By: Lubaba Mahmud, Staff Writer

What might students expect when they make a mental health appointment with SFU Health & Counselling? The Peak had a chance to conduct an in-person interview with Martin Mroz, Director of SFU’s Health & Counselling Services, and Tammy Nazaruk, Associate Director of Health Services, to talk about the mental health services that the clinic provides. 

Nazaruk explained that there are many factors that may intimidate students about seeking help for mental health. The stigma attached to mental health, which may be stronger in some cultures than others, is a crucial one. She also noted that it takes a lot of courage to discuss one’s vulnerabilities in a counselling session, and that developing a trusting relationship with a mental health professional may take time.

Health & Counselling makes a continuous effort to erase the stigma attached to mental health issues. 

“Our health promotion team works on trying to improve setting around the university to foster well being and eliminate unnecessary stress.” said Mroz. He also pointed out that a student initiative called HI-FIVE, which focuses on eliminating stigma attached to mental health by encouraging the values of compassion and respect, originated from the clinic.

Mroz expressed that Health & Counselling aspires to “make care about the client.” Their philosophy is to recognise that barriers to wellness may come in many different forms, and that they may not always be obvious. They try to work with the clients to understand what sort of care they need. 

After talking to Mroz and Nazaruk about barriers to accessing care, we spoke more at length about how students can start their mental health journeys at SFU Health & Counselling.

The Peak: I want help with my mental health, but don’t know where to start — where should I go first?

Health & Counselling: Talking to an Access Case Manager would be a good starting point. They can have a conversation around what’s going on with [students], and then help to determine the best avenue to go — whether it’s a referral to a doctor, a counsellor, or another mental health specialist. [They also help with] choosing resources like workshops and [The Student] Learning Commons. It’s all pretty individual. The best thing to do is to reach out. We implemented My SSP as a way to increase access, for people to reach out to a professional 24/7. It has information on services we provide. [It also] creates a lower barrier for someone not comfortable talking about mental health in English. 

P: How can I make an appointment with an Access Case Manager?

H&C: Same-day access is available [in the clinic]. 

P: Who is eligible for mental health services?

H&C: All SFU and FIC students, whether they are part-time or full-time, are eligible for mental health services. In some cases, if a student is taking a semester off, and they’ve been seeing us before, they can still make appointments with us. However, if the student is taking time off of university for a long time, we encourage them to seek care within the community.

P: If I am on the waitlist, how long will it usually be until I can see a mental health professional?

H & C: It varies and depends on what [you’re] looking for. If [the client] is suicidal, hearing voices, recently assaulted, or homicidal we’ll try to see them right away. We save a lot of appointments for same-day access, but they do get filled up quite quickly.

Our name “Health & Counselling” is a little deceiving. Someone may come in for a mental health issue and [automatically assume] that they need counselling. However, maybe they don’t need to see a counsellor, but to talk to somebody right then and there. We’re trying to create [a system] so that they don’t even have to go on a waitlist, but [rather] talk to somebody for 20 minutes and get the [necessary] resources. We’re trying to figure out ways of providing the level of care that’s needed right then and there. [On the other hand] if somebody comes in and they insist on seeing a counsellor [to work on a particular issue], then they will go on a waitlist.

P: Would my parents/guardians know I’m seeing someone/a professional at Health & Counselling?

H & C: No. [The] only time confidentiality is broken, is [when there is] imminent risk to self or others, [or if there are legal issues] like an ICBC claim — in the latter cases a conversation between physician and student would take place, and only information pertaining to that will be revealed. We might not know what the situation is in [student’s] home, and by sharing we can do a lot of damage. Sometimes family can be part of the solution, and hopefully we can work with the student if that’s the case.

P: Do all three campuses (Burnaby, Surrey, and Vancouver) provide counselling services?

H & C: All three do. In Surrey, we don’t have a physical clinic because we don’t have a doctor there. There is a conversation about providing equitable services at all campuses and trying to create better access.

P: What can students expect on their first mental health appointment?

H & C: It depends on what you’re coming in for. If you’re coming in for counselling [because] you have an issue that you want to start talking about, say, your relationship with your parents makes you unhappy and you want to work on that, you can expect to come in and fill out some paperwork and start from there. If you came in feeling like you’re in panic and you don’t know what to do and you’re highly escalated, then you should expect to have somebody that would try to calm you down. On the form, there is a ‘reason for visit’ section which helps providers to begin conversation.

P: There are different types of mental health professionals available in the clinic, like psychologists, mental health nurses, and clinical counsellors. How do the services they provide differ from each other?

H & C: [The] Access Case Manager is the first person to see to have that conversation. They can clear the understanding of what it is [you’re] looking for and help you get into the right avenue.

A counsellor is somebody you see for a period of time to work on something you want to change or improve in your life. That’s more therapy-based. 

Mental health nurses do more practical things. They would be seeing students who are identified in our forms as “going through crisis.” Sometimes they can be referred back from a provider/doctor to talk about tips around sleep, hygiene, stress management, or side-effects of medication. If the client is recently diagnosed, nurses can give them a description about their diagnosis.

Doctors can diagnose mental health conditions and prescribe medication. People might never think to see a counsellor or see somebody for mental health reasons, but they might see a doctor for physical symptoms like sleep issues, pain in chest, weakness in legs, etc., so the doctor may recognise signs of anxiety or depression. They will work with the client to make a care plan that is appropriate. They may continue to see them if the patient doesn’t want to see a counsellor, and the doctor might provide some counselling in the exam room [if necessary].

P: How frequently can I see a mental health professional?

H & C: Depends. It might be every other week. Somebody might be seeing a counsellor but have regular check-ins with a mental health nurse. They might be able to see a nurse during the time they’re waiting for the counsellor.

P: How can I get follow-up appointments with the same person?

H & C: You can book when you’re about to leave, or you can call, or drop by anytime we’re open.

P: Can I change my counsellor if they are not a good fit for me?

H & C: Yes. Getting a counsellor should be like trying out shoes. That’s one of the reasons why we got My SSP. You can get one-on-one counselling and multi-session counselling. It was designed for an international student population, so you can get it in a lot of different languages and you can get counsellors from different cultures.

P: How can I evaluate whether the treatment/counselling is working?

H & C: There are some tools we use in the clinic that assess anxiety and depression. It would also be a conversation between the student and counsellor around what’s going on, and making note on that each session — [like] where improvements are and what areas they struggle with. We use PHQ-9 (Personal Health Questionnaire with nine questions) to assess depression and GAD-7 (Generalized Anxiety Disorder questionnaire with seven questions) to assess anxiety. Forms may be part of the session. Sometimes doctors can ask you to fill it online while they leave the room, or the clinician may have a conversation with you while filling out the form.

Throughout the interview, Mroz expressed that Health & Counselling strives to provide the best care that they can. 

“It’s heartbreaking to hear people coming in trying to access care [but] they [might] not know how to advocate for themselves or they don’t know what they want [yet]” said Mroz.

“With limited resources, we want people’s experiences in Health & Counselling to be positive. They might not necessarily get what they want, or what they thought what they wanted when they came in, but we want them to leave with the feeling that somebody cares.”