The number of third-level students seeking help with depression, anxiety, relationships problems and academic issues has reached unprecedented levels, according to counsellors working on Irish campuses. Members of Psychological Counsellors in Higher Education point to a 40 per cent increase in demand for counselling over the last 10 years, with waiting lists for counselling services at many colleges.
There is now a "tsunami" of students presenting with mental health problems, according to Dr Declan Aherne, clinical psychologist and head of counselling at the University of Limerick (UL). Approximately 10,000 students are attending counselling at any one time across Ireland, which represents 6- 8 per cent of students on every campus, he says. At UL, numbers of students seeking counselling has doubled over the last five years.
So what is the matter with our new generation of students? The reasons behind the increases seem to be multiple. Firstly, many more students attend third-level colleges, with recent estimates suggesting more than 60 per cent of secondary school students continue on to third level education now. Among these increases are students with complex learning needs, which can include mental health difficulties.
Esther Murphy, author of the recent Mental Health Matters – Mapping Best Practices in Higher Education, says "the stresses of the transition to third level, the move away from home, the workload, new friendships all may trigger a latent mental health difficulty".
The current cohort of third-level students is also one of the first to witness widespread mental health awareness and anti-stigma campaigns, both from within campus and across society. More specifically, the student-led Please Talk and Chats for Change campaigns encourage third-level students to talk about their mental health and seek help if they need it.
Dr Aherne says increased demand for counselling is linked to stigma reduction but is also due to a rise in mental health difficulties. “Yes, the mental health promotion campaigns have increased demand, but students are coming to us with more complex problems now, too. We have two- to three-week-long waiting lists for counselling for the first time, with 10-12 new students coming in each day,” he says.
The so-called stepped care at UL includes free daily drop-in workshops on wellbeing and resilience, stepping up to talk therapy for six to eight weeks, longer-term talk therapy if needed and at the top step, specialist medical or psychiatric supports. Students can move up or down the services, depending on their specific needs.
Counselling services similar to UL exist in other universities, but some third-level institutions have much more limited counselling services and a lack of funding to develop them. Funding for third-level counselling services currently comes from core funding provided by the Higher Education Authority. Some college counsellors say the Health Service Executive should fund colleges for the free counselling services they offer students.
John Phillips is the chair of Psychological Counsellors in Higher Education Ireland. He says student counselling services are under resourced considering the 40 per cent increase in demand over the past decade. Murphy, meanwhile, says that mental health training for academic staff would be a significant step forwards.
"The [Mental Health Matters] report calls for mandatory mental health training for all third-level lecturers as part of their induction into their jobs. This doesn't exist in any third level college at present," says Murphy.
She also says that on-campus mental health services should be signposted for students as part of their induction into college in 1st year. “Students say that they do better when mental health issues are normal part of the conversation on campus., but only half of the 16 third-level colleges who took part in this report have specialised mental health services. There are ad hoc and patchy in the other colleges.”
Murphy says there is also a role for mental health champions in third-level colleges, specific individuals who would promote the mental health services and campaigns on campus. Peer support is also cited as very useful for students although fewer than a third of colleges have this at present.
Meanwhile, Dr Aherne is adamant that the mental health difficulty needs to be dealt with before the academic issues. “The academic supports are a back-up to addressing the primary mental health difficulty. If they don’t have the mental health issue addressed first, the learning won’t happen.”
'I bawled my eyes out. I didn't know why I was down, which scared me' – Caolan O'Donnell, student welfare officer at UL
"My mental health difficulties started when i was in second year of my business, accounting and finance degree at the University of Limerick. I had a bit of a breakdown when I was in sixth year in secondary school but I got through it, sat my Leaving Certificate and got into college. I have three brothers, two of whom are suffering from rare illnesses, which has been very difficult for my family.
"When I was in first year, I decided to move out of the family home in Castletroy, Limerick, to have the full university experience. I had three part-time jobs to keep me going financially and I got through first year. In second year, I started to feel a bit low and rather than dealing with it, I started drinking. I wasn't comfortable in public without a few drinks. It got to the point that I couldn't see my friends without drinking. I stopped going to college but kept up my jobs.
“I had a fall one night when out drinking and after that, I began to completely isolate myself. I stopped socialising and ignored phone calls. I ate take-away food to avoid cooking and spending time around my housemates in case they asked what was wrong with me. After a while, one of my friends came to me and suggested I go for counselling.
“The first time I got to the counselling centre, I panicked and left. The second time, I saw questions about feeling suicidal and what emergency numbers would I provide and I made an excuse that I had a lecture and left. I did not have any suicidal tendencies - but I was terrified they might think that whatever was wrong with me was worse than I thought and they would contact my mother, whom I had not told about my problems yet. I wasn’t ready for that step yet.
“The third time, the receptionist saw me and said I could fill in as much as I liked on the form, so I stayed and saw the assistant psychologist. I bawled my eyes out. I didn’t know why I was down, which scared me. She reassured me, telling me it was perfectly normal what I was going through.
“I went to one-to-one counselling for about six months. It took six to eight weeks to start feeling better. I realised that I felt ashamed about feeling down because my two brothers had such serious illnesses. I almost wished I had cancer or something that I would have to fight against or give up on altogether.
“I learned that I needed to understand my triggers for depression. Now, I avoid certain drinks such as vodka. I exercise three times a week and I eat healthier foods. I also met one of my lecturers and told him what was going on. He organised lecture notes and slides for what I’d missed and put me in touch with a student in the year ahead who helped me out, too. I did the drop-in workshops at UL to help me deal with my mood, my thinking and behaviour.
“In fourth year, as part of my election campaign to become student welfare officer, I shared my experience of depression with two other students on a short video. I had a bit of a relapse after I did this. I got anxious and panicky about whether I could do the job.
“I graduated from my degree in August 2016 and am now taking this sabbatical year as student welfare officer and deputy president of the students union. I often talk to students about my experience. Many students deal with things for over a year before something triggers them to seek help.
“One thing I suggest to them it to write down every single thought that comes into their heads about their problems. When you see it written down, the problems don’t always seem so big. I also encourage people to set three realistic goals, no more. I go with students to the free drop-in workshops on anxiety or stress management, relaxation skills, resilience. I don’t give people advice but I do suggest counselling if they think they need it.”
TIPS FOR STUDENTS WITH MENTAL HEALTH DIFFICULTIES
1) If you're feeling depressed or anxious over a number of weeks, talk to the student welfare officer at your college. He/she will be able to suggest what's available on campus.
2) Go for counselling if you don't understand what's happening to you or you feel overwhelmed by your problems. Many campuses offer free counselling.
3) Explain your situation to your tutor and/or a lecturer who knows you well. Ask them for lecture notes and slides if you've been absent from lectures. Seek reasonable extensions on essays and assignments.
4) Attend stress management or resilience training workshops if they are available on campus. Set yourself goals to take regular exercise, eat healthily and have enough sleep.
5) Talk to your friends about what you're going through. You might be surprised to find out that many of them have also experienced mental health difficulties.