Written by: Naomi Frazer and Anjali Behal
Mental health issues are incredibly prevalent in the post-secondary student population and are only expected to continue rising. In Ontario alone, mental health disabilities in post-secondary students has increased by over 50% since 2013 (1). In fact, youth aged 15-24 are the most at-risk group for mental illness and substance abuse disorders (2). Student mental health is a diverse issue which not only affects the institutions that students are situated at, but society as a whole (1). Mental health disorders can impact an individual’s ability to work and contribute to the economy, in addition to increasing health expenditures and straining social services (1). Mental health issues often lie hand-in-hand with physical health concerns, as people with mood disorders are much more likely to also develop a long-term physical health condition, and vise-versa (2). Consequently, we can see that directing focus towards the population of university students is important when discussing mental health resources, treatments and support.
A question commonly asked by others is why exactly do students and youth experience mental health challenges more so than adults? While it’s still not entirely clear, there have been many speculations and theories addressing this important question. First, certain cultural trends such as an increase in social media and digital communication could contribute to the increase in mood disorders seen in younger generations (3). Research shows that electronic communication and social media can largely affect social norms and social interaction which could play a role in mental health issues (3). Another reason that post-secondary students can be seen as more vulnerable is due to the fact that the transition to an institution which houses individuals with diverse cultural backgrounds, identities, and experiences can be a challenging adjustment (4). Academic difficulties as well as being separated from family or support systems can affect an individual’s ability to cope with negative thoughts (4). Many students then find themselves immersed in a campus culture that fuels loneliness and perfectionism (4). These factors create a complex web that needs to be deconstructed when talking about mental health specifically within the demographic of post-secondary students.
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Gaps in McMaster’s Care
At McMaster University, there are several mental health support services available to students, however, many barriers to access still exist. McMaster’s healthcare hub, the Student Wellness Center (SWC), pledges to “provide health care and support to enhance the emotional, physical, and personal wellbeing of McMaster students” (5). We reached out to the SWC via email to ask them more about their services. They graciously provided us with up-to-date information about how their services are offered based on a pathways system which directs students to the type of mental health care they may need, including workshops, group programs or counselling services. The SWC initially works based on a triage system which prioritizes students with urgent needs so that they may see a counsellor within a day or two (6). There are over 60 triage appointments per week to accommodate students, including evening appointments which makes accessing services easier. First, there is an initial evaluation and then the student will receive a referral for individual counselling, group counselling or another avenue of support. In this sense, the students do not face a traditional wait time because they are referred to support right away, however, the student may be asked to follow-up. Follow-up appointments become inconsistent, as they can vary between two to six weeks, introducing a wait time (6). This triage system, while important in prioritizing those who need it most, can leave out those who may not be as “urgent” in the eyes of the system. Students who do not require immediate services may be required to wait for a counseling appointment due to the incredibly high demand of mental health services that of the SWC (6).
The SWC is considered to be a primary care facility (5,6) which means that it focuses more on day-to-day basic health care services as opposed to a secondary care facility which offers regular and specialized appointments with professionals such as psychiatrists (6,7). While a primary care facility is definitely considered a necessity, it may not be the best when treating mental health conditions. This is where a secondary care facility may be more appropriate and beneficial because frequent follow-ups are necessary for the overall treatment of mental health conditions as well as to meet the needs of every individual who is attempting to access services (8). Another barrier that exists in accessing mental health support through McMaster is that academic faculty and counsellors or primary care staff are often not on the same page (6). Faculty members are not trained to identify students who present with emotional problems and therefore, they may label the student as “lazy” or “withdrawn” instead of supporting the student and referring them to appropriate services (6). This allows students to fall through the cracks. Lastly, the SWC faces restrictions in their budget, especially considering the high volume of people requiring access to their services (6). Consequently, these barriers make it incredibly difficult for students to access high-quality, consistent mental health care. Integrating avenues to support, such as utilizing an approach that combines community care and music therapy, can be considered to help overcome these obstacles.
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Combating Mental Health Challenges among Youth through Music Therapy
Music therapy (and in this case particularly community music therapy) is an under-utilized but extremely promising option for combatting the challenges that students face when in need of mental health services. There is a lack of research focused specifically on music therapy for maintenance and improvement of mental health, and an even bigger gap in research within the context of support groups or community mental health care specifically within the youth and young adult population.
Within the university setting, there is a high prevalence of loneliness and feelings of isolation among students, especially at large institutions such as McMaster University (4). The competitive and isolating environment of academics takes a serious toll on one’s mental, emotional, social and spiritual health. Community music therapy is an evolving approach in the domain of music therapy, aimed at addressing the larger “cultural, institutional and social context” in which a broader group of people and their situations are taken into consideration, as opposed to each individual separately (9). In the words of Evan Ruud, “A community music therapy talks about how to humanize communities and institutions, it is concerned with health promotion and mutual caring” (9). In this way, the individual is not separated from their environment enabling a unique form of mental health care can take place in which the broader context of a university student’s experience is understood and taken into account. Community music therapy would then be able to connect students sharing similar experiences, potentially reducing feelings of isolation and loneliness by fostering a community of support through music.
Given the high prevalence of mental health issues among this population and the lack of current research available, there is a need for academic literature to explore the potential of integrating music therapy on a wider scale into the mental health resources available to university students (1). Currently, the gears are shifting at McMaster University in this direction, where research projects and studies are in the works, under the direction and supervision of Rachael Finnerty.
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What’s happening at McMaster University?
Rachael Finnerty, RP MMT MA MTA Founder of the Music Therapy Academy and the music therapy courses at McMaster commenced her first year of her PhD at McMaster University in the Department of Psychology, Neuroscience & Behaviour (PNB) under the supervision of Dr. Laurel Trainor. Rachael’s thesis will focus on developing Community Music Therapy as proactive approach to mental health care among university students at McMaster University. Through a randomized controlled trial (RCT), the stress and anxiety levels of students will be measured to assess whether music therapy could provide an option of mental health care for future wide-scale implementation. If results show that music therapy is a promising option for mental health care in students then wide-scale implementation of this could also help to combat some of the existing obstacles that McMaster currently faces, such as the sheer number of students attempting to access services.
Secondly, Ritika Arora, a Level IV Bachelor of Health Sciences student, is currently working on her 4th Year Thesis Project under the supervision of Rachael Finnerty and focusing on the same topic of the effect of community music therapy for anxiety and stress, but will be conducting a pilot study that will help inform Rachael Finnerty’s RCT. This non-randomized quasi-experimental trial will involve drop-in community music therapy sessions for the experimental group, and group verbal sessions through Open Circle McMaster for the control group. In order to measure stress and anxiety levels, the State-Trait Anxiety Inventory (STAI) test will be completed before and after each session by the participant, to compare any differences in stress levels across groups. Of course, some feasibility issues will have to be considered when conducting this study, such as attendance levels of students and whether students will continue attending the sessions on an ongoing basis. Through understanding both the successes and areas of improvement through the pilot study, this will provide a helpful framework for Rachael Finnerty when conducting her RCT. The long-term goal will be to implement a functional structure for community music therapy sessions at McMaster University, as a method of addressing the gaps felt within the mental health care system, and act as a preventative measure that can be applied across universities and young adult populations.
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Concluding Thoughts: What’s next?
Due to the overwhelming prevalence of mental health challenges and illnesses among the university student population, there is a pressing need to search for pro-active and alternative methods of care that students may access more readily and frequently (1). Music has the incredible power and ability to connect us, ground and re-center our mental well-being and provide therapeutic benefits that affect our physical, mental, emotional, social and spiritual domains of health. As such, community music therapy shows promise as a safe and supportive environment for young people to bond with peers while receiving care with the aim of reducing their individual stress and anxiety levels, hopefully resulting in a positive impact on their overall mental health and wellbeing. Through the research currently underway at
McMaster University, more details as to the potential applications of community music therapy within university settings will be discussed and brought to the table when discussing mental health. Ultimately, the long-term goal will be to bridge the gaps in mental health care among the university population, so that youth and young adults are able to access the resources that they need and be provided with proactive tools for self-care. Music therapy holds a lot of promise when combined with other mental health care approaches and resources. We look forward to understanding the future applications as a step towards prioritizing proactive mental health care.