Mental health in Ireland is getting more stage time than it has in the past. Since 2009, the number of students using the Student Counselling Service has increased by 68 per cent, with almost 15 per cent of students using either the counselling service or Student Learning Development last year. This increase is explicable: we talk more about mental health these days, and so people are becoming increasingly comfortable accessing support when they need it. As discussing depression and anxiety and suicidal thoughts becomes normalised, visiting a counsellor becomes just as natural as popping to the doctor when you feel a bit unwell.
However, the Student Counselling Service also saw a 150 per cent increase in demand for its emergency counselling appointments, meaning more students now require the service than there are hours available. This emergency use could imply increasingly severe issues in students, but could also reflect an inability to access standard services. Maeve DeSay, former welfare officer with University College Dublin Students’ Union (UCDSU), believes that the increase in demand for counselling is due to “awareness of supports available, as well as a growing acceptance in their use”. More individuals do seem to be availing of services, something that is reflected in the increasing rates of mental health issues reported in this country. While in 1993, 15.5 per cent of people between 15 and 64 met the criteria for one common mental disorder, that percentage grew to 17.6 per cent by 2007. DeSay acknowledged that “we have seen a dramatic increase in public discussions about mental health, suicide and depression”, an increase that has encouraged us all to seek support and “tell our friends and families how we are feeling”.
The Student Counselling Service also saw a 150 per cent increase in demand for its emergency counselling appointments, meaning more students now require the service than there are hours available
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Perhaps the clearest indicator that increases are due to greater understanding rather than suffering are the deviations in who reports. In the National Health Service (NHS)’s Psychiatric morbidity in England study, women were more likely to present with a disorder than men, and those aged 75 and over were least likely to report one. Older people are less familiar with discussions of mental health than our younger generations, and women are often happier sharing feelings with friends than men have traditionally been. For someone from an older generation faced with bizarre symptoms, depression was not the obvious answer. But we’ve now reached a point where it’s “okay to talk”.
And it’s not just okay to talk – it’s also okay to seek help. According to the 2012 My World survey, 77 per cent of young adults between 17 and 25 would use the internet for informal help, with 71 per cent using friends and over half using parents. 46 per cent of people reported that they would use a doctor, followed by a psychologist, their student counselling service, or a relative. 13 per cent said they would seek help from a phone helpline. Young people are growing to recognise and access sources of support when they need them, reflected in the Student Counselling Service’s year-on-year increases. And if we calculate distress based on suicide, we see that rates of suicide in Ireland have fallen in recent years, according to the National Suicide Research Foundation. These rates are not reflective of a student population, but there’s no reason to believe that students would differ wildly from the rest of the country. So why the dramatic spike in emergency need?
Much of the emergency demand may be due to an inability to get appointments in the standard way. If you’re someone experiencing distress, and you’re put on a waiting list several weeks long, then it makes sense that even this waiting alone may distress you further. DeSay recognised the challenges faced by university counselling services, admitting that “there are huge volumes of students availing of these services and they are not able to meet these demands”. Worryingly, the seriousness of someone’s need is often not assessed unless they directly bring it to attention. “No one determines if the student is in crisis, is suicidal, or is simply in need of a brief chat with someone to help get things back on track,” DeSay said. “A student whose issues may have been quickly addressed and the situation controlled could be waiting weeks or months to see someone.” At this point, a small issue may have blossomed into something much worse.
As DeSay pointed out, students may sometimes just need a place to vent, someone to talk to, a brief chat to figure out what’s going on in their own head. Services such as Samaritans and Niteline, both offering listening support, know that this is what many of their callers want. Speaking to The University Times, Aoibheann Maxwell, Niteline’s Public Face for Trinity, explained that their calls cover a varied range of issues: “While mental health issues do feature in a large percentage of calls, it’s also very common to take chatty and upbeat calls”, she said. Students may not need support services solely because they are highly distressed, but because other services aren’t available when they need to talk. According to Rachel Wright, policy and communications manager with Samaritans, their research indicates that one in two people between 16 and 25 feel they have nobody they can talk to. Speaking to The University Times by email, she said that “it’s important that people know that there is somewhere they can turn for support”. While calls to Samaritans have increased by 60 per cent since 2014, Wright warns that this may be due to a new free caller number, making the service easier to access, rather than growing demand.
Online Support Programmes are popular and can help to reduce the demand on traditional one-to-one services and emergency sessions
According to Chuck Rashleigh of TCD’s Student Counselling Service, new ventures such as their Online Support Programmes are popular and can help to reduce the demand on traditional one-to-one services and emergency sessions, which are “increasingly resource-intensive”. Maxwell agreed that launching online listening for Niteline was a vital step that has paid off immeasurably. “With social media and online chatting taking up a huge role in many of our lives, it was important for us to provide our callers with an online platform,” she said. “Sometimes chatting online without the immediacy and intimacy of a voice-to-voice phone call can be more comfortable.”
The public outcry at the €12 million cut to the mental health budget indicated the breadth of the need felt by the sector. Trinity’s Student Counselling Service annually pleads for more resources in its reports. Maxwell admitted that more resources would take the pressure off: “while services like Niteline and Samaritans can provide some help to those with mental health issues beyond office hours, there is only so much we can do”. An increase in emergency appointments likely reflects a sense of helplessness among those seeking support – unable to access standard services, they are forced to resort to alternative means of being seen. The solution to this is not a simple one, and likely involves – as always – more funding. But maybe alternative interventions such as online support and risk assessments can stop issues from spiralling out of control. And by addressing smaller concerns before they grow into larger problems, maybe emergency appointments won’t be as in demand.
