The news today in the UK is that nearly a quarter of young women have mental health problems – Here.
A similar message appeared in this article from New Zealand a few days ago – Demand for university counselling services grows 25 per cent in two years – the text without photos and videos is below.
North or South
University students say they are on suicide watch for friends and flatmates as demand for on-campus counselling grows. One in 13 university students – 13,000 in total – accessed campus counselling services last year, nearly a 25 per cent increase on the 10,500 who used the services in 2015, according to data released to the New Zealand Union of Students’ Associations (NZUSA).
Universities have increased their offerings in response: Waikato University recently recruited a full-time mental health nurse, Lincoln has enlisted a GP to develop a wellbeing strategy, Otago University hired three clinical psychologists in a restructure of its student health service, and a University of Auckland spokeswoman said it added two positions to its student wellbeing team “due to the growing need for support”.
A recent NZUSA survey of 1762 students found a third waited more than two weeks for a counselling appointment. Wait times range from two to five weeks at Victoria University, are about three weeks at Canterbury University, one week at Waikato, or under a week at Auckland. Otago University was “delighted” not to have a waitlist “for the first time in our recent history”, a spokeswoman said.
All universities offered same-day “crisis” counselling sessions – some students said they felt they had to exaggerate their distress to get a timely appointment.
Several students spoke to Stuff under the condition of anonymity about their difficulties accessing help after public providers rejected referrals from university counsellors.
University counsellors can refer complex cases like eating disorders, post-traumatic stress and suicidal thoughts to district health board (DHB) specialists. Official Information Act requests to five DHBs in university regions for the number of referrals were unsuccessful, as most recorded the referring GP rather than the university health centre.
Students said they were routinely supervising friends to keep them from harm – or that they were the ones being cared for.
“Pretty much all my friends have been through the exact same thing … It’s got to the point where we’re all having to take care of each other,” one student said.
She claimed she was pressured to discharge herself to her hall of residence during three suicidal presentations to Wellington Hospital’s emergency department. The responsible DHB, Capital and Coast, said patients and their assessors agreed upon a “crisis resolution plan” before discharge.
One crisis team worker “kept telling me ‘no-one feels happy all the time’. I’ve even been told [by hospital staff] ‘you haven’t tried to kill yourself yet, so we don’t think you’re going to’,” the student said. She attempted suicide for the second time in March.
“Feeling dismissed and not taken seriously by professionals has put me and so many others that I know off of seeking help when we desperately need it.
“It can be really hard if you have a friend who’s suicidal and you’re in the middle of exams but you’re the only help they have.”
Universities New Zealand (UNZ) chief executive Chris Whelan said institutions’ counselling spend – up from $14.9 million in 2013 to $17.3m in 2016 – had failed to keep pace with what the organisation called “a here-and-now tsunami of need” in its submission to a Government mental health inquiry. Universities had become “a substitute for underfunded community mental health services”, it claimed.
Massey University had experienced the biggest jump in demand for counselling since 2015 (69 per cent), a “difficult” situation its student president, Ngahuia Kirton, attributed to greater willingness to seek help.
Victoria University had the most students accessing counselling, at nearly 10 per cent. Students’ association president Marlon Drake said demand was so high that “we have students choosing not to see a counsellor because they do not want to take somebody else’s session”.
“In Wellington, we have a really high cost of living. It’s a university where students have moved away from home. All those support systems they used to talk to, that’s all gone and then [there is] this new environment in this highly transformative part of their lives,” Drake said.
The students’ association was “constantly lobbying” the university to change its academic practice to alleviate pressure during exam time. “It makes no sense if you’re a student taking four or five papers that you have all those assessments lined up at the same time. It’s just unnecessary.”
Victoria University psychology professor Marc Wilson said it was possible the growing demand for services was fuelled in part by more willingness to seek help.
However, research indicated stress, depression and anxiety among students was growing – problem behaviours related to those disorders were up “perhaps as much as 10 per cent”.
“The pressures are the same, but they are bigger,” Wilson said.
“Where it might have been possible in years past to work a couple of days to pay your rent, you now have to work three, and that is time from study. Time [away] from study adds stress because you’re spread too thin, and it becomes a vicious cycle.”
Youth mental health expert Dr Sue Bagshaw said anxiety and depression have become a global concern as our brains struggle to keep pace with technology-driven lifestyles. The World Health Organisation estimated close to 10 per cent of the world’s population was affected in 2013, a nearly 50 per cent increase since 1990.
Common mental disorders are “more obvious” in young people because the amygdala – the part of the brain that processes emotion – is still developing its responses to stress, Bagshaw said. Past trauma can accelerate its development, but many people’s don’t develop fully until they are about 25 years old.
“For university students demands are high in terms of the cost. If you fail, it’s not just pride – it’s a hell of a lot of money,” Bagshaw said.
Students said self-medicating with alcohol and marijuana was common, particularly during periods of high stress.
“If it’s exam time the doctor might be booked and then some of us might not get our medication,” one Victoria University student said.
A Facebook group guided that student towards a psychiatrist known for prescribing ADHD medication after an initial appointment with a different, private doctor cost $400 . The waitlist for a publicly-funded ADHD assessment is seven years long, according to UNZ.
The student conceded seeking medical advice online was “pretty dangerous” but said it was the only affordable option.
UNZ has claimed students who arrived at emergency departments with mental health concerns waited up to 10 hours for help, while others were put at risk by being sent back to their university halls.
A 2017 Massey University graduate said she became police and hospital support for a friend with bipolar disorder. She took her to the emergency department during multiple manic-depressive episodes, where they would wait up to six hours overnight to be seen.
Once, she helped crisis team staff coax her friend out of an emergency room bathroom when she “freaked out” and locked herself inside. “It just becomes sort of a normality,” she said.
Another 21-year-old student said her partner force-fed her medication during depressive episodes.
“I try to hurt myself or pull out my hair or run away … It’s not really something a partner should have to do, especially at this age.”
A DHB psychiatrist prescribed her anti-psychotics but warned her away from the waitlist for therapy, she said.
NZUSA wants Health Minister David Clark to expedite a promised $10.5m initiative to provide free counselling to under-25s.
In the meanwhile, students’ associations are focused on harnessing the “empathy” apparent in the student population, he said.
“Sometimes reaching out to a friend might be the difference between them having a good day or a bad day, dropping out of university or staying, or in the worst case losing their life.”
[Aside from the ludicrous Stuff about amygdalas this article is fairly standard].
Emotionally Unstable Personality Disorder
As sure as eggs are eggs, most of these students, especially the women, will be diagnosed as Emotionally Unstable Personality Disorder. A very large proportion of people hitting mental health services – from N Zealand to the USA get this label today.
Tons of doctors and others ask me – what is this Emotionally Unstable Personality Disorder, which seems to have come from nowhere and now seems to be applied to so many?
It used to be called Borderline Personality Disorder in DSM III
“characterised by a pattern of unstable and intense interpersonal relationships, impulsiveness, recurrent self‑mutilation or attempted suicide, frantic efforts to avoid real or imagined abandonment and marked and persistent identity disturbance and a generalised sense of boredom and emptiness”.
Before DSM III, it used to be called Hysteria. Here is Sydenham in 1681:
“the very slightest word of hope creates anger… They have melancholy forebodings. They brood over trifles, cherishing them in their unquiet bosoms. Fear, anger, jealousy, suspicion and the worst passions of the mind arise without cause… there is no moderation. All is caprice. They love without measure those whome they will soon hate”.
For millennia, men looking at this have seen the wandering uteri of women, or their weak nervous systems or their organic mendacity.
The exception was Jean-Martin Charcot who in the 1870s said that men could become hysterical too. No-one paid any heed to him. This idea was as incredible as if he had said you know men have uteri too.
Forty years later, men were becoming hysterical in their tens of thousands on the Western Front, while women were running the hospitals and doing the surgery in Britain and Germany – until Armistice Day when men were restored to their rightful place.
His teria topy
A woman diagnosed as hysterical by a male doctor today might well have a case to take a lawsuit against him or the services. Certainly there would be a case to take to the Regulator or others to get a medical record doctored to remove this slur.
There is no substantive reason why exactly the same rules shouldn’t apply in the case of a diagnosis of Emotionally Unstable Personality Disorder.
The defence in such a case would likely be that there had been suicidal behavior – but this will almost certainly have followed the prescription of a psychotropic drug. I get to see many completely normal women diagnosed with EUPD following an antidepressant induced suicidal event.
It would be fascinating to see if women diagnose other women with EUPD as often as men do.
But the bottom line is that when society is distressed, its individuals are more likely to attract meaningless diagnostic labels of the mental health sort.