Commentary  I Am Not Your Canary

How McGill Added $3,120 to My Costs This Year

There’s a saying that goes something along the lines of “a canary in a coal mine,” meaning a warning of things to come, a red flag that there’s danger ahead. Until around thirty years ago, miners would bring along small birds, kept in tiny cages, down below the earth. If the birds became sick or died, it was a warning to the miners that there was toxic gas, and they needed to get out. Unlike McGill’s heraldic martlets, canaries are real birds — small yellow creatures whose bright bodies became sacrifices.

This is my message to McGill University: I am not your canary. I am still alive.

Last year, McGill administrators made the decision to stop “offering” – their wording, not mine – long-term counselling. This unannounced change came after many restructurings of the fractured pieces that make up the “McGill mental health system,” making it more difficult for students to access services, and more difficult for staff members to provide assistance. I initially found out about this most recent change when I met with a point-of-contact in what had previously been called Counselling Services. After our third meeting, and consistent pressure to switch to group workshop sessions – group meetings which had done more harm than good, a previous counsellor agreed – she handed me two pieces of paper. She told me they were no longer offering long-term counselling, and that I should use community resources instead. She told me to keep trying the EmpowerMe website, though I had told her that EmpowerMe had never called or emailed me back the many times I had contacted them. She was surprised when I told her that EmpowerMe does not offer support beyond a few sessions. She said that of their own initiative, the Counselling Services office had created the two sheets of paper with contact information to aid students in finding help, and she circled a few offices that she thought would be particularly helpful.

She told me good luck, and I left. I cried. The papers are still on my coffee table.

From early December 2018 to the end of May 2019, I found myself on a waitlist for a sliding-scale appointment at two different Montreal therapy centres. During that time, I changed medication – at the suggestion of my psychiatrist, due to a complex medical situation – and became increasingly suicidal, depressed, and anxious. I spent most of the months between March and June sitting on my sofa, watching YouTube videos, trying desperately to write, or grade, or do anything to distract myself from the choppy seas of suicidal ideation. I reached out again to Counselling Services, and was told I could have a one-off appointment, but would be unable to access any kind of regularized care. My partner became my de facto support system, putting immense pressure on him. Floating in an SSRI/SNRI-shift-inducing haze, I was consistently told there would be no long-term counselling option, though this was not and is still not noted on any McGill website. I was repeatedly encouraged to find resources in a nebulous “elsewhere.”

This is my message to McGill University: I am not your canary. I am still alive.

On days when I could get myself out of my apartment, I did everything I could to advocate for myself (even while being consistently misgendered, both by administrators and whenever I sought help through the now “Wellness Hub”). Previous experiences in my own department (my Graduate Program Director losing my disability paperwork, faculty complaining about students with mental illnesses in department meetings, and receiving pushback in regards to necessary accommodations) dissuaded me from seeking out support there. I had a meeting with Graduate and Postdoctoral Services (who asserted it would simply be “better” for students to take time off, without medical insurance and away from support systems), a meeting with the Office for Students with Disabilities (who said that graduate student accomodation effectively ends when coursework does), and a few meetings with the Deputy Provost of Student Life and Learning (who complained about students “faking” mental illnesses and “clogging” the system). I participated in a number of McGill-hosted surveys and focus groups about mental health, with those running the groups pushing back when I shared my own experiences.

“It couldn’t be that bad,” I was told, over and over again.

I am so grateful to the staff in what was formerly known as Psychiatric Services for their support – I am not the only one who has put a line dedicated to the Psychiatric Services secretaries in a thesis! – but mental illness cannot be “solved” through medication alone. Or spin bikes. Or yoga. Or TEDx talks. Or handing someone with a long history of mental illness a list of tips that border on insulting. Or yet another restructured system, forcing those of us with chronic illnesses to exhaust ourselves by bouncing between short-term fixes. I fully support people whose wellness is improved through things like exercise or meditation, but switching long-term counselling for cheaper alternatives is yet another violent, neoliberal act parading as “care.”

I fully support people whose wellness is improved through exercise or meditation, but switching long-term counselling for cheaper alternatives is yet another violent, neoliberal act parading as “care.”

We have too many administrators for it to fall on me to figure out a way forward for supporting students with disabilities. I have met with a number of administrators, including Martine Gauthier (Executive Director of Student Services) and Vera Romano (Director of the Wellness Hub). I have been told that McGill is “shifting to short-term, episodic care,” with few details on what is left for those of us who don’t fit that model. I have been told that McGill staff are “referring” students out of McGill and towards community resources – but when I asked about specifics guidance for students who had been part of this “referred out” process, I was told that things are “in development,” with no firm date or plan. I have been told that there is “no cap” to counselling appointments, but that it’s been “limited.” I have been told that the decisions to use approaches not backed by research are part of an “evidence-informed” strategy. I have been given numbers of students who accessed McGill’s mental health care services when I pointed out the economic burden and privilege of accessing care, as if more students accessing free care somehow cancelled out those of us who pay thousands to access care that keeps us living. I have been told that changes “only affect a few students,” thereby justifying violent and bureaucratically- quantified collateral damage. I have been told that “transparency is key” when the current Executive Director of the Wellness Hub has a history of cutting vital services without notifying students who use them. I have been given conflicting accounts about services like access to EmpowerMe and Peer Support, while in reality these are student-run initiatives, not something the Wellness Hub should take credit for, and not a substitute for long-term medical care. When I brought up the issue of financial hardship in meetings with senior staff of the Wellness Hub, I was met with confusion: they had no idea how insurance for international students works, though almost a third of McGill students are from outside Canada.

I have been told that changes “only affect a few students,” thereby justifying violent and bureaucraticallyquantified collateral damage.

After these meetings, the director of the Wellness Hub later reached out to my psychiatrist to have her (my doctor) try to talk to me about my administrative concerns during an appointment about my medical care. I do not believe that my feedback to administrators necessitates contacting my care provider, and efforts like these are similar to ableist attempts to discredit concerns about healthcare by painting those who complain as “crazy.” Breaches of ethics – and perhaps law – like this have added to my anxiety, have made me unlikely to suggest that students contact the Wellness Hub to give feedback. They also mean I cannot support programs like McGill’s Early Alert System, a way for teaching staff to anonymously refer students to the Dean of Students through e-mail or a MyCourses widget. It also means that I might need to leave yet one more care provider in order to seek support outside McGill, further adding to my financial strain.

After so many meetings with administrators, I still do not know who made the decisions to stop students from accessing long-term mental health care, or why those who need long-term care for chronic needs have not been informed. I also do not know how (or if ) we disabled people were included in the Wellness Hub’s restructuring. What I do know is that my budget for the 2019-2020 academic year is a constant source of stress, as the Wellness Hub’s lack of a clear plan – as well as sudden lack of services – means that as a disabled student, I have had to take on a second job to pay for my medical care, while also trying to write my thesis. I calculate that I will need an additional $3,120 to cover the outof-pocket costs just for my therapy (not including medication costs, for which I’ve paid up to $1,000 upfront). According to my own research, I can reclaim a maximum of $750 from the Blue Cross insurance that I pay for as an international student, and StudentCare will pay for a maximum of $500, which means that I can hopefully get half of my projected costs eventually covered. These recouped amounts are not guaranteed, and do take time to process, but will go some distance to help make ends meet.

My current budget also came with a very real cost to my wellbeing: when I was suddenly pushed out of Counselling Services, I made the decision to wait for a slidingscale appointment at a therapy center recommended by a nonMcGill friend. Counselling Services originally referred to me services that would have been at least $150 an appointment, totalling $7,800 for the academic year. Making a serious financial decision while in crisis – and afraid of future, uncertain medical costs – I decided to wait until I was off a waiting list. This choice meant that I spent months waiting for an appointment until I finally was accepted at a Montreal-based therapy center. While I now have an amazing care provider outside of McGill, over the summer, I did end up in the Emergency Department of a local hospital.

No one should ever have to do what I did.

In full disclosure, I am lucky. I have an amazing partner who literally saved my life. English is my first language, I speak advanced French, and I know how to quickly rattle off my medical history and current medications. I know how to navigate the Montreal hospital system. I have parents who can loan me some money to tide me over, ensuring I could still access care when my medical needs suddenly spiked beyond my graduate student budget. But all of this does not mean what is happening to me is okay, acceptable, or even that I’m the only one. Substituting spin bikes for therapy, quietly removing access to evidence-based mental health services, and relying on local units’ initiatives to create printed handouts in order to solve complicated, longterm medical problems will result in casualties. Making accessible mental health care a low priority – when there is so clearly and desperately a need for it – means that there will be preventable deaths, alongside the pain and distress that comes with fighting for medical care when just fighting to live is overwhelming enough.

Making accessible mental health care a low priority means that there will be preventable deaths, alongside the pain and distress that comes with fighting for medical care when just fighting to live is overwhelming enough.

In making the case for accessible mental health care, I have had people ask me for specific information, for statistics. I could refer you to the fact that 37 per cent of OSD-registered students are registered for a mental health disorder (not including those who are registered for multiple reasons). I could continue to shout about how forcing students to take leaves of absence is ableist nonsense. I could quietly tell you that every time I see an article about the Wellness Hub’s “integrated” approach to mental health, or McGill’s rankings, my stomach drops. I could print out yet another article about mental health in academia – including how neoliberal approaches like McGill’s don’t work – and slide it over. I could send you an op-ed about how mental health shouldn’t be an issue of institutional reputation, but of care. I could pull up the Canadian Association of College and University Student Services (CACUSS) website on campus mental health, to illustrate how McGill’s mental health support pales in comparison to their recommendations. I could e-mail you the most recent NCHA/ACHA data, showing that over 20 per cent of university students have been diagnosed with depression, and nearly 12 per cent of university students – at McGill, that would be almost 5,000 students – have seriously considered suicide. I could also explain that for transgender and non-binary young people, rates of suicide attempts hover at around 50%. I could pull up the Wellness Hub website, and point to the 12-13 week wait time to see a psychiatrist. I could show you how there is little data behind the very broad apps that McGill promotes, and how these apps raise serious concerns about privacy, as well as very serious questions as to whether they are even appropriate for certain mental illnesses. But, unpaid and unasked, I have done this over and over again, and I am so, so tired.

Instead, what I will say is this: I am still here. Thanks to my partner, a close friend, and the Emergency Department at St. Mary’s, I am still here. I have not died yet. For now, I am not your canary.