What role should faculty play in supporting student mental health?

On a fall night in 2017, shortly after dinner and before evening classes began, John Walsh, a classical studies professor at the University of Guelph, and his wife, Mary Walsh, a university administrator, joined other staff and faculty members in pre-arranged visits to students, most in their first year, in campus residences. “We knock on the door, make some small talk, ask them how they’re enjoying their time at university,” says Dr. Walsh. “And then we let them know that the university takes a great interest in their well-being – they’re not just academic units to us, they’re people. And we remind them that the university has a lot of resources available to them, hand them some information,” he says. “It’s not invasive, it’s a quick hello.”

The volunteers, who were paired with a residence staff member during the house calls, used feedback forms to track any concerns they may have had about a student they met, and to note questions they were asked but couldn’t answer. Staff at the residence life office reviewed the forms after the event and, when they deemed it necessary, followed up with outreach and referrals to services available on campus.

Mostly, though, the visits took a light tone. One of the best moments, Dr. Walsh recalls, was meeting two students who were sharing a room and happened to be in his class. Both were working on assignments that were due the next day. “We did a few footnotes together,” he says. “It was heaps of fun.”

No less than 60 staff and faculty members met with 2,200 students over three days. Response to the get-to-know-you initiative has been so positive, the university is making it a regular part of residence programming in October and March. It has also inspired a one-night house calls program during the winter term, with upper-year student leaders as the volunteer visitors.

Sending faculty out to meet students and humanize the institution is just one action U of Guelph is taking to address mental health on campus – an urgent priority for postsecondary institutions everywhere. At U of Guelph, it became a pressing concern following four student suicides during the 2016-17 academic year, including two deaths in residence. The loss sparked student protests for additional mental-health services on campus. It became clear that the university would have to examine its mandate and take more steps towards a “whole-person view” of students, an approach that makes the personal concerns of students as much an institutional priority as their academic needs.

Dr. Walsh, for one, is passionate in his commitment to ensuring that students in his classes and in the larger community feel respected and heard, especially on the issue of mental health. “I can think of no more important conversation we can be having right now,” he says.

It is no secret that more young people than ever before report that they are struggling with mental health. The negative impact of social media is often cited, along with, on the other hand, the positive impact of campaigns that urge people to disclose their problems and seek help.

Whatever is fuelling this urgent demand for more mental-health services on university campuses, it’s happening fast. The Canadian release of the 2016 National College Health Assessment (NCHA), a survey of student behaviours, attitudes and perceptions about their health over the course of 12 months, indicated that serious mental-health concerns, including depression, anxiety, suicide attempts and self-harm had all gone up since the last survey conducted in 2013. Nearly 45 percent of students reported feeling so depressed that they had difficulty functioning (up from 38 percent in 2013); 65 percent experienced overwhelming anxiety (up from 57 percent); 13 percent had seriously considered suicide (up from 10 percent); 8.7 percent had self-harmed (up from 6.6 percent); and just over 11 percent had been diagnosed with or treated for anxiety and depression (up from 6.9 percent).

Throughout Canada, universities are recognizing that they have a key role to play in maintaining the well-being of their students. Backed by targeted government funding, they are significantly expanding their mental-health service budgets, hiring more counsellors, instituting online and peer-support programs, and training staff to deal with the increasing number of students in need of help.

At the national level, the Mental Health Commission of Canada has partnered with Universities Canada and other stakeholders on a two-year project to develop a “pan-Canadian standard on psychological health and safety” for postsecondary students. The new framework, which the commission hopes to launch in early 2020, will offer guidelines to help Canada’s academic institutions to protect and promote students’ mental health, and to support students’ success.

In all the strategizing, expanding and refining of services on offer to students who struggle with anxiety, depression or any number of other serious mental illnesses, faculty are asking, where do we fit?

It may not always be clear to faculty – both full-time and contract instructors alike – how best to help students succeed academically while also helping them to deal with conditions that may range from ordinary stresses to all-out emotional and psychological crises. And yet, professors are often in key positions to notice performance issues or behaviours in students that could signal a deeper suffering; they may receive requests for formal accommodations, for leeway on assignment deadlines, or a student may even outright tell an instructor about their mental-health struggles or illnesses.

As the U of Guelph example suggests, when it comes to student mental health, professors are being called upon to extend their role beyond the classroom. “I think we’re starting to interconnect what’s going on in the classroom and all the social supports on campus,” says Charlotte Yates, provost and vice-president, academic, at U of Guelph. Reaching out to students in their residences last year got positive reviews, but more “evidence-based planning” is needed, says Dr. Yates, to establish benchmarks for what works best in supporting students. “I can understand faculty feeling like maybe we don’t have all the tools we need, that they’re teaching under challenging conditions. We are opening up the conversation, but we’re playing catch-up.”

Many others echo Dr. Yates on the need for more research and clear guidelines on how to deal with any number of situations that may arise surrounding student mental health in the classroom. Most universities offer faculty training in this area, but it’s voluntary. In the flood of email the average professor receives from administration over a semester, it would be easy to miss the one containing a link to the webpage where policies and protocols for dealing with student mental health are outlined. It’s valuable information, but only if everyone knows where to find it and what to do with it.

The benefits of ensuring that students feel supported in a campus community are obvious. But how far should that shifting of boundaries go? A recent letter to Kwame Anthony Appiah, a professor of philosophy at New York University and author of The Ethicist column for The New York Times Magazine, came from a professor who wondered if she’d done the right thing by paying for a distressed student to see a psychologist when wait times for on-campus counselling seemed unreasonable.

While the situation had a happy ending (the student felt better after the counselling sessions and later graduated), and the gesture itself was “generous and humane,” it was also inadvisable, Dr. Appiah judged: “Teaching and learning wouldn’t work very well if we could never become friendly with our students. But setting limits on these relationships protects both them and you from unprofessional entanglements. As sad as it is to lose stories like yours, I’ve come to think that there really is a case for handing over a student who is having such difficulties to people who are trained in dealing with them.”

“Faculty deserve better professional development,” says Maria Lucia Di Placito-De Rango. A professor of English at Humber College in Toronto, she has researched and written extensively on how universities and professors see their role in helping students with mental-health issues. In a 2017 article in the International Journal of Mental Health and Addiction entitled “Situating the Post-Secondary Instructor in a Supportive Role for the Mental Health and Well-Being of Students,” she writes: “Despite the increased consideration of student mental health and the ongoing efforts of bettering intervention systems, one aspect remains relatively under-explored: the role of the instructor.”

Leaving faculty to wade through grey areas may have more serious consequences than we realize. A survey of 52 academics in the U.K., published in January by the non-profit-group Student Minds, found that participants were confused about how they should handle students with mental illness. According to the report, “Most academics acknowledged that their role involved pastoral care [defined as a teacher’s responsibility for the general well-being of their students].” However, most respondents didn’t understand what that responsibility involved, “resulting in uneven responses for students, uncertainty for staff and unequal levels of accepted responsibility for student mental health.” The report’s authors note that “getting the balance right between pastoral and academic responsibilities is difficult and nuanced, and cannot be addressed by structural descriptions alone; students approach approachable academics for support regardless of how the role is described to them.” The report also indicates that “responding to the range and complexity of issues that students present to academics was seen to have ongoing cognitive, emotional, relational and practical effects.” The academics surveyed said that worrying about students’ well-being had led to disruptions in their sleep and in their home lives, among other impacts to their health and wellness.

In her coverage of the report for Times Higher Education, Sophie Inge quotes study co-author Gareth Hughes, who observes that “the signposting we’re asking academics to do is a more complex and nuanced task than we realized. And we absolutely need to get student services and academics working more closely together.”

The dilemma of the compassionate professor will strike a chord with many instructors who may be juggling more mental health-related accommodation requests than ever, and who wonder how best to help students exhibiting signs of distress. Solutions mandated by staff without input from faculty can certainly create tensions and doubts. And opinions vary among faculty about how best to offer certain accommodations to students.

“In defense of late papers,” a March 2018 opinion column in University Affairs by Andrew Moore, an associate professor at St. Thomas University, elicited both supportive and critical online comments. One endorsed leniency on deadlines: “There will always be scammers but in today’s world there are strong arguments for cutting students some slack.” Another commenter noted that while he believes it is fair to accommodate genuine health concerns, “what about fairness in the other direction? Fairness to the person grading the paper who’s certainly on contract (and therefore has a tight deadline or doesn’t get paid) to get final grades in. What about fairness to those students who DID get their work in on time?”

Fair questions, say academics like Kim Hellemans, a professor of psychology at Carleton University’s department of neuroscience. As an undergraduate student adviser, Dr. Hellemans says she is frequently in the position of mediating between instructors and students regarding deadline extensions, exam rescheduling and class attendance. “There’s a slipperiness in this situation. We are loath to not accommodate and toe this line.” Yet, as a neuroscientist, Dr. Hellemans is fully aware that some stress is good for human development. Learning to manage time and to practise coping strategies for juggling assignments and writing exams helps students gain strength and resilience. When are staircases more helpful to students than pillows, she and many other faculty members wonder.

Dr. Hellemans argues that granting repeated deadline extensions, for instance, may not be in students’ long-term interest. “I get the sense that some students believe that, unless they are feeling 100 percent and acting under optimal circumstances, they have the right to defer an exam or rewrite an assignment,” she wrote in a column for University Affairs this past April. She and other colleagues in her department are now embarking on a study that will survey students to determine links between mental health and academic performance. She offers a number of ideas for how professors can help their students build “academic buoyancy,” including developing assignments that involve group study, becoming familiar with campus services for students, and leading classroom discussions on how to manage time and cope with stress.

That approach is in line with many others now being developed. In a lecture Dr. Di Placito-De Rango delivered this past spring at Simon Fraser University, she proposed a model in which professors are offered clear training and guidelines on how to “recognize students in their classes who may be facing mental-health challenges, to render equitable supports that facilitate the student’s successful course completion, and/or to redirect students to appropriate resources.”

As researchers across Canada continue to gather evidence about what models of support work best, the faculty role is likely to become more clearly defined, says Catherine Munn, lead psychiatrist at McMaster University’s Student Wellness Centre, and co-creator of Professor Hippo on Campus, an online training tool for faculty. She says that in workshops she has led for faculty members, participants have often said they felt underprepared and craved more information for addressing student mental health. She developed the Professor Hippo tool to offer specifics on which accommodations work best, and ideas for makings classrooms more “mental health friendly.” It also includes information on self-care for faculty and how to avoid burnout.

A well-defined “stepped” approach for dealing with students is becoming popular for mental-health programs involving faculty. Using this model, support staff can match the intensity of care to the complexity of the condition, “stepping” treatment up or down as needed. The goal in part is to make better use of low-intensity intervention options and alleviate some of the demand for counselling services where it isn’t needed.

Carleton offers faculty the option of participating in this model by writing an online “care report.” This process allows instructors to outline their concerns about a student and send the confidential report to a counsellor in student services. Dr. Hellemans calls this approach a “lifesaver” for both student and faculty. It means that the student gets the chance to speak with a qualified counsellor about options for staying on track with school work, and it helps the student access additional services they may need.

Faculty members also have a role to play in the model of stepped care being developed by the Association of Atlantic Universities, which last year appointed Elizabeth Cawley of Memorial University as its regional coordinator of student mental-health initiatives. “Everyone should have a level of basic mental-health literacy: how do you approach a student, how do you engage in a supportive conversation, and if required, make a referral,” says Dr. Cawley. “We know that professors and staff and lecturers are linchpins. They’re people that students see daily or weekly. In a lot of ways they have the ability to intervene.”

Whatever an instructor’s current level of mental-health literacy, kindness and common sense are a good starting point – kindness, like volunteering your time to visit first-year students in residence to let them know that professors value them as people; common sense, like being supportive of a student but stopping short of personally paying for their treatment. With more research, training and institutional protocols to guide them, faculty members can begin to feel more confident and clear about their role in helping students with mental-health concerns to succeed. As Dr. Di Placito-De Rango says, “doing nothing is not an option.”