Key Learning Points

This training opens up the conversation about mental health to increase understanding and reduce negative stigma surrounding mental illness. Key learning points of the training include the following:

• We can all play a role in supporting students’ mental health.
• Mental health and wellness can be viewed as a wheel in which we’re keeping many different dimensions in balance.
• Resilience can help us deal with stresses and challenges when the wheel is out of balance.
• Mental health can be viewed as a continuum, and we are all on some point the continuum at any given time.
• We can make a difference to a student in distress by knowing how to recognize the signs of distress, responding empathetically, and knowing how to refer the student to other resources.
• Staff and faculty are not expected to and should never diagnose or act as a counsellor, and they should be aware of their own boundaries and need for self-care.

Know the Procedures and Contacts at Your Campus and in Your Community

Consider your post-secondary institution’s resources, procedures, or policies for helping students in distress and make sure you are familiar with who to notify during the day, when the campus is open, and at night or on weekends, when the campus is closed. Procedures for non-emergencies will vary from institution to institution.

Find out what on-campus and community resources are available that support student mental health, or create your own contacts sheet to share with participants (or have a website ready for viewing on-screen).

Preparing for In-Person and Online Sessions: Practical Considerations

• Before giving a session, read through the Guidelines and Tips for Facilitation section and reflect on your own experiences and feelings about mental health.
• Download the slide deck and make any needed modifications.
• Read through the facilitator’s guide and handouts to familiarize yourself with the content. You may want to download the guide as a PDF file and print it.
• Prepare to give a territory acknowledgement to open the session. Also consider ways you can Indigenize the content. (See Indigenous Considerations.)
• Read through the scenarios and think about which scenarios you want participants to discuss. There are six scenarios to choose from, but it’s unlikely you’ll have time to cover them all. You may want to prepare a handout with just the scenarios (no responses) so participants can work through the scenarios and consider what to say before they see the suggested responses in Handout 2.
• Consider how many participants you expect to attend. The facilitator’s guide assumes a small to medium number of participants (approximately 6 to 30); if your group is large, you may need to modify some of the small group and reflection activities.
• Add relevant examples and additional insights that are based on your own experience or are relevant to the student population at your institution.
• Prepare the handouts. Either have them ready to hand out for an in-person session or have the links to the PDFs ready for an online session. Determine how you will share handouts and other resources, particularly when you are facilitating an online session. You can put PDFs in the chat, share a link in the chat, or email participants after the session.
• Have your institution’s workshop evaluation form ready to give to participants after the session.
• Consider providing participants with group guidelines before the session so people can prepare and create guidelines together. This will save time during the session. See Group Guidelines for more information.

Preparing for an In-Person Session

You will need the following:

• Laptop
• Projector
• Flipchart or whiteboard and appropriate markers
• Copies of Handouts 1 and 2 (see Handout 1: Wellness Wheel and Handout 2: Responding to Students in Distress)

You will also need to consider where participants can go if they need to leave the session for a while. Is there a place where they can sit that is close to the classroom? Arrange in advance for someone to check on anyone who leaves the session, whether a co-facilitator, an assistant, or another participant.

Preparing for an Online Session

If you are offering the session online, there are a few additional things to do in advance:

• Schedule a meeting time in your post-secondary institution’s preferred video-conferencing platform.
• Make sure that the screen-share function is enabled for sharing slides.
• If you will be using the chat or breakout rooms, make sure they are enabled.
• Share the meeting link and any passwords with participants before the session. (Consider sending the meeting information at least twice, including once the day before the session.)
• You may also want to share suggestions for online meeting etiquette for creating a safe learning space (e.g., sharing supportive comments, respecting confidentiality).
• Consider assigning someone to be the monitor responsible for responding to technical issues and questions posted in the chat.
• As noted above, make sure you have a plan for distributing any resources, such as the handouts, online. Remember to let participants know how and when they can expect to receive these resources.

Working in small groups online

If your video-conferencing software allows you to create breakout rooms, you can have participants work together in smaller groups. Take some time before the session to get comfortable with the process for setting up breakout rooms. It can be helpful to have someone assist you with setting up the breakout rooms during the session so you can facilitate while they handle the technical issues.

Breakout rooms will work well for discussing the scenarios, but you will need to do some preparation. It may be easiest to put the scenarios in the chat; if you are doing this, have the scenarios ready to add to the chat before the session. During the session, you can then assign each group to a specific breakout room to discuss the different scenarios. Alternatively, you could move participants into breakout rooms and then visit each room to verbally provide each group with a scenario.

Territory Acknowledgement

Acknowledging the Indigenous Peoples on whose traditional lands you live, work, and study is an important way to begin an event or meeting and can be included as part of classroom activities and taught to students. Meaningful territory acknowledgements allow you to develop a closer and deeper relationship with not only the land but the traditional stewards and peoples whose territory you reside, work, live, and prosper in. For more information on giving a territory acknowledgement, see Welcome and Territory Acknowledgement.

The Truth and Reconciliation Commission’s Calls to Action explicitly state that each of us as members of Canadian society has a direct responsibility to contribute to reconciliation; how we discuss colonization in relation to mental health is a direct response to that responsibility.

The United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) is an international instrument adopted by the United Nations on September 13, 2007, to enshrine (according to Article 43) the rights that “constitute the minimum standards for the survival, dignity and well- being of the indigenous peoples of the world.” UNDRIP was adopted by the government of British Columbia on November 26, 2019. Centring the history of colonization as a background to and framework for mental health from a perspective of historical and current ongoing struggle is in direct response to our legal and moral obligation as members of Canadian society.

Curriculum Development and Indigenous Ways of Knowing and Being

Indigenization is a process of naturalizing and valuing Indigenous knowledge systems. In the context of post-secondary institutions, this involves bringing Indigenous knowledge and approaches together with Western knowledge systems. This benefits not only Indigenous learners but all students, staff, faculty, and campus community members involved in or impacted by Indigenization.

As you adapt this training for your particular context, consider how and in what ways you might interweave Indigenous content and approaches. Here are some examples of how you might include an understanding of Indigenous ways of knowing and being:

• Incorporate Indigenous pedagogical approaches, such as holistic and relational perspectives, experiential learning, place-based learning, and intergenerational learning.
• Involve Indigenous students, faculty, and staff in reviewing, adapting, and evaluating resources.
• Integrate knowledge from Indigenous communities local to your institution.

As you do this work, as an Indigenous or non-Indigenous person, continue to draw from and build on existing relationships with Indigenous people, both within and outside of your institution. As a way of continuing to work in intentional and respectful ways, you may want to reflect on questions like these:

• How does this work benefit Indigenous communities and help them to meet their goals?
• Will there be benefits for Indigenous students, faculty, and staff?
• Have the community or communities identified their own priorities or goals related to this work?
• How can this work support Indigenous efforts related to healing from past and ongoing colonial violence?

Elders and Knowledge Keepers

Elders have always been the foundation for emotional, social, intellectual, physical, and spiritual guidance for Indigenous communities. As you find ways to naturalize Indigenous context, perspectives, and traditional ways of being in your session, consider inviting an Elder or Knowledge Keeper from your local community to support the sessions. One way of doing this is to speak with Indigenous services staff at your institution, share with them some of the recommendations in this guide, and see how they might wish to support this work.

Not all institutions will have an Elder in Residence, but each should have ways for you to contract with an Elder or Knowledge Keeper to come in and support your work. Elders and Knowledge Keepers often support the whole post-secondary institution community, not just the Indigenous students. Involving Elders and Knowledge Keepers can support reconciliation by helping to build respectful, reciprocal relationships that are deep and meaningful.

Whenever you plan to bring in a community member, an Elder, or a Knowledge Keeper, it is important to plan for the honorarium required to remunerate them for their time and for sharing their wisdom and traditional teachings. In many communities, it is seen as most respectful to offer payment on par with what you would pay a PhD holder to do a keynote presentation.

However, consulting with the Indigenous services staff at your institution on what is a typical amount for this type of event is also a good practice.

Text Attributions

• This chapter is adapted from Consent & Sexualized Violence Training and Facilitator Guide: Preventing and Responding to Sexual Violence in B.C. Post-Secondary Institutions by Sexual Violence Training Development Team (CC BY 4.0 License).

Creating a Safe Learning Space

Participants need to feel comfortable, safe, and respected during the training. We discuss several strategies for helping to create a positive learning space. As you prepare to facilitate, you will want to consider factors such as when and where to hold the session, key messages on promotional materials, whether to use group guidelines, how to ensure diverse representation, and ways of working with co-facilitators or guests. If possible, having a co-facilitator or someone to assist you during the presentation can be very helpful. If a participant is triggered and needs to leave the session, a co-facilitator or helper can follow up with the participant.

Opening with Intention

Facilitators have an enormous role to play in setting the tone for a session. As people enter the space (online or in person), you can welcome them and help them get oriented. You can let them know if you’ve started or whether you’re waiting for a few more people, and share housekeeping information such as where the bathrooms are, where they can put their things, or how to use online interactive features. You may want to consider using a breathing exercise together or an icebreaker activity to help put people at ease. As you begin the session, you can use opening questions that help create inclusivity, such as correct pronouns, check-in questions, or information about accessibility needs and requests.

Scope of the Session

It is important to hold space in a session for people’s feelings and experiences – shared or not. However, boundaries are also needed to allow the session to move forward and be completed within the stated time frame.

It is also important to establish at the beginning that the training is a learning space and not a counselling session (you may also want to send an email with this message to all participants prior to the session). If a participant is starting to take over the discussion with their personal experiences, you can gently redirect the conversation back to the material that you need to cover. Plan to stay after the session is over to talk to any participants one-on-one.

It’s also important to reassure participants who worry that they must “fix” a student who is in distress. Emphasize that faculty and staff are not expected to be counsellors or to provide mental health treatment.

What This Session Does Not Include

This training doesn’t focus on how to recognize and support a student struggling with substance use and addiction. Substance use and mental health are closely linked, but this topic is beyond the scope of this foundational training.

This session briefly addresses suicide, but suicide is a very serious issue that requires more in-depth training. BCcampus has a training resource on suicide awareness for faculty and staff. BCcampus also has a facilitated resource on suicide Let’s Talk About Suicide: Raising Awareness and Supporting Students.

Faculty and staff who have concerns about a student who is suicidal should consult a counsellor. If it’s an emergency, they should call 911 and campus security. Section 3 of this resource, “The Three Rs Framework: Recognize, Respond, Refer,” provides information on how to refer another student to campus and community resources.

Group Guidelines

It can be helpful to ask participants to agree to a list of guidelines or a code of conduct when they register for the session. You can either send the group guidelines to participants before the session or take some time at the beginning of the session to establish the guidelines together.

When you start the session, you can ask participants if they feel comfortable with the guidelines or if they have something they would like to add or change.

Group guidelines can be an important tool for supporting safer discussion about difficult topics. You can remind participants of the guidelines if the discussion is getting difficult. Important group agreements relate to listening to and showing respect for others (e.g., not talking when others are speaking, not making rude comments, not talking on the phone), confidentiality, and participation.

Group guidelines come in all shapes and sizes. Some groups have a few guidelines, while others have many. Here are some suggestions for possible guidelines:

• Share the learning, not the names or the stories (confidentiality).
• Participants have the right to “pass” on activities/questions that feel uncomfortable.
• It is all right to feel uncomfortable or to not know answers to everything.
• It is okay to step out of the session at any time.
• Treat others with respect.
• Be mindful of your language; respect everyone’s names and pronouns.
• Speak for yourself. Use “I statements” to state opinions or feelings.
• Seek to replace judgment with curiosity.
• Take care of yourself.
• Allow everyone a chance to participate.

Content Warnings

Content warnings (also called trigger warnings) are statements made before sharing potentially difficult or challenging material. The intent of content warnings is to provide participants with the opportunity to prepare themselves emotionally for engaging with the topic or to make a choice to not participate.

Different departments and institutions will have different approaches to content warnings, and this may guide your decision about including content warnings on registration or sign-up forms, in learning materials, and in the learning environment. Here is an example of a content warning:

We will be discussing topics related to mental health and mental illness in this training. During the training, you can choose not to participate in certain activities or discussions and can leave the room or virtual space at any time. If you feel upset or overwhelmed, please know that there are resources to support you.

There are a number of other facilitation strategies you may want to consider in addition to or instead of a content warning:

• When discussing difficult content, check in with participants from time to time. Ask them how they are doing, whether they need a break, and so on. Let them know that you are aware that the content is difficult.
• Ask participants to be mindful of their fellow learners during the discussions and remind them that people who have struggled with mental illness may be present in the room (regardless of whether this information has been shared with others).

Trauma Awareness

Some participants may have direct experience with mental illness or trauma. There are a number of strategies you can use to help create a trauma-aware learning space.

Before the Session

Before you start facilitating, ensure that you are knowledgeable about receiving disclosures and about available supports and resources on campus and in the community. Some institutions have developed practices such as expedited counselling for participants who might need support after a training session, or making intensive crisis supports available for a short time after a training session or other initiative.

To Start

At the beginning of the session, let participants know that they have the right and freedom to take care of themselves in a way that works for them. In particular, let participants know that they can leave the room or virtual space or choose not to participate in an activity. You could say something like “If at any time you feel you need to leave, that’s fine with me. You are empowered to take care of yourself.” You can also let participants know that reactions to difficult material can sometimes be delayed and that they may wish to connect with you a few days after the training or to access support from family, friends, or other people in their lives.

If you feel comfortable doing so, you can share information about grounding activities that may be helpful to participants during the session. Grounding activities, such as breathing exercises, are simple activities that can help people relax, stay present, and reconnect with the “here and now” following a trauma response – for example, pressing or “rooting” your feet into the ground, breathing slowly in and out for a count of two, repeating a statement such as “I am safe now, I can relax,” or using your five senses to describe the environment in detail.

During the Session

If you notice that a participant has left the group and you suspect that they were reminded of previous trauma by something in the session, follow up with them one-on-one after the session to check in and offer any resources that you think might be helpful to them.

During the session, if the conversation becomes intense or you believe that a number of participants have become overwhelmed or affected by the discussion, it can be helpful to take a break or use an activity that involves the body or movement to help people reconnect with the present moment.

Let participants know that you will be available after the training if they would like to debrief or share their responses to the session or how they are feeling. Schedule at least 30 minutes after a session so that you can be available to participants. If you are delivering the training online, let participants know that they can private message or email you.

Participants may need some time near the end of the session to ask questions, share a reflection, or simply sit with what they have heard and discussed. If possible, try to ensure that this time is built in at the end so no one feels rushed when concluding the session.

After the Session

Plan to stay after the session to talk to participants who have questions or concerns. If you are concerned about a participant, ask them if they would find it helpful for you to check in with them later in the day or the following day. You could also ask them if they have a friend or family member that they might find it helpful to speak with after the session. If so, help them make a plan to connect with them by phone, text, or in person or at a certain time.

For more information on trauma-informed practice, see the BCcampus recorded webinar Trauma-Informed Facilitation, by Dawn Schell, and the Education Northwest resource Trauma-Informed Practices for Postsecondary Education: A Guide, by Shannon Davidson.

Questions That May Come Up and How to Respond

Facilitating conversations about mental health can be challenging. Participants likely bring many different experiences, assumptions, ideas, and worries about how best to support students who are struggling with these issues.

It’s important to create a space where people feel safe and supported so they share and listen to others with respect and empathy. This section offers ideas and tips for creating such an environment, but you also have a time limit within which to present material. It’s important to keep an eye on the clock and know how, and when, to direct participants’ attention to the next topic.

As mental health and wellness affects all parts of our lives, participants may bring up related issues or concerns. Below are some questions that might come up during the presentation, with suggestions for responses. The goal is to acknowledge people’s comments, thank them for their contribution, and point them to resources they may find helpful. Then the discussion can move back to the specific topic at hand.

• Thank the person for bringing up this important topic.
• Acknowledge that there isn’t time to address this question in a meaningful way.
• Direct participants to the supports available at your institution around this topic.
• Invite the person to talk with you after the session for further assistance.

Transitions and Difficult Conversations

While facilitating, you may encounter challenging moments when you may not be sure how to respond. Someone may start to dominate the discussion, or the conversation may shift in a direction that makes you concerned for the comfort of other participants.

Here are some potential responses for bringing participants back to the topic or handling challenging moments:

• “This is a really great dialogue, but I would like to bring us back to the topic at hand.”
• “Thank you for sharing that story. I’d like to follow up with you after the session today if we can save this conversation for later.”
• “I’m getting conscious of time here. Let’s move on for now.”
• “Your feelings are important and I want to be able to give you my full attention. Would you like to step out and have a conversation about it? My colleague can continue with the session.” (This can work if there are two co-facilitators. If there is only one facilitator, you can suggest continuing the conversation after the session.)
• “It’s okay for us to agree to disagree. Let’s move on; I’d like to bring us back to some of the activities and questions we had planned.”

Self-Care and Community Care

Self-care and community care are about looking after yourself and those around you. The experience of facilitating a session on mental health can range from satisfying and rewarding to challenging and overwhelming. It is important to make sure that you are able to take the time to take care of yourself and that you are willing to reach out to co-workers, friends, and family, or for professional support if needed.

After facilitating a session, you may want to check in with a friend or colleague about your experiences and any successes or challenges in facilitating. This allows for time to reflect on issues related to your own mental health, to consider any feedback that you received from participants, and to discuss any facilitation successes and challenges. You might use the time after a session to reflect or use a journal to make notes as a way of processing the experience.

Check-In/Reflection Questions for Facilitators

Taking time after a session to debrief can be a helpful way to care for yourself. Here are some sample debriefing questions.

• What was a positive moment or a success in this session?
• How did participants engage with the different activities? Is there something I want to facilitate or do differently next time?
• Did I or a participant seem to have a response to the material, a shared story, or another participant that was challenging? If so, how was it responded to or resolved?
• Is there something that would be helpful for me to learn about or check with a colleague about?

Resources on Mental Health for Further Reading and Preparation

• Centre for Addiction and Mental Health (CAMH): Has many resources on mental health and addiction, including a Get Help page with information on crisis lines and immediate help.
• HeadsUpGuys: An online resource from the University of British Columbia that supports men in their fight against depression by providing tips, tools, information about professional services, and stories of success. Supports men’s mental health in a positive, inclusive, and mutually supportive way and is for people of all backgrounds, regardless of gender, race, or sexual orientation.
• Kelty Mental Health Resource Centre, B.C. Children’s Hospital: Provides mental health and substance use information, resources, and peer support for youth and young adults. Also provides information and resources for people of all ages with an eating disorder or disordered eating concern.
• Mental Health Commission of Canada: Offers a number of fact sheets, research reports, and webinars on mental health and mental illness.
• South Asian Mental Health (SOCH): A mental health promotion initiative tailored to provide the South Asian community with mental health support and start the conversation to break the stigma around mental health. The Pardesi Project, a film about the mental health of South Asian international students, is available on their website.
• We Matter Campaign: An Indigenous, youth-led, nationally registered organization dedicated to Indigenous youth support, hope, and life promotion.

Text Attributions

• “Creating a Safe Learning Space,” “Trauma Awareness,” and “Self-Care and Community Care” are adapted from Consent & Sexualized Violence Training and Facilitator Guide: Preventing and Responding to Sexual Violence in B.C. Post-Secondary Institutions by Sexual Violence Training Development Team (CC BY 4.0 License).

This agenda provides suggested timings for a two-hour session, the minimum time recommended for presenting the information and providing time for the activities. However, you may want more time to offer the training and could extend the session to two and a half or even three hours to allow more time for discussion, debriefs, and short breaks, and to give participants lots of time to work through the scenarios at the end. Some facilitators may want to offer this training over two sessions. While the training is adaptable, we recommend that you include the sections on marginalized groups, as it is important to maintain the integrity of diversity of voice in this resource.

Welcome

Welcome participants and open with a territory acknowledgement. If you’re unsure of your territory, the website Native-Land.ca is a helpful resource.

Opening Check-in Activity

After the welcome, introduce yourself. You could ask participants to very briefly introduce themselves, or you may want to start the session with a short participant check-in as a way to invite people into a learning space. You could ask participants to share very brief introductions or do an online poll that asks people to choose the type of weather that matches how they are feeling. There are many different ways to have participants check in with themselves and the group, and we invite you to use questions and reflections that are meaningful to you and the group.

Goals and Objectives

Review the overall goal of this presentation: to help faculty and staff develop the knowledge, skills, perspectives, and confidence to support student mental health and wellness.

After participating in the presentation, participants will be able to:

• Describe what mental health and wellness is.
• Describe how students show resilience to deal with common and reversible stress.
• Recognize the different ways a student may show they are in distress.
• Respond to a student with a mental health concern in an empathetic way.
• Refer a student in distress to appropriate resources.
• Explain the role of faculty and staff in supporting student mental health and the need for boundaries when supporting students in distress.

Participants will leave this session with a clear understanding of their role in responding to students in distress and have basic tools for approaching and referring students to campus resources.

Practical Information

Suggest that as people engage with the presentation, they reflect and think about how the information might apply to situations they have already had with students, or situations that they can imagine coming up in their role as faculty or staff.

Encourage people to provide feedback and share their input during the discussions as this helps improve the learning opportunities.

Encourage people to jot down notes during reflection activities. Encourage them to ask questions if they have any questions during the session.

Let everyone know that after the presentation, they will have access to printable (PDF) handouts of a Wellness Wheel worksheet and a handout on how to respond to students in distress. If possible, have a handout with contact information of your institution’s support services for students.

If you are giving this session online, remind online participants that they can turn off their cameras and move around the room during the session. Ask them to be mindful of using the mute button to reduce noise in the online space.

Supporting Participants

Most importantly, invite people to do whatever they need to take care of themselves throughout the presentation. Acknowledge this may be a difficult topic for some and suggest that participants do what they need to in order to care for themselves. Remind people that everyone is human and is touched in some way by the topics discussed in the presentation. People should feel free at any time to pause, take a break, stretch, and ground themselves.

For example, if a participant needs to leave or if some people prefer not to share, it’s okay. For in-person sessions, you could suggest that if a participant does need to leave a session that they give a thumbs up as they go to let you know they’re okay. Tell everyone that if you don’t see a thumbs up, you’ll ask a colleague to look for the participant outside the session to make sure they are all right.

Also, remind participants that they can share at the level that they feel comfortable with. Suggest that if anything comes up in the session that feels too important or difficult to handle on their own, people shouldn’t hesitate to reach out to the appropriate services – a counselling office or an employee assistance program – to debrief or discuss it further.

Text Attributions

• This chapter was adapted from Capacity to Connect: Supporting Students from Distress to Suicide. © Vancouver Island University. Added “Welcome,” “Opening Check-in Activity,” “Goals and Objectives,” “Practical Information,” and “Understanding the Role of Faculty and Staff” by Barbara Johnston. CC BY 4.0 license.
• Added “Territory Acknowledgement and Indigenous Ways of Knowing and Being” by Jewell Gillies. CC BY 4.0 license.

Media Attributions

• Cairn Stones and Body of Water in Distance by Pixabay is licensed under a Creative Commons 0 license.
• Sunrise at Okeover Arm in British Columbia, Canada by Islander61 is licensed under a CC BY-SA 4.0 International license.

What Is Mental Health and Wellness?

The Public Health Agency of Canada defines mental health as “the capacity of every individual to feel, think, and act in ways that enhance their ability to enjoy life and deal with challenges. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections, and personal dignity.”

Mental health is essential to overall health and influenced by the many different factors. We can all work to restore our mental health and wellness.

Wellness Wheel

The Wellness Wheel aligns with Indigenous traditional practices that view individuals holistically, recognizing that wellness means being in a state of balance with the physical, emotional, academic/career, social, creative, spiritual, environmental, financial, and intellectual aspects of your life.

The Wellness Wheel is not a static concept, but a way of viewing the many dimensions that support wellness. There are things we can all do as individuals to improve our own mental health and well-being, and how we manage our wellness is an ongoing reflective practice.

The Wellness Wheel helps us to see what aspects might be falling in and out of balance in our lives. We can try our best to be flexible and respond to aspects of well-being that may need additional care or attention. Using the concepts in the Wellness Wheel can help us visualize our journey and assist in not only mitigating stressful circumstances, but also in recognizing areas of our lives in which we are thriving.

Dimensions of the Wellness Wheel

Resilience

Resilience means being able to adapt to life’s challenges and setbacks. When something is out of balance in our lives or we’re experiencing stress, resilience helps us to shift back toward balance and mental wellness. It’s the ability to adapt to difficult situations and it can help protect us from various mental health issues, such as depression and anxiety. Resilience isn’t about avoiding or ignoring challenges in life; rather, it’s noticing when stress appears and taking proactive steps to manage the stress and pressure.

The Wellness Wheel can help us recognize what might be causing stress or pressure in our lives. It also reminds us of our own resilience and strengths; while we may be struggling in one area, we may be doing well in many other areas.

Text Attributions

• This chapter is original text by Jewell Gillies and Barbara Johnston. Added “Mental Wellness,” “Wellness Wheel,” “Resilience,” “Traditional Healing Practices,” “Small Group Activity.”  CC BY 4.0 license.
• “Dimensions of the Wellness Wheel” text adapted from Okanagan College, (n.d.), Wellness peer ambassador handbook. Kelowna, B.C.: Okanagan College. CC BY 4.0 license.

Media Attributions

• Wellness Wheel © Jewell Gillies and Amy Haagsma (designer) is licensed under a CC BY 4.0 license. All icons licensed as CC BY 4.0 » yoga by zidney from the Noun Project | heart rate by Naufal Hudallah from the Noun Project | Book by Studio TROISQUATRE from the Noun Project | Gears by Gregor Cresnar from the Noun Project | Lotus by Brad Avison from the Noun Project | landscape by Creative Stall from the Noun Project | forest by Creative Stall from the Noun Project | Sea Sunset by Creative Stall from the Noun Project | Park by Creative Stall from the Noun Project | gaining by Alice Design from the Noun Project | Tree by Brian Hurshman from the Noun Project.

Mental Health and Mental Illness

Mental health is a term that is often used interchangeably with mental health issues or mental illness, but they are not the same.

As we discussed, mental health is the capacity of every individual to feel, think, and act in ways that enhance their ability to enjoy life and deal with challenges.

Mental health issues refer to diminished capacities – whether cognitive, emotional, attentional, interpersonal, motivational, or behavioural – that interfere with a person’s enjoyment of life or adversely affect interactions with society and environment. Feelings of low self-esteem, frequent frustration or irritability, burnout, feelings of stress, or excessive worrying, are all examples of common mental health problems. Most people will experience mental health issues like these at some point in their life.

Mental illnesses are conditions that affect a person’s thinking, feeling, mood, or behaviour, such as depression, anxiety, post-traumatic stress disorder (PTSD), bipolar disorder, or schizophrenia. Such conditions may be occasional or long-lasting (chronic) and affect someone’s ability to relate to others and function each day.

Mental health is more than the absence of mental illness. It includes our emotional, psychological, and social well-being. It is influenced by many factors, and it affects how we handle the normal stresses of life and relate to others.

A person diagnosed with a mental illness can have good mental health and be flourishing and thriving. Likewise, a person can be languishing or experiencing poor mental health and not be diagnosed with a mental illness. The Corey Keyes Dual Continuum Model illustrates this.

Mental Health Continuum

The Mental Health Continuum is another way to think about mental health. All of us have a mental health life; we all experience changes in our mood, changes in our level of anxiety – from life stressors or from crises – and those changes can be considered on a spectrum or a continuum. On this continuum, we can move from healthier to more disrupted levels of functioning and back. At each level, there are resources to promote health and reduce disruption.

Marginalized Groups and Mental Health

When we talk about mental health, we also need to be aware of factors like race, sexual orientation, social class, age, disability, and gender and the unique life experiences and stressors that accompany them. Some students face inequality, discrimination, and violence because of their race, gender orientation, or disability. These unique and specific stressors impact mental and physical health, and these students often experience greater mental health burdens and face more barriers to accessing care.

By providing a culturally safe environment, we can all play a role to ensure that each student feels their personal, social, and cultural identity is respected and valued.

International Students

Both undergraduate and graduate international students are often under a lot of pressure and the stakes are often very high for them. Their tuition is expensive, they’ve travelled a long way to attend a post-secondary institution in B.C., and they feel a lot of pressure to do well academically. They may be struggling to adjust to a new culture or learn English, and they may be missing home, family, and friends. The understanding of mental health and wellness differs between cultures, and international students may have a different understanding of how mental health impacts academic performance, and they may not be aware of the support systems available to them when they arrive.

Indigenous Students

Indigenous students may be struggling as they adjust from living in a community where they are surrounded by family and neighbours who share the same culture and spiritual beliefs to living in an urban academic setting. They may be the first generation to pursue post-secondary education, and they may be missing their home, family, Elders, and community. The impact of residential schools and other colonial policies have created ongoing adversity for Indigenous people, and there is evidence that this has created intergenerational trauma. Many Indigenous students may also lack trust in educational and health care institutions because of the negative or traumatic experiences they or family and friends have experienced in the past.

LGBTQ2S+ Students

People who are LGBTQ2S+ (lesbian, gay, bi-sexual, transgender, queer, Two-Spirit) are at a much higher risk than the general population for mental health disorders, substance abuse, and suicide. Homophobia and negative stereotypes about being LGBTQ2S+ can make it challenging for a student to let people know this important part of their identity. When people do openly express this part of themselves, they worry about the potential of rejection from peers, colleagues, and friends, and this can exacerbate feelings of loneliness. Their health needs may be unique and complex, and health care settings can feel unsafe or uncomfortable for some.

Students with a Disability

Many students live with some form of physical, cognitive, sensory, mental health, or other disability. Students of all abilities and backgrounds deserve post-secondary settings that are inclusive and respectful. Unfortunately, many institutions are not designed to fully support people who need extra accommodation, and students with a disability frequently encounter accessibility challenges and extra barriers to achieving academic success. In addition to navigating the complex environment of a post-secondary institution that is not set up for them, students with a disability also often have to combat negative stereotypes, bias, and discrimination. These many extra challenges can take their toll on mental health.

Racialized Students

Black, Indigenous, and other racialized students have likely faced racism and discrimination multiple times throughout their lives. Racism can encompass a range of words and actions, from the overt racism of violence or slurs to microaggressions (everyday, subtle interactions that demean or put down a person based on their race). Sometimes microaggressions are not intentional, but they can still be very harmful, and they are a form of racism that many students experience. These repeated negative interactions can be overwhelming at times, especially in post-secondary spaces where a  student could reasonably assume they would be free from any form of bullying, harassment, or discrimination.

Racism and discrimination in various forms can have a significant impact on a student’s mental health and can lead to increased risk of depression or suicide, increased levels of anxiety and stress-related illnesses, and post-traumatic stress disorder.

Text Attributions

• This chapter was adapted from Capacity to Connect: Supporting Students in Distress © Vancouver Island University. Added “Mental Health and Mental Illness,” “Continuum of Mental Health,” “Marginalized Groups and Mental Health.” Adapted by Barbara Johnston. CC BY 4.0 license.

Media Attributions

• Dual-Continuum Model © BCcampus based on the conceptual work of Corey Keys and a diagram created by CACUSS and Canadian Mental Health Association is licensed under a CC BY-NC 4.0 license.
• Mental Health Continuum model, based on the University of Victoria continuum of mental health, which is adapted from on Queen’s University continuum of mental health and the Canada Department of National Defence continuum of mental health.
• Icon on slide 6. reflections of the heart by www.mindgraphy.com, ES In the Heart and love 2 Collection,  from the Noun Project is licensed under a CC BY 4.0 license.

Mental Health Problems Are Common

Mental illness is common and in any given year, one in five people will experience a mental health problem or illness. This means that if we count all of our friends, family, associates, people we work with, students in our classrooms, or even ourselves, we’re going to encounter a significant number of people who have a mental health problem or illness.

People in their late teens and early twenties are at the highest risk for mental illness; in these years, first episodes of psychiatric disorders like major depression are most likely to appear. We know that mental health problems actually create more lost time from work and more lost pleasure in life than any physical health conditions. Mental health problems can be hugely disabling.

According to the Mental Health Commission of Canada, only one in three people (and only one in four children or youth) who experience a mental health problem or illness say that they have sought and received services and treatment. This means a lot of people who need treatment and support are not seeking help.

The National College Health Assessment collects data related to health and health behaviours of post-secondary students across Canada and the U.S. In 2019, the study of Canadian students found that over the prior year at least one time:

• 51% of students had felt so depressed that they found it difficult to function
• 69% had felt overwhelming anxiety
• 16% had seriously considered suicide

Pursuing a post-secondary education is often a demanding and stressful time. These stressors can play a role in a student’s mental well-being and contribute to increased risk for mental health problems.

Adaptations

You need to give participants only a few statistics to illustrate that mental health issues are prevalent. There may be statistics on student mental health at your institution that you can use. Check with counselling services, student services, or Indigenous student services to see if they have statistics specific to your student population.

As you select and present statistics, you might want to consider using:

• Statistics that show the long-term impacts of the pandemic on mental health. For example, this resource was created during the COVID-19 pandemic, but in the next few years, other issues such as economic concerns or intergenerational trauma caused by the pandemic could affect students’ mental health.
• Research that has been done in your community or at your institution.
• Statistics that show how global issues impact students’ mental health, such as the environmental crisis or natural disasters.
• Statistics that show the magnitude of suicide and overdose deaths of young people.
• Both quantitative data (numbers) and qualitative data (for example, brief statements from students about how they are feeling).

The COVID-19 Pandemic and Global Environmental Stressors

The arrival of COVID-19 upended the functioning of post-secondary institutions around the world. This created new challenges and stresses for students, faculty, and staff, as well as the larger community. While the pandemic will end, there are other global factors, such as the environmental crisis, that have a great impact on students’ mental health; you may want to find statistics on this.

If you want to address the stressors of COVID-19, here are some statistics about the effect it’s having on mental health.

From the beginning of the COVID-19 pandemic, Statistics Canada reports:

• 52% of participants indicated that their mental health was either “somewhat worse” or “much worse” since physical distancing.
• 64% of those aged 15 to 24 reported a negative impact on their mental health.
• 41% of youth report symptoms consistent with moderate or severe anxiety.

Also, in a May 2020 a Canadian Alliance of Student Associations study of 1,000 post-secondary students found the following:

• Over 70% of respondents reported they have felt stressed, anxious, or isolated due to the pandemic.
• 82% reported worry about their future beyond the pandemic.
• Students are reporting more stress about everything, from their health, to their finances and future.

Text Attributions

• This chapter was adapted from Capacity to Connect: Supporting Students from Distress to Suicide. © Vancouver Island University. Added “Adaptations” section and “The COVID-19 Pandemic and Global Environmental Stressors.” Adapted by Barbara Johnston. CC BY 4.0 license.

Media Attributions

• Icon on slide 3. reflections of the heart by www.mindgraphy.com, ES In the Heart and love 2 Collection, from the Noun Project is licensed under a CC BY 4.0 license.

Recognize

The Three Rs Framework – recognize, respond, refer – is an important way that we can support students. The first R is recognize. How do we recognize when someone is distressed and struggling? Thinking about your students and any times you might have been concerned about them, what are some signs you have noticed that they may be experiencing distress, which we define as more than predictable day-to-day stress? What did you notice? (Make the key point: the main sign is a change in a student’s presentation.)

Students often give us clues about the state of their wellness through either their words, body language, or actions. What are some signs of distress that you’ve noticed in students?

Either share the slide “Recognizing Signs of Distress” or write “Academic, Behavioural, Physical, Emotional” on the board and invite participants to share signs of distress that they’ve noticed in students. (For online sessions, ask participants to write their responses in chat.) You could also refer back to the exercise done earlier, where participants identified different behaviour changes they might see when there is an imbalance in the wheel.

Some possible signs that a student is not doing well include:

Academic signs

• Significant decline in the quality or quantity of classroom/research work
• Change in attendance
• Repeated lateness, missed appointments or deadlines
• Missed assignments or exams

Emotional signs

• Exaggerated emotional response (e.g., intense anger, sobbing, persistent worry)
• Overly confident and enthusiastic
• Absence of emotion – appearing flat, disengaged
• Lack of motivation or interest

Physical signs

• Falling asleep in class
• Noticeable decline in hygiene or looking unkempt
• Significant change in energy level
• Appearing drunk or high
• Visible bruises, cuts, or injuries

Behavioural signs

• Describing difficult circumstances or experiences (e.g., loss, conflict, trauma, assault)
• Ranting emails
• Disregard of rules or authority
• Peer reports of concerns about, or discomfort with, a student

Signs that a Student Might Be Thinking About Suicide

Now let’s shift to talk a little more about suicide, which may be a concern for anyone trying to support students who are in crisis. A student could give warning signs such as:

• Talking or writing about death, dying, or ending their life.
• Misusing substances, like drugs, alcohol, and inhalants, or showing signs of other harmful behaviours like excessive gambling or self-harming.
• Saying things like, “I don’t see any point,” or “They’d be better off without me.”
• Withdrawing from friends, family, and activities.
• Missing classes and avoiding help.
• Showing changes in feelings, appearance, or behaviour that are outside their norm.

For more information on signs that a person is considering suicide, see the IS PATH WARM tool, which is based on research from the American Association of Suicidology and used worldwide. It’s available on the Canadian Association for Suicide Prevention website. This tool helps you think about some of the signs that a student could show if they are thinking about suicide and need help. It is important to remember that faculty and staff are not in a position to diagnose and are not expected to act as a counsellor, but if they are aware of the signs, they can help refer the student so they get the help they need.

You now have a sense of some signs of distress that you may see in students, and you have all seen and experienced some of these before. This is the first step: Recognizing.

Text Attributions

• This chapter was adapted from Capacity to Connect: Supporting Students from Distress to Suicide. © Vancouver Island University. Added new paragraph to introduce the Three Rs Framework and “Signs that a Student Might Be Thinking About Suicide.” Adapted by Barbara Johnston. CC BY 4.0 license.

Respond

The second R is respond. Start this section with a reflection activity.

You have all had experiences with various responses when you were distressed. From your own life experience, you have developed an understanding of what is helpful that you can draw on when you are responding to students. The responses you have identified as helpful are examples of an empathic response.

Video: Brené Brown on Empathy (2:53 min)

This short video from well-known sociologist Brené Brown demonstrates how to respond in a helpful, compassionate way – empathy in action. (Show the Brené Brown video or share the link in chat): Brené Brown on Empathy.

After the video, remind participants that there is not a script you need to follow, nor one way that will always work. The most important thing is to be yourself and to be authentic – and this can include being honest when you’re not sure what to say.

The role of an empathetic listener is not to “fix” the student or tell them how to respond. Instead it is to listen and try to help them find appropriate support. Your expression of concern may be a critical factor in saving a student’s academic career or life.

In many cases it’s not the things we have to say that make the difference, it’s the things that we allow the other person to say and get off their chest that will make room for more life-affirming options to come forth. Just being there, giving support, and offering a listening ear can help create a turning point for a student who is struggling.

When responding to students in distress, consider an appropriate balance of desire to help and provide solutions and respect for students’ autonomy and their own capacity.

Some Tips for Responding to Students in Distress

Before you talk to a student, make sure you are in a private place to have the conversation. Here are some suggestions:

• Give the student your complete attention. Listen without judgment and let them talk without interruption.
• Acknowledge the student’s thoughts and feelings with compassion and empathy.
• Try using an “I” statement to start a conversation to express your concern. For example, “I’ve noticed that you haven’t handed in the last two assignments and have missed a lot of classes lately, and I’m concerned.”
• Repeat their statements to clarify and ensure that you understand what the issues are. For example, you could say, “I want to be sure I understand what you are saying. Is this what you meant?”
• Let them know you are concerned and want to help them find the right resources.

You don’t need to “fix” the student, and you are not expected to act as the counsellor. You can assist many students simply by listening and referring them for further help.

Should I Ask About Suicide?

Ask the group: what comes up for you when you consider asking about suicide? Invite them to share (either in person or in chat for online) and address answers, which may include:

• I’d be afraid that by asking they would start thinking about it more.
• It’s so much responsibility.
• I don’t have time to deal with the issue fully.
• I won’t know what to do if they are considering suicide – what next?
• What if it’s insulting to the student?

Validate all responses, reinforcing the notion that it is frightening to ask about suicide. Reinforce that one of the greatest fears most people have about asking is, what if a student says “yes”?

One concern that people often have is that if they bring up suicide and a student isn’t considering it, they may start thinking about it as an option. That is untrue. Asking about suicide will not put the thought into someone’s mind. It can give the person a sense of relief – for example, “Finally, someone has seen my pain” – or give them permission to open up further about something they have been keeping hidden.

If you do ask about suicide, it can be helpful to be open and direct in your questioning – this approach will convey a level of comfort. If a student says they are contemplating suicide, here are some ways to be helpful:

• Ask if they want to talk about it.
• Ask if there is anything you can do, and offer to help them access support.
• Be non-judgmental and empathic.
• Do not minimize the feelings expressed by the student.
• Do not be sworn to secrecy. Seek out the support of appropriate professionals.
• Do not use clichés or try to debate with the student.
• In an acute crisis, take the student to counselling services or call a crisis line or 911 and campus security.
• If there seems to be an immediate risk, do not leave the student alone until help is provided.

Reinforce that it isn’t the expectation that everyone ask about suicide. If a participant is still nervous or uncomfortable with the question, that’s okay. It’s okay to have limits. Within your role, the expectation is that you would help get the student connected to someone who will ask.

Text Attributions

• This chapter was adapted from Capacity to Connect: Supporting Students from Distress to Suicide. © Vancouver Island University. Added “Reflection: Responding to Distress,” “Some Tips for Responding to Students in Distress,” and “Should I Ask About Suicide?” Adapted by Barbara Johnston and Liz Warwick. CC BY 4.0 license.

Media Attributions

• Practicing empathy © Melissa Hogan is licensed under a CC BY-SA 4.0 license.
• Brené Brown on Empathy © RSA is licensed under a Standard YouTube license.
• Icon on slides 1 and 3. reflections of the heart by www.mindgraphy.com, ES In the Heart and love 2 Collection, from the Noun Project is licensed under a CC BY 4.0 license.

Refer

Let’s talk now about the third R, referring students for further support. Often a few minutes of effective listening are enough to help a student feel cared about. If their distress is more significant and they are open to accessing more support, there are several services that can help. Knowing what these services are and how to contact them will help you in your role.

Services and Resources at Your Institution

If you have a list with names and contact information for these services at your campus, share this information with participants.

Below are some of the services available at most campuses.

• Counselling services help students manage personal, academic, and life concerns. Professional counsellors provide individual and group counselling sessions for students.
• Campus security helps coordinate responses to student emergencies and crises. If you call 911, call security first, as security can help first responders locate you.
• Indigenous student centres offer programs, mentorship, and a gathering place. They may have an Elder available to talk to students.
• Health services offer health and mental health care for students.
• International student services help students with personal or academic issues, study and work permits, and visa applications.
• Accessible learning centres provide services, coordinate academic accommodations for students, and act as a resource to work with the university community.
• Financial aid helps students needing financial support for their education.

Provincial Crisis and Support Lines

Some larger campuses have a crisis line for students. If your institution does not have this service, there are also provincial crisis and suicide lines that have 24/7 support. These crisis lines also provide support to anyone who is helping a student in distress and needs to talk to someone and debrief.

Some provincial supports include:

• BC Suicide Line: 1-800-784-2433 (1-800-SUICIDE)
• Mental Health Support Line: 310-6789 (no need for area code)
• Here2Talk: 1-877-857-3397 (a 24-hour phone and chat counselling support for B.C. post-secondary students that offers free, confidential counselling and community referral services via app, phone, and web: Here2Talk)

Provincial Supports for Indigenous Students

• For Indigenous students, the KUU-US Crisis Response Services (24/7) provides culturally safe support: 1-800-588-8717
• The First Nations Health Authority website has Indigenous resources: eHealth & Virtual Health.

If the Student Won’t See a Counsellor or Seek Help

Sometimes a student may not want to see a counsellor or refuses help.

Your first step in these cases will be to consider safety: is anyone at risk of immediate harm, whether it’s the student or someone else? If so, share your concerns with a counsellor or someone who can help ensure safety. If a student expresses thoughts about suicide, you don’t have to carry that knowledge alone or assess the risk yourself – consult, refer, and if the risk is imminent, then contact emergency services.

If there is no risk of harm to anyone, keep in mind that ultimately it is the individual’s right to choose whether to seek help. Individuals are resilient and often come to their own solutions or find their own supports when they are ready.

Ensure you are supported! Talk to friends, family, other instructors, an Elder, or a counsellor to share your concerns and decide how to proceed.

Privacy

Please be aware that if you refer a student to Counselling Services and are hoping to follow up to find out about the student, it is up to the student to give consent to release information.

Unless a student gives permission, faculty and staff won’t be notified of what has happened.

Text Attributions

• This chapter was adapted from Capacity to Connect: Supporting Students from Distress to Suicide. © Vancouver Island University. Added “Services and Resources at Your Institution,” “Provincial Crisis Support Lines,” “Provincial Support for Indigenous Students,” and “Privacy.” Adapted by Barbara Johnston. CC BY 4.0 license.

Maintain Your Own Boundaries

When helping students, it is important to remember to maintain your own boundaries. Recognize what you can and can’t do, given the limitations of your role, and be clear with others. Refer students as appropriate and access your own support when needed.

We’re going to consider a list of some feelings people might have as they try to support a student. These feelings may be signs that you are taking on too much and not maintaining boundaries. You may need to step back, consult, and take time for self-care. As you read this list, check in with your body and notice which of these resonate with you. They may remind you of an experience you’ve had with a student.

• You feel overly responsible for the student.
• You often think about how to solve the student’s problems outside of work hours.
• You think the problems the student brings are more than you can handle.
• You feel stressed out by the student’s issues or behaviour.
• You feel pressure to solve the student’s problems.
• You feel uneasy or have a gut feeling that the student is not okay despite the student denying it.
• You see a pattern repeating itself in your interactions with a student.
• You find yourself avoiding the student.
• You feel anxious or angry when the student approaches you.

All of the above responses are common, and we can all likely relate to many.

We all have our limits of comfort challenged in different ways. When you notice any of these responses within yourself, it may be time to consult or refer.

Consult with Others

We encourage you to consult with your colleagues, chairs, deans, or others whom you trust. Counsellors can meet with staff and faculty who are concerned about a student and are unsure how to handle the situation. You can also call a crisis line if you have serious concerns about a student. You are encouraged to consult when:

• You are concerned about a student’s safety, academic performance, or well-being but unsure how or whether to intervene.
• You are uncertain how to respond to a student’s approach for help.
• You continue to be concerned about a student who has declined help.

Text Attributions

• This chapter was adapted from Capacity to Connect: Supporting Students from Distress to Suicide. © Vancouver Island University. Adapted by Barbara Johnston. CC BY 4.0 license.

Media Attributions

• Flower of an Indian Lotus © Hong Zhang is licensed under a CC0 license.

An important thing to remember is that you don’t have to have all the answers for students, and you don’t have to act as a counsellor. You can really support students by opening up a conversation, showing your care and respect, and inviting them to access support services.

Options for Scenarios

The following six scenarios offer participants opportunities to think about and practise responding to situations of students in distress. People may also want to read and reflect on them in their own time.

Encourage participants to use these scenarios as starting points, not scripts, for discussions and continued thought about how we can respond with empathy to students while recognizing and honouring their strengths and capacity to achieve balance.

Text Attributions

• This chapter was adapted from Capacity to Connect: Supporting Students from Distress to Suicide. © Vancouver Island University. Adapted by Barbara Johnston and Jewell Gillies. CC BY 4.0 license.

To close the session, review the Wellness Wheel, the Mental Health Continuum, and the Three Rs Framework.

Review everything you’ve talked about: how to recognize signs of distress in students, how to respond empathically while considering your own limits and a balance of care and respect, and how to refer to appropriate supports for you and for students.

If you haven’t already shared resources, hand out or share the links to any resource sheets available as well as campus and community resources and Handouts 1 and 2.

You might also like to read aloud the Maya Angelou quote to conclude the session.

Invite questions and comments.

Text Attributions

• This chapter was adapted from Capacity to Connect: Supporting Students from Distress to Suicide. © Vancouver Island University. Adapted by Barbara Johnston. CC BY 4.0 license.

Media Attributions

• Wellness Wheel © Jewell Gillies and Amy Haagsma (designer) is licensed under a CC BY 4.0 license. All icons licensed as CC BY 4.0 » yoga by zidney from the Noun Project | heart rate by Naufal Hudallah from the Noun Project | Book by Studio TROISQUATRE from the Noun Project | Gears by Gregor Cresnar from the Noun Project | Lotus by Brad Avison from the Noun Project | landscape by Creative Stall from the Noun Project | forest by Creative Stall from the Noun Project | Sea Sunset by Creative Stall from the Noun Project | Park by Creative Stall from the Noun Project | gaining by Alice Design from the Noun Project | Tree by Brian Hurshman from the Noun Project.
• Mental Health Continuum based on the University of Victoria continuum of mental health, which is adapted from Queen’s University’s continuum of mental health and the Canada Department of National Defence continuum of mental health.
• Diversity speech bubble icons by Louise Wigö is licensed under a CC0 license.