Lost in the system

The University is far from adept at dealing with students’ mental health, writes Natalie Czapski.

mental_illness

“It’s hard to come to grips with the fact that depression isn’t necessarily related to your life conditions. Sometimes it’s inexplicable – you don’t necessarily have to have experienced something terrible to have depression. When I first started feeling depressed I kept thinking ‘Just snap out of it, what do you have to depressed about, you have everything you could want’.”

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Maddison was in the second semester of her first year of university when she began struggling with poor mental health.“Arriving at university in the morning,” she tells me, “I would get panic attacks … I was crying all the time, sometimes I would start crying in my lectures.”

She sought professional help, and, when her panic attacks continued, she asked for medication.

“The anxiety I was experiencing was so debilitating that I really needed to take something just to function normally and to think normally,” she recalls.

Ultimately, she deferred that semester, and transferred from her Agricultural Economics degree into the Education Faculty. Now in her fourth year of her new degree, Maddison is a much better place, but still vividly recalls her struggles from several years ago.

She believes that University bureaucracy exacerbated her mental health condition.

“Organising special consideration was stressful in itself for me. I was studying a degree that was across three faculties, so every time I had an assignment, I had to go to three different places [with] a medical certificate.”

She felt deeply uncomfortable with the bureaucratic, dehumanised nature of her interactions with the university.“ You never actually deal with any person face to face, you just hand in a form.”

Struggling with mental illness is a common experience amongst University of Sydney students. Nationally, it is estimated that 27 per cent of 18 to 25-year-olds experience mental health problems each year. Of the approximately 4000 students who responded to a University of Sydney Mental Health survey in 2012, 49.8 per cent of students reported high to very high levels of psychological distress. 21.2 per cent of those surveyed were experiencing levels of distress indicative of probable serious mental illness.

Given these statistics, it would seem fair to expect our University to be adept at supporting students dealing with mental health concerns. But it appears that, in reality, this is far from the case.

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USyd students with ongoing mental health conditions will typically have to liaise with Disability Services, which works with faculty and administrative staff to help students get the most out of their time at university. Nicola, who is registered with Disability Services, believes that Disability Services often struggles to effectively assist students dealing with anxiety and depression. She cites poor communication and lack of responsiveness as key problems she has encountered with the service.

‘‘I’m always met with a lot of resistance,” she tells me. “For a student who is highly, highly anxious, not getting any feedback that they’ve received my requests or that they’re working on them really doesn’t help. For students who are more prone to anxiety than myself it would be almost unmanageable.”

Submitting a request to Disability Services for an academic adjustment takes place through on online, impersonal process, with strict requirements on documentation. Registered students go through this process every single semester, and submit individual requests for each subject and assessment. Students tell me that this process often becomes incredibly onerous.

“It’s a service for disability students, but it’s not geared to them at all it seems,” Nicola says. “It’s very much about going through the motions, it’s very strict on documentation, [and] it’s very unsupportive.”

Nicola believes that Disability Services’ strict documentation requirements can even exacerbate some students’ mental distress.

“You’ve got the stress of paying for seeing a specialist, getting there, taking the time to do it when you’re trying to finish an assignment, whilst other work is backing up,” she says. “It all just spirals out of control, not just due to the situation you’re in, but due to the system.’

These concerns are much the same for students who develop mental health issues over the course of a semester and need to apply for Special Consideration through their faculties. Documentation requirements are strictly enforced, and usually require students to provide medical certificates from specialist psychologists or psychiatrists.

One student who has been through this process said that she would always advise students dealing with mental distress to “go see someone [to obtain documentation] straight away, because you might need it later on”. She says that she has learnt from experience that it is necessary to plan ahead as much as possible if you think you may need Special Consideration, or other academic adjustments on account of your mental illness.

The current system, it seems, forces students to assess their own condition and punishes them if they fail to plan ahead. This can add additional anxiety to students facing trouble, and leaves any student who can’t get something done on time – perhaps due to their original health issue – with minimal recourse.

Whilst there are university-wide guidelines on Special Consideration, faculties implement their own individual policies, which vary widely in documentation and lodgement requirements and in the flexibility of adjustments provided. As Lawrence Muskitta, President of USyd’s Mental Health Awareness Society (MAHSOC), explained to me, “in the Arts Faculty there’s a less formal process that you have to go through, where you can email a lecturer and ask for an extension, whereas in the Science Faculty – you need to do a lot of different things and the documentation around that is confusing.”

Many students I spoke with spoke highly of the Arts Faculty and the flexibility they provide in dealing with mental health concerns. By contrast, the Law, Science and Business Faculties were all heavily criticised. Differences in faculty, unfortunately, can make a huge difference to the student experience, and in what might be deemed an ‘appropriate’ level of illness or misadventure to constitute special consideration. Much is left to the discretion of academic staff, who are not required to undergo formal training on how to deal with student distress and therefore commonly misunderstand students’ concerns and conditions.

In one incident, a lecturer told a student suffering from anxiety that their mental health condition was not “a legitimate excuse” warranting Special Consideration. Another professor told a student that anxiety would not be taken as a reason for being unable to sit an exam.

Maddison, who struggled with her faculties in the first year of her degree, recalls the relief she experienced upon transferring to the Education Faculty.

“It was a much more nurturing environment to be in, as compared to Agricultural Economics and the Business Faculty, which has very much a sink or swim mentality to it. It’s almost like it’s set up for failure and people don’t really want you to succeed,” she says.

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There are, of course, support services available for students suffering mental distress on campus. Perhaps most significant is Counselling And Psychological Services (CAPS), a free, drop-in service staffed by trained counsellors. CAPS helps hundreds of University of Sydney students every year, but is severely under-resourced.

The recommended counsellor-to-student ratio is 1:3000. CAPS currently operates at a hugely deficient 1:4240. This deficiency has led to a huge backlog of students waiting to access their services.

Even if the investment in CAPS were to be doubled, it would still operate with a waitlist. This makes it harder for CAPS to deal with emergencies, including the dozens of documented students who present to CAPS each year with signs of self-harm or high risk of suicide. It also means CAPS cannot dedicate enough time to raise awareness about the service to the student body, as the needs of attending students are undeniably prioritised.

Other organisations are set up to support students on campus- a Pscyhology Clinic, a branch of Headspace, and GPs at the University Health Service- but it seems unclear how they understand their roles in relation to one another. One student spoke to me of being referred between the different services multiple times; in the course of my own research, I was referred to CAPS when I tried to speak with Disability Services, which is somewhat inexplicable given that the two services fulfil quite distinct roles. As important as these services are, it takes initiative to access them and then endurance to persist long enough to find the right service for you, which poses potential problems for students suffering mental distress.

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The offices of the Students’ Representative Council (SRC) lie underneath the Wentworth Building. It’s a carpeted bunker, often thought to be solely populated by student politicians and office administrators. Few students know where it is. Fewer still know what it provides.

The SRC offers a free caseworker service on every campus, which can help with applications for special consideration and appeals for students whose academic performance has been affected by their mental distress.

To Leigh, who experienced depression and anxiety after one of her parents was diagnosed with a terminal illness, the service was a godsend.

“When my marks came out at the end of semester, I had failed three out of five subjects,” she recalls.

“When that happened, I went to the SRC and spoke to a caseworker there, and she recommended that I apply for DNF. She said that I had to write a letter to the Dean explaining why I had failed these subjects and why it was out of my control, and why I hadn’t discontinued them earlier. So I drafted a letter – I sent her some drafts, and she read them over.”

Leigh was ultimately successful in applying for DNFs, and again in recuperating the HECS fees she had been charged for those subjects.

But even with all this assistance, the remedies provided cannot always treat the unique sets of symptoms that students present.

Philippa Specker, one of the SRC Welfare Officers, commented that “often you’ll get an extension or an exam reschedule… [but] if you have severe anxiety or OCD or obsessive compulsive personality disorder – delaying or prolonging the task in that particular format might not be the most effective way to do it.”

Little wonder then, that many students avoid the Special Consideration process entirely, and end up dropping subjects, applying for DNFs, or deferring university. With a system full of hurdles, so laborious and unwelcoming, many students are put off. The process of reaching out for help can be incredibly traumatic, and if a student has a poor experience, they may be entirely dissuaded from seeking the alternative help that they need.

This university does recognise that mental illness can impact students as severely as physical sickness. Its great omission is the myopic, inflexible deployment of mental health services; the belief that time and extensions heal all wounds.

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But even if we were to reform the bureaucracy, we would still be forced to contend with the societal stigma which, it seems, can be a huge barrier in preventing individuals from seeking help. According to Lawrence, society pressures individuals “to look perfect and appear to be strong” such that “going to see a psychologist or student psychiatrist is something that is looked down upon, which it absolutely shouldn’t be.”

As individuals, we can play our part in looking out for each other – empathising and encouraging friends to seek help when needed – and we can educate ourselves about mental health so as to be able to do so better. CAPS, for example, runs a Sidekicks program which aims to educate students about how to support their friends, helping combat stigma and a chronic lack of understanding about how mental illnesses manifest themselves.

As Leigh tells me, ‘‘people, when they think of anxiety or depression, still think of it in terms of there being a stimulus for it, when it can just be general – it can just happen and there’s absolutely no explanation for it and you can’t find any reason for it happening.”

Fortunately, there are a number of student-led groups and initiatives on campus taking up mental health issues. MAHSOC, a student society founded in 2013, seeks to provide a safe social space for students on campus, and promote positive mental health within the University. They have weekly meditation and yoga classes as well as social events, and the society advocates to break down social stigmas associated with mental illness. As part of the USU’s Health and Wellbeing Week, MAHSOC displayed a photo exhibition with messages from nearly one hundred students who shared personal experiences or gave their messages of support – an incredibly evocative reminder of how much support truly does exist for students who are facing challenges.

The Health and Wellbeing Week is another new avenue for raising awareness about mental health issues on campus. The program included a support services information fair, Headspace speaker panels and training sessions run by counsellors.

Meanwhile, the Mental Health Action Group (MHAG), which was started earlier this year by Fahad Ali, is a non-autonomous student group seeking to raise awareness, challenge stigma, work with and lobby the university to provide greater support for students with mental illness.

“I have an ongoing condition which can sometimes flare up and a lot of people have interpreted that in different ways,” Fahad told me. “People have interpreted that to make generalisations about my behaviour which aren’t true. It was the utter disgust with that which led me to found the Mental Health Action Group.”

Fahad hopes that MHAG will give students suffering mental distress the opportunity to feel empowered.

“For many people who do have mental health conditions or poor mental wellbeing it’s really important to give them the power to create change,” he says.

“Often it tends to be administrators and psychologists and doctors organising your life for you and telling you what’s best for you. MHAG gives us the power to create change on our terms because we are the ones who have to deal with it at the end of the day.”

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Everyone I spoke while researching this piece emphasised the importance of talking, and asking for help if you believe you may be suffering from mental distress. No matter how mild as it may seem, if you are suffering, don’t isolate yourself for fear of being judged. Speak to a friend, or a family member, or go and see a professional, be it a GP, a counsellor or a psychologist. Help is there for you when you need it. At CAPS, they attested to the large portion of students who visit them saying “I don’t think it’s a big deal”, who certainly would benefit from their help. There are many more who simply never seek help in the first place; only one in four young people experiencing mental health problems actually receive professional help.

It can be difficult to recognise that your own situation is worthy of support. Nicola warns against comparing yourself to others and downplaying your own experiences: “Mental illness is difficult and unfair for everyone.”

Mental health concerns affect all of our lives. Every time we speak out about it, we break down the barriers that hamper support. If nothing else, after reading this feature, ask a friend how they’re feeling, or just start a conversation about it. You never know what difference it could make.

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