During the fall of 2020, Chen Yang noticed that some of her fellow students were in distress. On top of the usual academic demands and personal worries, the pandemic showed no signs of ending and virtual learning was still relatively new. As someone who had struggled with her own mental health in the past, Yang – a student at the Daniels Faculty of Architecture, Landscape, and Design – tried to help friends by sharing the wellness strategies that worked for her. But there was only so much she could do. Then she heard about a chance to improve students’ mental well-being on a much larger scale.
A university-wide email arrived inviting students to support a major new research initiative focused on post-secondary student mental health. “I didn’t hesitate to take this opportunity,” says Yang, who, along with eight others, was chosen from more than 270 applicants to be student advisers for U of T’s new Student and Youth Mental Health Research Initiative. “I often felt angry, upset and powerless since my influence is so limited. I wanted to turn my emotions into the motivation and action that would improve the mental health environment for students on campus.”
The initiative, which launched earlier this year, will produce research-based solutions to the complex challenges identified by U of T’s 2019 task force on student mental health. Created in response to a dramatic increase in Ontario post-secondary students reporting depression and anxiety and surging demand for counselling and related support, the task force recommended better access to mental health resources. In response, a redesign of campus-based services is ongoing. So far, it involves a new online portal that makes it easier for students to find mental-health resources across the three campuses, the expansion of same-day and drop-in counselling, and a new partnership with the Centre for Addiction and Mental Health (CAMH) that creates more options for students needing complex and acute care.
The task force also called for the development of a research network that includes: U of T faculty from different disciplines and staff, from across the three campuses; CAMH and other community partners; and students. “In recent years, there has been a lot of media focus on the ongoing mental health needs of students in post-secondary institutions,” says Kristin Cleverley, chair of the research initiative and a professor in the Lawrence S. Bloomberg Faculty of Nursing. She acknowledges that the sense of alarm has been warranted. In one 2019 national survey, for example, almost 70 per cent of post-secondary students reported feeling overwhelming anxiety within the last year and about half reported feeling so depressed that it was difficult to function.
“Now we’re generating evidence to address what many are calling a crisis,” says Cleverley, who is also the CAMH Chair in Mental Health Nursing Research. “To my knowledge, this is the first time a university in Canada has put focused resources into studying post-secondary mental health at this scale. And we’re taking the innovative approach, at least in this subject area, of conducting every step of the research with students. From formulating the questions to disseminating the findings, they will be partners.”
There is a research gap on the unique mental health needs of post-secondary students, says Andrea Levinson, the initiative’s clinical lead and the director of psychiatric care at U of T Health and Wellness. “We’ve relied on youth mental health research, which is relevant, but it doesn’t account for the interface with education. And there hasn’t been dedicated time and infrastructure to bring together researchers committed to student mental health with frontline professionals and students themselves. Now we’re creating a central hub to funnel great ideas and fund key projects.”
Lexi Ewing, another student adviser and a PhD candidate at the Ontario Institute for Studies in Education, belongs to a new generation of researchers exploring post-secondary student mental health. “There’s not a great understanding of what determines students’ risk and resiliency for the development of mental health concerns,” says Ewing, whose thesis is investigating how students cope with the transition to university, stressful events in college and university settings, and the effect of those coping behaviours on their well-being. “I’m especially interested in the first year of school, when we often see a decrease in mental wellness. I had a hard time then, and I want to know why this happens and how we can support others who are having that same experience.”
Cleverley asked colleague Emma McCann (BSc 2019 UC) to act as a liaison between the faculty working on the project and the student advisers, to ensure the students have the knowledge and resources they need to contribute on an equal footing. McCann says students are vital to the research process because they help researchers ask the right questions. “They can tell us which campus mental health issues are most important to them, where they’re going for help, what’s working and what’s not, and what’s missing.”
The student advisers include domestic and international students from a range of academic backgrounds on all campuses. Yang says it’s crucial to consider the distinct challenges – from language barriers to the strain of being separated from family – of international students such as herself in any research. “I know personally that these things can be overwhelming and can hold someone back from seeking help.”
The students’ backgrounds in mental health are also varied. Some have sought mental health services for themselves or others; some have conducted research in the field. Despite this diversity, however, McCann acknowledges that no single group can speak for all U of T students. “Our current focus is building connections in the broader student community – including recent alumni – and creating multiple routes to shape the research,” she says. This may involve surveys, focus groups or community forums. “Not everybody wants to raise their hand and say, ‘Hey, I’m struggling with my mental health,’” says Cleverley. “So, one avenue of research will be evaluating the effectiveness and cultural appropriateness of these and other methods of getting students’ perspectives on mental health.”
Other research priorities include the impact of socio-economic factors (such as financial security and access to social support) on students’ mental health, and the distinct mental health needs of students at key moments in their academic careers. The pandemic has also raised many issues for future investigation, says Levinson. “We need to increase our understanding of the role of in-person versus online support, for example, and how to foster social connection during lockdowns.”
Students have already influenced the direction of the initiative in several ways. “They’ve told us that we need to cover the continuum from mental wellness to mental illness,” says McCann, “and they’ve consistently underscored the importance of making sure the research reflects the student population’s diversity on all fronts.”
Beyond adding students’ voices to the conversation, the initiative is designed to offer them professional development and training opportunities at the local and international level. Cleverley recently received a Connaught Global Challenge Award for a project that will build a global research network on student mental health and fund international training, such as exchanges, for students. “We’re aiming to transform the landscape of student mental health research worldwide,” says Cleverley. “U of T is positioned to do that because of our size, our diversity, our internationally leading researchers and student affairs professionals, and our students, who are driven to be part of positive change.”
Ewing says she looks forward to more students hearing about the initiative in the year ahead and getting involved. “I hope they see that this is rooted in true compassion and wide recognition of the need to strengthen mental health not just for – but with – students.”