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How to make a crisis: Cracks in mental health care at U of O and U of T

Since mid-2018, nine students have died between the two universities. Photo: Shanna Hunter/The Varsity
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String of student deaths at two of Ontario’s biggest universities indicates institutional roots of mental health care crises

Content warning: Suicide

This story is a collaboration between the Fulcrum and The Varsity. 

University of Ottawa president Jacques Frémont held a press conference on Feb. 11, 2020 in the wake of the fifth student death in the previous 10 months. There, he stood before the cameras and reporters, the university’s emblem behind him, and finally uttered the word that had been exchanged among the student body for years: “crisis.”

“I know that at times, this university can feel big and impersonal,” the U of O president said. “But I want you to know that in reality it is filled with kind and caring people. It really is. We are a community of people who care.”

Frémont encouraged students who feel that they can “no longer cope” to reach out to the university’s counsellors — a request that he punctuated with several desperate “pleases.”

On March 14, the sixth U of O student death since April 2019 was confirmed. 

In a year riddled with crises, the attention of university administrations is understandably divided. But as the global COVID-19 pandemic has wracked the student population with isolation and grief, it’s now more important than ever that the university’s efforts to address the mental health crisis are not lost.

Jacques Frémont at a press conference on Feb. 11. Photo: Rame Abdulkader/The Fulcrum

At the University of Toronto, the word ‘Bahen’ has become synonymous with the campus mental health crisis.

The Bahen Centre for Information Technology is a tall and imposing building that sits on St. George Street, the main road that runs through U of T’s St. George campus. Since June 2018, it has been the site of three apparent deaths by suicide.

Each successive tragedy prompted ever-larger protests from students demanding better mental health services from the university administration. With each death, the university has taken increasing steps to keep up with students’ demands for comprehensive reform.  

Yet, this current groundswell of activism is not as sudden as it may seem. The protests that have sprung up in response to the recent deaths on campus are building on years-long discontent with mental health services and the nature of academic life at U of T.

Indeed, the mental health crisis began long before many of the students studying at U of T today ever stepped foot on campus.

In 1964, The Varsity published the results of a survey which showed that over 50 per cent of U of T students felt that they needed counselling at some point during their studies. At the time, this was a shocking discovery.

An editorial published a few issues later criticized the university for starting a committee in response to the survey and yet failing to take any concrete actions to address the findings.

“Will the problem of student mental health be allowed to sink into an oblivion of committee reports and counter-recommendations?” wrote The Varsity Editorial Board. “Or will [the university] take decisive action this year?”

Current U of T students may find the story familiar. After the second death at Bahen on March 17, 2019, and after students staged multiple protests to express their grief and anger, the administration announced the creation of the Presidential & Provostial Task Force on Student Mental Health on March 28, 2019.

The mandate of the task force was to conduct consultations with the community to “review mental health supports and services for students at U of T.”

Since its creation, the task force has received mixed reactions from the U of T community, with campus groups in particular criticizing its lack of student involvement.

Out of the 13 members of the task force, there are two graduate students, an undergraduate student from UTM, and an undergraduate student from UTSG.

Despite the criticisms, most student groups were cautiously optimistic when the task force finally released a report in January after months of consultations.

In the report, they recommended a redesign of U of T’s mental health services, which will include “the appointment of a tri-campus Clinical Director, as well as new technologies to facilitate appointment bookings and reminders, and help students become informed about the services we offer,” as vice-provost, students Sandy Welsh wrote to The Varsity.

While student groups were disappointed with the lack of specific solutions, such as those targeted toward the satellite campuses, the general consensus was that the administration was taking a step in the right direction.

At the U of O, students saw Frémont’s words at that February press conference, while sympathetic, as the reflection of a deep-seated disconnect between the intentions of the administration and the reality of the situation on the ground.

The reality is stark. Twenty counsellors serve U of O’s student body of over 40,000, and long wait times — which the school says it has now cut down — can make services inaccessible.

That was the case for Rayhane Mejlaoui, a third-year student studying biopharmaceutical science at U of O. The inflexibility of her co-op course requirements meant that she had to take a full course load, despite wanting to take fewer credits.

The stress began to take a toll on her mental health. When she started failing midterms in October 2019, she decided to seek help. She signed up for a family doctor at the campus clinic, and they referred her for counselling.

“A month after the appointment with my doctor, I got the screening phone call,” Mejlaoui said in an interview. 

“They asked me lots of questions and then they said it would probably still take a few weeks before I got a meeting,” she said. “What happened is I went to see my doctor in October. And then they gave me an appointment for January, which was in the middle of my work time, so it was kind of useless at that point.”

Experiences like Mejlaoui’s aren’t uncommon at the U of O. Rapid care is promised only to the most pressing cases, and in reality, it’s rarely provided even then. The immediate response that is often celebrated, in gatherings such as the February press conference where Frémont first acknowledged a mental health “crisis,” is a triage appointment. 

At a town hall on mental health at the U of O later that month, one student described the triage system as a short meeting with a counsellor in which students are asked to unpack their trauma and “sell themselves” on why they need therapy. And the next appointment could be weeks away. 

The U of O held a town hall on mental health on Feb. 27. Photo: Emilie Azevedo/The Fulcrum

For care that is more specialized, the answer is often “not yet,” or sometimes, simply “no.” 

Kelly El Ahl, a second-year student studying psychology and French, has attention deficit hyperactivity disorder (ADHD) and a personality disorder; this makes El Ahl what she says the U of O calls a “complicated case.” For cases like El Ahl’s, wait times for appointments can stretch into months, and sometimes, care through the university doesn’t arrive at all.

“Before I started university, I had a psycho-educational assessment done at the research clinic, and I was told I needed to have therapy when I start school and to sign up to start therapy with the psychological clinic at school,” she said in a February interview. “So I called and they put me on the waiting list. And that was like April [or] May 2018. And I’m still on the waiting list right now. They said it was too complicated.” 

In the meantime, the university referred her to counselling services, where El Ahl says she was turned away again.

“I was told that I already have my diagnoses,” El Ahl said. “I know a bit more about what my problem is. I know about my actions, and I know what needs to be done. So I was told that they couldn’t do much to help me because the counselling services are for people who are still at the beginning of their quest, I guess, who don’t really know what’s going on or have more academic issues.”

“My problems were a bit too advanced for them,” El Ahl added. “So I left and they sent me an email with a link to Psychology Today to find a private practice therapist.”

El Ahl found a private therapist, but now has to pay $170 a week for their services, a fee that is no longer covered by insurance through the University of Ottawa Students’ Union after she quickly surpassed the $1,500 limit set for each policy year. 

The university’s approach to providing mental health care and cultivating a general sense of wellness on campus is, however, undergoing slow but certain change. This approach is made evident in part by the recent establishment of the Wellness & Recreation sector of Student Life, which will replace Student Academic Success Services as the department responsible for counselling services.

In addition to counselling, the Wellness & Recreation sector, under the guidance of its director, Rachelle Clark, will oversee residence life, campus recreation, and health promotion. 

“I think what it does is it brings together all of the services that really are focusing on wellness so that we can have a more streamlined and intentional, strategic approach to enhancing wellness on campus,” Clark said in a January interview.

Clark admitted that one of the university’s greatest challenges in terms of mental health support is the lack of a streamlined path to care.

“It’s not even just accessing services at the U of O,” she said. “It’s navigating the different levels of support, and the resources and the services. Understanding the services that are available within the mandate of the university, and those that are available within the mandate of the provincial health system can be very confusing, and can even pose a barrier to accessing care.”

In terms of streamlining, Michel Guilbeault, associate vice-president student services, is on the same page.

“We need to do more awareness,” Guilbeault told the Fulcrum in a December interview. “Unfortunately, students are not educating themselves about those services until they need them. And that’s probably the worst possible time because they may be in a situation where they’re just not at their best for whatever reason.”

Guilbeault cited a revamped orientation package which offers an increased emphasis on how to access support services for incoming students as an example of administrative efforts to improve awareness. Currently, mental health support and treatments are also dispersed throughout campus and the community beyond. Guilbeault hopes that, in the future, they’ll be able to co-locate mental health care at U of O into one facility.

“Let’s be real about it,” he said. “There’s still a lot more that can be done to improve in this area.”

One of the catalysts of this recent wave of student mental health activism at U of T was the introduction and eventual passing of the university-mandated leave of absence policy (UMLAP).

The UMLAP was first introduced in October 2017, though it had been in the works for at least two years prior. Its purpose was to allow the university to place a student on a non-punitive leave of absence if their mental health was negatively impacting their studies, or if it was putting them at risk to themselves or others.

The policy received immediate backlash from students, many of them criticizing it for taking away student autonomy, removing students from their communities and mental health services, having unclear procedures around invocation and application, and not requiring the input of medical professionals.

The university was forced to address some of these concerns when the Ontario Human Rights Commission (OHRC) criticized the policy for failing in the “duty to accommodate.”

“The Policy appears to allow the University to immediately put the student on leave and withdraw essential services (housing, health, and counselling services) at a time when the student is in crisis and most in need of support,” stated the OHRC.

The university’s response was to withdraw the policy and reintroduce it three months later with some updates. These included a definition of ‘accommodation,’ more information about when the policy could be invoked, and a note that medical professionals may be involved in individual cases, though this was not required.

In the midst of consultations and protests surrounding the policy, U of T experienced the first student death at the Bahen Centre on June 24, 2018. Three days later, the Governing Council passed the UMLAP to the sound of student protests outside their council chambers.

In August 2019, a year after the UMLAP’s approval, U of T reported that the policy had been invoked eight times. Welsh previously told The Varsity that medical professionals were involved in all cases, and that the families of the students generally gave positive feedback. Little information about these cases is otherwise available.

The policy’s passing has not brought an end to student protests. When current activists speak on the state of mental health on campus, many inevitably point to the UMLAP as an area that needs heavy reform, if not a complete withdrawal.

Criticisms of the UMLAP came to the fore most recently in October, when U of T’s ombudsperson Dr. Ellen Hodnett faced backlash for saying that student activists were using the campus suicides to unfairly criticize the policy.

Hodnett explained to The Varsity in an earlier interview that she saw the concerns surrounding the UMLAP as stemming from online misinformation, maintaining that the policy was fair and made in students’ best interest.

Thus, the U of T community has reached an impasse on the UMLAP, with the administration standing by its implementation and use, and the students continuing to protest it years after its introduction.

In addition to the blatant disconnect between the administration and the community that students have taken issue with, others have since criticized Frémont’s February address for containing more than a few broken promises.

“The U of O is committed — and I am committed — to ensuring that the mental health needs of our students are addressed as comprehensively as possible on campus,” he said at the press conference.

Despite that proclamation, he was noticeably absent from the much-anticipated town hall on mental health on Feb. 27, and it did not go unnoticed by the students who spoke there.

“I’d just like to say that I truly believe and hope that Frémont will host another town hall where he is present,” said one student. These sentiments were echoed many times throughout the event.

“We look at wellness, including mental health wellness, as a continuum,” Clark added in her January interview. “And I think we need to start working with students before mental health becomes an issue [for them].”

However, in the face of the COVID-19 pandemic, the mental health crisis at U of O has faded into the background. When the death of the sixth student in one year was announced on March 14, it seemed to vanish in the firestorm of pandemic-related news.

But despite slow action from the U of O administration, student activism has risen to a peak since the string of student deaths began in April 2019.

Following the fourth student death in December 2019, outrage over the state of mental health care on campus triggered a student mobilization, represented chiefly in the launch of uOCollective 4 Mental Health, a Facebook group that sits at nearly 1,000 members.

The collective launched a petition that demands improvement, and contains several recommendations for doing so, including increasing staff training, hiring more specialized personnel, alleviating costs for students, and increasing discussion between stakeholders. At the time of publication, the petition has over 8,000 signatures.

The student mobilization is largely credited with pushing forth the town halls. The U of O also launched a mental health task force that has promised to implement recommendations from a January report on wellness at the U of O, while also incorporating student feedback from forums like town halls. But since then, further administrative response has yet to materialize. 

Camelia Skaf, a second-year student studying French and applied ethics, is an active participant of the student movement for improved mental health care at the U of O. She admits that the momentum of the movement can be hard to maintain.

Camelia Skaf is a second-year student at the U of O. Photo: Rame Abdulkader/The Fulcrum

“Obviously we still care,” said Skaf in a March interview. “It’s just we’re all so fucking tired. This is hurting my school, it’s hurting my friends’ school — everyone’s burned out. We just don’t know what to do and how to do it to get what we want.”

According to Skaf, what most in the movement want is concrete policy changes, amendments to academic regulations that disadvantage those who are disabled or mentally ill, and, perhaps most of all, open discourse.

“Jacques (Frémont) spends too much time in Tabaret,” said Skaf, speaking about the administration’s main building on the U of O campus. “There is a full disconnect between the administration and the students of the school.”

The lack of consistency and the lack of understanding from the university has increasingly driven a wedge between student activists and the administration over the course of the academic year. 

At the town hall on Feb. 26, for example, Angela Toubis and Laura O’Connor, two of the co-founders of the uOCollective 4 Mental Health, pointed out that Frémont had failed to deliver on his promise to meet with them, which he had made at one of the protests that the collective organized earlier that month.

Several students at the town hall also noted that, despite an informal apology at the impromptu Feb. 13 town hall for the faculty of arts, Frémont has also failed to issue a public apology for the widely-condemned Scientology linked anti-psychiatry exhibit that was set up on campus for a week in January. 

“Nothing is being done,” added Skaf. “Everyone just puts on a suit and comes to school and talks. I’m tired of empty promises.”

Although the language used by university officials when discussing the crisis is collaborative, it is experienced by students very much on their own. 

Disconnect between the administration and the student body, lack of access to competent and specialized mental health care, and the necessity of continued and strenuous protest in order to garner attention from U of O’s decision makers prove that the burden of improving the system falls primarily on the shoulders of its students. 

At U of T, it’s difficult to identify a precise source of the mental health crisis, but one thing that students continually point to is the unhealthy and competitive nature of academic life.

The computer science department is one particularly stark example of how academic pressures are placing unbearable stress on students.

The Bahen Centre is well known around campus for being a hub for the mathematics, computer science, and engineering departments. A student in any of those programs is likely to spend much of their time passing in and out of the building.

With each death at the Bahen Centre, more attention was paid to the computer science department and what students saw as unfair academic requirements.

The department is well known for its competitive program of study (POSt) requirements, meaning that students who are admitted into the program in first-year must achieve certain marks in order to remain in the program. Students who want to transfer into the program also must attain equally high grades, and space is very limited.

Since the deaths on campus, computer science students have been outspoken about how the department needs reform to fix its competitive nature.

In the past year, the department has begun introducing changes, including plans to increase the number of students admitted to the program and change POSt requirements in order to “eliminate competition among [first year] students.”

These are among the first changes that any department at U of T has proposed to target the academic culture. They will be implemented for this upcoming school year, and it remains to be seen whether other departments and faculties will follow.

It took three deaths in the Bahen Centre before U of T installed safety barriers on the higher floors of the building. Since then, there have not been any suicides in the building.

However, student groups have not stopped pushing the administration to follow through on its commitments to improve mental health services and address the criticisms raised by students of the academic culture at the university.

“We are deeply committed to student well-being and success. As demand for mental health services has increased, we have increased supports and services for student mental health over the last few years,” wrote Welsh. “We know that there are areas where we can do better, and we’re taking action to make these improvements.”

At U of O, it took four deaths in under a year for the acknowledgment of a crisis and no amount of student suffering has succeeded in summoning a public audience with the university’s highest-ranking officials. 

The U of O’s Tabaret Hall. Photo: Rame Abdulkader/The Fulcrum

But structural shifts and acknowledgement of failures by the university’s mental health care providers are reason enough to hope. 

Clark is inheriting her role at the forefront of U of O’s mental health crisis at a turbulent time, but feels confident that she has experienced some successes thus far nonetheless. She cites increased hours, the introduction of a stepped-care model, the wait-free triage system, and the hiring of four new counsellors as some of her victories so far.

And like U of T, the students at the U of O are not ready to give up the fight.

At the end of her interview for this article, Skaf pointed to something Frémont said at a March 12 public forum promoting inclusion and anti-racism: “You have to change the ideas of the majority.” 

“I don’t want [anything] to do with your majority,” said Skaf. “I don’t want none of it. Minor, minor, minor — they always say it’s not a lot of people, but it’s actually more prevalent than [you’d think]. There’s no majority, there’s no minority. It’s just us.”

A non-comprehensive list of local mental health resources appears below…

On campus…

  • University of Ottawa Health Services (UOHS), 100 Marie-Curie Private
    • Offers counselling, psychiatric services, individual, couple or family therapy, access to psycho-educational groups and referrals to specialists off-campus
  • Student Academic Success Service (SASS), 100 Marie-Curie Private
    • Offers individual counselling, peer-counselling, workshops, online therapy and group counselling using new stepped model; referrals
  • Faculty mentoring centres (locations differ by faculty)
    • Specialized mentoring services catered to the needs of students in each faculty

Off campus…

Warning signs of suicide include:

Talking about wanting to die

Looking for a way to kill oneself

Talking about feeling hopeless or having no purpose

Talking about feeling trapped or being in unbearable pain

Talking about being a burden to others

Increasing use of alcohol or drugs

Acting anxious, agitated, or recklessly

Sleeping too little or too much

Withdrawing or feeling isolated

Showing rage or talking about seeking revenge

Displaying extreme mood swings

The more of these signs a person shows, the greater the risk. If you suspect someone you know may be contemplating suicide, you should talk to them, according to the Canadian Association for Suicide Prevention.

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