From therapy dogs to walk-in counselling services, Carleton seeks to provide a variety of services to support students’ mental health and well being.
But many students from universities across Ontario have said they have either had difficulties with mental health supports’ intake processes or were unaware of the available resources.
According to some experts, stigma can also deter some people from accessing mental health support. The Centre for Addiction and Mental Health (CAMH) reported that 40 per cent of people with anxiety or depression do not seek medical help because of negative stigma associated with mental health.
These barriers are what Jonathan Friedman is trying to combat with The Journal That Talks Back, an interactive journaling and coaching application.
Friedman’s application acts as a mental health support tool to help users with daily concerns about relationships, career and school through text-based coaching. The application is meant to work in tandem with therapy.
Launched on Oct. 4, The Journal That Talks Back has been developed in a time when the demand for mental health resources from university students has increased. Students are faced with the ongoing challenge of online school during the COVID-19 pandemic and often, the resources offered to those with mental health issues are not enough.
The reasoning behind the application
Friedman worked as a child and youth counsellor in Ontario for eight years and through this experience, he noticed two main deterrents of accessing mental health supports: cost and stigma. He said the COVID-19 pandemic amplified these factors.
“One of the silver linings of the past two years is more and more people experienced isolation and as a result of that, more and more people are starting to talk about feeling low,” Friedman said.
Crisis support staff for mental health resources are overworked, according to Friedman. These resources often rely on volunteers or low-paid positions leading to burnout.
However, these crisis support centres are only short-term supports in a mental health crisis. The long-term support for people struggling comes from coaches or therapists.
As someone who has gone through therapy for social anxiety, Friedman said there are many merits to diagnosis and structured treatments like cognitive behavioural therapy (CBT). According to CAMH, CBT is a form of structured psychotherapy meant to help people identify their thoughts and attitudes, relating them to their reactions. But there is less focus on relationships, career, school, leadership and finances, he said.
All coaches on Friedman’s application are certified through the parent company Frame of Mind Coaching. The client could anonymously journal with their coach every day of the week, pushing a fast and easily accessible coaching process since they can interact more frequently.
However, The Journal That Talks Back is not offering therapy, Friedman said. The application is strictly a coaching app designed as an interactive journal.
“We’re 100 per cent the first people to say that if coaching is not a fit based on certain behaviours, like harming self or others, then we’re the first people to make that referral because ultimately, the client comes first,” Friedman said.
Burning out over Zoom
The launch of the Journal That Talks Back is very timely as the COVID-19 pandemic has put increased stress on mental health care professionals treating students affected by virtual schooling.
Alana Sham, a registered psychotherapist at Your Story Counselling located in Vaughan, Ont., said she noticed her clients had extra difficulties with online learning and adjusting to other education models.
“In a pandemic, there’s just a lot of added worries and fears,” Sham said, which includes concerns about contracting COVID-19 and the safety of at-risk loved ones.
Sham said the feeling of stress is inevitable for most people, especially for students who are under academic pressure.
“Stress is just a huge thing and everyone has their own reason and experience,” Sham said.
While schoolwork can be straining, personal circumstances are often greater reasons for students’ stress. For example, Sham said students who do not enjoy their programs typically struggle more with their courses.
Alex Ferrington, a third-year statistics major at Carleton, said the switch from online to in- person and hybrid learning makes it hard to develop a routine and effective study strategies.
“There’s definitely more the school could do, just because of the challenge that it’s unprecedented times,” he said. “What changes have been made for the changing of the times?”
During the pandemic, Carleton continued to offer mental health resources to its students. Health and counselling services remained open virtually and undergraduate students could still access Empower Me, a confidential and free 24/7 counselling service. International students could also access International SOS’s Emotional Support for help.
Although the services exist, promotion can be an issue. Ferrington said he’s not familiar with Carleton’s mental health support.
“I wouldn’t know where to start looking,” he said. “The fact that the school doesn’t promote any of the services negatively impacts accessibility, but it doesn’t necessarily mean it’s inaccessible. I’m just unaware.”
He said he thinks there are less resources available for students off residence.
“When I was living in residence, I was more aware of what was available, but since not living on res, I would say I have gained little to no information on what exists for students outside of res,” Ferrington said.
Despite resource offerings, some students at other universities said they were met with long and daunting processes to access their school’s mental health resources. These wait times are where Friedman is hoping The Journal That Talks Back can offer some relief.
“Traditionally with therapy, if it’s on a Thursday and you have an anxiety attack on a Saturday, you need to wait,” Friedman said. “[With the application,] you always have a really fantastic coach in your corner.”
Gracie Sun, a second-year medical sciences student at Western University, said she sought mental health support after feeling overwhelmed by stress. Her intake process for mental health support took about two weeks.
“If you’re in a state where you’re questioning if it’s even worth it to ask for help, then it could be difficult to follow through,” she said.
Sun said the long administrative and intake process due to many repetitive forms asking for personal data may deter students from seeking help. But even though her intake process was strenuous, Sun said she still had a positive experience.
“I feel like I got really lucky,” she said.
Annie Li, a second-year health science student at McMaster University, also struggled accessing her school’s mental health resources.
“Mental health is definitely something that is stressed [by McMaster], but in terms of accessing and finding those resources, it is a little bit of a treasure hunt,” Li said.
Like other students, Li sought help after feeling overwhelmed by stress. But she only found tests and quizzes repetitively asking her about her mental health condition rather than offering any helpful solutions.
Ultimately, Li found an Instagram post about Real Campus, a program that offered students flexible virtual counselling sessions. Real Campus terminated its services on Sept. 1. Its services used to be covered by student fees for select post-secondary institutions, including McMaster University, York University and Centennial College.
Li was offered six sessions with Real Campus between January to May 2021. However, one week after she signed up, the number of available sessions was halved.
“It was unfortunate because I was thinking of how difficult it was to find this resource,” she said.
Highs and lows of virtual support
Sham agrees with Friedman that mental health stigma can act as a major deterrent for people who are considering seeking help. She also said a coaching application can be a beneficial and accessible tool.
Along with suggestions and techniques that therapists use in their practice, “a coaching app can provide some psychological education into what an individual is going through,” she said.
Though the application is a useful placeholder while waiting for another therapy session, Sham said it is still best to directly engage with a therapist during sessions. Sham’s one worry is that users will become more dependent on the application rather than resiliency that is typically taught in therapy.
In therapy, the goal is to help the client feel independent and rely on themselves, Sham said. Therapeutic relationships are not day-to-day, so the therapist focuses on providing ways for the client to cope and build self-reliance and resilience.
Sham said she is apprehensive because of Better Health’s failures. Better Health is an online therapy platform where individuals sign up for virtual sessions and are matched with a therapist who fits their profile. A membership ranges from $80 to $110 per week, billed every four weeks.
Sham does not recommend this tool because of data sharing, blurring of professional boundaries since users can message the therapist at any time and low wages for therapists. Therapy sessions are also marked by the word count, so therapists would not be paid for conversations past the word limit.
The Journal That Talks Back does have personal data tracking, but Friedman said it is not for collecting and distributing—it is strictly for the client and coach to view progress over time.
Accessibility through affordability
Individuals can sign up for The Journal That Talks Back through the application’s website. A subscription costs $200 a month. Friedman said $5 of every month’s subscription is added to a pay-it-forward fund for individuals who struggle to afford the application’s services.
According to an article published in the Healthcare Management Forum, private insurance services coverage ranges from $400 to $1,500 annually, which equates to only two to eight therapy sessions.
While it is not currently covered by insurance, Friedman said the company is working with human resources programs and insurance companies to make the application a benefit for employees, as well as reaching out to universities to have its services covered by student fees.
“We want to make sure everybody gets the care they need,” he said. “We’re just another piece of that.”
Featured image from The Journal that Talks Back.
