This post is in honour of Mental Illness Awareness Week, October 6 to 12, 2019, and World Mental Health Day, October 10, 2019.
While I’ve been writing about mental health for a long time, my understanding of mental illness has deepened over the past few years, due to personal circumstances. This has included supporting loved ones through addiction, depression, anxiety, eating disorders and suicide. I’ve had a few missteps along the way, which has taught me that you can be the most help when you drop your own agenda and meet people who are dealing with mental health issues where they are at.
In a way, this describes the concept of peer support. While I’m not an authority on the topic, I worked with experts to write about peer support for individuals and organizations, for Workplace Strategies for Mental Health. We shared Peer Support Canada’s description: “Peer Support work is rooted in a trusting relationship between a person who is currently struggling and striving to find understanding and assistance, and the peer supporter whose personal history allows them to understand, support, and above all model a sense of hope.”
I credit my daughter for her courage in admitting she was struggling with anxiety and depression while attending school thousands of miles away at the Nova Scotia College of Art & Design (NSCAD). She’s not alone. In a recent article, the Mental Health Commission of Canada shared that 75 per cent of mental health problems and illnesses develop between the ages of 16 and 25.
As we looked for supports that might be available to her*, I learned that NSCAD offered a peer support program. I sat down with Bill Travis, NSCAD’s Accessibility Resources Coordinator, and also spoke with a NSCAD peer mentor, to gain an understanding of peer support strategies being used at the post-secondary level. We also talked about the unique stressors and challenges facing students in art school.
Bill shared that one of the issues for students is that they often can’t see past the demands of homework and projects to understand they need help. “That requires looking at themselves and saying, ‘I have a mental health problem. I’d say 50 per cent of students who are suffering can’t do that.”
He added, “A student might be thinking I’m not feeling like myself right now but it’s because I haven’t slept for five days and I’m working twice as hard as I ever have.”
NSCAD’s peer support program rose out of tragedy. In 2013, Fred and Elizabeth Fountain bequeathed an extraordinary gift to Queen Elizabeth II Health Sciences Centre Foundation, in honour of their son Alex who had died by suicide. He was a university student at the time of his death. The gift funded the Stay Connected Mental Health Project, which integrated a process of identifying young people with mental health and addiction challenges early on, teaching youth health care self-management, and building rapport between pediatric and adult services in Halifax.** It also included reaching out to local universities about mental health issues.
“The Fountain’s gift recognized that young people with mental health issues often keep their struggles to themselves,” said Bill. “They felt this was a way to open more doors.
“When we heard the funding was coming we wanted to get ahead of the curve,” he said. A call was put out asking third year students with lived experience of mental illness to apply to become peer mentors. The hospital provided the training and, with some additional funds, NSCAD was able to hire seven part-time peer mentors.
Hennah Verhoeven, one of NSCAD’s peer mentors, said having that many has been positive as it takes “lots of emotional labour.” Hennah said this also makes it possible to have a diverse group of mentors that can be more relatable to different students.
“A big draw was the training on how to do active listening and support people going through all kinds of things in life,” said Hennah. “I was already doing this with friends and family so I liked knowing what to do in a more structured way.”
Investing in student health
Appointments are on a drop in basis and peer mentors are seeing approximately 15 to 20 students a week. The program has seen steady uptake since it began. Bill hopes this helps to make a case for the program to continue when the funding ends next year.
The peer mentor team leaders also meet with NSCAD’s staff counsellors each week to talk about challenges and successes and to share ideas.
Hennah said peer mentors become “invested” in the students they see week after week. “We care about them, and when they keep coming back we hear about how they are doing.” This also provides a gateway for students, who may be in crisis for the first time, to get the help they need. The peer mentors will talk through things and connect them with some other supports in the city. “Knowing what’s available in the community and how to navigate the system is a vital part of the role,” said Bill.
“There have been a few times where it was obvious the person’s situation was outside my ability to help,” Hennah said. “Ideally, we’d want them to go see one of our on-site counsellors but this isn’t possible if it’s an evening shift. So, we call the mobile crisis hotline and we’re there to support and listen until that help arrives.”
Bill added that meetings throughout the year with other schools are also beneficial. This facilitates the sharing of ideas and opens lines of communication between the different schools and the hospital. “Every department in the Nova Scotia Health Department that a student would use is part of this.” With the student’s permission the post-secondary institution is advised that the student has accessed services related to a mental health issue. This enables the school to reach out to the student earlier to develop a plan to support both their wellness and return to school.
At NSCAD, Peer mentors are always on hand for events that could be triggering for some students, such as presentations or rallies on issues like violence, sexual exploitation, racism, etc.
Bill acknowledged there are distinct challenges in art schools, like NSCAD, where students are constantly exposed to criticism as well as competition with one another on work that is often very personal.
This is why he has supported a move away from a culture of competitiveness to one of collaboration.
Even with that, there’s still significant anxiety about “crit”, which is the process by which art students stage their work for instructor and peer feedback. “It’s more than anxiety about a test. It’s not just about a good grade. They’re presenting something that came from a point of inspiration that they’re deeply connected to and they’re going to potentially have someone tell them it was a waste of their time,” Bill said. Fortunately, there has also been a movement toward constructive vs. destructive crits. “It’s different for everybody, rehearsing is important, even asking yourself what’s the worst thing someone could say and how that might make you feel can help. Having some resilience also helps.”
He added, “There is a push toward isolation in art. Instructors don’t want students to copy anyone else. They want the student to look deep within themselves to find their unique voice. If you’re struggling with a mental illness, this isolation can be difficult.”
“Deadlines are intense and workloads are huge,” said Hennah. “Students pull all-nighters for periods of time. It’s hard to watch someone go through that.” Support often requires working with students who have reached out for help to set boundaries on how they’re going to make it through the semester. “In some cases, that means helping them to stop judging themselves by how much work they produce.”
Peer support can also prompt conversations that may never happen otherwise and help to reduce the stigma around mental health. “It’s an ally you can trust,” said Bill. “Normalizing the conversation is important. We talk about our physical health. We can talk about our mental health too.”
“Some of these students are in such a vulnerable place,” said Hennah. “They’re young, away from family and home for the first time. The peer mentor program recognizes that this can be a breeding ground for mental health problems, and that it can be stressful just finding the resources that are available.” That again is a role a peer mentor can fill, which can mean helping the student understand what’s covered in the student health care plan (which may include psychiatric services), financial assistance, and other services that may be available in the school or community.
Hennah has also supported international students who can have a different set of stressors. “They may be here on an exchange for a semester or on a student visa – that in itself creates so much stress. If English isn’t their first language it can be hard to find people to connect to; it’s a culture shock.” Peer support and opportunities to connect through activities like the mental health tea hour that happens throughout the week have proven to be successful for these students and others who struggle making social connections.
Bill explained how attendance is also different in practical schools like NSCAD. “We’re teaching skills as well as in-class use of those skills. Students are being evaluated all the time in class, not just through a project. You really can’t miss a class.” This he said can put students with episodic mental illnesses at a disadvantage. He now works with students and teachers to determine the number of classes students can miss and still stay in the course. “That way they know, as much as they can, to bank those days for when they need them.”
“The bottom line is that there’s a lot of pressure to be creative and vulnerable and technically adept all at the same time,” said Bill. “These are somewhat different pressures than other universities.”
Closing the gaps
Can more be done? “Absolutely,” Bill said, noting that peer support is just one solution. “We need more full-time hours for counsellors so they are able to integrate more fully into the community of the school.
“We’re always responding to gaps. Every year, we find holes but at least they’re a lot smaller than they used to be.”
Benefits of Peer Support
Peer support can be a step towards recovery and its benefits can include:
Discovering a safe person, who has experienced something similar, to share concerns with in confidence.
Hearing how others have coped and survived their journey to well-being.
Being listened to in a non-clinical, non-judgmental, and compassionate way that empowers you to make your own decisions.
Connecting to resources that have worked for others in their recovery.
Courtesy of Reaching out for Peer Support.
More information and resources
Reaching out for peer support – Information about accessing peer support and becoming a peer supporter.
Peer Support Canada – Peer Support Canada connects peer supporters and organizations, helping share information and building capacity for peer support.
Post-Secondary Student Resilience – Resource can help post-secondary students plan ahead so they are better able to cope with the personal and academic stressors they may encounter.
Online Peer Support for Eating Disorders – A safe, pro-recovery space for those with eating disorders to connect, learn, and grow.
*Note to reader: For personal reasons, my daughter has not yet used NSCAD’s peer support services but may in the future.
**Some information also courtesy of https://www.heretohelp.bc.ca/stay-connected-mental-health-project