Your Health

Mending minds

Red River College initiative aims to enhance student mental health

Meghan Franklin
Meghan Franklin thinks about mental health at Red River College.
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Mental health online

Students at risk

Mental health services

Mind It website

BY BOB ARMSTRONG
Winnipeg Health Region
Wave, November / December 2014

Meghan Franklin knows what it is like to struggle.

She also knows what it takes to overcome.

In 2003, when she was 17 years of age, Franklin developed an eating disorder called bulimia.

Like a lot of women who develop eating disorders, she didn't spend much time worrying about it at first. After all, from a distance her life appeared to be just fine.

"I think I'm typical of a lot women who develop eating disorders. I have a very Type A personality, so I still managed to get As in school. I had a lot of friends. I had a boyfriend."

But while Franklin's life appeared to be normal from a distance, the opposite was true. Eventually, it caught up with her.

"It took a toll in terms of me being able to feel happy and reach my potential because I was dealing with something that not a lot of people knew about," she says. "I was this happy person on the outside, and on the inside I was struggling to maintain my life."

In time, Franklin realized that she could no longer ignore the elephant in the room. At the age of 20, she started seeing a professional counsellor.

"I reached a point where I couldn't deny it any longer, and I didn't want to live like that anymore," she says.

The counselling worked, in part because she was ready to be helped. "I was really motivated to get better, and I think that is the key. You have to be ready and willing for it to work. I was at a place where that was the case. I went to my appointments. Nobody came with me, nobody forced me." Within six months, Franklin says she was in recovery.

Now, seven years later, Franklin is feeling good about herself. She is also committed to using her experience to help others. She is one of several student volunteers who are helping to drive a new initiative at Red River College called the Healthy Minds, Healthy College Charter.

Launched earlier this year by Red River and its students with support from the Winnipeg Health Region, the charter represents the college's commitment to a comprehensive mental health strategy that includes promotion, prevention and early intervention.

Laureen Janzen, Co-ordinator of Counselling and Accessibility Services for Red River, says the initiative is needed because there has been a virtual explosion in the number of students seeking help for mental health issues over the last decade.

The number of students identifying with a mental health diagnosis has steadily increased over the past decade (about 15 per cent a year), and continues to grow, says Janzen. In the 2013/14 academic school year, about 1,700 students contacted or used Counselling and Accessibility Services at Red River, representing nearly 17 per cent of the college's full- time enrolment. The number of students who present to counselling services in crisis has also increased, with more than 100 students stating to a counsellor that they had thought of suicide between June 2013 and July 2014. 

The reasons for this increase in mental health issues on campus are many and varied, says Janzen. Post-secondary education today seems to be more demanding, more competitive, and more expensive than in the past, she says. Added to that are the additional challenges faced by many Red River  students, including those with families, growing numbers of students who speak English as an additional language, and Aboriginal students who may have relocated to Winnipeg from small communities in order to study.

In addition to this greater diversity of the student body, Janzen notes that a growing number of young people appear to have less "resiliency" - meaning that they have trouble bouncing back from difficulties.

It all adds up to more pressure on many students, who may be juggling finances, deadlines, family responsibilities, isolation and other sources of stress and anxiety.

Franklin agrees. "Students are stressed for many reasons," she says. "They aren't just college students. They might also be employees, parents, girlfriends, boyfriends, homeowners, renters. There are students working two jobs and trying to finish assignments late at night."

The Red River charter has three main goals:

  • To be a healthy college community.
  • To better meet the mental health needs of the college community.
  • To enhance mental health literacy within the college community.

To achieve these goals, the college has committed to 18 initiatives, including promises to conduct an environmental scan of current mental health activities, resources and services, provide tools that support and encourage students, faculty, and staff to accept responsibility for their own health and well-being, and to deliver mental health awareness education within the college community.

For example, in September, it started conducting an assessment of how the campus supports positive mental health. Surveys went out and focus groups were held to ask students, faculty and staff about what Red River needs to improve and what it's doing well. The focus groups have been facilitated by the Winnipeg Health Region, which is working with the college in support of the initiative.

The assessment carried out at Red River this fall follows a series of activities on campus to start the conversation about mental health. Students stepped forward to talk about mental health, and show their peers what it's like to deal with mental illness while dealing with academic pressure. Franklin hopes that by talking about her experiences she can help others.

I've met a lot of people struggling with mental health issues over the years," she says. "For me, counselling was helpful to learn skills for managing stress. This isn't the answer for everyone though. Each person's situation is unique."

And she also learned that one person in five will struggle at some time with a mental health issue, a fact that, until recently, wasn't being discussed widely.

Two students who joined with Franklin in promoting openness about mental health and mental illness have been telling their stories online and in person to break that tradition of silence.

"In a program like CreCom (Creative Communications), it can feel at times like you can't show any weakness and you just have to power through," says Kieran Moolchan, who has been outspoken about his depression and the effect a former roommate's suicide had on him.

When Moolchan needed help, he spoke to one of the staff in counselling services. "He was a huge help for me. I was in a position where if I hadn't been able to talk to somebody, I wouldn't have been able to stay in school."

Moolchan notes that while his instructors understood, "there's still the expectation that you'll get the work done."

Like many programs at Red River College, Creative Communications (which prepares students for careers in advertising, public relations, journalism, broadcasting, web communications and related fields) is designed to expose students to the actual working conditions of their future careers. As in those careers, meeting deadlines is an important part of the experience.

"The pressures are hammered home by the instructors, but they're willing to be flexible and supportive too."

Moolchan and fellow student Justin Luschinski gave presentations on campus this fall on their mental health experiences. They sought both to encourage people to seek mental help and to be more understanding of the mental health challenges of their fellow students.

"Justin and I aren't just talking to the person with mental illness. We're talking to the people who will be hearing his story. Not everybody is confident talking about this publicly," he notes. But Moolchan finds it helpful to think that his story can help others.

In fact, his work is having an effect far beyond Red River College; one of his blog posts, about his former roommate's suicide and his own suicidal thoughts, had more than 100,000 hits and was read by readers around the world.

The students also wanted to show that having a mental illness doesn't have to prevent you from getting on with your life. "We wanted to show people that a mental disorder is not a death sentence," says Luschinski, who starts a job in his field this winter. "It doesn't ruin your life."

Luschinski says that he's always felt that he doesn't really fit in, as a result of his autism spectrum disorder, and that in turn has contributed to depression. "I had all these unresolved issues from my past and just couldn't handle things."

When he sought help from counselling, one of the things he discovered was that he could take a reduced course load, which has allowed him to continue in the program.

One of the challenges he faced in coming forward with his story was the fear that "people wouldn't want anything to do with me if they knew. But I have yet to meet a prof or anyone at the college who has had a problem with this," he says. "They all have a good understanding of mental illness. Everyone's been supportive and super nice."

Like Moolchan, Luschinski found talking to a counsellor on campus was a big help. "The guy I talked to is a great guy and I give him props for that," says Luschinski.

Both found that the flexibility to take a reduced course load or get an extension on a deadline helped greatly when they were feeling stress or anxiety.

That experience is a contrast to the approach taken at many colleges and universities a few decades ago, when incoming students would be bluntly warned by instructors or deans about heavy workloads and high dropout rates. For previous generations, extensions on deadlines were frowned upon, and in many programs there was little flexibility to reduce the course load and take longer to complete.

The sink-or-swim approach was considered a way of preparing students for the harsh demands of the work world. But ironically, the work world has come to understand mental health and stress and no longer believes in a sink-or-swim approach for employees.

At Red River's counselling service office, Janzen says part of the inspiration for a focus on positive mental health came from attending the annual national conference of campus counselling professionals. A few years ago, a big topic of discussion at the conference was the fact that one Ontario university had experienced five student suicides in one year.  That fuelled the discussion of ways to make campuses more mentally healthy, she says.

Janzen then got funding from the college's Program Innovation Fund so that she could assemble a steering committee on positive mental health with wide representation on campus and later hire Franklin for a temporary job writing for a mental health promotion website she developed called Mind it!

Part of the project so far has involved communicating with the college's instructors to make sure that mental health is on their radar. Instructors are the ones who see students daily and are likely to notice if a student has begun missing classes or deadlines or seems to be behaving differently.

Her office encourages instructors to make referrals to the counselling office if they think a student is having a mental health difficulty. In some cases, she says, instructors will "take that extra step" and offer to walk a student down to the counselling office to make sure they get help.

"We have a really supportive team of instructors," she says.

As responses come in from the focus groups and surveys, Janzen hopes the college can examine ways of reducing academic stress - which can have a major impact on the mental health of students, especially for those who may be vulnerable to begin with. Such an effort might take the form of reconsidering how exams are scheduled and when deadlines for projects are set, in order to reduce pressure on students.

But the campus-wide initiative, to be effective, has to look at mental health for everybody. "We decided it can't just be for students," she says. "Our staff and faculty have mental health needs too."

While one part of the program's focus is to encourage people who need professional help to ask for it, a positive mental health philosophy is also dedicated to creating an environment where everybody has the chance to feel a bit better. That means creating an environment in which students, faculty and staff are encouraged to reach out to one another, to fight loneliness and encourage involvement.

"We want to get students talking to each other about how they're feeling. Maybe they don't need professional help. Maybe they don't need counselling . . . . People need to feel connected," says Janzen.

"There are so many well-intentioned people who want to make a difference, so we just need to come together and have a systematic approach," she says.

Marion Cooper, Manager of Mental Health Promotion and Early Intervention for the Region, says Red River's mental health initiatives were a good fit with the Region's goals in that area. "Our work here (at the Region) is about supporting different sectors and systems that take a proactive approach to building positive mental health and well-being," says Cooper.

Positive mental health isn't just about programs and supports for people in crisis or experiencing a mental illness. Rather, it's an approach that emphasizes healthy living and coping skills for everybody.

Cooper points out that people sometimes think of "mental health" as if it were only a euphemism for mental illness. "It's as if you thought immediately of cancer when you heard the term ‘physical health.'"

A proactive approach to positive mental health involves examining the entire culture of an organization to see how it can reduce stress and anxiety or encourage positive coping strategies. In such an approach, there are still counselling and crisis programs and interventions for those with acute needs, but there's also a commitment to helping everybody remain mentally healthy.

Part of the challenge with campus mental health is that it is naturally a stressful time. Young adults still comprise the majority of college and university students (Red River's average student age is 26) and are often going through personal changes that bring anxiety. Youth is also often a time of experimentation, which can involve substance use.

Add to that the financial anxiety of student loans - and this can particularly be stressful for older students who are returning to school - and it's no surprise that stress and anxiety are such big issues on campus.

How big? A recent study of six Ontario universities revealed that 15 per cent of students had been treated for mental health problems, with more than 53 per cent of those reporting overwhelming anxiety and 36 per cent reporting depression that affected their ability to function. The three main factors that interfered with the performance of college students were stress, sleep problems and anxiety.

Karen Kyliuk, a mental health resource and education facilitator with the Region, says Red River's efforts can make a huge difference to students on campus. "A strategy like this can shift the culture to be supportive and strength-based so that everyone flourishes," she says.

Aspects of the cultural change include shifting the college culture away from the "work hard, party hard" tradition of binge drinking, to encouraging strategies to be more mentally healthy and better equipped to manage pressures that are a normal part of student life. This could take the form of relaxation, breathing, meditation or personal practices - and creating a space that is comfortable for students, faculty and staff to talk about mental health. Part of the cultural change is breaking down the sense of isolation many students can feel when they're all alone on a campus of thousands of students.

As Cooper notes, there's plenty of research to show the harmful effects of isolation. "Social isolation is even more dangerous than smoking."

Cooper says Red River College's mandate is to develop skilled citizens who can contribute to the economic well-being of Manitoba. So encouraging positive mental health - which can reduce drop-out rates and boost the success of future graduates in the workplace - is very much in keeping with the college's core goals.

"For them, it's an investment in student success," says Cooper.

The partnership between the college and the Region started in 2013, with the development of a college advisory group and strategy. Three subcommittees were formed: one to gather information and carry out focus groups, one to work with faculty and staff on mental health, and the other to develop the Mind it! website.

Colleges and universities have long offered counselling services for students in crisis and held study-skills and time management workshops to help students stay on track. The new approach moves beyond the idea of a specific program to reach a few people. Instead it's about developing ways of incorporating mental health into all aspects of college life.

At other institutions that have developed such comprehensive strategies, ideas like changing the way exams are scheduled have come to the forefront. Changing schedules so that students don't have back-to-back exams is an example of the kind of action that can come from taking a mental health perspective on all aspects of campus life.

Key to the college-wide promotion of mental health is that it has support from faculty, staff and students, as well as an endorsement from the college's leadership. Such efforts to change campus culture require student leadership, and the RRC Students' Association is on board.

In addition to working with Red River, the Region is also working the University of Winnipeg's healthy campus plan, which includes positive mental health, and a similar initiative at the University of Manitoba. In fact, the Region's mental health promotion team has worked with a variety of organizations to incorporate positive mental health into all levels of education, from daycare centres to programs for mothers-to-be. They have also partnered with high schools in Winnipeg to show the positive effect of involving students to develop healthy coping skills and reduce isolation.

It's an approach to health that doesn't involve waiting for a problem to become a crisis. "This is about taking health out into the community. It's a different way of thinking about health care - it's population health," says Cooper.

Bob Armstrong is a Winnipeg writer.

Wave

About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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