Questions of Control and Care: An LYAC Discussion on Mental Health

Report written by Sammy Roach

Why do mental health challenges seem to be increasingly entwined with the student experience?  The LYAC held a discussion about youth and mental health at the Boys and Girls Club of London on August 24th, 2016. Cynthia Gibney and Melanie-Anne Atkins of Western Health Services joined the meeting to give the LYAC a presentation on mental health, pausing for questions and discussion throughout. Overall, while we were able to tease out a few of the reasons why students are struggling with mental health, we weren’t able to dive as deeply into the structural factors at play, creating a sense of some frustration in the room.

Who Should Read This?

  • Students struggling with the jump from secondary to post-secondary education
  • Anyone who is facing mental health challenges or knows someone who is facing those challenges

A Mental Health Checkup

Cynthia introduced the presentation by stating that the need for services in post-secondary school has tripled in the past 5 or 6 years. She shared some statistics to show her point:

  • Students have the highest concentration of mental health issues.
  • 80% of psychiatric disorders emerge in adolescence.
  • Suicide is the 2nd leading cause of death for youth aged 10-24.

Cynthia explained that once students have reached post-secondary institutions, student services like those at Western have sometimes missed the boat on some issues that should have been addressed earlier in a student’s life. Her purpose in speaking with the LYAC was that she wanted the group to advocate for for not only post-secondary students, but also younger students to try and address issues earlier in their lives to create a smoother transition to post-secondary education.

Melanie-Anne also shared some statistics from a National College Mental Health Survey that Western University took part in in 2013. These were some of the findings:

  • Generally increasing rates of people with suicidal thoughts
  • 46% of people indicated that they were feeling more stress than normal
  • 10% of people indicated that they were under tremendous stress

Addressing the changes in suicidal thoughts, Cynthia explained that suicide rates weren’t changing, but people talk about it more, which can make it feel like it is changing.  When asked about the Woodstock crisis in context of this fact, Cynthia argued that while mental health is not contagious, there can be a contagion factor.

(Sometimes) Controllable Risk Factors

Cynthia discussed the idea of controllable risk factors, explaining that controlling sleep, exercise, and eating habits along with social interaction can amount to preventative self-care and maintenance of mental health. The concept of controllable risk factors quickly generated discussion.

  • One member of the circle explained that she has often missed sleep from helping friends through their own mental health crises. Cynthia explained that she should look after herself first.
  • When asked what she would say to a person who has to work to support their family on top of going to school in terms of controlling their sleep, Cynthia explained that controllable risk factors are intended for the average person, not the extremes.
  • One of the councillors argued that it is already clear that getting enough sleep is healthy. The problem is that we need to figure out why people aren’t getting enough sleep.

A chord was struck that seemed to resonate in the room: We know these factors (eating well, exercise, sleeping, connecting with others) will lead to better mental and overall health. Why are youth struggling with mental health on an increasing scale with such intensity if these risk factors are apparently controllable?

Some of the “why” that was missing surfaced as Melanie-Anne began to delve into some of the societal issues surrounding mental health. She asked the group: When did you last talk about your feelings? At this, there was laughter throughout the room as the circle communally acknowledged the societal taboo of discussing emotions. Melanie explained we were allowed express our feelings in early childhood, whereas as we grow it seems like a weakness to seek support, and we don’t necessarily practice the self-care habits we learn at that young age.  Melanie-Anne asked the circle for some other reasons why someone might choose not to engage in self-care. These were some of the group’s thoughts:

  • It feels selfish to care for yourself.
  • You might be in a state of mind where you feel you are not worthy of being cared for, whether by yourself or someone else.
  • It’s a matter of convenience: it’s easier to take the worse action in the moment.

These are definitely reasons why someone might lose control over those risk factors. Feelings of unworthiness when tied into someone’s mental health state can quickly create a situation where self-care becomes nearly impossible. Melanie-Anne discussed stress next, arguing that normal amounts of stress can offer a positive effect. Parts of the room seemed to be disengaged during the conversation. There was a sense that the presentation was treading well-worn ground.  Youth and particularly students are thoroughly familiar with stress. What was missing was a discussion of the structural factors that might be contributing to stress, particularly factors that might be built into the institution of the university.

Early Interventions

Cynthia explained that Western Health Services wants to get their messages to young people before they get to post-secondary. However, reaching a younger audience is not without its challenges, as councillors shared their experiences of attitudes towards mental health from their high schools.

  • Getting help in high school often requires parents to have some sort of health insurance, and even then, there is a limit to the number of sessions.
  • One person in the group explained a student committed suicide because his school didn’t have the mental health supports needed to help that student.
  • Teachers can sometimes prioritize achievement over self-care.
  • Teachers and later, professors, can sometimes buy into the stigma by thinking that students are using mental health as an excuse.

Cynthia argued that because health care has not caught up in high schools, we have to focus on self-care through controllable risk factors. However, is educating young people before they get to university enough?  There are still seemingly insurmountable barriers, systemic issues such as poverty and racism, that can stand in the way of someone taking care of their mental health. Cynthia made an analogy to smoking. She explained that when she was young, everyone smoked, but over the years, people were recultured to stop smoking. One of the councillors argued that smoking is a visible practice, while mental health issues can often be an invisible illness, to which Cynthia responded that mental health issues are more visible now than they have been in the past. Melanie-Anne added that the change has to start with individuals.

With that call to action, the meeting drew to a close. After thanking the presenters, the group began to break off and depart, with some councillors going to chat further with Cynthia and Melanie-Anne. As I prepared to leave, I overheard a councillor talking about how he had just taken on a second job. While I didn’t know this particular councillor’s full story, there are many young people who may need to work multiple jobs to support themselves or their families. At that point, how much control can a young person have when the choice is between maintaining basic needs versus personal mental health?

Personal Stories

One member of the circle shared some insight on how mental health was perceived at her high school, having grown up in a small town. Access to mental health care was rare, and because of that rarity the students who could get help were then stigmatized as being the “troubled kids.” This is important to keep in mind when thinking about both early intervention and what works for the “average person.” There are so many factors that influence a person’s ability to receive care and their experience if they are able to get help, and this includes the community setting. An “average person’s” experience in a small town can vary greatly from an “average person’s” experience in a densely populated city.

Big Question

  • How can we change the conversation around mental health to include intersectionality, thereby examining all of the different factors that can prevent someone from caring for their mental health?

Reporter’s Notes

I picked up on a sense of disconnect with some of the presentation. Looking around the room, it was clear that not everyone was fully engaged, and perhaps that’s because the councillors were looking for something more from the conversation. We already know that eating well, exercising, getting enough sleep, and social interaction are important to maintaining health. Self-care is definitely an important practice, but depending on someone’s situation, the level of control someone has over those risk factors is questionable. It’s true that Cynthia explained that the controllable risk factors are intended for the average person, not the extremes, but who is the “average” in these discussions? How many youth are putting themselves through school and/or financially supporting their families? The numbers might be less extreme than we think.

Things We Still Need to Learn

  • What are the reasons for the increasing stress in student’s lives? Can we break the statistics down further and find the reasons that might reveal why students are having less control over the risk factors that are an essential part of self-care?