STUDENT HEALTH & WELLBEING REVIEW
September 2018
Concordia University’s ongoing mission is to support its students and create an environment where they can thrive. According to research, the presence of health and wellness services for students is only one component of a wider strategy for a healthy campus. Resilient communities and a university-wide culture of care have been shown to be most successful ways to promote health, wellbeing, and success in students.
Recently there has been an increase in the number of students requiring mental and physical health support in post-secondary institutions. As part of the University’s ongoing efforts to support the health and wellbeing of our students, President Alan Shepard requested a formal review on student health and wellbeing in 2017. As a Next Generation University with significant research expertise in preventive health, it is important to review and to explore how Concordia can build on its strengths and infuse prevention and wellbeing into the core of its academic operations and services.
This review considers how to build on existing programs and services and identifies new areas in which the University can support student wellbeing to promote a culture of health and wellness across campus.
For the purpose of this review, mental health is considered as a part of overall health and wellness.
Student Health and Wellbeing Review Committee
- Co-chair Gaya Arasaratnam - Director of Campus Wellness and Support Services
- Erik Chevrier - CUPFA Representative
- Josie Fomé - Graduate Student Representative
- Alexis Lahorra - Undergraduate Student Representative
- Sophie Mailloux - Staff Representative
- Co-chair Lisa Ostiguy - Deputy Provost
- Geneviève Robichaud - CUFA Representative
- D'Arcy Ryan - Director of Recreation and Athletics
The Review Committee designed and determined a process which began with meetings in Campus Wellness and Support Services, an environmental scan of other universities, and a review of the 2015 International Charter for Health Promoting Universities and Colleges. The framework developed by Simon Fraser University (SFU) in British Columbia was found to be particularly robust and holistic in promoting student health and wellbeing in Canadian campus settings. SFU’s approach shows that a healthy campus community is created by “the words people speak; decisions that are made; actions that are taken, and the culture and systems that are created” (SFU, “Healthy Campus Community”).
In recognition of Concordia’s primary mission as an academic institution, the Review Committee adopted a holistic lens that would be suitable to a university with a large and diverse population studying on two campuses. It adopted six domains as a framework to collect information for the Review:
- The academic environment
- Concordia policies and practices that support student wellbeing
- On-campus support services related to health and wellbeing
- On-campus opportunities for student personal development (i.e. outside of classes)
- Campus spaces that promote health and wellbeing
- Opportunities for students to connect and interact on-campus
The review process consisted of input from diverse sources including:
a. Subject Matter Experts (SMEs) in Concordia and Montreal
Twelve interviews were held with 30 SMEs from the internal and external community. SMEs met with Review Committee members in order to answer questions pre-identified by the committee. To see a full list of SMEs and interview questions, see Appendix 1 and 2. For a summary of the National Health Survey data, see Appendix 4.
b. Environmental Scan of North American Universities
An external consulting firm, Keeling and Associates (K&A), was engaged to review best practices and innovations in health and wellbeing programing at universities. K&A also examined trends in Canadian and American student health and wellbeing data, and trends in adolescent health data (i.e. the potential health profile of Concordia’s future students).
c. Community Engagement
Concordia’s students, staff, and faculty were invited to attend three Idea Cafés designed and facilitated by Dr. Rosemary Reilly (Applied Human Sciences) and a team of graduate students in the Human System Intervention program. The feedback was summarized in three graphic displays and in summary format. The Idea Café graphic summaries were also displayed at Senate on December 8, 2017. Senators were invited to examine the data from Idea Cafés during the meeting and, indicate their priorities, and offer suggestions and ideas. (Appendix 5)
d. Student Services
Student Services directors informed the Review by contributing information on current services, practices, supports, and emerging data on Student Engagement and Student Success. Directors noticed significant convergence between conceptualizations of “student health and wellbeing”, “student engagement”, “student success,” and “student communication.” The input from different sources included discussions with students, faculty, and staff. The committee reviewed the data from each source and synthesized it into a summary format to inform recommendations for priorities and planning.
This section provides an executive summary of input from multiple sources.
2.1 Interviews with Subject Matter Experts from Concordia and Montreal
A number of ideas were suggested across these meetings to promote campus health and wellbeing for students. For a more detailed summary of the findings, see Appendix 3. The most recurrent were:
-The need to shift away from the “survival of the fittest” mentality in courses to make room for a culture of health and wellbeing to be enacted in classroom and across campus.
-Training is needed for faculty, students, and staff on how to incorporate healthy practice in the post-secondary sector and specifically as part of academic programs.
-Expand Concordia’s existing health related services and partner with external services and groups and programs that promote health and wellbeing.
-Centralize health and wellness information so that students and faculty know what resources are available at the university. This includes greater coordination on health and wellness initiatives across the university.
-Create spaces where students can meet and foster community.
2.2 Environmental Scan of North American Universities
The findings from K&A’s literature review suggested that a good method of promoting health and wellness is training faculty, students, teaching assistants gatekeepers, non-health professionals, and other personnel across campus on supportive conversations so that health and wellness can be practiced at all levels. Their summary also reported that building communities (through peer-to-peer relations, clubs, cross-participation, etc.) is an effective method of crisis prevention and overall health improvements of students. A detailed summary can be found in Appendix 7.
K&A’s trend analysis suggested that Concordia University’s statistics related to health of our students are not far from other Canadian universities, but that the University should be prepared to address an increase in mental health diagnoses, as well as continued care around sexual health and substance use and abuse. A detailed summary of K&A’s trend analysis can be found in Appendix 8.
2.3 Community Engagement
The Ideas Cafés emphasized promoting a community of care and a culture of wellness across campus by building networks, escaping the “survival of the fittest” mentality of in the academic environment, providing spaces for connection and making sure that resources are available, accessible, and effectively communicated across campus. For a more detailed summary of findings for each Ideas Café, including the questions posed and the graphics that were created as a result, see Appendix 5.
The committee met with members of senate to get a sense of priorities on the ideas generated by the 3 cafés. For a list of senate’s priorities, see Appendix 6.
2.4 Student Services
Student Services directors reported both convergence and duplication of efforts to support student wellbeing and health. Shared priorities were identified in the area of promoting services to support holistic student health and wellbeing.
An extraordinary amount of ideas were generated using these four methods. These findings show the most common suggestions. For more detailed findings, consult the appendices. The ideas that emerged from these four methods were considered by the committee in order to compile viable recommendations to improve the health and wellbeing of students.
Following the review of all of the internal and external data, several priorities emerged to enhance the health and wellbeing of Concordia’s students. Recommendations have been put forward in seven areas. Each recommendation is infused with preventive health principles and demonstrates an effort to bring these principles to Concordia’s services and operations through practical, initiatives that have been prioritized by Concordians. To quote an old adage: An ounce of prevention is worth a pound of cure.
3.1 Curriculum and Training
Students, staff, and faculty asked that life skills and healthy behaviors be taught in classrooms and to not assume that emerging adults could or would acquire these skills on their own. The Review also found that students are most inclined towards credit-level courses and that given the University’s strategic imperative to offer “next generation education that is … fit for the times,” that the cornerstone to Concordia’s commitment to student health and wellbeing would lie in education and innovations for a healthy learning environment.
a. Develop curriculum (credit and non-credit) on life-management skills and healthy behaviors that reflect the journey of a student as they transition in, through, and out of Concordia as life-long learners.
i. “Healthy behaviours” course material should include current and emerging health concerns such as anxiety, sleep hygiene, drug use, nutrition, and sexual health. These concerns can have recognizable upswings across a calendar year.
ii. “Life management” curriculum should include next generation skills in communications and inter-personal skills, financial literacy, cultural literacy, prioritization, time management, and emotional intelligence. There is opportunity for greater integration with faculties, PERFORM and Student Success Centre in curriculum development.
b. Create more health related course options that are accessible to students across faculties, with a possible certificate option in health and lifestyle.
c. Create opportunities to support student research and innovation projects in student health and wellbeing.
d. In partnership with faculties and the Learning and Teaching Office, train and support faculty and staff on how to foster healthy environments for their classrooms and learning environment.
3.2 Supporting Services for Student Health and Wellbeing
Since 2012, Concordia has seen a persistent increase in the complexity of mental health concerns. Similarly, requests for academic accommodations for students with mental health-related disabilities have more than doubled across the same time frame. In 2013, a national survey on college health (NCHA), found that stress, anxiety, sleep difficulties, and internet use/computer games[1] were the top four reasons for poor academic performance at Concordia, and if one were to look ahead, on-the-horizon emerging health concerns include sexual health, nutrition and drug use. Taken together, past and current data indicate that today’s student profile is different from its predecessors and that as the profile continues to evolve, so too must Concordia’s approaches to service delivery.
a. Develop a comprehensive plan to deliver mental health services with a Working Group. The plan should consider Concordia’s culturally diverse student population and include the following components:
i. Adequate staff resourcing in Campus Wellness and Support Services to help students receive psychological care and manage their symptoms, and for students with diagnosed illnesses to receive the academic accommodations they need in order to learn alongside their peers without disabilities.
ii. Faculty and staff training to recognize signs of distress and refer appropriately (this includes revisiting the level of contribution to support student services which has not increased in over nine years).
iii. Continued support of Concordia’s work in examining and improving its service delivery models including peer support, drop in service options, and crisis support, as well as careful consideration of our diverse student population and the manner in which they require support.
iv. Partnerships with internal departments within Concordia and external community organizations to maximize access to expertise.
[1] There is collinearity between these factors. For example stress can directly impact the other three, and internet use can influence sleep.
b. Support Concordia’s efforts in building and sustaining inter-unit partnerships in health, allied, and social services in order to promote seamless care across sectors and reporting lines, and explore intersections between practice and health-related research so that practice stays at the forefront of research.
c. Develop more recreational options on campus.
d. Support students in the faculties through embedded health and wellbeing teams to promote access and availability of services and programs.
e. In partnership with units such as Campus Wellness and Support Services and PERFORM, develop programs, and services that promote better student health outcomes through prevention with a focus on the current and emerging health concerns.
f. Strike a working group to examine the impact of social media and internetuse on students and its effect on education and healthy lifestyles. Today’s generation is remarkably different from their predecessors: they were born into a hyper-connected world that has never before been experienced in human history[2]. In the words of one Subject Matter Expert, “We know how to use technology, but not how to live with it.” This working group will have the mandate to develop recommendations for a Next Generation University support for students.
[2] Social media platforms are relatively new inventions. For example, popular sites such as Facebook was launched in 2004, Youtube in 2005, Twitter in 2006, and Instagram in 2010. Put differently, Facebook was around when today’s 19 year-old youth was only 5 years-old. Emerging research has only just begun to point connections between social media and anxiety. More anecdotally, these connections were a recurrent theme during the Review and were discussed at Idea Cafes and underscored at Senate.
3.3 Health Communications
Concordians called for greater visibility of health-related services and programing, citing that they were often unaware of what was available on campus. Students, staff, and faculty also called for an online hub where all health and wellbeing related information, services, and programing could live. In the words of one participant “we only need one place to go to for information instead of a hundred different websites – we’re not going to check them all.” An intuitive, well-designed single “port of entry” will make it easier for Concordians to find information.
a. Centralize all health and wellbeing related information, programs, and services in a single website for easy navigation. Progress on this Review’s recommendations can be tracked on the website.
b. Develop awareness campaigns on health and wellbeing related services and programs on offerings on both campuses.
3.4 Concordia Connections
The physical environment was highlighted as an important contributor to overall student health and wellbeing. Ideas generated from this Review will be summarized and submitted to facilities management team for design considerations of new space that becomes available. The Review identified the need to create opportunities for students to relax, interact, form social connections, and discuss issues of concern to them. Spaces can be facilitated or un-facilitated:
a. Quiet, peaceful spaces (e.g. nap rooms), women only spaces, and support initiaties that create flexible, creative spaces where students can de-stress, socialize and form friendships.
b. In recognition of Concordia’s student demographic which includes many part-time students, we recommend a committee be formed to review programs and services to reflect the needs of our students.
c. Develop recreation spaces for informal connection. Games in the hall atrium, table tennis, chess boards in open areas, and stationary bikes around campus were suggested.
3.5 Policies and Processes
Efforts to promote health and wellbeing require Concordia’s attention to policies and processes – both to areas that may appear self-evident such as health and wellbeing policies, but also to less obvious areas that obliquely intersect with wellbeing but dramatically improve it. During the course of the Review, Concordians spoke earnestly of two key areas that would offer relief: attention to exam culture and to introducing flexibility to student schedules.
a. Examine Concordia’s policies and processes to review support health and wellbeing.
b. Promote awareness on existing Senate policies that limit the number of final exams that students can write in a single day, as well as its policy for no exams or tests in the final week of classes.
c. Introduce a Fall break to help students prepare for exams.
3.6 Student Engagement
The Review unearthed a significant amount of information. It is vitally important that 2017’s efforts in data collection and sense-making are not contained to 2017, but continue into future years so that Concordia’s efforts remain current.
a. Strike a working group through the Concordia Council on Student Life (CCSL) to advise Student Services on health and wellness programing.
b. Create a recreation student advisory group to work with Recreation and Athletics to promote recreation and leisure opportunities on campus.
c. Participate in health surveys and data efforts across Canada.
3.7 Foster a Culture and Community that Supports Student Health and Wellbeing
Students, staff, and faculty often spoke of a desire for a campus community where everyone’s wellbeing thrived, and where everyone looked out for each other’s wellbeing. Our desires suggest an innate understanding that the health and wellbeing of our community is broader than its access to campus health and counselling services. However, in order to impact the overall health and wellbeing of Concordia, a shift will need to be made by the entire community. A culture change is needed to inspire Concordians to adopt a community-centric approach to student health and wellbeing.
a. The effort towards a collective responsibility would be well-served by a statement of commitment to a health and wellbeing of the community. The lack of a unified statement of support in this area was noted throughout the review.
b. A campaign to destigmatize mental health supports and promote healthy behaviors is needed.
c. Recognize the important role that parents play in the lives of their students -- emerging adults who are experiencing their first freedoms.
d. While the review focused on student health and wellness there was an expressed need for a review on supports in health and wellness for faculty and staff with HR in the future.
In an effort to move these recommendations forward, the Committee recommends a five-year project time line with project leads assigned to each priority. See Appendix 9 for a proposed Action Plan. It must be noted that an extraordinary amount of excellent ideas were generated at Idea Cafés. The Committee had the challenging task of reviewing and prioritizing ideas that could produce the biggest impact to student health and wellbeing within five years. Ideas that were not assigned to project leads will be shared with relevant academic and administrative departments for their consideration.
Guided by its nine directions, Concordia University is no stranger to the type of bold thinking and dedication that can revolutionize the academic experience. By drawing on its current strengths in preventive health research and capital fund priorities in health and wellbeing, the University has a unique opportunity to “go the extra mile” and infuse prevention and wellbeing into the very core of its academic operations and services and build a healthy campus community where we can all thrive. It is important to note that over the course of this Review, the Committee found significant convergence between “student health and wellbeing,” “student success” and “student engagement,” thereby demonstrating that gains in one area can dramatically benefit the other two, and that the National College Health Assessment underscores the impact of poor wellbeing on academic outcomes such as grades.
Concordia’s efforts to improve student health and wellbeing must be accompanied by a clear action plan to ensure that we deliver on our community’s aspirations. To that end, an Action Plan is included in this report and will have oversight by the Special Advisor to the Provost on Campus Life.