Posts Tagged "Mental Illness"


‘One size doesn’t fit all’: Canadian campuses desperately need better mental health services – National

by BBG Hub

This is the fourth story in a four-part series about the transition between high school and “the real world” — whether that’s college, university, the workforce or something completely different. Failure To Launch examines the gaps in Canada’s education system. Read Part 1, Part 2 and Part 3 here.

When Ellie needed help from a university campus counsellor, she got up extra early so she could get to the office when it opened at 8:30 a.m.

The 24-year-old, whose name has been changed for privacy reasons, is a pharmacy student at the University of British Columbia (UBC).

Ellie struggles with depression and anxiety, and her conditions were getting worse. Her university’s counselling office has limited appointments available for students, and they are on a first come, first served basis.

READ MORE: ‘Failure to Launch kids’ — Canadian students aren’t prepared for adulthood

Because of demand, these drop-in sessions book up quickly — often an hour or two after the office opens. Going in for an appointment meant she would have to skip her morning class.

Missing class made her even more anxious.

Since it was Ellie’s first time at the centre, she needed a triage appointment to determine the urgency of her needs.

“I waited and waited in the office for a couple hours until I finally got to see someone,” Ellie said.

“And then I was told that I had to wait eight weeks for an appointment with a counsellor. This was incredibly devastating.”

Ellie’s depression had worsened, and it took a lot of effort to ask for help. Being told she’d have to wait two months by a triage adviser before a counselling session was incredibly discouraging.

“I had just spent my whole morning telling someone how awful I had been feeling, and all they could tell me was that I had to wait even longer for help,” she said.

“[The triage adviser] gave me brochures for on-campus yoga, a crisis line that was open 24-7, and I was on my way.”

Why it’s so common for mental health issues to develop at school

Post-secondary students across Canada often face the same problem: they need mental health services, but schools don’t have enough resources to meet the demand.

Services are failing to catch up, and in the meantime, students are left in the lurch.

The number of students on college and university campuses with identified mental health conditions “has more than doubled over the past five years,” according to the council group Ontario’s Universities.

More students are anxious and depressed, too, the council found: 65 per cent of those surveyed reported “overwhelming anxiety” in 2016, up from 58 per cent in 2013. When it came to depression, 46 per cent said they were “too depressed to fully function” — a six per cent increase from three years prior.

The majority of people experience their first mental health issue between the ages of 15 and 25, said Tania DaSilva, a child, youth and family therapist at Toronto-based Behaviour Matters. That’s the same age range during which people usually enter or are in post-secondary institutions.

If a student enters post-secondary with an existing mental health condition, support is vital to their academic success, DaSilva said.

“There’s so many things that go into mental health, and for every child or teen, it’s different,” she said.

“They’re transitioning from childhood into adult life, and that’s something that kids struggle with a lot.”

The onset of 75 per cent of mental health disorders happens before 25, according to Ontario’s Universities. These mental health issues include anxiety, depression, bipolar disorder, schizophrenia and suicidal ideation.

READ MORE: Canadian school counsellors are spread thin — and it’s our students that suffer

Then there’s the pressure of post-secondary school itself: multiple looming deadlines, social issues and homesickness, DaSilva said. All of this can affect mental well-being — especially if a student doesn’t have strong coping skills.

For women in particular, sexual assault on campus is another concern. One in five women experiences sexual assault while attending a post-secondary institution, according to a 2015 report by the Canadian Federation of Students.

Sexual violence can have psychological, emotional and physical effects on a survivor, according to the anti-sexual violence organization Rape, Abuse & Incest National Network. This can include depression, flashbacks, post-traumatic stress disorder and self-harm. Proper support is needed to help deal with these effects, the organization says.

Not enough campus resources

In September, a student at the University of Toronto (U of T) died by apparent suicide in the school’s main computer science building, the Bahen Centre for Information Technology. (The university did not use the term “suicide” in reference to the student’s death, but the union representing academic workers at U of T has.)

Sadly, the student was not the first to die at Bahen.

At least two other students died by suicide in the same computer science building: one student died in March, while another died in June 2018.

Their suicides prompted a student-led protest in March decrying what they called a mental health crisis. Students cited long waiting lists and limited options for campus mental health services, a situation the university acknowledged needs to be addressed.

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Mental health “services and supports are provided in a number of ways through a number of offices,” a spokesperson for U of T said in a statement to Global News in response to the issue of student suicides.

“We have been consistently putting more resources into this over the past several years and have worked with community partners to provide additional services,” Sandy Welsh, vice-provost of students at U of T, said in the statement.

The university spent an addition $1.3 million on wellness counsellors during the 2017-18 school year, Welsh said. In the 2018-19 academic year, $1.5 million was put towards having accessibility advisers within programs “in response to the growth in students seeking mental health accommodations.”

Why students have a hard time even getting in the door

Ellie’s experience with UBC’s counselling services was frustrating. She says the school’s model does not help students in a timely manner and can even make them feel like they’re being turned away.

“It honestly has a really big effect [on students],” DaSilva said.

“In most school settings you get to see a counsellor, but you’re not seeing them weekly or regularly because there’s just such a high population of people that also need the services.”

“Schools don’t have the capacity to support in the way most of the kids need.”

UBC’s counselling model includes 45-minute drop-in sessions and 15- to 20-minute “wellness advising” appointments.

READ MORE: University isn’t ‘better’ than college. Why does it get all the glory?

The school has other resources on top of counselling appointments, says Cheryl Washburn, director of counselling services at UBC, including workshops, online and telephone support services and peer support groups.

The goal of UBC’s “integrated” care system, Washburn says, is to provide students with services in a timely and effective manner — not discourage them from getting help.

“One of the things that we’ve come to be aware of over time… is that one size doesn’t fit all,” Washburn said.

“Students really do need different types of resources depending on the level of concern, the nature of the concern and also depending upon their specific goals and other circumstances that might impact access to one service or another, as well as their readiness to engage and at what level.”

Last year, UBC provided 28,000 mental health appointments to its Vancouver students, said a spokesperson for the school, including visits with physicians, counsellors, mental health nurses and psychiatrists.

An additional 4,669 appointments were provided through Empower Me, an online and telephone service that connects students with off-campus professionals.

UBC’s Vancouver campus had nearly 55,000 enrolled students in its 2018-19 academic year.

When it comes to stories of students waiting months to see a counsellor, Washburn acknowledges there is still work to do. But she maintains that eight weeks — the time Ellie said she was given — is not typical. Up to three to four weeks is more likely during busy periods, she said.

If a student is told there’s a wait to see a university counsellor, Washburn says they are reminded they have access outside therapists, too. Students have benefits that include a limited amount of money for professional services, she said, which can be used for counselling.

“We have developed a database of practitioners in the community that offer sliding-scale or lower-cost [services],” she said. “Students have the option if they want [that], and sometimes, they prefer that if they can get to see somebody closer to their home.”

But long wait times are only one of the barriers students face.

Part of the reason Sonya Sevadjian, 20, says she left the University of Waterloo was its hard-to-navigate support services. When Sevadjian was a student at the school from 2016 to 2017, she was struggling with the demands of university and needed help.

“My workload and relationships affected my well-being, but what impacted my mental [health] was the school atmosphere,” Sevadjian said.

Illustration: Laura Whelan

“It felt isolating and stressful, even when [it] didn’t need to be. Enrolled in a top university, there is constant pressure to live up to the expectation of what you need to be, what marks you have to reach, and with this constant comparison and competition, it takes a toll.”

Sevadjian said it was challenging to find out what student services Waterloo offered and how to access them. She felt like she was left on her own to figure out the system.

In a statement sent to Global News, a spokesperson for the university said the school has recently revised its services.

“Following an extensive review of student mental health services on campus in 2017-18, we learned that there was more we could do to ensure students were aware of mental health services available to them on campus and how to access them,” said Matthew Grant, the director of media relations at the University of Waterloo.

“The review, which resulted in 36 recommendations overall, resulted in increased services, more training for faculty and staff, and increased communications efforts to students to advise them of the services available and how to access them. Currently, the University of Waterloo has more than 70 professionals — including counsellors, psychiatrists, mental health nurses and intake workers — who can assist students with mental health concerns.”

Sevadjian eventually decided to transfer to Ryerson University in downtown Toronto. She hasn’t used any of Ryerson’s mental health services yet but said the school’s student services are more clearly advertised. This alone makes her feel better about the pressures of being in school.

There were approximately 36,000 students enrolled at Ryerson last year, and the school’s Centre for Student Development and Counselling (CSDC) supported 2,253 of them with on-campus mental health and counselling services, a spokesperson for Ryerson told Global News.

The CSDC currently has 18 counsellors on staff, up from 15 in 2017.

“The wait for ongoing therapy depends on student needs and can be from a few weeks to a few months,” the spokesperson said.

Numbers can also look similar at Canadian colleges. In the last academic year, Humber College — one of the largest community colleges in Ontario — had a total of 4,250 counsellor visits on campus, along with 1,500 mental health nurse visits, according to a spokesperson.

This year, the college is also offering psychiatry services for students.

For Interpreet Gill, a positive experience with campus mental health services benefited her well-being.

Gill went to Queen’s University from 2010 to 2016, and in her third year of her studies, she accessed counselling services. Gill knew Queen’s counselling office sometimes had wait times — which are roughly anywhere from two to six weeks — but was also aware there were emergency mental health services for high-need students.

The psychology student was able to book an appointment with a counsellor fairly quickly.

“The sessions are meant to help students [manage in the short-term], but I felt really comfortable with the counsellor that I had that I didn’t want to go elsewhere,” Gill said.

Nearly 3,000 students accessed counselling services during the last academic year, a spokesperson for the school told Global News — that’s roughly eight per cent of the total full-time student population.

There’s one counsellor or psychologist for every 1,225 students, and one mental health provider, such as a psychiatrist, for every 950 students.

Queen’s acknowledged that wait times for mental health appointments have been a “chronic issue” despite annual increases in resources.

“This is a sector-wide issue,” a spokesperson for the university said.

Still, Gill managed to see her Queen’s campus counsellor once every few months to check in. It was up to Gill, to schedule those appointments, but the sessions did help.

“I couldn’t see her every week just because of the regulations and the policies that they had,” Gill explained, “but I could see her every now and then, which was nice.”

What helps students?

Having a strong support system is vital for students, DaSilva said — especially if they have a recognized mental health condition.

If a student has a therapist they’ve been seeing before going off to college or university, continuing sessions via Skype or FaceTime is a way to help ensure any issues are being addressed, DaSilva said.

There are also ways students can put protective measures in place should they need help. Talking to academic advisers early on about accommodations can be useful, as can orienting yourself with a school’s mental health services off the bat, she said.

It’s also important for students to be aware of what mental health issues look like so they can get help as soon as they start struggling. This means recognizing the warning signs of conditions, including anxiety and depression, and knowing the importance of talking to someone right away.

Lastly, if campus wait times are simply too long, DaSilva suggests seeing if parents’ insurance plans cover therapy. Some plans, she says, cover kids until they are 25, meaning a student can use those benefits to see an off-campus therapist.

Ultimately, Ellie says, university mental health services just need to improve — UBC’s in particular. Students need to be able to access help when they need it. Posing barriers to access can leave students in dangerous situations, she said.

Ellie’s ability to function at school was hindered by her mental health issues. As her anxiety went untreated, her problems worsened.

She says she struggled to keep up with school because her mood was so low and she eventually started skipping classes. Sitting in a large lecture hall surrounded by hundreds of students was incredibly hard.

“I think anybody who has the courage to go out and ask for help should get help,” she said.

“I don’t think we know enough about mental health to have a risk assessment and try to decide if people should get help or not. We need to start treating it like any other disease.”

If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911 for immediate help.

The Canadian Association for Suicide Prevention, Depression Hurts and Kids Help Phone 1-800-668-6868 all offer ways of getting help if you, or someone you know, may be suffering from mental health issues.

© 2019 Global News, a division of Corus Entertainment Inc.

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Ketamine for depression divides experts: ‘I’ve seen these drugs come and go’ – National

by BBG Hub

Depression can be completely debilitating, making it difficult to do even the simplest tasks — like getting out of bed or brushing one’s teeth.

Unfortunately, it’s very common. According to the World Health Organization, more than 300 million people around the world are currently suffering from depression.

Now, there may be a new way to treat the illness: ketamine.

READ MORE: ‘Emotionally draining’: The effect depression has on tasks like brushing hair, showering

Ketamine is commonly used as an anesthetic and painkiller in animal and human surgery. It also rose to popularity as a party drug in the 1990s. Now, it’s being lauded as a possible cure for treatment-resistant depression.

“We have a large sub population in our country with depression who can’t work… they just can’t break this vicious cycle,” said Dr. Roger McIntyre, president of the Canadian Rapid Treatment Centre of Excellence (CRTCE).

McIntyre hopes ketamine can break that cycle.

The CRTCE, which administers rapid onset treatments for depression in the form of ketamine injections, is the first of its kind in Canada.

How does the treatment work?

At the CRTCE, ketamine is delivered through intravenous infusion. According to the clinic’s website, “the protocol for administering ketamine is still being refined. Nonetheless… most individuals will receive four infusions (i.e. two infusions per week for two weeks).”

The cost of this treatment at the CRTCE is $3,000, and it is not paid for by the public health plan of Ontario (OHIP).

The process is overseen by a physician trained in anesthesia, as well as a nurse.

“The dose of ketamine by someone on the street… is about 10 times higher than the dose [you would be given] if you went to the hospital this afternoon for a procedure that required anesthesia,” said McIntyre. “The dose that we use to treat depression is about one-10th… of the dose used in anesthesia. So we’re using ‘sub-anesthetic doses.”

According to McIntyre, this does not mean the process is without safety concerns.

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“[We] know it’s generally well received by patients, but it would be inaccurate to say that you don’t get any side effects,” said McIntyre. 

According to Centre for Addiction and Mental Health (CAMH), ketamine can produce “vivid dreams and a feeling that the mind is separated from the body.” This effect is known as “dissociation.”

The intensity of the effects depend on several factors, including: your age, your body weight, how much you take, how often you take it, how you take the drug and more.

“Some people do become addicted, and continue to use ketamine even when they plan not to or despite its negative effects,” as stated on the CAMH website.

Ketamine works faster than other treatments

If a patient presents with intense suicidal thoughts, ketamine may be a more effective short-term treatment than other antidepressant medication.

“Most antidepressants take approximately four, six or even eight weeks to work. That’s a long time,” said McIntyre. “If you’re suffering, ketamine can work within one day.”

Dr. David Gratzer, a psychiatrist at CAMH, is hopeful about the effects of ketamine on depression for this reason.

READ MORE: 8 signs your child may be going through depression

“We are looking for a way of providing more rapid relief of depression than one might ordinarily see with Prozac and [similar] drugs,” said Gratzer.

“The evidence is there but we have to take it with a grain of salt because it’s early days. That being said, we do seem to find evidence that it helps people very quickly, particularly people who have many thoughts of suicide.”

Ketamine is a last-ditch effort for those who have tried everything else

Depression is difficult to understand — even for medical professionals.

“As with most diseases in physical medicine and mental health, we have a sense of what’s involved but we don’t exactly know,” said Gratzer.

According to Gratzer, doctors do know that family history and certain traumatic life events are connected with a higher risk of depression.

“However, two people can be raised in the same household and eat the same foods and have a relatively similar childhood and one can get heart disease while the other doesn’t,” said Gratzer.

WATCH BELOW: Study links exposure to infection in the womb to increased risk of autism, depression

“Likewise, you can get [depression] and your sibling may not. So, while we do recognize there’s a strong genetic component… it’s not 100 per cent. There’s more going on.”

Because of the evasive nature of depression, finding a treatment that works can be difficult.

Once someone is diagnosed, they are usually prescribed one of or a combination of three kinds of treatment: exercise, talk therapy and medication. According to Gratzer, patients “do the best” when they do all three.

READ MORE: Is ASMR an effective way to treat anxiety and depression?

But, for some patients, none of these treatments work. And that’s where ketamine can be an exciting option.

“Ketamine is one of a handful of medications that is out of the box,” said Gratzer. 

To be eligible for treatment at the CRTCE, there are three criteria: you are over the age of 18, you are medically stable and you have had a minimum of two other treatments for your depression.

‘Early reports are good, but now we need to take it to the next step’

McIntyre admits that the full effects (positive and negative) of the drug are unknown.

An issue McIntyre and his team are paying close attention to is the impact ketamine can have on other organs, like the kidney or the bladder.

Another is whether ketamine can act as a gateway to other, more severe drug abuse, said McIntyre. 

The CRTCE website states that, “it is critical to understand that ketamine researchers are still exploring a multitude of ways that ketamine infusions impact the human brain. They are working towards understanding why this form of treatment works so quickly and effectively.”

Despite its positive impact thus far, Gratzer isn’t ready to call ketamine a “wonder drug” yet.

WATCH BELOW: 5 ways to help a friend with postpartum depression

“I’m optimistic, but I’ve got a few gray hairs, so I’ve seen these wonder drugs come and go,” he said.

“We need to take it to the next step… can we use it on more people safely? What sort of side effects do they get? Are the effects [on depression] we see with ketamine lasting?”

Gratzer is interested to see whether the effects of ketamine can remain beyond the days after it’s injected.

“It’s great that some people might see relief… if you’ve got a pain on your left hand, it’s great that you feel better with a Tylenol. But that tends to fade and maybe what you really have is a little infection of the skin and what you should really take is antibiotics,” said Gratzer. 

“I hope this is working out because it will be helpful, but I don’t really know and I don’t want to be too optimistic. Like a lot of private healthcare, the sales pitch may not be as good as the reality.”

If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911 for immediate help.

The Canadian Association for Suicide Prevention, Depression Hurts and Kids Help Phone 1-800-668-6868 all offer ways of getting help if you, or someone you know, may be suffering from mental health issues.

[email protected]

© 2019 Global News, a division of Corus Entertainment Inc.

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