Key Learning Points

This training opens up the conversation about mental health to increase understanding and reduce negative stigma surrounding mental illness. Key learning points of the training include the following:

• We all have a role to play in supporting our own and each other’s mental health.
• We can learn ways to foster and maintain good mental health.
• It’s important to understand the differences between mental health, mental distress, mental health problems, and mental illness.
• International students and students who are marginalized and/or racialized may face more barriers to accessing mental health supports.
• Talking openly about mental health and mental illness as well as being thoughtful about the language we use helps destigmatize mental illness.
• There are many strategies for coping with stress.
• We can learn and model effective ways to seek support for our own mental health or mental illness.

Practical Considerations for In-Person and Online Sessions

To prepare to facilitate this workshop, consider the following:

• Read through the Facilitator’s Guide and handouts to familiarize yourself with the content. You may want to download and print the guide as a PDF file.
• Download the slide deck and make any needed modifications.
• Prepare to give a territory acknowledgement to open the session. Also consider ways in which to Indigenize the content. (See Indigenous Considerations.)
• Determine how you will share handouts and other resources. You may want to print out and share during in-person sessions and share the links in the chat for online sessions. You may want to share Handout 1: Wellness Wheel with students ahead of the session and ask that they review it beforehand. Handout 3: Supporting Other Students: Mental Health Resources is a fillable PDF so you can customize it with your institution’s contact information prior to the session.
• Think about which scenarios you want students to discuss. Handout 4.1 has just the scenarios (no responses); Handout 4 has the scenarios with suggested responses. There are 11 scenarios to choose from, but it’s unlikely you’ll have time to cover them all.
• There are two videos you may want to bookmark (and have ready to play in a browser) prior to offering the session: Why Stress is Good for You (Scientific American ) (2:32 min.) and Brené Brown on Empathy  (2:53 min.)
• Think about how many participants you expect will attend. The guide assumes a small to medium number of participants (approximately 6 to 30); if your group is very large, you may need to modify some of the small group and reflection activities.
• Add relevant examples and additional insights that are based on your own experience or that are relevant to the student population at your institution.
• Think about the international student populations at your institution. Are there specific cultural differences to consider? For example, in some cultures, such as South Asian cultures, mental illness is still very much stigmatized, and students may be uncomfortable talking about it. A great resource about the mental health of South Asian students is The Pardesi Project. Keep in mind that the mental health words we use in English may not exist in other languages as mental health is rarely discussed in some cultures.
• Consider providing participants with group guidelines prior to the session so people can prepare and create guidelines together. This will save time during the session. (See Group Guidelines for more information.)

Know the Procedures and Contacts at Your Campus and in Your Community

• Become familiar with who to notify at your campus if a student is concerned about another student. For example, does the student contact counselling services? If they’re a residence assistant or teaching assistant do they contact their supervisor? Is there an alert form they should fill out? Who do they contact in an emergency? The procedures may vary from institution to institution.
• Consider which resources, procedures, or policies at your institution are relevant to helping students who need assistance.
• Find out what on-campus and community resources are available that support student mental health, or create your own contacts sheet to share with participants (or have a website ready for viewing on-screen).

Preparing for an In-Person Session

You will need the following:

• Laptop
• Projector
• Flipchart or whiteboard and markers
• Handouts
• Handout from your institution with contact information for student supports on campus

Preparing for an Online Session

• Schedule a meeting time in a video-conferencing program.
• Check that the screen-share function is enabled for sharing slides.
• If using chat or breakout rooms, check that they are enabled.
• Share the meeting link and any passwords with participants prior to the session.
• Consider sending the meeting information at least twice, including once the day before the session. You may also want to share suggestions for online meeting etiquette for creating a safe learning space (i.e., sharing supportive comments, respecting confidentiality, etc.).
• Consider asking someone to be the monitor responsible for responding to technical issues and questions posted to the chat.
• As noted above, make sure you have a plan for distributing any resources, such as handouts, online. Remember to let participants know how and when they can expect to receive these resources.

Working in small groups online

If your video-conferencing software allows you to create breakout rooms, you can have people work together in smaller groups. Take some time before the session to get comfortable with the breakout room set-up process. It can be helpful to have someone assist you with setting up the breakout rooms, so you can facilitate the session while they handle the technical issues.

Breakout rooms will work well for discussing the scenarios, but you will want to do some advance preparation. It may be easiest to put the scenarios in the chat, so have the scenarios ready to add to the chat prior to the session. During the session, you can then assign each group to a specific breakout room to discuss the different scenarios. Alternatively, you could move people into breakout rooms and then visit each room to verbally provide a scenario to each group.

Text Attributions

• This chapter by Barbara Johnston and Liz Warwick is licensed under a CC BY 4.0 License.

Developing and delivering training on mental health can be an opportunity to build on existing work at your institution toward Indigenization, decolonization, and reconciliation.

Territory Acknowledgement

Acknowledging the Indigenous Peoples on whose traditional lands you live, work, and study is an important way to begin an event or meeting and can be included as part of classroom activities and taught to students. Meaningful territory acknowledgements allow you to develop a closer and deeper relationship with not only the land but the traditional stewards and peoples whose territory you reside, work, live, and prosper in. For more information on giving a territory acknowledgement, see Opening the Session.

The Truth and Reconciliation Commission’s Calls to Action explicitly state that each of us as members of Canadian society have a direct responsibility to contribute to reconciliation; how we discuss colonization in relation to mental health is a direct response to that responsibility.

The United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) is an international instrument adopted by the United Nations on September 13, 2007, to enshrine (according to Article 43) the rights that “constitute the minimum standards for the survival, dignity and well-being of the indigenous peoples of the world.” UNDRIP was adopted by the government of British Columbia on November 26, 2019. Centring the history of colonization as a background to and framework for mental health is in direct response to our legal and moral obligation as members of Canadian society.

Curriculum Development and Indigenous Ways of Knowing and Being

Indigenization is a process of naturalizing and valuing Indigenous knowledge systems. In the context of post-secondary institutions, this involves bringing Indigenous knowledge and approaches together with Western knowledge systems. This benefits not only Indigenous learners but all students, staff, faculty, and campus community members involved in or impacted by Indigenization.

As you adapt this training for your particular context, consider how and in what ways you might interweave Indigenous content and approaches. Here are some examples of how you might include an understanding of Indigenous ways of knowing and being:

• Incorporate Indigenous pedagogical approaches, such as holistic and relational perspectives, experiential learning, place-based learning, and intergenerational learning.
• Involve Indigenous students, faculty, and staff in reviewing, adapting, and evaluating resources.
• Integrate knowledge from Indigenous communities local to your institution.

As you do this work, as an Indigenous or non-Indigenous person, you will want to continue to draw upon and build on existing relationships with Indigenous people, both within and outside of your institution. As a way of continuing to work in intentional and respectful ways, you may want to reflect on questions such as these:

• How does this work benefit Indigenous communities and help them to meet their goals?
• Will there be benefits for Indigenous students, faculty, and staff?
• Have the community or communities identified their own priorities or goals related to this work?
• How can this work support Indigenous efforts related to healing from past and ongoing colonial violence?

Elders and Knowledge Keepers

Elders have always been the foundation for emotional, social, intellectual, physical, and spiritual guidance for Indigenous communities. As you find ways to naturalize Indigenous context, perspectives, and traditional ways of being in your training, we recommend that you consider inviting an Elder or Knowledge Keeper from your local community to support your sessions. One way of doing this is to speak with Indigenous student services staff at your institution, share with them some of the recommendations in this guide, and see how they might wish to support this work.

Not all institutions will have an Elder in Residence, but each should have ways for you to contract an Elder or Knowledge Keeper to come in and support your work. Elders and Knowledge Keepers often support the whole post-secondary institution community, not just the Indigenous students. Involving Elders and Knowledge Keepers can help support reconciliation by helping to build respectful, reciprocal relationships that are deep and meaningful.

Whenever you plan to bring in a community member, Elder, or Knowledge Keeper, it is important to plan for the honorarium required to remunerate them for their time and for sharing their wisdom and traditional teachings. In many communities, it is seen as most respectful to offer payment on par with what you would pay a Ph.D. holder to do a keynote presentation. However, consulting with the Indigenous services staff at your institution on what is a typical amount for this type of event is also a good practice.

Text Attributions

• This chapter is adapted from Consent and Sexualized Violence Training and Facilitator Guide: Preventing and Responding to Sexual Violence in B.C. Post-Secondary Institutions, by the Sexual Violence Training Development Team (CC BY 4.0 License).

Creating a Safe Learning Space

Participants need to feel comfortable, safe, and respected during the training. We discuss several strategies for helping to create a positive learning space. As you prepare to facilitate, you will want to consider factors such as when and where to hold the session, key messages on promotional materials, whether to use group guidelines, how to ensure diverse representation, and ways of working with co-facilitators or guests. If possible, having a co-facilitator or someone to assist you during the presentation can be very helpful. If a student is triggered and needs to leave the session, a co-facilitator or helper can follow up with the student.

Opening with Intention

Facilitators have an enormous role to play in setting the tone for a session. As people enter the space (online or in person), you can welcome them and help them get oriented. You can let them know if you’ve started or whether you’re waiting for a few more people and share housekeeping information, such as where the bathrooms are, where they can put their things, or how to use online interactive features. You may want to consider using a breathing exercise together or an icebreaker activity to help put people at ease. As you begin the session, you can use opening questions that help create inclusivity, such as correct pronouns, check-in questions, or information about accessibility needs and requests.

Scope of the Session

It is important to hold space in a session for people’s feelings and experiences – shared or not. However, boundaries are also needed to enable the training to move forward and be completed within the stated time frame.

It is important to establish at the beginning that the training is a learning space and not a counselling session. (You may also want to send an email to all participants with this message prior to the session.) If a participant is starting to take over the discussion with their personal experiences, you can gently redirect the conversation back to the material that you need to cover. It is a good idea to stay after the session is over to talk to any participants one-on-one.

It’s also important to provide a clear scope to reassure participants who worry that they must “save” a student who is in distress. Emphasize that students are not expected to be counsellors or “fix” a student who’s experiencing mental health problems.

What This Session Does Not Include

This session does not include content on suicide, which is a very serious issue that requires more in-depth training. This training also doesn’t focus on how to recognize and support a student struggling with substance abuse and addiction. Substance abuse and mental health are closely linked, but this topic is beyond the scope of this foundational training.

Participants who have concerns about a student who is suicidal or abusing substances should consult a counsellor – or call 911 if it’s an emergency. The “Helping Other Students” section of the guide provides information on how to refer another student to campus and community resources.

Group Guidelines

It can be helpful to ask participants to agree to a list of guidelines or a code of conduct when they register or sign up for the training. You can either send the group guidelines to participants before the session or you can take some time at the beginning of the session to establish the guidelines together.

Or, you might share a list of guidelines at the beginning of the session and ask participants if they feel comfortable with them or if they have something they would like to add or change.

Group guidelines can be an important tool for supporting safer discussion about difficult topics. You can remind participants of the guidelines if the discussion is getting difficult. Important group agreements relate to listening to and showing respect for others (e.g., not talking when others are speaking, not making rude comments, not talking on the phone), confidentiality, and participation.

Group guidelines come in all shapes and sizes. Some groups have a few guidelines, while others have many. Here are some suggestions for possible guidelines:

• Share the learning, not the names or the stories (confidentiality).
• Participants have the right to “pass” on activities/questions that feel uncomfortable.
• It is all right to feel uncomfortable or not to know answers to everything.
• It is okay to step out of the session at any time.
• Treat others with respect.
• Be mindful of your language; respect everyone’s names and pronouns.
• Speak for yourself. Use “I statements” to state opinions or feelings.
• Seek to replace judgment with curiosity.
• Take care of yourself.
• Take space, make space (allow everyone a chance to participate).

Content or Trigger Warnings

Content warnings (also called trigger warnings) are statements made prior to sharing potentially difficult or challenging material. The intent of content warnings is to provide learners with the opportunity to prepare themselves emotionally for engaging with the topic or to make a choice to not participate.

Different departments and institutions will have different approaches to content warnings, and this may guide your decision about including content warnings on registration or sign-up forms, in learning materials, and in the learning environment. Here is an example of a content warning:

We will be discussing topics related to mental health in this training. During the training, you can choose not to participate in certain activities or discussion and can leave the session at any time. If you feel upset or overwhelmed, please know that there are resources to support you.

There are a number of other facilitation strategies you may want to consider in addition to or instead of a content warning:

• When discussing difficult content, check in with participants from time to time. Ask them how they are doing, whether they need a break, and so on. Let them know that you are aware that the content is difficult.
• Ask participants to be mindful of their fellow learners during the discussion and remind them that people who have struggled with mental illness may be present in the room (regardless of whether this information has been shared with others).

Trauma Awareness

Some participants may have direct experience with someone close to them who has a mental illness or has taken their own life. There are a number of strategies you can use to help create a trauma-aware learning space.

Before the Session

Before you start facilitating in this area, ensure that you are knowledgeable about receiving disclosures and about available supports and resources on campus and in the community. Some institutions have developed practices such as expedited counselling for participants who might need support after a training session or making intensive crisis supports available for a short time after a training or particular initiative.

To Start

At the beginning of the sessions, let participants know that they have the right and freedom to take care of themselves in a way that works for them. In particular, let participants know that they can leave the room or choose not to participate in an activity. You could say something like “If at any time you feel you need to leave, that’s fine with me. You are empowered to take care of yourself.”

If you feel comfortable doing so, you can share information about grounding activities that may be helpful to participants during the session. Grounding activities, such as breathing exercises, are simple activities that can help people to relax, stay present, and reconnect with the “here and now” following a trauma response – for example, pressing or “rooting” your feet into the ground, breathing slowly in and out for a count of two, repeating a statement such as “I am safe now; I can relax,” or using your five senses to describe the environment in detail.

During the Session

If you do notice that someone has left the group and you suspect that they were reminded of previous trauma by something in the session, follow up with them one-on-one after the session to check in and offer any resources that you think might be helpful to them.

During the session, if the conversation becomes intense or you believe that a number of participants have become overwhelmed or affected by the discussion, it can be helpful to take a break or use an activity that involves the body or movement to help people reconnect with the present moment.

Let participants know that you will be available after the training if they would like to debrief or share their responses to the session or how they are feeling. If possible, schedule at least 30 minutes after a session so that you can be available to participants. If you are delivering the training in an online context, you can let participants know that they can private message or email you.

Participants may need some time near the end of the session to ask questions, share a reflection, or simply sit with what they heard and discussed. If possible, try to ensure that this time is built in at the end so no one feels rushed when concluding the session.

After the Session

Plan to stay after the session to talk to any participants who have questions or concerns they want to discuss. If you are concerned about a participant, ask them if they would find it helpful for you to check in with them later in the day or the following day. You could also ask them if they have a friend or family member that they might find it helpful to speak with after the session. If so, help them make a plan to connect with them (e.g., via phone or text or in person or at a certain time).

Questions That May Come Up and How to Respond

Facilitating conversations about mental health can be challenging. Participants likely bring many different experiences, assumptions, ideas, and worries about how best to support students who are struggling with these issues.

It’s important to create a space where people feel safe and supported so they share and listen to others with respect and empathy. This section offers ideas and tips for creating such an environment, but you also have a time limit within which to present material. It’s important to keep an eye on the clock and know how, and when, to direct participants’ attention to the next topic.

As mental health and wellness affects all parts of our lives, participants may bring up related issues or concerns or they may disclose confidential information about another student. Below are some questions that might come up during the session, with suggestions for responses. The goal is to acknowledge people’s comments, thank them for their contribution, and point them to resources they may find helpful. Then the discussion can move back to the specific topic at hand.

Transitions and Difficult Conversations

While facilitating, you are likely to encounter challenging moments when you may not be sure how to respond. Someone may start to dominate the discussion, or the conversation may shift in a direction that makes you concerned for the comfort of other participants.

Here are some potential responses for bringing participants back to the topic or handling challenging moments:

• This is a really great dialogue, but I would like to bring us back to the topic at hand.
• Thank you for sharing that story. I’d like to follow up with you after the session today if we can save this conversation for later.
• I’m getting conscious of time here. Let’s move on for now.
• Your feelings are important and I want to be able to give you my full attention. Would you like to step out and have a conversation about it? My colleague can continue with the session. (This can work if there are two co-facilitators. If there is only one facilitator, you can suggest continuing the conversation after the session.)
• It’s okay for us to agree to disagree. Let’s move on; I’d like to bring us back to some of the activities and questions we had planned.

Self-Care and Community Care

Self-care and community care are about looking after yourself and those around you. The experience of facilitating a session on mental health can range from satisfying and rewarding to challenging and overwhelming. It is important to make sure that you are able to take the time to take care of yourself and that you are willing to reach out to co-workers, friends and family, or professional support if needed.

After facilitating a session, you may want to check in with a friend or colleague about your experiences and any successes or challenges in facilitating. This allows for time to reflect on issues related to your own mental health, to consider any feedback that you received from participants, and to discuss any facilitation successes and challenges. You might use the time after a session to reflect or use a journal to make notes as a way of processing the experience.

Check-In/Reflection Questions for Facilitators

Taking time after a session to debrief can be a helpful way to care for yourself. Here are some sample debriefing questions:

• What was a positive moment or success in this session?
• How did the participants engage with the different activities? Is there something I want to facilitate or do differently next time?
• Did I or a participant seem to have a response to the material, a shared story, or another participant that was challenging? If so, how was it responded to or resolved?
• Is there something that would be helpful for me to learn about or check with a colleague about?

Mental Health Models: Options for Institutions

The training uses the Mental Health Continuum to show different states of mental health and help participants differentiate between different mental health states.

Mental Health Literacy

Some post-secondary institutions already use what is known as mental health literacy to frame their mental health training and support. Mental health literacy is defined as:

• Understanding how to foster and maintain good mental health
• Understanding mental disorders and their treatments
• Decreasing stigma
• Understanding how to seek help effectively

For more information on mental health literacy, see Kutcher and Wei (2020).

If your institution uses the mental health literacy framework, this framework can easily be integrated into this training or replace the mental health continuum.

A good introduction to this model is a nine-minute video from the Mental Health Collaborative, The Mental Health Literacy Pyramid, which gives an overview of the framework and the different mental health states. If you have the time, you may want to show it to participants:

A YouTube element has been excluded from this version of the text. You can view it online here: https://opentextbc.ca/studentmentalhealth/?p=28

Resources on Mental Health for Further Reading and Preparation

Here is a list of videos and other resources on mental health. The resources are also listed in Handout 5: Videos and Other Resources on Mental Health.

Videos

How to make stress your friend (14:28 min.).
– Ted Talk by Kelly McGonigal on the many advantages of stress.

The mental health literacy pyramid (9:28 min.), Mental Health Collaborative.
– Provides an overview of the Mental Health Literacy Framework and the different mental health states.

Why stress is good for you (Instant Egghead #40; 2:32 min.), Scientific American.
– Explains how stress can be viewed as helpful.

Other Resources

Comninos, A. (n.d.). Stress. Mindfulness and Clinical Psychology Solutions.
– Web article on the stress curve, different types of stress, and how to cope and manage stress. https://mi-psych.com.au/what-is-stress/

Kutcher, S., & Wei, Y. (2020). School mental health: A necessary component of youth mental health policy and plans. World Psychiatry, 19(2).
– Article on mental health literacy.  https://doi.org/10.1002/wps.20732

Ohrnberger, J., Fichera, E., & Sutton, M. (2017, December). The relationship between physical and mental health: A mediation analysis. Social Science and Medicine, 195, 42–49.
– Article on the connection between physical and mental health. https://www.sciencedirect.com/science/article/pii/S0277953617306639

TeenMentalHealth.org. (n.d.). How not to bubble wrap kids: Learning how to use daily stress to develop resilience.
– Information sheet on using daily stress to develop resilience. https://mentalhealthliteracy.org/wp-content/uploads/2017/09/Stress-Two-pager.pdf

Text Attributions

• “Creating a Safe Learning Space,” Trauma Awareness,” and “Self-Care and Community Care” are adapted from Consent and Sexualized Violence Training and Facilitator Guide: Preventing and Responding to Sexual Violence in B.C. Post-Secondary Institutions, by the Sexual Violence Training Development Team (CC BY 4.0 License).
• “Scope of the Session,” “Questions that May Come Up and How to Respond,” “Transitions and Difficult Conversations,” “Mental Health Models: Options for Institutions,” by Barbara Johnston (CC BY 4.0 License).

Media Attributions

• Mental Health Continuum © BCcampus based on the University of Victoria continuum of mental health, which is adapted from on Queen’s University continuum of mental health and the Canada Department of National Defence continuum of mental health.
• The Mental Health Pyramid was adapted from Mental Health Literacy for Student Leaders © UBC Student Health and Wellbeing staff.
• The Mental Health Literacy Pyramid by Mental Health Collaborative, Inc. Standard YouTube License.

This agenda provides suggested timings for a two-hour session, the minimum time recommended for presenting the information and providing time for the activities. However, you may want more time to offer this training and could extend the session to two-and-a-half or even three hours to allow more time for discussion, debriefs, and short breaks, and to give students lots of time to work through the scenarios at the end. Some facilitators may want to offer this training over two sessions. While this training is adaptable, we recommend that you include the sections on Indigenous perspectives on wellness, diversity, and marginalized groups, as it is important to maintain the integrity of diversity of voice in this resource.

Welcome

Welcome participants and open with a territory acknowledgement. If you’re unsure of your territory, Native-Land.ca is a helpful resource.

Opening Check In

After the welcome, introduce yourself. You could then ask participants to very briefly introduce themselves, or you may want to start the session with a short participant check in as a way to invite people into a learning space. You could ask participants to share their name, what they study, and what they are hoping to get out of the session. If you’re offering the session online, you could also do an online poll that asks people to choose the type of weather that matches how they are feeling. There are many different ways to have participants check in with themselves and the group, and we invite you to use questions and reflections that are meaningful to you and the group.

Goals and Objectives

The overall goal of this session is to help you develop the knowledge and skills to maintain good mental health, cope with stress, and support other students who are struggling with stress and mental health.

After participating in the session, you will be able to:

• Describe mental health and wellness.
• Explore different models and frameworks that help us understand and talk about mental health and mental illness.
• Use accurate language to describe emotions and feelings.
• Examine different ways we may respond to and manage stress and recognize that stress can be a positive signal to adapt to change.
• Listen and respond in an empathetic way to other students who are struggling, while maintaining healthy boundaries.

This session offers foundational information on mental health, as well as opportunities to practise listening and supporting other students in an empathetic way.

It is important to remember that you are not a counsellor or mental health professional. Nobody expects you to act as a counsellor, and you cannot, and should not, diagnose mental illness, nor should you provide mental health care. However, you can be an important component of the caring community of people who can surround and support another student in need.

Structure of the Session

The session covers four main areas:

• Mental health and wellness
• Language and marginalized groups
• Stress and taking care of ourselves
• Helping other students (how to respond and refer to students to campus and community resources)

This is foundational training in mental health. It doesn’t cover suicide awareness, which requires more in-depth training. However, we do cover what to do in an emergency.

Practical Information

As you engage with the content of the session, reflect on how it might apply to situations you have experienced yourself or with your peers.

You are encouraged to:

• Provide feedback and share your input during the discussions, as this will increase the learning opportunities
• Jot down notes during reflection activities
• Ask any questions you might have during the session

After the session, you will have access to printable (PDF) handouts.

If you are facilitating this session online, remind participants that they can turn off their cameras and move around the room during the session. Ask them to be mindful of using the mute button to reduce noise in the online space.

Support and Self-Care for Participants

You are invited to do whatever you need to do to take care of yourself throughout the session.

This may be a difficult topic for some of you. Everyone will have been touched in some way by the topics that will be discussed in the session. Feel free to pause, take a break, stretch, and ground yourself at any time.

You can share at the level that you feel comfortable with. If anything comes up in the session that feels too important or difficult to handle on your own, don’t hesitate to reach out to the appropriate services, such as counselling services, to debrief or discuss it further. If you prefer not to share, that’s okay.

If you need to leave, that’s okay too.

For in-person sessions, you could suggest that if a participant does need to leave a session that they give a thumbs-up as they go to let you know they’re okay. Tell everyone that if you don’t see a thumbs-up, you’ll ask a colleague to look for the participant outside the session to make sure they are alright.

Breathing Exercise

To begin, you could have the group engage in a breathing exercise to set the tone for the session, to give participants a few moments to become aware of their own emotional well-being, and to practise a stress management technique. Note: There is also an opportunity to do a box breathing later in the session in “What to Do When We’re Stressed” if you prefer to wait to do this exercise.

We’re going to start with a breathing exercise called box breathing. You can do this if you start to feel overwhelmed at any point in the session. It can help bring your heart rate back to normal, so you feel a little more relaxed. Here’s how how you do it:

• Step 1: Inhale (preferably through your nose) for a count of four.
• Step 2: Hold your breath for a count of four. You’re not trying to deprive yourself of air; you’re just giving the air a few seconds to fill your lungs.
• Step 3: Exhale slowly through your mouth for a count of four.
• Step 4: Pause for a count of four before breathing again.

Box breathing is a simple stress management exercise that can be practised anywhere. You can practise it for only a minute or two and experience the immediate benefits of a calm body and more relaxed mind.

Group Guidelines

It is helpful to set some expectations and boundaries for the discussion. For example:

• This is a learning environment, and not a therapy group.
• What comes up in this room – whether in person or online – stays in the room.
• We expect you to be non-judgmental of each other and show extra sensitivity when engaging in discussion during the session. This session is about gaining a little more comfort and confidence in dealing with this topic.

You could also ask participants to share ideas for group guidelines at the beginning of the session, or you could share a list of guidelines before the session begins to save time during the session. (See Group Guidelines.)

Text Attributions

• “Territory Acknowledgement and Indigenous Ways of Knowing and Being” by Jewell Gillies (CC BY 4.0 License). All other text in this section by Barbara Johnston and Liz Warwick (CC BY 4.0 License).

Media Attributions

• Clear Blue Running Water at Daytime by Leo Rivas is used under an Unsplash License.
• Lake in Dome Creek, BC by Jakub Fryš is used under a CC BY-SA 4.0 license.

The Wellness Wheel

Let’s first look at what mental wellness looks like. The Wellness Wheel is a model that aligns with Indigenous traditional practices, which view individuals holistically. It recognizes that wellness is about being in a state of balance with the physical, emotional, academic/career, social, creative, spiritual, environmental, financial, and intellectual aspects of our lives. The Wellness Wheel can help us identify what might be causing us stress and understand what aspects might be falling in and out of balance in our lives.

The Wellness Wheel is not a static concept but a way of viewing the many dimensions that support wellness. There are things we can all do as individuals to improve our own mental health and well-being, and how we manage our wellness is an ongoing reflective practice.

The goal is not to be perfectly balanced; you will not always be able to attend to different aspects of your wellness equally. The Wellness Wheel can be used as a reflection tool to help you consider where you might want to focus some energy if you want to invest in your wellness.

We can try our best to be flexible and respond to aspects of well-being that may need additional care or attention. Using the concepts in the Wellness Wheel can help us visualize our journey and assist not only in mitigating stressful circumstances but also in recognizing areas of our lives in which we are thriving.

The Wellness Wheel and Dimensions of Wellness

The Wellness Wheel is made up of the following dimensions:

• Physical wellness
• Emotional wellness
• Academic/career wellness
• Social wellness
• Creative wellness
• Spiritual wellness
• Environmental wellness
• Financial wellness
• Intellectual wellness

Let’s look at some suggestions for taking care of different aspects of your wellness. Keep in mind that these are just suggestions, and often activities are beneficial in many different dimensions. For example, taking a walk in the park with a friend could support your physical wellness, emotional wellness, social wellness, and environmental wellness.

Physical wellness means taking care of your body through physical activity, nutrition, sleep, and mental well-being. For example:

• Engaging in some form of physical activity every day for at least 30 minutes
• Eating a variety of healthy foods
• Getting an adequate amount of sleep every night (7–9 hours)

Emotional wellness means making time to relax, reduce stress, and take care of yourself. It also means paying attention to both positive and negative feelings and understanding how to handle these emotions. For example:

• Practising mindfulness
• Starting a gratitude journal
• Paying attention to self-talk and shifting toward positive self-talk
• Tracking emotions daily to look for patterns and possible triggers

Academic/career wellness means expanding your knowledge and creating strategies to support continued learning. For example:

• Setting up academic goals
• Creating a study schedule and plan ahead
• Connecting with a mentor to further your understanding of career ideas
• Reviewing your short- and long-term career goals regularly to make sure you are on track

Social wellness means taking care of your relationships and society by building healthy, nurturing, and supportive relationships and fostering a genuine connection with those around you. For example:

• Making an effort to keep in touch with individuals who are supportive
• Practising active listening skills
• Joining a club or an organization to meet new people
• Being mindful of commitments you make – know your limitations (don’t spread yourself too thin)

Creative wellness means valuing and actively participating in arts and cultural experiences as a means to understanding and appreciating the world around you. For example:

• Playing an instrument or making music
• Engaging in the visual arts
• Trying creative writing
• Engaging in creativity through movement (e.g., dance)

Spiritual wellness means taking care of your values and beliefs and creating purpose in your life. For example:

• Volunteering
• Meditating
• Expressing gratitude
• Practising forgiveness and compassion for yourself and others

Environmental wellness means taking care of what is around you. Living in harmony with the Earth by taking action to protect it and respecting nature and all species. For example:

• Spending time in nature
• When possible, travelling by walking, riding your bike, or taking public transportation
• Recycling and composting
• Using reusable water bottles and shopping bags

Financial wellness means learning how to successfully manage your finances so you can be financially responsible and independent. For example:

• Creating and maintaining a budget
• Paying your bills on time
• Packing your lunch to limit how often you eat out
• Meal planning before grocery shopping

Intellectual wellness means being open to exploring new concepts, gaining new skills, and seeking creative and stimulating activities. For example:

• Trying a new activity at school or in the community
• Exploring things that you are curious about
• Reading and writing for pleasure

Let’s keep the Wellness Wheel in mind as we look at other mental health models. We’ll come back to the Wellness Wheel and do a group activity a bit later in the session.

Text Attributions

• This chapter is by Jewell Gillies and Barbara Johnston (CC BY 4.0 License).
• “Dimensions of the Wellness Wheel” is adapted from Okanagan College, (n.d.), Wellness peer ambassador handbook. Okanagan College (CC BY 4.0 License).

Media Attributions

• Wellness Wheel © Jewell Gillies is used under a CC BY 4.0 International license. All icons licensed as CC BY 4.0 » yoga by zidney from the Noun Project | heart rate by Naufal Hudallah from the Noun Project | Book by Studio TROISQUATRE from the Noun Project | Gears by Gregor Cresnar from the Noun Project | Lotus by Brad Avison from the Noun Project | landscape by Creative Stall from the Noun Project | forest by Creative Stall from the Noun Project | Sea Sunset by Creative Stall from the Noun Project | Park by Creative Stall from the Noun Project | gaining by Alice Design from the Noun Project | Tree by Brian Hurshman from the Noun Project.

In the last 10 years, mental health awareness has increased to a point where we can openly discuss mental health in many contexts. Talking about mental health is an important part of decreasing the stigma associated with mental illness. However, when we are talking about mental health, we often use words loosely and interchangeably so that they can start to lose their true meaning.

We’re going to look at some models to help us understand the language of mental health. Mental health models challenge us to be more thoughtful about how we are using our words. They can help us differentiate between different mental health states: no distress, mental distress, mental health problems, and mental illness.

Mental Health Continuum

The Mental Health Continuum is one way to think about mental health. All of us have a mental health life; we all experience changes in our mood, changes in our level of anxiety – from life stressors or from crises – and those changes can be considered on a spectrum or a continuum. On this continuum, we can move from healthier to more disrupted levels of functioning and back. At each level, there are resources available to promote health and reduce disruption.

While it is important to recognize different people’s backgrounds and experiences when dealing with this language, it is crucial that we also recognize that there are a number of words that are specifically reserved for talking about diagnosed medical conditions. The Mental Health Continuum shows four different states: no distress (healthy functioning), mental distress (common and reversible stress), mental health problem (significant functional impairment), and mental illness (severe and persistent functional impairment).

Mental Health Terms

No distress

(Healthy – Normal functioning)

Starting at the left side of the continuum, we see the category No Distress. Most of us are in this state most of the time. This is when we’re having fun with our friends and families, engaging at school or work, enjoying ourselves in a recreational activity, reflecting on the day’s events, or even asleep. We can cope with whatever comes our way, and we can do the things we need or want to do. Thinking back to the Wellness Wheel, this is when everything is mostly in balance on the wheel or in our lives.

Mental distress

(Mild – Common and reversible distress)

When we experience daily mental distress and feel sad, disappointed, angry, or overwhelmed in the moment. These experiences of stress are to be expected at times in our lives; they may be common and reversible, and they are usually temporary, such as the stress we experience during exam time. We can maintain hope that when it’s all over, we’ll likely feel a lot better – the stressor will come to an end and there is usually some relief.

We may not need any intervention; people are often resilient and able to adapt by themselves by engaging positive coping strategies and with support from family or friends. We can share our troubles with others and talk about ways to change the situation.

Mental health problem

(Moderate – Significant functional impairment)

Mental health problems may arise when a person is faced with a much larger stressor than usual. These occur as part of normal life – for example, in response to the death of a loved one, moving to a new country, or having a serious physical illness – and are not mental illnesses.

When faced with large stressors, people can sometimes experience strong negative emotions (such as grief, anguish, or desolation). These emotions are also accompanied by substantial difficulties in other domains, such as:

• Cognitive/thinking – for example, “nothing will ever be the same,” “I don’t know if I can go on in my life”
• Physical – for example, sleep problems, loss of energy, numerous aches and pains
• Behavioural – for example, social withdrawal, avoidance of usual activities, angry outbursts

Sometimes someone experiencing a mental health problem will exhibit noticeable difficulties in everyday functioning. People experiencing mental health problems may need extra help, such as counselling, in addition to support from family, friends, and their community. Medical treatment (medication or long-term psychotherapy) is usually not necessary.

Mental illness

(Severe – persistent functional impairment)

A mental illness is very different from mental distress and from a mental health problem. It arises from a complex interplay between a person’s genetic makeup and the environment in which they live or have been exposed to at different times in their lives.

A mental illness (also called a mental disorder) is a medical condition diagnosed by a trained health professional (such as a doctor, mental health clinician, psychiatric nurse, or psychologist) using internationally established diagnostic criteria. People with mental illnesses will require the best evidence-based care from properly trained health care providers.

The Relationships Between Mental States

The Mental Health Continuum is just one way to help us to differentiate between different mental health states. It’s important to understand the differences because different mental health states should be managed or supported differently.

A person can be in each of these states at the same time. For example, over the course of one day a person can be laughing and having fun with their friends (no distress, problem, or disorder), can experience distress (lost their house key), be experiencing a mental health problem (their uncle with whom they were close died earlier this week), and have a mental disorder (such as depression).

Dual Continuum Model of Mental Health and Mental Illness

Mental health is more than the absence of mental illness. It includes our emotional, psychological, and social well-being. It is influenced by many factors, and it affects how we handle the normal stresses of life and relate to others.

The Corey Keyes Dual Continuum Model illustrates how a person diagnosed with a mental illness can have good mental health and be flourishing and thriving. Likewise, a person can be languishing or experiencing poor mental health and not be diagnosed with a mental illness.

Personal Use of Mental Health Terms

Using mental health terms accurately is important, and it is helpful to check in with yourself to ensure that you are using the right words to describe your experience. It is equally important not to make assumptions about others who are using mental health terms, even if you suspect that they are not doing so correctly.

This is because we cannot assume to know another person’s history or experiences that are leading them to use those terms, and we also do not want to apply terms to others that may not accurately fit their experience – for example, assuming someone with depression is simply feeling unhappy or dramatizing minor concerns, or assuming that someone who is having a bad day has depression.

By checking in with your own use of words, you are making a great start at modelling the appropriate use of mental health terms.

Text Attributions

• This chapter was adapted from Mental Health Literacy for Student Leaders © UBC Student Health and Wellbeing staff (CC BY 4.0 License).

Media Attributions

• Mental Health Continuum © BCcampus based on the University of Victoria continuum of mental health, which is adapted from on Queen’s University continuum of mental health and the Canada Department of National Defence continuum of mental health.
• Dual-Continuum Model © BCcampus based on the conceptual work of Corey Keys and a diagram created by CACUSS and Canadian Mental Health Association is licensed under a CC BY-NC license.
• Clear Blue Running Water at Daytime by Leo Rivas is used under an Unsplash License.

When we talk about mental health, we also need to be aware of factors like race, sexual orientation, social class, disability, and gender and the unique life experiences and stressors that accompany them. Some students face inequality, discrimination, and violence because of their race, gender orientation, or disability. These unique and specific stressors impact mental and physical health, and these students often experience greater mental health burdens and face more barriers to accessing care and resources.

Indigenous Students

Indigenous students may be struggling as they adjust to living in an urban academic setting after living in a community where they are surrounded by family and neighbours who share the same culture and spiritual beliefs. They may be the first generation in their family to pursue post-secondary education, and they may be missing their home, family, Elders, and community. The impact of residential schools and other colonial policies have created ongoing adversity for Indigenous people, and there is evidence that this has created intergenerational trauma. Many Indigenous students may also lack trust in educational and health care institutions because of the negative or traumatic experiences they or family and friends have experienced in the past.

LGBTQ2S+ Students

People who are LGBTQ2S+ (lesbian, gay, bi-sexual, transgender, queer, two-spirit) are at a much higher risk than the general population for mental health disorders, substance abuse, and suicide. Homophobia and negative stereotypes about being LGBTQ2S+ can make it challenging for a student to let people know about this important part of their identity. When people do openly express this part of themselves, they worry about potential rejection by peers, colleagues, and friends, and this can exacerbate feelings of loneliness. Their health needs may be unique and complex, and health care settings can feel unsafe or uncomfortable for some.

Students with a Disability

Many students live with some form of physical, cognitive, sensory, mental health, or other disability. Students of all abilities and backgrounds deserve post-secondary settings that are inclusive and respectful. Unfortunately, many institutions are not designed to fully support people who need extra accommodation, and students with a disability frequently encounter accessibility challenges and extra barriers to achieving academic success. In addition to navigating the complex environment of a post-secondary institution that is not set up for them, students with a disability also often have to combat negative stereotypes, bias, and discrimination. These many extra challenges can take their toll on mental health.

Racialized Students

Black, Indigenous, and other racialized students have likely faced racism and discrimination throughout their lives. Racism can encompass a range of words and actions, from the overt racism of violence or slurs to microaggressions (everyday, subtle interactions that demean or put down a person based on their race). Sometimes microaggressions are not intentional, but they can still be very harmful, and they are a form of racism that many students experience. These repeated negative interactions can be overwhelming at times, especially in post-secondary spaces where a student could reasonably assume they would be free from any form of bullying, harassment, or discrimination.

Racism and discrimination in various forms can have a significant impact on a student’s mental health and can lead to increased risk of depression or suicide, increased levels of anxiety and stress-related illnesses, and post-traumatic stress disorder.

International Students

Both undergraduate and graduate international students are often under a lot of pressure, and the stakes may be very high for them: their tuition is expensive, they’ve travelled a long way to attend a post-secondary institution in B.C., and they feel a lot of pressure to do well academically. They may be struggling to adjust to a new culture or learn English, and they may be missing home, family, and friends. The understanding of mental health and wellness differs among cultures, and international students may have a different understanding of how mental health impacts academic performance, and they may not be aware of the support systems available to them when they arrive. There are also system barriers that international students may face, including visa requirements, that don’t allow for flexibility in course workloads when they are struggling.

Socio-economic Status

Post-secondary education puts significant financial strain on students. Students from lower-income families are especially vulnerable to financial uncertainties and pressures, which take a toll on mental health. These students are frequently juggling work with classes, and they can’t rely on financial support from their families. Some students may be the first in their family to pursue post-secondary education, and this can add stress. Given the high cost of renting in many locations, some students have trouble finding appropriate accommodation and the worry of being homeless is a significant concern.

What We Need to Keep in Mind

It’s important to remember that we all have underlying assumptions and biases about others, which may impact how (and if) we provide support. While educating ourselves about mental health is an important component of supporting others, it is also important to take some time to learn more about your own unconscious biases and the impacts of systemic discrimination and historical oppression.

We need to take care to understand and acknowledge oppressions faced by Indigenous people, people who are LGBTQ2S+, people with disabilities, and people from racialized and other marginalized groups. By providing a culturally safe environment, we can all play a role in ensuring that each student feels that their personal, social, and cultural identity is respected and valued.

It is helpful to know the campus and community resources for students from marginalized groups. Connecting an Indigenous student with an Elder or with someone from Indigenous services or introducing an LGBTQ2S+ student to a pride centre on campus can help to reduce feelings of isolation and help students feel heard and supported. We’ll talk more about supports and referrals a bit later in the session.

Text Attribution

• This chapter is by Barbara Johnston (CC BY 4.0 License).

Media Attribution

• Reflection of hearts icon by Álvaro Bueno, ES is used under a CC BY 4.0 License.

One of the most common challenges students face is stress. While stress and mental distress is part of the human experience, and definitely part of the post-secondary experience, people cope differently with stress, depending on their background, environment, relationships, and specific circumstances (e.g., living with an illness). In similar situations, two people may experience stress differently.

Rethinking Stress

You need to take on reasonable challenges to help condition your brain for responding to stressors in order to become more resilient.

The stress response is a response that your body can use to prepare you for a challenge. As post-secondary students, it’s important to remember that you are here to learn and to grow, and with that comes challenges. If you experience the stress response as an opportunity to adapt, you can make stress work for you and help support your growth and resilience.

Remember:

• Stress is part of the post-secondary experience.
• The stress response is normal. It signals our body to adapt.
• Each time we adapt to a daily stressor, we develop the skills to be more resilient and cope with stress the next time.

Video: Why Stress Is Good for You (2:32 min.)

This short video from Scientific American shows how stress can be viewed as helpful. (Show the video or share the link in chat): Why Stress Is Good for You.

A YouTube element has been excluded from this version of the text. You can view it online here: https://opentextbc.ca/studentmentalhealth/?p=70

In speaking about adapting when experiencing the stress response, we can think about ways to solve problems, try something new, or seek support. For example, you might feel stressed about starting classes online. Initially, you can acknowledge that, yes, this is a concern, then you can then move on to planning your time/schedule, setting up your work space, connecting with your classmates, and so on. Once you put this into effect, you’ve developed a new skill that can be applied to other scenarios.

The Stress Curve

The Stress Curve shows that small amounts of stress help increase our alertness and energy for meeting challenging situations, but if stress lasts a long time or overwhelms our ability to cope, it can have negative effects.

The curve demonstrates that when performance demands are too low, we become bored and inactive. But as performance demands increase, our physiology kicks in and we start to feel alert and focused. We are motivated and we feel capable of dealing with the demands of life. However, when performance demands become too high – or we have become exposed to too many demands over a prolonged period – we become fatigued and experience a cascade of stress hormones that can wear us down. This can lead to problems with health, relationships, and work, and can affect our general enjoyment of life. Prolonged stress can often lead to burnout, serious illness, or mental health problems.

Resilience

Resilience is about being able to adapt to life’s challenges and setbacks. When something is out of balance in our lives or we’re experiencing stress, resilience helps us to shift back toward balance and mental wellness. It’s the ability to adapt to difficult situations, and it can help protect us from mental health problems. Resilience isn’t about avoiding or ignoring challenges in life; rather, it’s noticing when stress appears and taking proactive steps to manage the stress and pressure.

The Stress Curve helps us recognize that some stress can be a good thing. The Wellness Wheel, which we discussed earlier, can help us recognize what might be causing stress or pressure in our lives. It also reminds us of our own resilience and strengths; while we may be struggling in one area, we may be doing well in many other areas.

Text Attribution

• This chapter was adapted from Mental Health Literacy for Student Leaders © UBC Student Health and Wellbeing staff (CC BY 4.0 License).
•  “Traditional Healing Practices” by Jewell Gilles (CC BY 4.0 License).

Media Attributions

• Why Stress Is Good for You – Instant Egghead #40 by Scientific American. Standard YouTube License.
• Stress Curve © BCcampus is used under a CC BY 4.0 License. Adapted from Yerkes-Dodson Law (1908).

How can we help ourselves and others who are experiencing the stress response?

The Wellness Wheel helps us to identify what might be out of balance and causing us stress. There are also three important steps to remember when we want to make stress work for us.

Three Steps for Coping with Stress

You may want to share Handout 2: Coping Strategies with participants now.

1. Reframe the Stress Response

• Think of it as a signal for your body and brain to adapt to changes in your environment and prepare for a challenge. The stress response is your body’s way of letting you know that you need to adapt to changes in your environment. Learning how to effectively manage the stress response can help you build resilience.
• Reframe the stress response: “My body and brain are getting me ready to face this challenge. I am getting ready for an important task.”
• Identify the source of your stress response: “Why am I feeling this stress response?” (Refer to the Wellness Wheel to identify what may be out of balance.)
• Make a plan: Use past experiences or brainstorm new ways to approach a difficult situation. Discuss the situation with friends and family and ask for help, if needed.
• Apply your solutions to the problem.

For example:

• If your studies are the source of your stress response, access support and resources to develop your learning strategies.
• Feel like you have too much to do and don’t know where to start? Consider how you are managing your time.

2. Model or Apply Effective Coping Skills

Before, during, or after a stressful experience, effective coping strategies include:

• Considering solutions to the problem
• Connecting with your social support
• Practising healthy habits for sleeping, eating, and physical activity

There are also things you can do on a daily basis to help you feel ready to face the various challenges in school, work, and life. For example:

Take care of the basics:

• Focus on getting enough sleep.
• Fuel up on healthy foods.
• Exercise – walk, stretch, go to the gym, dance, or do yoga.

Make time to unwind:

• Create art or write – draw, journal, write poetry or a compassionate letter to yourself.
• Curl up on a couch with a book.
• Enjoy a hot beverage with a friend or family member.
• Listen to comforting music.
• Spend time on your favourite course.
• Remind yourself of your strengths. (I’m good at …)
• Garden – grow something, bring flowers into your room.
• Laugh – read a funny book, watch a comedy, visit a local garden.
• Try muscle relaxation exercises.
• Find a quiet, safe space, such as a garden, park, or library, where you can relax.

Stay connected or get involved:

• Call friends or family when you need to talk.
• Build a support network – contact old friends or join a club.
• Have fun and meet new people by volunteering in your community.
• Connect with individuals with similar experiences and interests.

Refer to the Wellness Wheel for more ideas.

3. Try Reducing Your Stress Response in the Moment

For example, try this box breathing technique. It can help bring your heart rate back to normal, so you feel a little more relaxed. Here’s how you do it:

If possible, sit and close your eyes. If not, just focus on your breathing.

• Step 1: Inhale (preferably through your nose) for a count of four.
• Step 2: Hold your breath for a count of four. You’re not trying to deprive yourself of air; you’re just giving the air a few seconds to fill your lungs.
• Step 3: Exhale slowly through your mouth for a count of four.
• Step 4: Pause for a count of four before breathing again.

Repeat this process as many times as you can. Even 30 seconds of deep breathing will help you feel more relaxed and in control.

Practising mindfulness can also reduce the stress response. Apps such as Headspace, Calm, and Insight Timer provide guided or unguided mindfulness options.

Taking Charge of Your Health

Another important aspect of dealing effectively with stress is taking care of your overall health so that you have energy and resources to adapt to the challenge you are facing.

Research shows that strategies for attaining and maintaining physical and mental health are the same:

• Sleep, exercise, nutrition, social connections, and activities that give you a sense of purpose, such as helping others, have all been shown consistently to positively impact mental and physical health.
• These five strategies consistently show positive impacts. You likely do many other things to maintain and enhance your health.

Maintaining your physical and mental health is a lifelong process:

• Every time your life situation changes – where you live, where you work, who you spend time with, how you spend your time – your health behaviours can undergo a shift.
• It’s important to reflect on how and whether you are engaging in activities to maintain these five areas of your life. For example, maybe you don’t have time to exercise all the time, but when you are feeling like you need a break from studying for your midterms, you can go and be active to feel at your best.
• More importantly, what physical and mental health looks like for you – given your likes/dislikes, unique life situation, physical ability, and so on – may be different from other people you know. What works for one person – say, swimming twice a week at an aquatic centre – may not work for someone else.

ACTIVITY: Discussion on Taking Care of Your Health

Have participants break out into small groups to discuss the following:

• You can be a role model for other students. You can be proactive with your own health and you can encourage your peers to engage in activities that will help them attain and maintain good health.
• What does this look like for you as a student? Consider the ways in which you maintain your physical and mental health in terms of these areas of your life.

Short Break

If you would like to give participants a short break, this is a good time to do it. It will give them a chance to get up and stretch and reflect on all they’ve learned about mental health and taking care of themselves before moving on to the next sections, which focus on how students can help other students who are struggling with stress or experiencing mental distress.

Text Attributions

• This chapter was adapted from Mental Health Literacy for Student Leaders © UBC Student Health and Wellbeing staff (CC BY 4.0 License).
• “Global Events and Mental Health” by Barbara Johnston is licensed under a CC BY 4.0 License.

You have all had experiences with various responses when you were distressed. From your own life experience, you have developed an understanding of what is helpful that you can draw on when you are responding to other students. The responses you have identified as helpful are examples of an empathic response.

Video: Brené Brown on Empathy (2:53 min.)

This short video from well-known sociologist Brené Brown demonstrates how to respond in a helpful, compassionate way – empathy in action. (Show the Brené Brown video or share the link in chat): Brené Brown on Empathy.

A YouTube element has been excluded from this version of the text. You can view it online here: https://opentextbc.ca/studentmentalhealth/?p=88

There is no script that you need to follow, nor one way that will always work. The most important thing is to be yourself and to be authentic – and this can include being honest when you’re not sure what to say.

The role of an empathetic listener is not to “fix” the student or tell them how to respond. Instead, it is to listen and try to help them find appropriate support. In many cases, it’s not the things we have to say that make the difference, it’s the things that we allow the other person to say and get off their chest that will make room for more life-affirming options to come forth. Just being there, giving support, and offering a listening ear can help create a turning point for a student who is struggling.

When responding to students in distress, maintain an appropriate balance between your desire to help and provide solutions and respect for the student’s autonomy and their own capacity.

Steps to Take When Helping Others

It is important to recognize when others are experiencing stress. Here are the steps to take when helping another student.

Refer participants to Handout 1: Wellness Wheel and pass out Handout 2: Coping Strategies. 

Handout 1: Wellness Wheel and Handout 2: Coping Strategies, as well as active listening and responding with empathy, can be used together in peer-helping situations when the student you’re helping is experiencing the stress response.

Here are some steps you can follow in your interactions with your peers.

1. Listen actively.
2. Respond with empathy and understanding, and normalize stress as part of the university experience.
3. Ask an open-ended question to help your peer process and understand their situation. (This is to help the student better understand their own situation, and not necessarily for you to better understand).

These first three steps may be all that are required. Sometimes connecting with someone else, feeling heard and understood, and having an opportunity to verbalize their struggles is enough to help a person move ahead. But sometimes a person might need some help in identifying the next steps, which is where the Coping Strategies resource comes in.

4. Review the Wellness Wheel and Coping Strategies handouts to explore options.
5. Identify key next step(s).

Ask the student what they would like to try (from the Wellness Wheel and Coping Strategies handouts, or based on what’s worked before).

Sometimes another student’s problems are more than you are able to help them with. It is important to remember that you are not expected to solve another student’s problems, and you are never expected to be a counsellor. There are many services and resources on campus and in the community that you can suggest they connect with.

Services and Resources at Your Institution

You may want to share Handout 3: Supporting Other Students: Mental Health Resources now.

Post-secondary institutions have a range of services and supports designed for students’ well-being. It is helpful to be aware of what is available on your campus, so that if you’re talking to a student who you think would benefit from extra support, such as a counsellor, you can encourage them to talk to someone.

What are some resources that you can think of at your institution? (You could ask participants to brainstorm resources on their campus that they’re familiar with. If you are presenting online, you could ask them to add their ideas into the chat.)

If you have a list with names and contact information for these services at your campus, share this information with participants.

Here are some of the services that are available at most campuses:

• Counselling services help students manage personal, academic, and life concerns. Professional counsellors provide individual and group counselling sessions for students.
• Campus security helps coordinate responses to student emergencies and crises. If you have to call 911, also call campus security, as security can help the first responders locate where to go when they arrive at the campus.
• Indigenous student centres offer programs, mentorship, and a gathering place. An Elder may be available to talk to students.
• Health or medical services offer health and mental health care for students.
• International student services help students with personal or academic issues, study and work permits, and visa applications.
• Accessible learning centres provide services, coordinate academic accommodations for students, and act as a resource to work with the university community.
• Pride centres provides support to LGBTQ2S+ students.
• Sexualized violence resource centres offer support for victims of sexualized violence.
• Financial aid helps students needing financial support for their education.

Provincial Crisis and Support Lines

Some larger campuses have a crisis line for students. If your institution does not have this service, there are also provincial crisis and suicide lines that have 24/7 support. These crisis lines also provide support to anyone who is helping a student in distress and needs to talk to someone and debrief.

Provincial supports include:

• Mental Health Support Line: 310-6789 (no need for area code)
• Here2Talk:1-877-857-3397 – a 24-hour phone and chat counselling support service for B.C. post-secondary students that offers free, confidential counselling and community referral services via app, phone, and web
• BC Suicide Line: 1-800-784-2433 (1-800-SUICIDE) – a crisis line for anyone considering suicide or concerned about someone who may be
• KUU-US Crisis Response Services: 1-800-588-8717 (1-800-KUU-US17) – provides culturally safe support, 24/7, for Indigenous people in B.C.
• The First Nations Health Authority website lists Indigenous resources.

If you’re concerned for another student’s immediate safety:

• If it’s an emergency situation, such as a student who has taken pills, is experiencing psychosis, or is a danger to themselves or others, call 911 and campus security.
• If it’s not an emergency, but you are concerned, it can be helpful to offer to contact support services on the student’s behalf while they are with you. You may also offer to walk with the student to counselling services.

If the Student Won’t See a Counsellor or Seek Help

Sometimes a student doesn’t want any help.

Your first step in these cases will be to consider safety: is anyone at risk of immediate harm, whether it’s the student or someone else? If so, share your concerns with a counsellor or someone who can help ensure safety. You should never assess the risk yourself – consult, refer, and if the risk is imminent, contact emergency services.

If there is no risk of harm to anyone, keep in mind that ultimately it is the student’s right to choose whether to seek help. Individuals are resilient and often come to their own solutions or find their own supports when they are ready.

Ensure that you are supported! Talk to friends, family, other instructors, an Elder, or a counsellor to share your concerns and decide how to proceed.

Privacy

Please be aware that if you help another student access counselling services and are hoping to find out about the student, it is up to the student to give consent to release information. Unless a student gives permission, you won’t be notified of what has happened.

Text Attributions

• This chapter is adapted from Capacity to Connect: Supporting Students from Distress to Suicide © Vancouver Island University (CC BY 4.0 License) except for “Steps to Take When Helping Another Student,” which is adapted from Mental Health Literacy for Student Leaders, by University of British Columbia Student Mental Health and Wellbeing staff, University of British Columbia (CC BY 4.0 License).

Media Attributions

• Practicing Empathy by Melissa Hogan is licensed under a CC BY license.
• Brené Brown on Empathy by RSA. Standard YouTube license.
• Reflection of hearts icon by Álvaro Bueno, ES is used under a CC BY 4.0 License.

Sometimes when you’re talking to another student, you may realize that they need more support than you can give them. You may think they have a mental health problem or mental illness and need help from a professional. It is important to remember that you are not a counsellor and you should never diagnose another student’s mental health. You can, however, encourage the student to talk to a counsellor.

Remember: you are never expected to be a counsellor or to “fix” another student.

Check In with Your Feelings

Here is a list of some of the feelings you might have as you try to support another student. These feelings may be signs that you are taking on too much and not maintaining boundaries. You may need to step back, consult, and take time for self-care. As you read this list, check in with your body and notice which of these resonate with you.

• You feel overly responsible for another student.
• You often think about how to solve the student’s problems.
• You think the student’s problems are more than you can handle.
• You feel stressed out by the student’s issues or behaviour.
• You feel pressure to solve the student’s problems.
• You feel uneasy or have a gut feeling that the student is not okay despite the student denying it.
• You see a pattern repeating itself in your interactions with a student.
• You find yourself avoiding the student.
• You feel anxious or angry when the student approaches you.

All of these responses are common, and we can all likely relate to many of them.

We all have our limits of comfort challenged in different ways. When you notice any of these responses within yourself, it may be time to consult or refer.

Consult with Others

You can consult with campus counsellors, support services, or faculty and staff if you’re unsure about how to handle a situation. You can also call a crisis line if you have serious concerns about a student.

You are encouraged to consult when:

• You are concerned about another student’s safety or well-being but are unsure how or whether to intervene.
• You are uncertain about how to respond to a student who you think may need help.
• You continue to be concerned about a student who has declined help.

Text Attribution

• This chapter is adapted from Capacity to Connect: Supporting Students from Distress to Suicide © Vancouver Island University (CC BY 4.0 License).

Media Attribution

• Flower of an Indian Lotus © Hong Zhang is licensed under a CC0 license.

We are now going to focus on some scenarios to give you a chance to practice or think through how you would respond to different situations in which students are showing distress.

Options for Scenarios

Scenario Debrief

After students have completed the practice scenario activity, invite them to share what they learned. Some of the scenarios are about serious issues or situations that some students may not be familiar with. Remind students there are many resources on campus and in the community that can help students. They are not expected to have all the answers or know what to do in all situations. If you haven’t already shared Handout 4: Talking about Mental Health: Scenarios and Responses with participants, you could share it now.

To close the session, review the Mental Health Continuum, the Wellness Wheel, and the Stress Curve.

If you haven’t already, you may want to share Handout 5: Videos and Other Resources on Mental Health and hand out or share the links to any other handouts you haven’t yet shared.

Review everything you’ve talked about: how to respond to stress, how to respond empathetically to another student experiencing stress (while considering your own limits and a balance of care and respect), and the various services and resources available on your campus to support students.

Invite questions and comments and offer to stay after the session for anyone who has questions.

Media Attributions

• Wellness Wheel © Jewell Gillies and Amy Haagsma (designer) is licensed under a CC BY 4.0 license. All icons licensed as CC BY 4.0 » yoga by zidney from the Noun Project | heart rate by Naufal Hudallah from the Noun Project | Book by Studio TROISQUATR~E from the Noun Project | Gears by Gregor Cresnar from the Noun Project | Lotus by Brad Avison from the Noun Project | landscape by Creative Stall from the Noun Project | forest by Creative Stall from the Noun Project | Sea Sunset by Creative Stall from the Noun Project | Park by Creative Stall from the Noun Project | gaining by Alice Design from the Noun Project | Tree by Brian Hurshman from the Noun Project.
• Mental Health Continuum © BCcampus based on the University of Victoria continuum of mental health, which is adapted from on Queen’s University continuum of mental health and the Canada Department of National Defence continuum of mental health.
• Stress Curve © BCcampus is used under a CC BY 4.0 License. Adapted from Yerkes-Dodson Law (1908).
• Diversity speech bubble icons by Louise Wigö is licensed under a CC0 license.

Text Attributions

• Wellness Wheel Handout. Adapted from Okanagan College. Wellness peer ambassador handbook. Kelowna, B.C.: Okanagan College.

Text Attribution

• This handout is adapted from Coping Strategies Handout by University of British Columbia Student Health and Wellbeing staff. CC BY 4.0 License.

Text Attribution

• This resource is adapted from Vancouver Island University, Counselling Services, Capacity to Connect: Supporting Students from Distress to Suicide. This handout is licensed under a CC BY 4.0 License.

Authors

Dagmar Devine, University of Victoria

Jewell Gillies, Okanagan College

Jenny Guild, Langara College

Arica Hsu, Langara College

Hamza Islam, University of British Columbia

Barbara Johnston, West Coast Editorial Associates

Mehakpreet Kaur, College of New Caledonia

Jackson Mackenzie Nicholls, Thompson Rivers University

Malena Mokhovikova, University of Victoria

Calla Smith, Langara College

Liz Warwick, Limestone Learning

University of British Columbia

We gratefully acknowledge that this facilitator’s guide and the associated presentation have been adapted from University of British Columbia’s training Mental Health Literacy for Student Leaders by University of British Columbia (UBC) Student Health and Wellbeing staff. While we don’t have the names of all of the authors who contributed to the UBC resource over the years, we would like to thank those people who worked with BCcampus on this newly adapted version: Tam Uden, Freeman Woolnough, Karen Moss, Kelly White, Patty Hambler, and Levonne Abshire.

Contributors

Susan Butland, Thompson Rivers University

Rafael de la Pena, College of New Caledonia 

Jagjeet Gill, Langara College

Michelle Glubke, BCcampus

Matty Hillman, Selkirk College

Sara LaMarre, Vancouver Island University

Rhonda Schmitz, Selkirk College

Kaitlyn Zheng, BCcampus

Project Advisory Group Members

Post-Secondary Institutions

Susan Butland, Thompson Rivers University

Rafael de la Pena, College of New Caledonia

Jagjeet Gill, Langara College

Patty Hambler, Douglas College

Claire Hewson, Selkirk College

Evan Hilchey, Camosun College

Sara LaMarre, Vancouver Island University

Shelley McKenzie, University of Northern British Columbia

Tanya Miller, Langara College

Romana Pasca, College of New Caledonia

Amy Rowes, North Island College

Dawn Schell, University of Victoria

Rhonda Schmitz, Selkirk College

Lisa Sookochoff, Okanagan College

Students

Grace Dupasquier, Alliance of B.C Students

Carol Johnston, University of Northern British Columbia

Tanysha Klassen, British Columbia Federation of Students

Sarthak Tembhekar, North Island College

Ministry of Advanced Education and Skills Training

Andrei Bondoreff, senior policy analyst

Kelly Chirhart, director

BCcampus

Valerie Cross, director

Michelle Glubke, project manager

Declan Robinson Spence, project assistant

Student Authors

BCcampus is grateful to the eight post-secondary students who completed this training, wrote the practice scenarios, and offered feedback.

Dagmar Devine is a student at the University of Victoria, completing her bachelor’s degree in social work through distance learning and living in the beautiful West Kootenays, in the unceded territory of the Syilx, Sinixt, and Ktunaxa, with her husband and four of her five children. She is passionate about destigmatizing mental illness and normalizing open conversations around mental health and well-being.

Jenny Guild is a Métis woman living and working in Vancouver on the unceded territories of the xʷməθkʷəy̓əm (Musqueam), Sḵwx̱wú7mesh (Squamish), and Stó:lō and Səl̓ílwətaʔ/Selilwitulh (Tsleil-Waututh) Nations. She is a library and information technology student at Langara College with a passion for psychology and literature, who hopes to one day provide library programming to children and marginalized groups.

Arica Hsu is studying to complete her bachelor of science in nursing. As a trans woman of colour, Arica’s lived experiences have given her insight into how the education and health care systems (including the health care professionals it produces) can be improved to better help, support, and protect her people and community. In addition to volunteering for various social and advocacy committees, she mentors other nursing students. Arica’s career goal is to eliminate barriers that prevent queer and other under-represented people from accessing culturally safe care and succeeding in society.

Hamza Islam is in his second year studying engineering at University of British Columbia. He has yet to declare a major, but is interested in computer engineering. Prior to engineering, Hamza worked as a community support worker—starting off as an intern, working with mentally disabled individuals in a community outreach program. Having completed certifications in the Mandt System, Person Centered Thinking, and Mental Health First Aid, Hamza hopes to bring his mental health experience to the private sector.

Mehakpreet Kaur is the women’s representative and treasurer at College of New Caledonia Student Union, Prince George. She is originally from India and is completing the kinesiology program at the College of New Caledonia. Mehakpreet lost her dad in 2019, which was the worst thing to happen to her, as he was her biggest supporter. She came to Canada to pursue higher education and fulfill her and her dad’s dreams. With the definitive goal of becoming a physiotherapist, she is working hard to become an outstanding and successful woman.

Jackson Mackenzie Nicholls is an undergraduate student in psychology at Thompson Rivers University and lives in the beautiful Okanagan, in the traditional unceded territory of the Syilx tmixʷ Nation. Jackson’s main interests lie within social psychology and the study of mental disorders.

Malena Mokhovikova came to Vancouver as a refugee from Russia in 2012 as a result of racism, discrimination, and fear of prosecution. She studies psychology at the University of Victoria and loves to write, travel, and hike in her free time. She is an active advocate for mental health destigmatization and studies toward one day becoming a clinician and supporting others overcoming trauma.

Calla Smith is studying kinesiology and is interested in sports psychology. She is privileged to live, work, and play on the traditional unceded territories of the xʷməθkʷəy̓əm (Musqueam), Sḵwx̱wú7mesh (Squamish), and Sel̓íl̓witulh (Tsleil-Waututh) Nations with her dog and family. Calla loves road cycling and trying new foods.

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