anecdotally, there is a shortage of precise data about how often it occurs, its psycho-social effects, and the best ways to prevent stigmatization in the first place. To gather the missing numbers, Stuart is working with the Mental Health Commission of Canada on a program comprising dozens of mental health school outreach programs across Canada. Together, the partners have devised a survey that has enabled them to measure the mental-health stigma knowledge of 10,000 Canadian elementary students before and after they participated in awareness programs in which someone who has experienced mental health problems spoke about what it’s like. Stuart says this “contact-based education” is one of the most effective ways to get the anti-stigma message across.
As a follow-up, one of her grad students is now researching the most effective anti-stigma programs to figure out exactly what made them successful. Were the speakers specially trained? Was the program one hour long or a half-day?
Once these and other details are known, Stuart and her colleagues will be in a better position to design a best-practices manual for organizations that wish to launch or improve mental-health outreach programs.
The hope is that the programs that result will better prepare high school students for the stresses of postsecondary education – and will help create a supportive milieu for postsecondary students across Canada who struggle with mental health problems.
That outcome can’t come soon enough, says Josephine Tsang. “People have to know that it’s okay to have depression,” she says. “And it’s also okay to talk about it.”