This post was written by Tobin LeBlanc Haley, ELA postdoctoral fellow, Ryerson University in response to an article in University Affairs titled: Our role is to support students when they are ready to be students.
I would like to thank Dr. Costopoulos for raising the important topic of student distress and attendant university responses in his August article for University Affairs. Regrettably, the piece does not factor in the social conditions that contribute to or create student distress, such as student debt, gendered violence, racism, ableism/saneism, and homo/transphobia on campus and the hostile post-crisis political climate and labour market.
Instead, the piece collapses distress and mental illness. To put this another way, in the original article all distress is equated with mental illness and any person with a mental illness label is perceived as distressed. In this context the ‘problem’ is mind/body of the student in distress, in particular, those who Costopoulos identifies as the “severely mentally ill and sometimes actively suicidal” who take up a “very significant portion of [university] resources” (a claim which is not cited). The ‘solution’, the fix, is to have these students take time off and access mental health care systems until/if they can “function as students” (something which is not defined) and be less of a burden on the university.
In addition to ignoring the social nature of distress, the significant problems with mental health care systems in Canada are also sidelined. Yet, these are problems that have been well documented. A very few examples include long-wait times (Canadian Institute for Health Information 2012), services that do not make space for Indigenous knowledges and expertise related to mental health (Clark et al 2017) and involuntary treatment practices which have been identified as a violation of the UN Convention on the Rights of Persons with Disabilities to which Canada is a signatory (Minkowitz 2014). Is medicalizing distress and simply passing students off to mental health care systems (although certainly, they should be able to access public mental health services if they desire) while de-enrolling them from the university a solution?
The collapsing of distress and psychiatric diagnosis, the silence on broader systemic issues that can lead to or exacerbate student distress and the misrepresentation of mental health care systems belies an unawareness of Disability Studies or an unwillingness to engage with this scholarship. For more than forty years, Disability Studies scholars and activists, many of us who have been students in distress and/or students with psychiatric diagnoses, have argued against the individual/medical approach (see for e.g. Oliver 1983), most recently its mobilization under neoliberalism (Morrow and Halinka Malcoe 2017), developing instead a rich body of work about the social production of disability and mental illness (see Meekosha & Shuttleworth 2009, LeFrancois et al 2013). Briefly, in challenging the individual/medical model, Disability Scholars caution against a myopic focus on the individual body drawing attention to the social relations that define and often limit bodies. The focus on bodies obfuscates external factors (e.g., oppression) while simultaneously explaining the implications (e.g., distress) through the mobilization of solely pathological explanations. Certainly, we, as scholars, can understand that distress is not produced in a vacuum but rather emerges from the location of bodies in the current conjuncture discussed above and the devaluing of bodily/mind difference. The very notion of “functioning as a student” must be understood within this broader context, especially as university educators rank people thereby opening up or foreclosing future opportunities. How can we not take into account the world in which we are situated and the challenges it brings for our students when mobilizing this power?
Which brings me to the issue of accommodation. Typically, universities provide accommodation for those barriers to education that can be quantified (e.g., more time on exams to create an equitable testing experience). Should we not also be thinking about how issues like poverty, unaffordable childcare, systemic racism and colonialism, gendered violence and pathologized difference create material inequalities that can make living in the world more “distressing” for some people than others (whether they have a psychiatric diagnosis or not)? Simply telling students who experience distress to leave until they get better (even if financial and academic penalties are eliminated) means we are asking students in distress to individually cope with unequal social relations of power, the very social relations of power which are present on university campuses. Moreover, such an exclusionary practice is discriminatory and would likely be a violation of students’ Human Rights.
We must not treat students in distress as if they have nothing to contribute and/or as people who must be protected from their ‘poor decisions’ (e.g. remaining enrolled). Instead, we must ask them what they want and need and cultivate this support to ensure that they are not unfairly excluded from universities (permanently or temporarily). The following recommendations are potential first steps:
1. That the language used to describe students in distress recognizes that distress is related to oppression within and outside of the university including poverty, ableism/saneism, racism, homo/transphobia, and patriarchy.
2. That it be recognized that student distress will always exist so long as oppression persists, and all efforts to deal with distress must be connected to decolonizing, anti-racist, anti-sexist, anti-poverty, pro-LGBTQ work on campus.
3. That in lieu of “the mentally ill”, language about mental health be fully representative of the diverse identities of people living with mental illness labels; for example, consumers/survivors/ex-patients/Mad people (or c/s/x/m) or some agreed upon alternative developed by impacted students. This grouping of terms, which comes from a robust social movement, represents the multiplicity of understandings of mental illness categories developed by the c/s/x/m communities.
4. That students experiencing or who have experienced in distress, especially including c/s/x/m students, BIPOC students, and LGBTQ students, lead all consultations and changes related to mental health and associated support services on campus (including accommodation) and be paid for this labour.
5. That all administrators, faculty members and services providers involved in mental health care and associated services on universities campus take a course on the history of mental health care in Canada.
6. That this course be offered by scholars and/or community members who belong to the c/s/x/m community, especially including BIPOC and LGBTQ peoples, and that all involved be paid for this labour.
This is not an exhaustive list, but a starting point to shift the recent attention to mental health and distress on campuses away from a conversation about pathologization and exclusion.
Canadian Institute for Health Information. (2012). Chapter 4: Waits for Specialized Care. Health Care in Canada 2012: A Focus on Wait Times. Available at: https://www.cihi.ca/sites/default/files/document/hcic2012_ch4_en.pdf
Clark, N., Walton, P., Drolet, J., Tribute, T., Jules, G., Main, T., & Arnouse, M. (2017). Melq’ilwiye: Coming Together: Intersections of Identity, Sovereignty and Mental Health for Urban Indigenous Youth. In M. Morrow & L. Halinka Malcoe (Eds.) Critical Inquiries For Social Justice in Mental Health (pp. 165-193). Toronto, ON: University of Toronto Press.
LeFrancois, B., Menzies, R., & Reaume, G. (eds). (2013). Mad Matters: A Critical Reader in Canadian Mad Studies. Toronto, ON: Canadian Scholars Inc.
Meekosha, H., and R. Shuttleworth. 2009. What’s So ‘critical’ about Critical Disability Studies? Australian Journal of Human Rights 15 (1), 47–75.
Minkowitz, T. (2013). Convention on the Rights of Persons with Disabilities and Liberation from Psychiatric Oppression. In B. Burstow, B. LeFrançois and S. Diamond (Eds.) Psychiatry Disrupted (pp. 129-144). London: McGill-Queens University Press.
Morrow, M. & Halinka Malcoe, L. (eds.). (2017). Critical Inquiries For Social Justice in Mental Health. Toronto, ON: University of Toronto Press.
Oliver, M. (1983). Social Work with Disabled People. Basingstoke: Macmillan.