Hitting the panic button: How Camosun is dealing with student mental health, and what needs to change

Features April 4, 2018

Mental health is talked about now more than ever before. Efforts to reduce stigma are seen online, on television, on bus ads and billboards, and pretty much everywhere else we look. Here at Camosun, there are year-round efforts to make it easier for students to reach out and find the help they need.

But is it enough? As it turns out, no. The college is struggling to keep up with the number of students who need help. The current Camosun College Student Society (CCSS) student wellness and access director is worried about what will happen once she’s no longer in that position. Students are struggling, students are stressed out, and everyone is concerned about what will happen next.

MORE THAN MEETS THE EYE

Cam Webster is a 22-year-old student taking Health 110 at Camosun’s Interurban campus; he’s enrolled in the Mental Health and Addictions (MHA) program, and will start that in September.

Outwardly, Webster looks like the median Camosun student: at a glance, he’s young, energetic, athletic, and enthusiastic. But every one of us has a story that the public can’t see; Webster, for example, found his way to Camosun by a different route than most.

“I found out about the MHA program because I do lots of public speaking through the British Columbia Schizophrenia Society’s Victoria branch,” says Webster. “The first time I did public speaking at Camosun was for a MHA class. I talked to the teacher and the program seemed interesting—right up my alley. I did some more research and signed up, and I’m going to come back part-time after the summer.”

Webster’s life took a sharp turn a few years back, when he first had psychosis less than a month after his 19th birthday. That developed over the next year into schizophrenia.

“It kind of came from out of nowhere, in a way,” says Webster. “I started isolating, and I wasn’t sleeping very much. I had full-blown paranoia and delusions. There were hallucinations and I was hearing stuff. Sometimes I was afraid to go outside. I thought there were people on my roof who were going to attack me if I left the house. When you look back, it makes no sense, but when you’re psychotic, your insight fluctuates. Most of it, even hypothetically, couldn’t happen, but at the time you’re 100-percent sure that that’s the way things are.”

Webster has since been diagnosed with schizoaffective disorder, which is schizophrenia with a concurrent mood disorder. Webster says most people aren’t familiar with the disorder, so he calls it “schizophrenia and depression” when describing it.

“Most of the psychotic symptoms I had, like hallucinations and delusions, are gone, but there are still impairments with executive functioning,” says Webster. “Avolition, which is problems with initiation and motivation. Attention and memory are affected. There is no medication to treat those. It can get better with time, but you have to grind, because there is no medication for that.”

Webster says it was hard to get the right medication, because it doesn’t kick in right away.

“They give it to you, and you have to wait at least a month to see if it makes any difference,” says Webster. “So I was on risperidone for a few months, and then olanzapine for a few months, and then clozapine, which works pretty well. That’s the strongest medication they have. I’m on an antidepressant right now called venlafaxine, which apparently increases the potency of clozapine; that’s the only reason my psychiatrist put me on it.”

Webster says that medication has helped a lot. After two years, he says, all of his psychotic hallucinations and delusions were gone.

“I definitely couldn’t work or go to school without [medication],” says Webster. “I’d probably still be in the psych ward.”

This story originally appeared in the April 4, 2018 issue of Nexus.

While he admits that life isn’t perfect, Webster says that it gets better, and he knows where he wants to go with his education.

“I want to work in a field that I’m interested in,” he says, “somewhere I can help people and make a difference for them. That’s my main focus—somewhere I can interact with people in small groups and help them out as best I can. I’m doing MHA, but I’m interested in psychology, health care, or social work.”

Now that he’s back in school, Webster says he can get agitated, and sometimes he feels irritable and stressed out.

“It’s hard to focus and keep up sometimes, and remember everything they talk about,” he says. “It’s getting better. It used to be really bad. There are still some issues with that. I can get disability resources with the college.”

Webster says he takes advantage of the counselling services Camosun offers, mainly at Interurban, because it’s closer to home for him.

“They can help to get me extra time,” says Webster, “or quiet rooms for assignments. They help to get me in touch with tutors. I can talk to them about where I want to go with my schooling, stuff like that.”

Webster says that he may one day pursue a degree, but he doesn’t want to get too far ahead of himself.

“I’ll do Mental Health and Addictions and work for a bit and see how much I like it,” he says, “then maybe take more school.”

Webster has done a lot of work outside of school and says that cognitive behavioural therapy has been particularly helpful.

“You look at thinking, behaviour, and feelings,” he says. “You can’t really change how you feel, but if you change how you think and behave, that, in turn, will affect how you feel. Over the long term you can change the way you feel. My counsellor tells me that every emotion is the same—it comes and it goes. You’ve all been insanely stressed out, but you’re not now. You’ve all been ecstatically happy, but you’re not now. Stress might suck, but it will pass. Focus on what you can do in the moment. I also use support networks of friends and family. That’s also very helpful.”

Webster currently uses lived experience to help others in the community. He did a stint facilitating a course through the BC Schizophrenia Society called the Wellness Recovery Action Plan, which Webster says is a contingency plan that focuses on teaching people who are unwell how to stay well. He also co-facilitates a mental-health group every Thursday night through the Stigma-Free Society, where, he says, people with lived experience can talk about it and have someone to listen to them.

STUDENT SOCIETY HELP

CCSS student wellness and access director Melanie Winter has had more than her share of difficulties with trauma in her life, and now she uses her lived experience to help others on their journey.

“My school route is unlike most people,” says Winter. “I lost my dad to suicide when I was 17. Somewhere in between that grief and wanting something more in my life, I just realized that I couldn’t run away from that grief. I had to face it head on, and kind of be okay with it. I did that by doing volunteer work, and it made me understand suicide, mental health, and people in that position more than I ever would have on my own.”

Winter thinks that hearing other people’s stories helped make her realize that it wasn’t her fault.

“It’s been pivotal in my journey of grief,” says Winter, “because you never get over something; you get through it. When you work through the inside stuff, you are, literally, tearing down walls. If you work on the inside stuff, you can trailblaze. If you don’t work on the inside stuff, you have bushes in front of you. There is a big difference between the two.”

Winter went to Grant MacEwan College in Edmonton for a couple of years after graduating high school; she thought at the time that she wanted to be a social worker.

“I knew at that point I wanted to find work where I gave back,” she says. “Many people do; that’s why so many people get into counselling. A very wise person said to me, ‘If you’re the type of person who’s meant to help somebody, maybe think about the options of helping.’ I only had one vision of what help looked like. At that point, I was trying to help myself, while helping other people, which is really tricky. You cannot help others unless you help yourself first.”

Winter says that she was a small-town girl with this giant world around her, and she was navigating it alone because everyone around her was also grieving; grief just feeds grief, she says. Winter dropped out of school after not getting good grades and became a dental assistant, because it was a one-year program.

“I wanted to be in school, and I didn’t want to stop moving forward in life, because I knew the opposite,” she says. “Who was going to pick up the pieces, other than myself? Everybody around me was struggling.”

Winter then moved to Victoria to work as a dental assistant. She says that within a year of being here, she was homesick for the experience of post-secondary.

“It’s a university town and I felt really withdrawn,” says Winter. “I went back to school for a business degree in human resources, because I think I realized that we spend all of our time in the workplace, and I wanted to focus on employee wellness in the workplace. I can’t support everyone in their home life, but I can support people in their work life. I started volunteering, and it’s all just lining up the way it should.”

After returning to school, this time at Camosun, Winter soon saw that there was not a lot of conversation around mental health. She says she was doing a lot of work on campus with Camosun College counsellor Chris Balmer, and she wanted to get into the student society to see how it works.

“I actually started as the women’s director, because there wasn’t really a place on the student society for mental health,” says Winter. “There was not a lot of conversation, in my opinion. There wasn’t really a lot of room to create a new position, but there was room to change the definition of the students with disabilities [director] to student wellness and access. This is the first year for this position, but in three of my years here at Camosun, it was focused pretty heavily on bringing mental-health conversations to the college.”

Winter says that she has talked to the college in depth about having students who graduate become a part of the college community, and to create jobs around mental-health awareness and related issues. In her current role with the CCSS, Winter has already had practicum and co-op students want to be a part of the work she does, but she says there is not enough support in place to make that happen on an ongoing basis.

“Chris [Balmer] mentored me, but I have to graduate and leave at some point,” says Winter. “There isn’t one single person right now that I think I can pass the torch over to right now. It should be expected that somebody should be the next person in line. Student elections are going to happen soon. If nobody runs for my position, or the person who runs has no clue what I’ve been up to, it’s going to be lost. Three years of work, completely gone.”

FROM THE INSIDE OF THE COLLEGE

Chris Balmer is very familiar with Camosun’s Counselling Centre services: he’s been with the department for 30 years. Aside from being a counsellor at the college, Balmer is involved in coordinating the implementation of the Student Mental Health and Well-Being Strategy.

“We provide what we feel is a very flexible, full suite of services for students around counselling,” says Balmer. “Career counselling, support around learning, academic support in terms of stresses like test-writing anxiety. Anything that we can do to help with supporting students that are having difficulty within their program—personal difficulties, academic difficulties, and, of course, in counselling.”

The counselling department works alongside Camosun’s Centre for Accessible Learning; Balmer says the two departments consult each other frequently and cross-refer students if necessary. Balmer says that they work together to support students with disabilities who need to get support or accommodation from an instructor.

“We also consult directly with instructors who are having difficulty supporting students in their classes,” says Balmer, “or dealing with situations that are either upsetting or confusing to instructors, through the mental-health lens, helping them understand these behaviours—for example, people having anxiety triggers in classes. If that person is an anxiety sufferer, so to speak, it’s normal that certain types of demands are going to trigger them more predictably and more quickly than others—unexpected pop quizzes, this kind of thing.”

Balmer says that the majority of the role of personal support counselling, for the last 10 years at least, has been supporting students who are experiencing anxiety and depression, often around relationship issues, trauma, grief, breakups, or deaths in the family.

“60 percent of the psychopathological disorders seem to show up between the ages of 14 and 24,” says Balmer. “That’s the range of students entering college and university. We see many students who have emergent signs and symptoms of psychological distress. We see lots of students who have [been] pre-assessed, diagnosed, and are currently being treated for bipolar disorder, schizophrenia, and some issues around anxiety and depression… It’s very much the case that we’ve had to become very informed and aware of mental-health disabilities, issues, and treatment strategies for those.”

CAMOSUN NEEDS MORE

Jody Watson is an instructor in Camosun’s MHA program and is currently acting as program lead. Watson has a master’s in counselling and a private counselling practice. She’s worked in the mental-health field for about 20 years in different settings.

The MHA is a 10-month certificate program that starts in the fall and ends with a six-week practicum in the spring; Watson says that it used to be a mental-health program but the addictions component was added a few years back, as well as an indigenous populations component. Watson says that this all makes for a far more comprehensive program.

“We cover therapeutic communications,” says Watson, “which is basic listening skills, and what we call microskills, which is about asking open questions and how to reflect content back to people. We are really trying to work from a trauma-informed practice, how to work with people with the assumption that many of the people we are working with have some sort of trauma in their background. We teach support strategies. We have an entire course just on understanding addictions, where we cover different substances and recovery methods. They do a course that covers different psychological issues. Most of the people out there with mental-health issues are affected by schizophrenia and bipolar, so we cover them both quite a bit. They do the indigenous course and a health course. It is a pretty full program. It used to be a three-month program, so it has grown quite a bit to cover more area.”

Watson says that mental-health struggles have become more prevalent throughout society.

“For children and youth, it’s anxiety, which has had a big increase,” says Watson. “As an instructor, I can tell you that I have seen an increase in anxiety in students, as well. For the population we are trying to support with substance use, the mental-health concern we almost always see there is a trauma history. Often with people you see every day on the streets, or on the bus, or in the classroom, it’s anxiety or depression.”

Watson says that depression and anxiety just make everything feel harder.

“That is something we see with students with anxiety,” says Watson. “It’s really hard to get their work done, and then the work piles up, and that causes even more stress and more anxiety, and they’re feeling overwhelmed, and it becomes a cycle.”

Watson says the college recognizes what’s happening, but she says students don’t have enough support.

“We do not have enough counsellors at the college,” says Watson. “Our students need more support. We’ve seen a growing trend in our program with students dropping out, or cutting back their courses. They are just getting so overwhelmed, and we don’t have enough supports in place. What we do have in place is awesome—Chris Balmer has done an amazing job working to reduce stigma and talking about mental health, but we still need more support. That goes for our community, as well. People shouldn’t have to wait for support when they need it.”

Balmer says Watson’s statements “seem accurate” and really resonate with him.

“I think [we need] different levels of support, too,” he adds. “I think we can always use more counsellors. Right now, with one counsellor sick at Interurban, we have six students, four of whom are urgent, that need to be placed with other counsellors at other campuses today—just in one day. When they are urgent, that means they cannot wait for the next appointment. Recognizing that we haven’t had an increase in counsellors in 10 years, while the population has grown steadily every year… That sounds like a political leverage statement, but it’s true. Our coordinator, myself, and the chair of the department talked the other day, and I heard that Camosun is at almost twice what the recommended ratio is for students to counsellors in a post-secondary institution.”

After hearing Watson’s statement and Balmer’s reaction, Winter was reminded of a powerful quote she heard from mental-health advocate Scott Chisholm at Mental Health Week back in October.

“He said something,” she says, “that really resonated with me: ‘We will do anything after somebody dies by suicide to make sure it never happens again at our post-secondary institution, but we won’t put in the preventative work to make sure that nobody ever gets to that point.’”

Winter says that we know that, historically, change has usually occured because something traumatic has happened.

“When we have this crisis overload of students needing support,” says Winter, “we have to scramble to get the supports in place, instead of having it so people can come for help when they need it. Preventative work is having counselling in place to have a casual conversation about your life and your mental health. We focus way too hard on postvention-style work, rather than prevention. When people are at crisis, that is too late.”

Camosun vice president of student experience Joan Yates oversees the college’s counselling department. Yates agrees with Watson regarding the shortage of counselling support at the college.

“The reality is, at Camosun, like many institutions, in fact, in society in general, we need more support,” says Yates. “I think it’s an incredibly important area, and I believe very strongly that when students need help, it needs to be there. We need to be providing help. I understand that completely.”

Yates says that this is an area of concern that is currently being addressed at the college. She says there is a new portfolio of student experience at Camosun, and counselling is part of that. A new director will be coming in to assess all of the college’s services; Yates says it needs to be clear to students where they can go to get help.

“Part of our focus is looking at how we provide all of these services,” says Yates, “and how we do them in a way to maximize the resources that we have. The college has, over the last two years, invested considerably more in support for students, to the tune overall of $1,300,000. Across the board, not just counselling.”

Yates says that there has been conversation around an increase in the number of counsellors, but she sees that as a short-term solution. Yates points to the work that Balmer does as being really proactive, because it’s about getting to students ahead of time.

“The primary goal is to help students be more resilient in general, then look at what we need when students have issues,” she says. “Maybe Camosun is not always the best place for that, so we are talking to folks in the community who provide these services right now, as well as looking at what our counselling department needs, overall.”

Yates says that students being overwhelmed with programs is also something that the college needs to take a look at.

“Part of the examination we should be doing as a college is to find out whether that is the students’ fault, or is it the way we design programs? Is it chicken, or is it egg? For example, why is every assignment due on the same day, or in the same week? Why are all the exams happening in a compressed time frame? Why do exams even have time limits? Are these things that actually pedagogically make sense, or are they things that cause undue stress? It is a big, big conversation that I am willing to tackle and have as an organization,” she says. “I think with the support I’m getting at the college from senior leadership, students will be seeing some of that dialogue happening, certainly within the next six months.”

A SOCIOLOGICAL PERSPECTIVE

Camosun sociology instructor Peter Ove has a psychology degree and has taught courses on mental health at UVic in the past. He says that in order to understand the increase in diagnosed cases, there are a number of things to think about.

“One is whether we’ve gotten ‘better’ at diagnosing these conditions,” says Ove, “or whether or not they’re actually on the rise. That is the same across the board, for autism and things like that, as well. There have been changes in diagnostic criteria and our sensitivity to these conditions. The question is whether they existed before and we simply ignored the people who had them, or the prevalence has actually increased.”

Another issue, says Ove, is if they are more prevalent, what is actually causing them? Ove says that the prevalence of these conditions might be related to the way we think about them. Depression and anxiety, he says, have always been diagnosed according to how much harm or challenge they are causing the person involved, and usually that is determined by self-report.

“If you’re depressed and you agree with the professional that it is causing you significant challenges in your life, then you can be diagnosed with depression,” says Ove. “If you’re feeling depressed but you’re saying it’s not affecting you, then you won’t be diagnosed with depression, and you may not consider yourself depressed. What I’m saying is there is a difference between what might be seen as the underlying condition or emotion or state and our societal acceptance, or thoughts around it.”

There is an anti-psychiatry movement that Ove says was popular two or three decades ago, and it has had a small resurgence in critical theory.

“I always teach about the medicalization of society,” says Ove, “which is consideration around how, more and more, we are encouraged to see ourselves as ill. It’s not supposed to mean that we don’t respect people’s opinions about it, and we don’t think that people shouldn’t be taken seriously when they are depressed or anxious. For example, through the sale of some antidepressant drugs, we are encouraged to see ourselves as ill, because then we are needing of these drugs. The anti-psychiatry movement and the critical perspective kind of focuses on the fact that our society creates an environment such that people do end up being more anxious.”

Ove says that another point that’s worth noting is that the prevalence of depression and anxiety hasn’t risen equally across the board—it’s always been gendered. For example, Ove says women have always been diagnosed with depression and anxiety more often than men.

“Whether or not that’s because they are more willing to come forward and discuss it more than men has been a debate,” says Ove. “Some people have said that this actually relates to the sexism in our culture. You get this combination of women being able to be, and encouraged to be, more emotional than men. Therefore, they end up being able to talk about, and maybe even feeling, that sadness and depression more than men.”

On a personal note, right now I should be editing this piece leisurely rather than madly typing in order to meet deadline. The truth is that, as the result of recent circumstances, I’ve had some struggles of my own, and I lost a day of work. Yesterday, while I had planned on writing the body of this story, I was sitting on the couch in my office, with the lights off, staring expressionless at the wall, when a friend walked in and asked me if I was okay. Thankfully, I took that opportunity to talk about it, calming myself down enough to pull up my socks and go to class and give a presentation—which was improvised, because I was so stressed out I couldn’t put pen to paper the night before.

While I sat in the darkness, the world was on fire inside my head. This isn’t a unique scenario, but I knew the solution, and that is a telling fact. I moonlight at a desk where I offer support to others if they’re struggling. I’m well aware of the counselling services here at the college. I have a widespread network of family and friends supporting me. I could have sent an email, or told my teacher what was going on, and I would have been given an extension.

But I didn’t. I stared at the wall.

Why is it so hard to reach out?