Mental Health Working Group Report June 5, 2014

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Report of the Mental Health Working Group

May 2014

Written by:

Marilyn Fitzpatrick, MHWG Chair Lina Di Genova Professor Manager Program Director, Counselling Psychology Student Assessment, Student Services

Contact: Marilyn Fitzpatrick T: (514) 398-3476 E: marilyn.fitzpatrick@mcgill.ca Lina Di Genova T: (514) 398-7072 E: lina.digenova@mcgill.ca

Mental Health Working Group Report June 5, 2014

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ACKNOWLEDGEMENTS This report is the result of the significant contributions of the following individuals in the Mental Health Working Group (MHWG): Nicole Allard Director, Advising Services, Faculty of Science Lorraine Bush Administrative Coordinator, Counselling & Tutorial Services

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Lina Di Genova Manager, Student Assessment Elizabeth Cawley Graduate student, Member Services Officer PGSS Jack DeStefano Director, Psychoeducational & Counselling Clinic Karine Goddard Staff, Mental Health Service Marilyn Fitzpatrick Chair, Director Counselling Psychology Program Clare Foa Graduate student, Service provider: Counselling Services Robert Franck Director, Mental Health Heather McCombie Advisor, Desautels Faculty of Management Vera Romano Director, Counselling & Tutorial Services Max Rossiter Graduate Student Catherine Thompson Counselling Service Pierre Tellier Director, Student Health Service Joey Shea Undergraduate student, VP University Affairs, SSMU In addition, the MHWG would like to thank those stakeholders who agreed to be interviewed and gave their perspectives and ideas to inform this report. Spencer Boudreau Ombudsperson Elizabeth Cawley Graduate student, Member Services Officer PGSS Andre Costopoulos Dean of Students Heather McCombie Advisor, Desautels Faculty of Management Lesley Morin Student Affairs Officers Records Chidinma Offoh-Robert Director, Faculty of Engineering Ria Rombough Associate Director, Residence Life Susie Vodopivec Student Affairs Administrator Students Melissa Dick Graduate student Avik Ghoshdastidar Graduate student Samara Perez Graduate student Emily Yung Graduate student Student Services Staff Frederic Fovet Office for Students with Disabilities Robert Franck Mental Health Service Darlene Hnatchuk Career Planning Service Paige Isaac First People’s House Pauline L'Écuyer International Student Services Sara Parks Office of Religious and Spiritual Life Cara Piperni Scholarships & Student Aid Vera Romano Counselling & Tutorial Services Ian Simmie, Leslie Copeland & Mitchell Miller Campus Life & Engagement Pierre Tellier & Amanda Unruh Student Health Service

1 Notes of thanks. Particular thanks go to Jack DeStefano for help in conducting the interviews and to Lina Di

Genova for her essential role in organizing data collection and analysis in both phases and for substantial input in developing this report. In addition, thanks to Zuzanna Kuza for her assistance with the data transcription

Mental Health Working Group Report June 5, 2014

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The Mental Health Working Group has consulted a number of resources including the following:

1- Boudreau, S. (2014). Twenty-Six Annual Report, (June 1, 2012 – May 31, 2013). Office of the

Ombudsperson, McGill University:

http://www.mcgill.ca/ombudsperson/sites/mcgill.ca.ombudsperson/files/annualreport20122013pdf.pdf

2- Canadian Association of College & University Student Services and Canadian Mental Health Association

(2013). Post-Secondary Student Mental Health: Guide to Systemic Approach. Vancouver, BC: Author.

3- Canadian Graduate and Professional Student Survey (2013). McGill University Results:

http://www.mcgill.ca/pia/surveys/survey-results/cgpss.

4- Cooper, N.J., & Fuller, R. (2012). McGill University Counselling and Tutoring Services: Review of Service

Spring 2012.

5- Di Genova, L. (2011). McGill University Counselling Service Survey Results Summary.

6- Di Genova, L. (2011). McGill University Mental Health Service 2011 Satisfaction Survey Executive

Summary.

7- Di Genova, L. (2013). McGill University Post-Orientation Week Survey Results Summary.

8- Di Genova, L., & Romano, V. (2013). Student Psychological Wellbeing at McGill University: A report from

the Counselling and Mental Health Benchmark Study.

http://www.mcgill.ca/senate/sites/mcgill.ca.senate/files/student_psychological_well-

being_at_mcgill_october_2013.pdf

9- Harassment, Sexual Harassment and Discrimination: http://www.mcgill.ca/harass/forms

10- National Survey of Student Engagement (2011). McGill University Results:

http://www.mcgill.ca/pia/surveys/survey-results/nsse

11- Office of the Dean of Students, Helping Students in Difficulty:

http://www.mcgill.ca/deanofstudents/helpingstudents

12- Office of the Deputy Provost Student Life and Learning, McGill University (2014). Summary notes from the

Joint-Board Senate meeting on mental health (held on November 12, 2013).

13- Principal’s Commission on Mental Health (2012) Queen’s University,

http://www.queensu.ca/cmh/index.html

14- Students’ Society of McGill University (2014). SSMU Policy on Mental Health: http://ssmu.mcgill.ca/wp-

content/uploads/2013/09/Addenda-SSMU-Mental-Health-Policy-2014-02-20.pdf

15- Tellier, P.P., & Di Genova, L. (2014). National College Health Assessment II: Preliminary McGill / Canadian

Benchmark Report (Mental Health Section Only).

16- University of Manitoba (2014). Success through Wellness: Enhancing the Campus Community to Promote

and Support Mental Health and Wellbeing. University of Manitoba’s Campus Mental Health Strategy.

Mental Health Working Group Report June 5, 2014

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EXECUTIVE SUMMARY

Constitution and mandate. The Mental Health Working Group (MHWG) was constituted by Jana Luker, the Executive Director, Services for Students in October 2013. The mandate of the committee was to review the current state of counselling, mental health and wellness services for students at McGill and to make recommendations to Jana Luker and Ollivier Dyens, Deputy Provost, Student Life and Learning, concerning opportunities for change. The group was chaired by Professor Fitzpatrick, the Director of the Counselling Psychology Program. It included the Directors of the Counselling, the Mental Health and the Student Health Services, the Director of the Psychoeducational and Counselling Clinic, the Manager of Student Assessment, academic advising representatives, undergraduate and graduate student representatives, an administrative coordinator and a recording secretary.

Process. The MHWG met weekly between October 2013 and February 2014. Data from multiple surveys and reports were consulted. The group conducted a consultation process in two phases. First, a survey of selected stakeholders was conducted to provide information on student needs and existing services for mental health and wellness. The results indicated richness in the range of services offered and a diversity of groups offering help. The second phase included interviews with 16 stakeholder individuals and groups. Respondents were asked four questions about counselling, mental health and wellness services: what is working well, what is missing, what changes they would recommend, and what barriers exist to making suggested changes. Categorization of the interview data and the input from the rich MHWG discussions were used to develop recommendations in three categories:

Create a more supportive campus environment. Reports from stakeholders indicated that awareness and support for mental health is increasing momentum at McGill. Initiatives that would help to sustain the momentum include the following:

- Increase the focus on wellness in graduate and undergraduate student orientations. - Expand and offer more professional support for student-to-student initiatives that are easier

to access for students for whom professional services are stigmatizing. - Provide students with wellness information throughout the academic year closer to their

needs for it. - Offer a wellness course for credit. - Offer training in mental health to faculty members and TAs. - Provide mental health training for advisors and program coordinators who are the first line

of intervention for many students. - Match first-line staff with counselling or mental health staff to facilitate referrals. - Develop an integrated case-management approach across services. - Make mental health awareness part of the new mandatory training of faculty in supervision.

Improve faculty awareness of student mental health. Offer training for experienced faculty who have supervision difficulties.

- Increase communication among the licensed professionals, the front line staff working with students, and the students involved in student-led initiatives.

- Task a Senate group to monitor wellness initiatives including those recommended here. Optimize and better coordinate the use of existing resources. McGill has a broad array of

excellent University-offered and student-offered services across the campus. However many

Mental Health Working Group Report June 5, 2014

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respondents highlighted how difficult it is to keep track of McGill mental health and wellness resources

and initiatives. The professional services Counselling Services (CS) and (Mental Health Services (MH) have

been regularly overwhelmed and wait times have been long. Recommendations that could improve the communication about existing resources and help to optimize their use include the following:

- Develop and distribute (to students & staff) a McGill Student Services app. The app should include services offered by the licensed professionals, services delivered by front-line staff working with students, and student initiatives. The MHWG data from first phase of consultation can be used to assist in the development of the initial contents.

- Extend the online graduate orientation program currently in development to undergraduate students.

- Further investigate and pilot options to reduce the blockages in professional services created by requests for medical notes.

- Extend the use of validated progress tracking methods to better manage session limits. - Further develop the McGill Nightline with input from licensed professionals as an after-

hours helpline for students in distress. - Examine the feasibility of weekend services for crisis situations.

Review and harmonize service delivery. Currently, reviews of service delivery could be

conducted on a more regular basis and services could have more consistent policies. For example, the

Counselling Service (CS) and the Mental Health Service (MH) have some different policies in important

areas that create inequities and gaps in how students are served. Recommendations for reviewing service delivery include the following:

- Conduct an external review of the Mental Health Service. - Harmonize the administrative processes and clinical offerings of the Counselling and Mental

Health Services and give them a single public face. - Conduct and publish regular evaluations of services with valid indices of service

effectiveness. - Use licensed professionals as consultants for services delivered by front-line staff. - Develop and implement a robust case management approach for difficult cases.

Mental Health Working Group Report June 5, 2014

Create a More Supportive Campus Environment

Context While students’ mental health and wellness is dependent on a number of genetic and environmental factors that pre-date their university experience, it is also influenced by academic and social experiences at McGill, and by the availability of services that enhance wellness across those experiences. There is currently a tremendous diversity of services along a continuum from crisis intervention to social interaction that offer a framework for a campus environment that supports wellness. Further development of that environment should occur across multiple groups2. For that development to occur, a broad level discussion of the importance of wellness needs to be initiated and supported in an ongoing way. Stakeholders can be helped to endorse wellness as a goal, by linking it to tangible benefits. For faculty members, the benefits of student wellness include more productive undergraduate and graduate students who complete excellent work in a timely way. For the administration, a campus with healthy students supports recruitment and drains fewer resources. For students, wellness leads to increased opportunities to realize potential with concrete benefits, such as, improved employability. Reports from both staff and student stakeholders indicate that awareness and support for mental health is becoming a well-recognized priority at McGill. There are many initiatives from students and service groups that indicate this increased focus. The joint meeting of the Senate and Board of Governors was particularly important for its visible commitment to this priority. This is a key moment to extend initiatives to sustain this momentum. In creating an environment of wellness, the staff members who have the regular contact with students and a potentially great impact on wellness include advisors, program coordinators, professors, instructors and residences staff. Currently many of these people are over-taxed. In addition, they do not necessarily view student wellness as a part of their core mandate or as something over which they have influence. The following table outlines issues that were highlighted to the MHWG that bear on creating a campus environment to support of wellness.

2 A culture of wellness would embrace not just students but also faculty and staff at all levels.

February April

1.1.b.Investigate methods of evaluating faculty in the area of supervision.

GPSO, TLS, PGSS TLS PGSS, GPSO TBA

1.1.c.Offer/require training for faculty who do not meet supervision standards (e.g. Supervisory alliance workshop)

Counselling, TLS, GPSO

GPSO Counselling, TLS ongoing

1.1.d.Make student mental health awareness part of the new mandatory training for supervisors.

GPSO, TLS, Counselling, Mental

HealthGPSO TLS ongoing

mandatory nature to be discussed

1.1.e.Improve communications to faculty on the link between student wellness and student productivity

Counselling, Mental Health

Counselling, Mental Health

Counselling, Mental Health

ongoing

1.1.f.Offer training (e.g., Mental Health First Aid) to know how to recognize and to refer students in distress

Counselling Counselling ongoing

1.1.g.Offer training to know how to recognize and refer students in distress

Counselling Counselling EDSS, ODoS ongoing

1.2.a.Continue to increase the focus on wellness in Orientation Week

CLE, Counselling, Mental Health

CLE Counselling ongoing

1.2.c.Expand "buddy" and mentoring programs for first year students CLE CLE ongoing

1.2.d. Offer a wellness course for creditCounselling, Eucational &

Pyschology Dept. Counselling

Educational & Pyschology Dept.

TBA

1.2.e.Offer training in mental health for faculty and T.A.s

Counselling, TLS Counselling TLS in development

1.3.a.Increase mental health awareness training for advisors ODoS, Counselling ODoS Counselling TBA

1.3.b.Match advisors and program coordinators with mental health professionals Mental Health, ODoS Mental Health ODoS TBA

1.5.a.Adopt a more robust case management approach Counselling, Mental

HealthMental Health Counselling ongoing research/discussion

1.5.b.Expand "buddy" and mentoring programs

CLE CLE ongoing

Apr-16Counselling, OSDAssessmentCounselling,

Assessment, OSD

ongoingHealth Promotion

Create a more supportive campus

environment

1.1.a.

Provide student with wellness information throughout the academic year based on a student academic cycle needed

1.2.b.

1.1Graduate student and Post

Doc. Wellness

1.2.Wellness support from first year through to graduation

1.3.Competitive academic

environment

1.4. Inclusive and safe spaces

1.5. Stigma of treatment

CLECLE, Health Promotion

Allocate ongoing funding and effectively assess the following projects: The McGill Counselling Substance Misuse Program for harm reduction; Pride Team - specialized clinical service for the LGBT community; OSD Universal Design program to support diverse learners

1.4.a.

Mental Health Working Group Recommendations

Recommendations ObjectivesProjected

CostsUnits Involved Timeline

Status update (% completed)

Project LeaderProject 2nd

LeaderActivities

Review Orientation to allow comfortable access to information about mental health and Services

Summer 2015Mental Health,

CounsellingCLE

CLE, Counselling, Mental Health, Health

Promotion

Comments

Status update (% completed)

1.6.a. Further develop of a robust early alert program ODoS, Mental Health ODoS Mental Health completed 100% 100%

1.6.c.

2.1.a.Develop a McGill Student Services app. According to several parameters suggested

SLL, CLE SLL CLE COMPLETED

2.1.b. Extend online Orientation to undergraduate students

CLE CLE Sept. 2015

2.2.a. Review of system for medical notesEDSS, CSS, ESAAC,

Health, Counselling, Mental Health

EDSSCSS, ESAAC, Health, Counselling, Mental

HealthDec. 2015

2.2.d. Examine the feasibility of weekend servicesEDSS, Mental Health,

CounsellingEDSS

Mental Health, Counselling

Dec. 2015

3.2Two sites with different

administrative processes3.2.a.

Harmonize administrative processes between CS & MH

Counselling, Mental Health

Counselling, Mental Health

May 2015 50%

3.3.b.

3.3.c.Publish annual reports of services with valid indices of service effectiveness Assessment, EDSS Assessment EDSS ongoing to include in Briefing Book

3.3.d.Solicit faculty expertise and collaboration to continue to build resource effectiveness

TLS, EDSS TLS EDSS TBA

3.4.a.Use licensed professional as consultants for first-line services

EDSS EDSS TBA prior needs full investigation

3.4.b.Require consultation on the service offered prior to disseminating information

EDSS EDSS TBA

3.5.a.Develop and implement a robust case management approach across Student Services

Counselling, Mental Health, OSD

Mental Health Counselling Services Dec. 2015

3.5.b.

Use progeress tracking methods to identify not on track cases and manage risk in complex cases in mental health services. Collaborate with faculty members to use their expertise in this process

Mental Health, Counselling

Mental Health Counselling April. 2016

Review and harmonize service

delivery

EDSSEDSS, Assessment

ongoingAssessmentAssessment

Expand only services that have well-rationalized needs and built-in methods of program evaluation

Effective allocation of resources for mental health

and wellness 3.3

Apr./May 2015

ongoingAssessment

Conduct and external review of the Mental Health Services and establish a regular schedule of such reviews

Professional service training for members of the McGill

Community3.4

Severity and complexity of some student mental health problems

3.5

3.1.a.Regular and equitable external reviews

3.1

Continue to develop methods of evaluating the effectiveness of existing services. Implement needs assessments of new services3.3.a.

Mental HealthMental Health

Dec. 2015CounsellingCounselling

ongoing, Summer 2015

Lack of information about services

2.1

Manage session number limits by implementing validated methods of tracking client progress

Further develop and expand the capacity of Nightline and use CS & MH professionals or community helpline professionals to train students involved

2.2.b.

2.2.c.

Access to Services2.2

CSS (to be reported on website)

EDSSIdentify a senate committee to monitor progress of MHWG recommendations and other ongoing wellness inititiatives

Have regular meeting and communication among professional staff, front line services staff and student who offer wellness services

1.6.b.

CLECLE

Sept. 2015Mental Health,

Counselling, CLEEDSS, Health Promotion

TBA

Optimize and better coordinate the use

of existing resources

1.6.Multiple stakeholder

approach to student mental health

Mental Health Working Group Report June 5, 2014

Create a More Supportive Campus Environment

Context While students’ mental health and wellness is dependent on a number of genetic and environmental factors that pre-date their university experience, it is also influenced by academic and social experiences at McGill, and by the availability of services that enhance wellness across those experiences. There is currently a tremendous diversity of services along a continuum from crisis intervention to social interaction that offer a framework for a campus environment that supports wellness. Further development of that environment should occur across multiple groups2. For that development to occur, a broad level discussion of the importance of wellness needs to be initiated and supported in an ongoing way. Stakeholders can be helped to endorse wellness as a goal, by linking it to tangible benefits. For faculty members, the benefits of student wellness include more productive undergraduate and graduate students who complete excellent work in a timely way. For the administration, a campus with healthy students supports recruitment and drains fewer resources. For students, wellness leads to increased opportunities to realize potential with concrete benefits, such as, improved employability. Reports from both staff and student stakeholders indicate that awareness and support for mental health is becoming a well-recognized priority at McGill. There are many initiatives from students and service groups that indicate this increased focus. The joint meeting of the Senate and Board of Governors was particularly important for its visible commitment to this priority. This is a key moment to extend initiatives to sustain this momentum. In creating an environment of wellness, the staff members who have the regular contact with students and a potentially great impact on wellness include advisors, program coordinators, professors, instructors and residences staff. Currently many of these people are over-taxed. In addition, they do not necessarily view student wellness as a part of their core mandate or as something over which they have influence. The following table outlines issues that were highlighted to the MHWG that bear on creating a campus environment to support of wellness.

2 A culture of wellness would embrace not just students but also faculty and staff at all levels.