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‘You’re swimming upstream’: Students highlight gaps in U of O’s mental health system

Natasha Landry, Magalie Lefebvre, Matthew Henry, and Rachel Harrison. Photo: Zoë Mason/The Fulcrum
Reading Time: 16 minutes

Students push for lower wait times, more specialized counsellors, and better training for professors

Content warning: Suicide

On Dec. 6, 2019, phones buzzed in the pockets of the University of Ottawa’s over 42,000 students as, simultaneously, they received an email. The fourth of its kind in eight months, it was another message from the administration. “Dear Members of the University Community,” it began, “I am saddened to share the news of the death of a member of our student community.”

The same 23 words began the three emails that preceded it, and the words that followed nearly always matched as well. The emails, and the students whose passings they mark, are symptomatic of what can only be described as a mental health crisis here at the U of O.

The university’s health and wellness webpage rings off some fast facts: 26.3 per cent of post-secondary students report being diagnosed with and treated for a mental illness by a professional sometime in the last 12 months; 64.5 per cent report “overwhelming anxiety;” and 44.4 per cent have felt “so depressed it was difficult to function.”

The statistics would imply that the university understands the scope of the demand for mental health support. But if this recent string of deaths tells us anything, it’s that the U of O is not providing enough.

I was pretty sure I had an anxiety disorder all my life. 

I didn’t sleep through the night for two straight years. I’d get up and pace my room until my heartbeat slowed and the feedback in my head cleared enough that I could think. Sometimes my mother would rub my back until I went back to sleep. 

But she didn’t believe in anxiety disorders, she believed in “overdiagnosis” and in things “being in your head.” Then she got sick, and when the panic attacks started and I had to leave school twice a week, she told me if I called her again she wouldn’t come to get me anymore. So I started going to the bathroom to wait until I didn’t feel like I was going to die.

I learned the words “anxiety” and “panic attack” from friends, teachers, and the guidance counsellor at school, but never from doctors. I learned to subdue them on my own terms and I moved on, certain I had cured myself. And then I moved out.

At it’s very worst, I didn’t leave my apartment for weeks except to go to class, and eventually, not even then. When it became impossible to ignore, I did what I had always been too proud to do and I asked for professional help at the U of O.

I waited for three weeks. I saw a counsellor twice who did very little except let me talk and hand me tissues. I left without answers and then I never saw him again. But when second year began and I felt anxiety creeping down my throat again, I went to the walk-in clinic on campus. The doctor told me what I’d suspected all along, that it sounded like an anxiety disorder. She told me I would benefit from a psychiatric assessment and referred me for one.

That was the end of October 2019. In mid-December, I was processed by telephone: “Do you abuse drugs or alcohol?” “Have you harmed yourself or experienced suicidal thoughts?” In late December, I was finally given an appointment with a psychiatrist: July 30, 2020, at 9 a.m.

The path to mental health care on this campus is a treacherous one, and it could be costing students their lives.

As the clock keeps ticking

Matthew Henry is in his fourth year of French studies with a minor in history at the U of O. He hopes to go to teacher’s college in the fall, but there were times he wasn’t sure he would finish his undergraduate degree at all. 

Diagnosed with anxiety, depression, and obsessive-compulsive disorder (OCD), the stresses of moving away from his small hometown and adjusting to university quickly put a strain on his mental health.

“I don’t want to say I was flirting with the idea of death, but I’m an art student,” he says. “So that’s my metaphorical way to put it.”

He reached out to the Student Academic Success Service (SASS) in September 2016, which referred him for counselling. He recalls SASS telling him they’d get him in “quickly.” He assumed they meant the following week; he saw a counsellor the following month.

“I almost didn’t make it that month,” he says. “Both that I almost dropped out and that I was having suicidal thoughts, skipping classes. Things just kind of start spiralling downwards.” 

In fact, the four weeks he waited to access care is quick, by the standards established for on-campus help. According to an anonymous online survey conducted by the Fulcrum, 50 per cent of respondents said they waited one month or more for their first appointment, while nearly a third waited more than eight weeks. 

Rachel Harrison, a fourth-year student in software engineering and a U of O student ambassador, falls into that majority.

When the panic attacks she’s managed since high school peaked this October and began to impact her grades, her boyfriend and roommates urged her to seek help. Although describing her mental state at the time as “in crisis,” she didn’t step foot into a counsellor’s office until the start of winter term in January of this year.

“I remember that first year trying to get help, when you don’t know where to turn, and everything’s completely new, and what’s more is that usually with the mental illness you’re going through, it’s a lot of negative self-talk,” Henry reflects. “So, to do that research and kind of jump over hurdles to get that first appointment is the difference between life or death for some students.”

Henry’s own mental health was at an all-time low when one of his classmates died by suicide in his first year. He says he remembers thinking that “that was a place (he) wasn’t willing to go,” but his classmate’s suicide made it seem more reasonable. 

Henry was only coaxed off that ledge himself when his professor acknowledged the student’s death and urged his students to seek help if they needed it.

“The person who (died by suicide) in my class,” he continues, “I don’t know the situation of his life, but I can only speculate that if instead of jumping through hurdles, you had a clear cut path to help, a lot more people would access it.”

Natasha Landry, now two years into her master’s in sociology with a specialization in women’s studies, was surprised and disappointed to be met with impertinence when she reached out to the U of O for help in November 2018.

Having dealt with anxiety her whole life, Landry saw a psychologist for two years at home in New Brunswick but stopped when she moved to Ottawa. Finding her transition to graduate studies more challenging than she expected, she soon slid into what she describes as a “major depression” in her first two months of school. 

“I went to the health clinic and I didn’t really know what was wrong with me, all I knew was I had suicidal thoughts and something needed to be done,” she says. “And then the doctor didn’t really want to talk about it. He just said, ‘Oh, I’m going to refer you. What do you want? You want pills? Or you want time off?’ ” 

She’d avoided taking medication to treat her anxiety in the past, but eager for relief, she decided to try it under the understanding that she could supplement it with counselling. 

But the counselling didn’t come fast enough. She was unable to complete her semester, going home to New Brunswick at the end of the fall semester instead. When she returned in the new year, she finally got her appointment at the end of January, a date that was the fortunate product of a cancellation.

It wasn’t a psychiatrist, as she’d originally requested, but a counsellor nonetheless, and she took the help when it was given to her. However, she says her treatment was revoked after only two appointments because she didn’t have a family doctor registered with the U of O’s Health Services (UOHS).

“They decided that because I wasn’t referred by a family doctor, I couldn’t receive those (services),” she says. “They were like, ‘If you go back to the health clinic and ask for the forms, and do another request, it’s going to be fine.’ And I was like, OK, this is super overwhelming. I’m already really stressed. I don’t have time for this. You know what, I’m just gonna deal with this by myself. So that’s what I did.”

After that, she had her medication readjusted whenever her anxiety began to flare up again. But whenever the school asked if she wanted to return to counselling, she said no. However, she insists that her experience could easily have been much better if only she’d received a little more compassion from the start.

“Maybe just hold my hand and say what I need to do and just tell me where to go, because my brain wasn’t really functioning,” says Landry. “So if I had someone saying, ‘You just need to do all of those papers, and then we can do this,’ it would have been better.”

Magalie Lefebvre had never reached out for mental health help before she started at the U of O in the 2018-19 academic year. But a serious breakup left her wondering if she could handle it on her own.

“I didn’t know it could hurt like that,” she says. “I stopped eating and I lost 12 pounds. It was really intense.” 

When she returned to school in the fall, she decided to seek professional help. 

Five minutes before her first session meeting drew to a close, she told the counsellor about her thesis on the process and politics of constructing racial identities for biracial women with a black and a white parent. 

Falling into this category herself, Lefebvre’s passionate about the topic, but felt the intensity of her work could be contributing to her stress and low mood. She was taken aback by the therapist’s response.

“‘I really think today, racism is more reversed,’ ” Lefebvre recalls her therapist saying. 

“I was like, ‘Oh, no. If you’re talking about racism against white people, you are going to lose me right away.’ ” 

The therapist went on to try to defend her statement. 

“ ‘Sorry, but I think what I meant to say was that I worked with (Indigenous) people for a long time and they were really mean and racist toward me,’ ” quotes Lefebvre.

Unsure whether this was the type of microaggression she was accustomed to or an actual breach of therapeutic ethics, she called the service after her appointment. 

She was encouraged to file a complaint and was promised a call back, which she says she never received. Lefebvre says a follow-up was met with a second promise, but this too was broken when radio silence ensued.

Lefebvre returned to counselling and requested a new therapist, but she’s concerned that her complaint went no further than the empty words of the operator. As far as Lefebvre knows, the counsellor is still employed by the university and was never disciplined.

Her experience made painfully clear the lack of competent care for racialized students in particular. She’s not sure if the answer is mandatory racial and cultural training, more counsellors of colour, or specialized services catering to the needs of racialized students, but she knows something is missing.

“I can’t explain all this cultural package before I get answers for my problem,” she says. “It’s exhausting to explain who I am and how my culture is before (receiving counselling).”

Camelia Skaf is a second-year student studying French and applied ethics.

Skaf found herself in the UOHS building in September 2018 and was referred to a psychiatrist. In November 2018, she was told that they had found her one and was given an appointment for the next available slot: April 30, 2019. 

In addition to being nearly an entire academic year after her initial referral, the appointment was also three days past the residence move-out date. 

“You really don’t want to cancel that appointment because you know how hard it was to get that appointment,” she says. “How many times I’ve been to the hospital before I get this appointment. How much I’ve been through to finally end up in that office.”

She tried to find a way to stay in Ottawa, but it was an extra $50 per night to stay in her room at the 90U residence. She never saw the psychiatrist, and she was charged $100 for missing the appointment. 

In the summer that followed, she was diagnosed with borderline personality disorder (BPD).

“It’s so hard. Everyone’s like, ‘you get a diagnosis, you get treatment.’ I got diagnosed in July. Then I got a referral for psychotherapy recently, and then I didn’t submit it because I’ve been a mess,” she says. “My psychiatrist said ‘you need six to 10 years of treatment so that you’re not symptomatic enough to say borderline anymore.’ So my head I’m like, damn, I got time. But at the same time, wouldn’t it be great to just have access to what I need when I need it?”

Part of what she needs is dialectical behaviour therapy (DBT), a key part of the treatment plan for BPD. The university’s Centre for Psychological Services and Research (CPSR) presents an opportunity for students to receive specialized care for an affordable price. But when Skaf requested DBT there, she says she was made to run in circles before finally, she stopped getting responses. 

As of right now, she’s not undergoing DBT or seeing a counsellor at all.

“I just stopped because it was just not what I needed,” she says. “Why doesn’t the U of O offer specialized counselling? The thing with me is I’ve been (doing) talk therapy for two years. I just talk and they listen, you know, and that’s good for me to learn the situations in my life and how to manage that. But in terms of treatment, you need specialized counselling.”

For those suffering from personality disorders, the absence of specialized care can be devastating. For Skaf, it has meant nine visits in the past year to an emergency room that can’t really help her; they take her blood, check her out, and, invariably, send her away. She says the campus clinic has a habit of doing the same.

“One time I went and I was like ‘listen, I’m gonna burn out and I’m going to be suicidal,’ ” she says. “ ‘I just need like a stress leave for like two weeks.’ And the doctor looked at me and she’s like, ‘I can’t give you a note because I don’t know you.’ As she’s literally looking through my history.”

The clinic, despite its flaws, is not the target of student contempt. In light of high demand and understaffing, they expect nothing more. Rather the brunt of their anger is saved for the administration and those who represent it. 

Crisis? What crisis?

Michel Guilbeault’s work as associate vice-president of student services includes overseeing the U of O’s mental health care system.

The numbers provided by the university are troubling: in the 2018-19 academic year, 16 counsellors offered over 5,700 appointments to 1,760 students. That means the ratio of students to counsellors was 110 to one.

“And that number is continuing to grow,” says Guilbeault. “That’s just the reality.”

Rachelle Clark is the director of the newly established Wellness and Recreation Sector for Student Life, which is in the process of inheriting SASS’s counselling services. This year, after the introduction of the stepped care model and four new counsellors, Clark is confident the university is moving in the right direction.

“What the stepped care model has allowed us to do is essentially eliminate wait times to access services,” she says. “A student who finds themselves in need of support can attend the walk-in clinic and receive immediate support from a professional counsellor.”

On the fourth floor of the Health Services building at Marie-Curie, students can walk in and request to see a counsellor immediately.

This likely comes as a shock to many at the U of O. While the drastic systemic reorganizations that began last fall have, in theory, eliminated wait times, few students actually seem to be aware of the changes or are experiencing the system in this way. Many still access services through online requests, which often leave them waiting weeks for an appointment.

Clark admits this is perhaps the system’s greatest flaw.

“When I think about the multiple points of entry we have to our mental health services, I think it can really make navigating them very tricky and confusing for students,” she says. “I think that as we focus on future strategies, initiatives, and partnerships, we have to work towards reducing duplication and simplifying access to these critical services for students.” 

While undoubtedly steps in the right direction, Jamie Ghossein thinks they’re not enough.

Ghossein is a third-year medical student and a member of the university’s Board of Governors, a role he has filled since 2017. He is as close to this conflict as anyone; he’s been integral to lobbying for better mental health services as a member of the board, he just finished a rotation in psychiatry, and he was classmates with the last student to have died by suicide on campus last year. 

He describes the current state of affairs as “crisis mode.” 

“As you know, there’s a lot of student suicides on campus, but student suicides capture a smaller picture of the problem, because there’s actually a lot of students dealing with mental health problems,” he says. “It’s on the rise every year and I think we’ve definitely reached a level of crisis, students have lost their lives, but also there are many students that are on the brink of losing their lives that we have to help as well.”

A part of the administration himself, one might expect him to be defensive of the university’s efforts. But surprisingly, he is one of its most vehement and vocal critics.

Ghossein’s work on the board mainly consists of advocacy. But recently, he’s taken on a more active role in pushing what he sees as urgently needed reform of the school’s policies towards mental health. 

“In a five-minute conversation, to try to convince 30 board members to invest more funds when the university (is in a deficit) — it’s very difficult. But sometimes you have to be creative with things. And sometimes you just have to find other ways instead of asking. So that’s what I’m doing.”

His biggest victory so far came in the aftermath of the collapse of the Student Federation of the University of Ottawa (SFUO) last year. 

While the nascent University of Ottawa Students’ Union (UOSO) was readjusting its budget, Ghossein was involved in convincing them to redistribute money to SASS that had previously gone to student businesses managed by SFUO.

He lobbied the university to match the amount, resulting in an $800,000 increase to the SASS budget in total.

But money is just the beginning of what he has in mind. Another key piece that’s missing from the U of O’s approach to mental health care is any type of long-term mechanism for improving it. 

“It always comes in waves,” he says. “Every time a student loses their life, then the interest in re-looking at mental health services spikes, but it drops off after the buzz dies off. And I think that’s what we have to avoid.”

His solution is a committee, similar to the ones established to tackle racism and student satisfaction, tasked with the constant evaluation and reevaluation of the mental health care system in order to continually suggest improvements. 

At the Jan. 27 Board of Governors meeting, U of O president Jacques Frémont announced a presidential task force to do just that.

“Believe me, it would be worth it for you to meet with the people who intervene day after day, 365 days a year,” Frémont said in an interview this month. “We will adjust the system and we’re trying to be better.”

While an administrative body lays at the foundation of his vision for improvement, Ghossein thinks meaningful change can be enacted first on the front lines — a demand students unanimously support.

The frontlines

“UOHS and Marie Curie and SASS … have their hands full,” says Skaf. “They’re not going to reach those 40,000 students, but who is in contact with those 40,000 students every day? Profs.” 

How professors treat mental health varies significantly on an individual basis. But many students see professors as representing the university’s interest — or lack thereof — in the mental health crisis.

Henry has seen the good, the bad, and everything in between in his four years at the U of O. The psychology professor who urged his class to seek help was a turning point for the better, but his experiences weren’t always so positive. 

There were professors who he says dismissed mental illness entirely. He remembers one professor suggesting he “suck up and get over it or drop out and get out.”

“Multiple profs said stuff like that,” he says. “Some are thinly veiled, but as someone who’s heard these things before, it’s like ‘oh, there it is.’ And some are very overt.”

As for what students want from their professors, Skaf is unequivocal and blunt.

“Compassion and awareness.” 

Ghossein is well aware that some professors treat mental illness and the associated accommodations inadequately. He’s even aware of multiple occasions where professors asked students for their diagnoses before accepting their sick notes, in blatant violation of accommodation guidelines. He thinks that meaningful change has to be from the top down, and he doesn’t think involving professors and other front line workers is too big an ask.

“This is something that we repeat ad nauseum at board meetings; there needs to be some sort of directive from the university administration to the professor body and to support staff (and) to those that are front line with the students.”

This directive would include what he calls a “roadmap” to help guide students towards the services they need and often don’t know where to find. But Ghossein also believes that any directives are empty without accompanying sensitivity training with regards to mental illness and accommodations.

“They’re not mental health professionals. They’re not responsible for my life, they’re responsible for my education,” says Henry. “But that being said, it makes a lot of difference for them to approach me and say those things because you feel seen, and you can talk to them, and they can be like, ‘Hey, this is how you access care.’ ” 

Guilbeault told the Fulcrum that one of their recent initiatives involves online and in-person mental health awareness training as part of professor orientation. 

However, according to the Fulcrum’s online survey, 76 per cent of respondents said that staff training is inadequate. Harrison can’t even imagine a professor acknowledging mental health in the classroom.

“If one of my professors said anything about mental health, I would be shocked. I don’t know if it’s a faculty thing, if engineering is different, but no professors talk about anything other than the course, ever.”

There’s a consensus among students that the most immediate and tangible change must come from professors in their syllabi, lecture halls, and office hours. They are the most visible and accessible arm of the university, and as Skaf said, professors are in a unique position to communicate with struggling students every day.

Six students spoke to me for this article.

There was a stark difference in how each of them told their story. Henry was saddened; at times we stopped so he could gather his thoughts and composure. Skaf was indignant and alternated between unbridled rage, sardonic humour, and quiet disappointment. Harrison was careful with her words, wanting change and eager to contribute, but equally eager to avoid alienating the school that had given her a community and job she loves.

They all had different experiences, but the common thread was undeniable. Each experienced, in different ways, a system that failed to meet their needs. At the core of these five interviews, it was as simple as that. 

Henry says even his own therapist acknowledged the systemic roots of the crisis.

“ ‘The system we’re serving is putting you guys in a position where it almost feels like it’s pushing you guys down,’ ” he recalls his therapist saying. “ ‘Then you’re coming to be lifted up, but you shouldn’t be pushed down the first place.’ You know, my therapist loves to say ‘you’re swimming upstream.’ ” 

If there was any ambiguity with regards to that sentiment, it is quelled by quantifiable evidence. Of the 57 respondents polled in the Fulcrum’s survey, only one ranked university support for mental health over a six on a 10-point scale, while almost 70 per cent gave it a failing grade.

At an institution that every student pays tens of thousands of dollars to attend, this type of systematic failure is unacceptable.

At the end of our interview, Skaf sounded exhausted, but far from defeated.

“I have $10,000 in loans,” she said. “I’m not gonna pay that much money to be pushed around. You know … I’m here for a purpose. Hopefully I want to get out of here alive, and some people haven’t. That’s a very real thing. So, meet me halfway and I’ll meet you halfway.”

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…


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