Mental health services at their limits

A look at the serious issues facing the university's other health care clinic

When an anonymous article detailing one student’s struggle with suicidal thoughts during her university career appeared in the Harvard Crimson last month, the response from students was overwhelming. In the course of three weeks, over 100 students from across the United States posted comments to the article online, most either thanking the author for her courage to speak out or recounting an equally horrific experience. “[I] Guess this is the right platform to come out and address the dark underbelly of a supposedly successful IVY-League professional life – six unsuccessful attempts at suicide, three of which ended up in the ICU,” one Harvard student wrote.

The widespread response to this article is indicative of a recent upsurge in the number mental health problems among university students. According to a U.S. national survey, the number of students who visit university counseling services with serious mental illness has doubled in the last decade, along with an increase in the number of students requiring prescriptions or emergency care.

At McGill, the number of students using McGill Mental Health Services (MMHS) has risen at an equally alarming rate. According to the Director of MMHS, Robert Franck, the service has gone from caring for 1,000 students over the 2000-01 academic year, to having scheduled an estimated 20,000 visits from the beginning of June 2010 to the end of May 2011. Of these, 1,100 were emergency drop-ins and 1,500 were new patients.

The question of whether MMHS is prepared to meet these increased student mental health needs is one that must be seriously addressed.

In the past few years, MMHS has seen improvements in a number of areas. According to Franck, wait times have gone down since last year, and more effort has been made to introduce non-medicinal anxiety treatments to students. The introduction of mindfulness groups (or Cognitive Behavioral Therapy groups) and a university-based eating disorder program are some of MMHS’s recent achievements to have gained recognition from other universities.

But as the school population grows larger, MMHS’s current model is likely to fail certain students.

Financial and structural problems continue to prevent MMHS from obtaining its ideal goals to provide sufficient care for all students. Currently, MMHS has a staff of only twenty part-time workers – composed of ten psychiatrists, five PhD students, and five psychologists – the equivalent of ten full-time staff.

“I would like more full-time [professionals], but part of the problem with psychiatrists is that I’m in competition with the hospital system. So getting a psychiatrist to come and work here means that they really can’t work at the hospital and obviously hospitals can afford to be more generous financially than McGill can,” said Franck.

At the moment, MMHS receives its funding from both the provincial government and Student Services. In 2008, they tried to raise the mental health fee for graduate students, but the increase was voted down. “The only way we can increase funding is to get money from students…the implication of that [vote] was that the money we were relying on from PGSS to fund extra hours amongst clinicians wasn’t available.” This March, PGSS will  vote again on the increase.

When asked whether the administration would consider donating funds to MMHS in light of enrolment increases, Deputy Provost  (Student Life and Learning) Morton Mendelson insisted that there was no room in the administration’s budget for any new ventures: “It’s taken student money, that’s just the financial realities,” he said. “Some problems you can’t solve by throwing money at [them].”

And while Mendelson’s response echoes the adminstration’s neglectful attitudes toward students needs, there is indeed reason to criticize how MMHS currently functions. Although McGill is one of the few Canadian universities not to cap the number of sessions available to any student, and offers psychiatric consultation without referral, its open-door approach has both encouraged expedient means to health care and placed more stress on its current services.

Arden Keller, the pseudonym of a U3 Arts student used MMHS both when treating her anxiety disorders and working on suicide prevention. In an interview with The Daily, she discussed the failures of the system to deal with students whose mental conditions require more than just short-term care. “They can do assessment but they can’t do treatment,” she said. “‘MMHS’s system in my opinion is just a glorified triage center….”

In her own experience, Keller’s biggest criticism of MMHS was its lack of policy concerning how to care for suicidal patients: “I remember going in once – and it was a couple days after a suicide attempt and being like, ‘I think I’m going to do it again’. And I had this one doctor and she actually said, “I don’t know what to do here.’ That’s when I realized that they don’t have a system in place to deal with students who are really suicidal.”

The possibility that such established systems have been worn down because of MMHS’s overrun services is not unlikely. As Keller noted, “I don’t think that the people work[ing] there lack empathy or don’t care. I think they’re probably doing the best they can with a really, really broken system.”

In the upcoming year, Franck hopes to establish ways of getting more feedback from students and improving upstream health care. His plans include creating a student survey with the help of Students Services, and increasing Mental Health’s overall campus presence. “I’d like to see MMHS get more involved in outreach,” he said. “Mental health is more than just the absence of mental health it’s….looking at…how to encourage adaptive coping strategies amongst students early on.”

Yet more funding and a stronger presence from the administration is needed for MMHS to meet the demands of students. As Keller explained, the consequences of this continued neglect are dire: “The bottom line is, it’s not just about frustrating waitlists and being bounced around, it’s the system failing people.”