Draft Summary of Themes

This is what we heard: did we miss anything?

To support our work and engage the University of Toronto community, the Presidential & Provostial Task Force on Student Mental Health embarked on an extensive consultation plan in July 2019. The initial phases of the Outreach & Engagement Plan involved: in-person focus group and open campus listening sessions; an online feedback form; and student-led Innovation Hub feedback sessions. The Task Force also visited each of the three campus health centres. Phase 3 involved going back to the University of Toronto community in November, and saying, “This is what we heard: did we miss anything?” Overall, the feedback validated that we were on the right track and also identified some areas that needed additional consideration. Our goal was to address this feedback in our final report as well as by making minor updates to our Themes.

This is a summary of the broad themes that we heard from students, staff, and faculty during the Outreach & Engagement activities in summer and fall 2019. Thank you to everyone to participated in the online and in-person consultation activities. We greatly appreciate your time and effort to participate and share your comments with us.

Themes

Communication

• The paths to seek mental health supports need to be more transparent and accessible. Students, staff, and faculty struggle to navigate the array of services and resources available, not understanding how to access them and/or refer appropriately.
• Websites and online listings of services are confusing, difficult to navigate, and not user-focused
• Some students have a lack of understanding of the compassionate purpose of the University Mandated Leave of Absence Policy (UMLAP), which leads to uncertainty around how the policy is applied and fear about its potential impacts. There is some philosophical disagreement amongst community members (students, staff, and faculty) about the Policy that requires ongoing dialogue and review.  
• Students report wanting easier ways to communicate with health and wellness centers (including online and text-based booking and appointment management).
• There is a lack of clarity around the roles and responsibilities of the University when it comes to supporting mental health on campus. There is need for clarification and communication of information about the mental health services the University can provide to students.
• Some community members express concern over a lack of transparency in communication after tragic events.

Education, Training, and Awareness

• Many students, staff and faculty report having limited knowledge about mental health, how to support student mental health, and how to have conversations mental health and well-being. Training for identifying mental health issues and referring to appropriate services is needed across all members of the community.
• Community members recognize the need to increase education, information, and conversations about mental health to encourage help seeking behaviour and to reduce the stigma associated with mental illness.
• Students shared how significant – positive or negative – the impacts of interactions with staff and/or faculty are on their mental health and well-being.
• Though some progress was described resolving conflict in graduate student-supervisor relationships, these were emphasized as pressure points for graduate students.

Services

• Concerns about waitlists for initial assessment appointments and follow-up appointments are an issue and may deter some students from help-seeking behaviours.
• There is concern about limits on the number of appointments available per student for counselling, and confusion about how these limits are determined and applied.
• Students feel concerned that fees for missed appointments could lead to being locked out from accessing services.
• The lack of after-hours resources on all three campuses for evenings and weekends is a large issue, especially for crisis situations.
• Same-day and extended service hours at tri-campus health centres is positive and students want more of those services.
• On-location (embedded) counselling and accessibility in Divisions, Faculties and Colleges is working well and there is desire for more.
• Pop-up or just-in-time counselling, such as the Robarts pilot during Spring exam season at St. George campus has been well received.
• Accessibility Services and Health Services struggle to meet demand on all three campuses.
• There remains a need for increased diversity in counsellors, broader mental health knowledge, as well as comprehensive education and training for the whole staff complement to increase their competencies on providing services to students from Indigenous, LGBTQ+, and racialized communities with intersecting identities. Not all students from underrepresented communities feel the current counselling options are adequate to support their needs and experiences.
• In addition to an increase in the diversity of mental health providers and training, students would also like to see an expansion of services beyond traditional Western medicine and availability of supports in their preferred language.
• Case management of complex student cases is an area of weakness.
• Staff (including front line providers) and faculty also experience mental health concerns, and need support around mental health as well.

Space

• Space constraints related to where mental health services are provided on each campus limits the Health & Wellness/Counselling centres’ ability to expand services.
• Students, staff, and faculty noted that the physical locations of the H&W clinics on campus were often hard to find, were dark, poorly light and lacked comfortable furniture or greenery. This enhanced their perception that mental health is not a priority at UofT.
• Privacy is an issue in clinics due to lack of space for confidential intake and triaging.
• All three campuses – especially UTSC and UTM – lack wellness spaces, non-study lounge space where students could socialize, build connections, hold peer programming, and rest between classes and academic activities.

Partnerships

• The University works with community organizations and hospitals to provide the best possible supports, services, and expertise to meet the diversity of student needs represented (e.g. long-term care and complex cases).
• Community services are often overburdened and perceive that the University is better resourced, so they tend to refer students back to U of T mental health services for care, when community supports may be more appropriately matched to the students’ needs.
• Models where partners provide counselling services on campus for groups and individuals are well received.
• Students and staff note barriers and issues with accessing off-campus resources: resource lists can be confusing, long wait times for referrals and/or getting an appointment, location and transportation to off-campus resources, hours of care, matching care with need, follow up to make/attend appointments, financial constraints for private services, time, etc.
• The St. George campus benefits from proximity to downtown hospitals, but that is more challenging for UTM and UTSC given their geographic location and catchment areas of students.
• The University should consider enhancing and expanding partnerships with organizations that reflect and support the diversity of students.

Culture at U of T

• U of T’s culture of excellence can lead to intense competition and negative impact on well-being for some. Competition to ‘get in’ is expected, but competition to ‘stay in’ is problematic.
• Some students do not feel they are supported or that the University cares about their mental well-being.
• The University should continue to expand the notion of excellence to include wellness (not just research and academics) – become a ‘community of care’.
• Students face a heavy academic workload and some perceive structures as punitive when they do not excel. Academic struggle or failure (POSTs, exams, grades, etc.) without a community of support can be a challenging combination for student mental health.
• Students, staff, and faculty expressed the importance for the University to shift from a reactive to a proactive approach to mental health. This feedback included integrating wellness programming and personal skills building into core student experiences.
• Feedback underscored the importance of a “whole campus” approach to supporting student mental health (in which all community members are informed about mental health, share mental health information, and are engaged in efforts to support student mental health).

Isolation & loneliness

• Students’ determination to work harder because of U of T’s study culture can lead to more isolation.
• Some students have difficulty finding community on campus, due to not having time to adequately engage in social activities outside of all their other commitments.
• Emphasis for graduate students on the issues of isolation and loneliness impacting mental well-being due to time spent in labs for STEM, and writing for arts & humanities, especially during later stages of their programs
• Imposter syndrome is experienced by many students who are high-achieving and feel a need to measure up academically to meet what can seem like unrealistic expectations.

Added stressors on mental health

• Financial insecurity is a common stressor for U of T students, including recent changes to OSAP, costs of education, cost of commuting, high cost of living in the Toronto-region, and working part-time.
• Students shared that demands beyond classes (like working, commuting, family obligations, extra-curricular activities) impact their mental health and well-being.
• International students and/or first-generation students face unique additional stressors, including lack of family support, financial burdens, fear of failure, etc., that are compounded by a fear of losing their visas/status in country. Additionally, counsellors may not speak their primary language or these services may not be culturally aligned.
• Graduate students emphasized the impact of the student-supervisor relationship and their desire for more University services and resources in this area.
• Students who do not live close to campus or who are away from the University (e.g. study abroad, in placements, or doing fieldwork) face increased challenges accessing mental health resources and supports.
• Students also noted additional stressors like food insecurity, the climate crisis, political environment, job market changes, and the Toronto-region housing and rental market.

Institutional systems & policies

• Students face systemic issues of bureaucratic processes causing barriers, in part because access and processes are not streamlined. For example: there are different processes at each campus for accessing mental health services; students described issues with verification of illness forms (VOI); and the communication systems for appointments and websites are unclear, including the application process for appointments/referrals.
• Intake processes and forms are viewed as arduous, and issues with referrals create compounding challenges for some students: losing time, feeling of being shuffled around, and experiencing stress and anxiety of having to repeat their story to multiple people.
• There is concern that the University Mandated Leave of Absence Policy (UMLAP) fosters stigma around mental illness at the University and creates a barrier to student seeking support for mental health.
• Complex cases in which students need immediate care and connection with services can be complicated by U of T’s organizational structure and silos.
• Across the three campuses, there may be an inconsistent approach to cases involving Ontario’s Form 1 (“Application by Physician for Psychiatric Assessment”) as well as apprehension under the Mental Health Act, and therefore there is a desire for the University to undertake procedural review of how such cases are handled.
• There are discrepancies in benefit packages for students depending on their campus, and whether they are graduate or undergraduate, full-time or part-time. Many students are not aware of these benefits, how to access them, or that benefits are determined by their student unions or bargaining unit (including Teaching Assistants and Post-Doctoral Fellows).
• Some academic policies and processes are cumbersome and perceived as punitive, especially if a student is experiencing mental health/illness challenges.