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Not your 9 to 5: How young shift workers are missing out on mental health care

Inquiring into the precarious nature of student mental health care

Art by Isabelle Hans-Rosenbaum. Art by Isabelle Hans-Rosenbaum.

“What do you mean this product is out of stock?!”  

I wince, anticipating the berating that is about to become. Ask anyone working in retail or hospitality and they probably have a similar story, or worse.

Verbal abuse by customers is commonplace in the retail and hospitality industries. A recent survey conducted by the SDA shows that over 85% of respondents have been subjected to verbal abuse from a customer in the last 12 months and 24% of the respondents said that it happens every week. Sales assistant Sophie* tells Honi, “I honestly just feel so anxious about having to go to work knowing that I will likely be treated poorly. I worry about the next shift, and I never really want it to arrive.”

In addition to verbal and sometimes physical abuse at work, retail and hospitality staff live with the harsh reality of ongoing financial insecurity. Retail and hospitality have a very high concentration of casual workers compared to other industries, meaning these casual staff consistently have to manage irregular hours and unpredictable shift times.

As a young person, navigating a heavily casualised industry comes with additional concerns. Individuals are frequently managing mistreatment by their employers and with the additional stress of study and the amounting pressures that come with shift work, it is no wonder that accessibility to mental health services is crucial to young people’s wellbeing.

Mental health issues surrounding young people has gained traction in the past few years, however significant barriers remain for those employed in service industries, especially those further pressured by a low socio-economic status and financial insecurity. Underfunding certainly puts limits on the quality of care that mental health care providers can offer but Sophie believes that shift workers also require flexibility from their employers.  “I have no idea whether I am going to be free on a date in two to three months’ time, and I am not in the position to turn down work,” she said.

The University of Sydney (USyd) offers free mental health services to students but navigating this service is an incredibly complex and arduous process that is  riddled with vague boundaries and limitations. Advertised as a free service for all by the university, many mistake the service as offering unlimited counselling sessions but these services only extent to a maximum of 6 sessions. After the limit is reached, Usyd’s Counselling and Psychological Services (CAPs) has a policy to refer students to an external therapist as they are unequipped  to handle the long-term mental health concerns affecting students. This service limitation has a particular effect on students facing complications that have arisen from extraneous situations caused by shift work.

CAPS continues to deny the existence of this session limit. “There is no strict limit to the number of sessions a student can access” a CAPS spokesperson told Honi. “Demand fluctuates throughout the year, being less during semester breaks, meaning more appointments may be available at such times,” they said. “In periods of high demand and for longer-term support, CAPS may refer students to their GP for a Mental Health Care Plan, enabling access to Medicare-funded sessions.”

The vague rigidity of such a response on the part of CAPS is particularly unfair to these students.  When student services fail to provide crucial mental health support this kind of pressure leave shift workers feeling extremely isolated and dejected. It is expected that we work long hours, perform to the best of our ability, reach target sales, serve customers and satisfy all their needs – even difficult and rude customers, be friendly and bubbly for eight hours a day – despite whatever we are going through in our personal lives… .” said Anna, a shift worker and university student.  

“We are then forced to fit in personal or educational commitments around a shitty retail job – which are definitely more important than the job itself.”

International students that take up shift work face additional complications. The limited sessions provided by the University are the only option for international students who cannot afford expensive mental health services. Overseas Student Health Covers do not insure mental health care, and the process of finding appropriate help leaves international students feeling lost. These burdens and inequalities are particularly apparent when  considering the fact that internationals pay upwards of 40,000 dollars a year, double the amount of what domestic students pay.

A therapist at CAPS told Sara* after  her first and sixth session that if she was to return to CAPS after these sessions they would have no other choice but to recommend a long-term therapist. Sara turned to the Redfern Youth centre — a free service providing mental health support for young people –  only to learn that the organisation was overrun with patients and had been booked out for months. Eventually Sara turned to eHeadspace, she was requested to wait for an undisclosed amount of time to be matched with a counsellor over a chat window. After 20 minutes, Sara gave up, The process had made her feel hopeless and even worse than before, with no other option but to “suck it up, and push through.”

“The lack of consistent [mental health] help on campus, for me as an international student, meant that I was hesitant to return to CAPs, she said.

“Especially if they were going to refer me to an expensive therapist whom I could not afford while living on a budget. My insurance does not cover private mental health services.”

Many young people engaged in shift work have attempted to access free mental health services outside of the university. Whilst underfunding deserves significant consideration when discussing gaps in the mental health support system, until the boundaries that prevent shift workers from accessing mental health care are acknowledged, the problems young shift workers face cannot be duly addressed.

When she reached out for help after obtaining a Mental Health Plan, Sophie was informed by telephone that Headspace can only schedule regular appointments at the same time every fortnight.

“There was no way I could get there at the same time each week as a shift worker, and they unfortunately let me know that they couldn’t help me,” she said. “They recommended looking for private practitioners with a low charge  or a bulk billing service, but in reality I couldn’t afford to actually take time off work to go to talk to someone let alone pay for private help.”

With outside mental health support services struggling to meet the demand, it becomes clear how damaging CAPs’ 6 session limit really is.  The consultation limit is not explicitly stated on USyd’s CAPs website. When outlining policy regarding consultation after the first session, the website simply says their clinical psychologists, will “collaborate with you on the best way of moving forward.” The site states “they may make recommendations or suggest you book further sessions.” This vague policy along with the negative feedback that exists online (on Reddit and among peer groups) has deterred many students from even going for an initial visit.

“I did think about going to CAPS, and the GP recommended that as well, but I know there is only six sessions and I’ve been intimidated as all I have really heard has been negative,” Sophie said.

It seems that the vague nature of USyd’s services is not a homogenous issue across universities in Sydney. The University of New South Wales (UNSW) emphasizes in a detailed FAQ section on their website that there is no limit to how many times students can access on campus mental health services. In 2015, UNSW had an anonymous phone line run by students known as Here to Hear. The service is now defunct but in its prime, it offered an ear for students needing to discuss mental health concerns especially when university services were  booked out or when students felt embarrassed to approach peers or professionals in person.

USyd has taken an institutional approach to mental health support, one that differs from the hands-on approach at UNSW. CAPS told Honi, A CANVAS e-learning platform for students has also been developed by CAPS, providing a range of mental health and wellbeing resources, which will be launched shortly.”

The University of Technology Sydney (UTS), unlike USyd has hired a third party contractor for mental health services. It is clearly outlined on their website that students are only entitled to 4-6 sessions, after which students with a “valid Mental Health Treatment Plan can see their counsellors for up to 10 additional sessions per calendar year.” Such provisions are not provided at USyd and is a disservice to students — especially those who face financial stresses as shift workers.

Open dialogue about mental health is important but there needs to be more awareness of the barriers preventing accessibility to care. This is  impacting some of the most disadvantaged members of our university community. I just hate it when people say ‘that’s just how it is’ working in the service industry, but it’s only like that because we let it be,” said Sophie.

When it comes to change, acknowledging that vulnerable students , like shift workers, are being left behind by mental health care systems is the first step to developing a more considerate and inclusive service for all.

*Names have been anonymised.