Final Exam

Question 1

What hangs in the study-life balance?

Answer 1

While enrolled in university, students will have to make choices about how and when to prioritize studying over other factors.

Factors:
* Socializing
* Employment
* Volunteering
* Commuting
* Exercise
* Caring for a family member
* Hobbies/interests
* Holidays

Question 2

Why is a study-life balance important?

Answer 2

All of the things outside of your formal studies contribute to your overall experience of the world. A richer world experience will inform your daily life, work, and ultimately strengthen your understanding and of the world.

Time Commitment: the expectation for a full-time university student is around 30-35 hours of studying a week, including lecture, seminar, and lab times.

Rest: allocating time to rest is just as important as studying or exercising. The brain needs time and rest to process new information. Likewise, the body needs exercise and sleep to keep it in a proper state of alertness to focus on learning effectively.

Plan: if you commit to well-defined study times, there will be plenty of time to enjoy a range of other activities.

Question 3

What is the impact of overstudying?

Answer 3

• negative impact on relationships with family, friends, and partners.
• interfere with your ability to fulfil other non-study related obligations and interests.
• increase the likelihood of unhealthy behaviours such as smoking, excessive alcohol or drug use, unhealthy eating, feelings of loneliness and isolation, anxiety or depressive symptoms, and, for some, increase the risk of hopelessness and self-harm.

Question 4

What are the benefits to a healthy life balance?

Answer 4

Health & Absences: reduce worry and stress.

Efficiency: improves efficiency of work during the allotted study hours.

Engagement: supports greater connection to and interest in courses, lectures and relationships.

Focus & Concentration: facilitates attention on the task at hand and staying present.

Academic Success: improves learning efficiency and productivity, which is needed for academic success.

Question 5

Discuss the wheel of life.

Answer 5

To help assess how time is spent and if there is a balance you can use the Wheel of Life.

Academic/Professional: study and work commitments. Is there time for other interests and activities?

Finances: are your finances a worry to you?

Health: how would you rate your overall well-being?

Family and Friends: do you take the time to stay connected to family and friends?

Relationships/Love: do you take the time to maintain your personal relationships?

Personal Growth: it’s up to you what you define as personal growth.

Recreation, Culture, and Hobbies: recreation is a healthy pastime, and exercise has many important physical and mental health benefits.

Physical Environment: a safe and pleasant home and work environment is important to your well-being.

You can then use the wheel of life to assess where changes need to be made.

Balance: how would you like your Wheel of Life to look?

Overload: what areas are you spending too much time on?

Time on Self and others: are you spending enough time on activities/interest that support your own health and mental health? Are you taking enough time to connect with others?

Changes to Make: what areas on your Wheel would you most like to change and why?

Question 6

How can campuses be passionate about mental health?

Answer 6

It is important that universities consider how institutional contexts, environments, values, practices, and cultures can impact student mental health and well-being.

Building compassionate campuses involves working hard to ensure institutions are inclusive and kind learning communities.

Inclusive learning modules, flexible assessment, forming positive learning communities and tackling stigma and discrimination in all of its forms allows students to not just “survive” but “thrive” in higher education.

Question 7

What is connectedness?

Answer 7

Connectedness is important to well-being. Personally meaningful connections can be made on the basis of your world view, environment, values, relationships, work, and recreational interests.

Other People: include your friends, family, peers, and colleagues.

The Natural World: refers to all of the animals, plants, and other things existing in nature and not made or caused by people.

Meaningful Values: refers to faith-based activities, and activities that reflect importance with family or personal values.

Meaningful Work: refer to your work, hobbies, volunteering, or passion projects.

Culture and Heritage: include celebrating traditions, cultural holidays, or relating to people and places from your past. These connections can be physical, mental, emotional, or a combination, and they will be different for
everyone.

Question 8

What are the benefits of social connectedness?

Answer 8

Social connectedness refers to a personal sense of belonging to a group, family, or community. Social connection doesn’t necessarily mean physically being present with people in a literal sense, but rather someone’s subjective experience of feeling understood and connected to others.

Improve Quality of Life: social connection is an important determinant of health and mental health.

Boost Mental Health: increased feelings of belonging, purpose, increased levels of happiness, reduced levels of stress, improved self-worth, and confidence. Those with insufficient perceived social support were the most likely to suffer from mental health disorders like anxiety and depression.

Increased Life Expectancy: individuals with stronger social relationships had a 50% increased likelihood of survival.

Decrease Risk of Suicide: relationships can play a crucial role in protecting a person against feeling isolated, suicidal thoughts, and behaviours.

Build More Inclusive Learning Communities: increases compassion for self and for others while challenging stigma and discrimination.

Question 9

Discuss healthy relationships.

Answer 9

Forming strong, healthy relationships with others means opening up and actively listening.
These relationships can change the course of your life. Some relationships will endure and some will be shorter lived - but just because a relationship doesn’t last forever doesn’t mean that it didn’t serve its purpose at the time.

Question 10

Discuss loneliness.

Answer 10

Loneliness stems from a lack or reduced feeling of social connectedness. It is the unpleasant feeling when your social needs are not being met and is often accompanied by a desire for social connectedness. Loneliness can negatively affect your mental and physical health in a number of ways.

Increased Cortisol: increase your levels of cortisol, which can lead to depression, stroke, or heart attack.

Increased Sleep Disturbances: more frequent sleep disturbances.

Reduced Activity: you are less likely to be physically active if you experience loneliness.

Increased Risk of Heart Diseases: middle-aged adults who live alone have a 24% greater risk of dying of heart disease.

Challenge Immune System: compromises health, similar to chronic stress.

Question 11

Discuss self-harm in older adolescence.

Answer 11

A lack of connection can take many forms, including withdrawal, ignoring or being ignored, lack of support or approval, or the feeling of being abandoned.

Pathways to self-harm and suicide are complex, but social exclusion or lack of social connectedness, loneliness, and other risk factors such as substance misuse are important contributors.

Early Childhood Indicators: genetic factors, such as family history or psychiatric illness, certain biological factors, and early adversity.

Changes: temperament, personality, and psychological functioning can change. For example, mapping on to perfectionism, optimism, aggressivity or impulsivity.

Proximal: social isolation, academic failures, and substance use increase the risk of self-harm.

Question 12

How can you combat loneliness?

Answer 12

The mental health and healthcare sectors are using social prescribing as a way to improve connectedness, reduce loneliness, and optimize well-being.

Question 13

What is the difference between loneliness and social isolation?

Answer 13

Loneliness: the sensation or unpleasant feeling that accompanies the perception that one’s social needs are not being met by the quantity or quality of one’s social connections.

Social Isolation: an objective measurement of the number of people you interact with. It is a lack of quantity of social connections.

Question 14

What are the impacts of isolation?

Answer 14

Physical: poorer health and substance abuse, which in turn negatively impacts health further and increases risk of disease.

Emotional: reduced confidence, diminished self-worth, despair, depression, worthlessness, and self-harm.

Cognitive: shortened attention span or forgetfulness as individuals may not see any reason or opportunity to remain aware and alert.

Question 15

What is one of the strongest predictors of depression later in life?

Answer 15

Social isolation

Question 16

What is recreation?

Answer 16

A person involved in recreation is “re-creating” themselves. The whole point of recreation, as the original Latin word recreate implies, is to refresh and renew.

1. refreshment by means of some pastime, agreeable exercise, or the like.
2. a pastime, diversion, exercise, or other resource affording relaxation and enjoyment.

Question 17

What are the two types of attention?

Answer 17

Directed Attention: a form of focused attention that requires great effort to remain on task and process the information. This type of attention is mentally demanding, as more appealing external information must be blocked out.

Involuntary Attention: effortless fascination. This type of attention is held when the subject is interesting. Involuntary attention is a pleasurable way of processing information and, comes at no cost to the human in way of tiredness.

Question 18

What is directed attention fatigue?

Answer 18

DAF refers to a neuropsychological phenomenon indicating overuse of the brain’s inhibitory system necessary for maintaining focused attention

Input Deficits: misinterpretation of or failure to notice social cues.

Thinking Problems: restlessness, confusion, or forgetfulness.

Behaviour: act impulsively or recklessly

Executive Functioning: reduced ability to plan and make good decisions.

Emotions: short-tempered and have feelings of unpleasantness.

Worry and Rumination: easier to slip into worry and overthinking.

Question 19

How do you promote attentional recovery?

Answer 19

One way to promote attentional recovery is to engage in positive activities you find absorbing.

• Clearing the mind of internal distractions and take short breaks from directed attention tasks
• Getting good quality sleep
• Allowing the mind to wander freely

Attention Restoration Theory: you think better when you spend time connecting with nature.
This concept can be expanded to feeling restored mentally when immersing oneself in a restorative environment.

• Nature
• Creative tasks
• Kinaesthetic activities
• Highly sensory/sensual tasks

Question 20

What is the cost of physical inactivity?

Answer 20

As society takes on a more sedentary life, physical inactivity has become an increasing health problem. 3.3 million people die around the world each year due to physical inactivity, making it the fourth leading underlying cause of mortality.

The cost of physical inactivity is felt in the health care sector and in the economy, caused by people unable to work.

Canada: $6.8 billion.
UK: £8 billion.

Question 21

Discuss the importance of exercise.

Answer 21

• Exercise releases endorphins, that are beneficial to one’s overall well-being. Endorphins connect with receptors throughout the brain and body to trigger positive feelings and reduce pain sensitivity.
• Having completed exercise gives us a sense of self-effectiveness or self-efficacy in this feeling that we can do it.
• Regular exercise promotes healthy sleep patterns

Positive Emotion: pleasure, vigour, and energy,
decreased anxiety, tension, tiredness, and anger.

Unity of Body and Mind: feeling of more improved well-being and life satisfaction from active leisure. Students who engage in physical exercise may be more likely to engage in other health behaviours.

Heightened Self Esteem: sense of accomplishment, fulfillment, self-effectiveness, and self-esteem afterwards.

Leisure: for many people and they feel it is precious to invest free time for one’s own health. This freely chosen activity may enhance stress coping due to a heightened sense of control over their spare time as well as health.

Problem-Focused Coping: enhances problem-focused coping derived from positive emotion, such as seeking information to tackle problems rather than emotion-focused coping such as blaming, venting, denying, or avoiding.

Question 22

Discuss the relation between nature and well-being.

Answer 22

Being in touch with nature and spending time outdoors is beneficial for physical and mental health. Access to green space can also alleviate a range of problems, reducing levels of chronic stress, obesity, and improving concentration.

Physical Health: improves through increased physical activity.

Stress: reductions in stress and anxiety.

Emotional Regulation: increased positive mood and self-esteem.

Social Life: a better and healthier social life.

It is not a matter of spending lots more time in nature, it is about noticing nature wherever this may be. It is about engaging our senses focussing on how nature makes us feel, finding meaning in nature through the celebration of changing seasons, and appreciating the beauty you can find.

Question 23

How can you interact with nature everyday?

Answer 23

Indoors:
* Keeping plants in your home.
* Having photographs of nature.
* Having a landscape as your screensaver.
* Having your breakfast by a window or patio.
* Watching a nature show on tv.
* Meditate to the sound of nature.

Outdoors:
* Taking your laptop outside.
* Work near a large window.
* Walk around a park, garden, or field.
* Going outside on your lunch break.

Question 24

Discuss the relation between cultural activities and well-being.

Answer 24

Culture refers to the characteristics and knowledge of a particular group of people. It encompasses language, religion, cuisine, social habits, music, art, and more.

Like nature and exercise, participating in cultural activities, including art, music, reading, and writing, can be good for your well-being.

Engaging in purposeful and meaningful activities such as creative pursuits can work
like a natural antidepressant by improving mood.

Question 25

What is the flow state?

Answer 25

Flow is the state you get into when you are so engaged in a creative task that your sense of time disappears and you temporarily forget yourself and your “internal chaos”. Some people achieve the flow, when they’re swimming or running, but even the repetitive motion involved in a task like knitting can help regulate strong emotions and calm your nervous system Being in flow states reduces worry and rumination, increasing well-being

Question 26

What is living GLAM?

Answer 26

GLAM includes living a life with Galleries, Libraries, Arts, and Museums. Longevity: help keep us well, aid our recovery, and support longer lives better lived. Resiliency: help meet major challenges facing health and social care including ageing, long-term conditions, loneliness, and mental health. Community Connectedness: offer a range of non-clinical programs. Some are well-being programs helping communities with preventative lifestyles and others are early intervention support for mental health difficulties. Such programs can reduce pressure on money in the health service and social care.

Question 27

Discuss prescribe culture.

Answer 27

Prescribe culture allows individuals to take a holistic approach to health and well-being and encourages ownership and self-management of health. It is of positive benefit to mental well-being, as it helps people feel connected to the world around them. Prescribe Culture is heritage-based, non-clinical, and pro-actively engaging with the concept of social prescribing. Social prescribing: an approach for connecting people with non-medical resources to help with the health problems they are experiencing. It involves the referral of patients to local, non-clinical services such as museums, galleries, book clubs, film clubs, and exercise centres to improve their health and well-being. Results: 28% fewer GP consultations, reducing the workload for healthcare professionals and demand on secondary care services; gives people more choice over their lives; instills an improved sense of belonging.

Question 28

Discuss music and health.

Answer 28

Music releases dopamine which increases by 9% when people listen to music they enjoy.

Question 29

What are the three R's?

Answer 29

The three R's are reading, writing, and resetting. Reading and writing are activities that help to reset the mind and relax the body. However, in times of stress, reading and writing are often one of the first things to go. Writing or journaling about an emotional topic lowers cortisol levels, leading to better sleep and an improvement in mood.

Question 30

What is cultural heritage?

Answer 30

Cultural heritage implies a shared bond or belonging to a community. It represents history and identity; the bond to the past, present, and future. The social benefits of heritage range from increased social cohesion and a greater sense of identity to improved well- being and better learning and skills outcomes.

Question 31

Discuss resiliency and managing distress.

Answer 31

A normal part of life involves being faced with various disappointments and stressful life events. It’s important to be able to adapt and cope within reason with your ever-changing environment. Resiliency: the ability to adjust or recover from a stressor, threat, or adversity. Managing Distress: learning how to cope with negative or difficult emotional states. This is a form of self-regulation.

Question 32

What is the tipping point?

Answer 32

A small amount of stress can be adaptive, but too much stress can become harmful. There is a certain level of pressure or stress that results in optimal performance. However, sometimes the challenges and cumulative stress exceed this point and become too great to manage. Tipping Point: the point at which someone begins showing signs and symptoms of the strain/burden of perceived stress. The tipping point will be different for each individual.

Question 33

What is the stress diathesis model?

Answer 33

You can conceptualize the idea of the tipping point through the stress diathesis model. Stress: triggers several interconnected biological systems. The process by which the body adapts to changes in the body, such as stress, is called allostasis (balance). Diathesis: the concept of vulnerability or predisposition to a medical condition. - Biological - genetic inheritance - Psychosocial - stressor early in life - GxE - interaction between hereditary and environmental factors The stress diathesis model explains a disorder or behaviour through an interaction between genetic predisposition and a stressful exposure.

Question 34

How can stress impact the brain structure and function?

Answer 34

Stress can trigger allostasis-induced brain plasticity. Brain & Regulation: central in the stress diathesis model. The brain determines what are adverse and what are positive experiences. It is responsible for regulating an individual's physical, emotional, behavioural, and cognitive response to stressors, events, and experiences. Stress: if manageable, can lead to positive growth and adaptation which promotes resilience and good health. Stress and Health: too much stress, either chronic or acute stress, takes a toll on the brain and body, and is associated with poor mental and physical health outcomes. Brain Structure: when stressed, the brain changes its structure in an adaptive or maladaptive way in response. In fact, the loss of resilience is a key feature of disorders related to stress.

Question 35

Discuss the stress diathesis model and adaptation.

Answer 35

Stress influences how you think and feel both emotionally and physically. Too much stress can cause signs of wear and tear. Perceived Stress: the brain processes information from your internal and external environment. Given your genetics and life experience, your brain reacts differently to the same stress. Taken together, these factors determine your individual perceived level of stress. Physiologic Response: the brain controls and coordinates the physiological, psychological, and behavioural response to perceived stress. Some of these responses include influencing metabolism, heart rate, anxiety levels, emotions, what you tell yourself, and how you behave through signalling of systems including the HPA axis, ANS, metabolic system, gut, and immune system. Allostatic Load: the wear and tear on the body and brain resulting from chronic dysregulation or overactivity related to the process of allostasis. Interventions that alleviate allostatic load include a healthy diet, regular cardiovascular exercise, social support, connectedness, and good sleep which may also help develop resilience in the event of adversity.

Question 36

How do genotypes and environments impact susceptibility to experiences?

Answer 36

Reduces Risks: your genetic make-up interacts with life experiences good and bad to determine resiliency and sensitivity to stress. Developing healthy ways to cope with stress and adversity can reduce the risk of feeling overwhelmed and developing symptoms. Flourish: young people are at an important time in when a healthy lifestyle with accelerated brain development increases the likelihood of positive effects on well-being.

Question 37

What are common mental health problems in Canda?

Answer 37

The two most common mental health disorders in Canada are anxiety disorders (generalized anxiety disorder, social anxiety, phobias, panic disorder) and depressive disorders (major depressive disorder). Prevalence in Canada: 3 million Canadians reported that they live with an anxiety and/or mood disorder. Almost a quarter have not sought treatment. Comparing Depression & Anxiety: rates are similar among the population. 10.2% of youth have experienced a depressive disorder and 12.1% have experienced an anxiety disorder. Comparing Males & Females: more prevalent in females compared to males.

Question 38

What are signs and symptoms of mental health problems?

Answer 38

There are a variety of early warning signs and symptoms of emergent mental health problems. Anxiety: for a disorder, symptoms tend to persist and are associated with distress and impairment. - Emotional: feeling on edge, irritable, not fully enjoying things - Physical: restlessness, chest tightness, muscle tension, shortness of breath/hyperventilation, GI upset, headaches, sweaty palms, butterflies, changes in appetite, blushing/flushing, fatigue, rapid speech - Behavioural: avoidance of feared situations, short temper, difficulty sleeping, concentrating - Cognitive: apprehension, over-worry, distracted Depression: represent a change from normal functioning and are impairing and distressing. - Emotional: sad, non-reactive, despair, loss of enjoyment - Physical: changes in sleep, appetite, feeling slowed, pain, headaches - Behavioural: withdrawing staying in, missing work, thinking over bad memories, difficulty making decisions - Cognitive: guilt, suicidal thoughts, hopelessness, difficulty concentrating, dwelling on negative, difficulty making decisions.

Question 39

How do you differentiate stress from disorder?

Answer 39

Disproportionate Reaction: severity or intensity of symptoms and level of distress are disproportionate to the situation. Time: symptoms persistent for an extended period of time. Impairment: symptoms are associated with impairment and interfere with day-to-day life. Out of Character: the person does not seem themselves.

Question 40

How are mental health disorders diagnosed?

Answer 40

Mental health concerns and conditions require assessment by a mental health professional who takes into account the whole person. Bullying, academic problems, relationship problems, substance misuse, family history, recreation, and exercise are all taken into account during the diagnosis of a mental health concern. Developmental History: early trauma, abuse, or academic history. Family History: history of mental disorders to identify a predisposition, or genetic and familial vulnerability. Symptoms: the clinical course of distressing and impairing symptoms, in terms of onset and nature and relationship to stressors. Treatment: the response or worsening to any treatment tried to date and other physical or medical problems that might be contributing. Other Factors: use of alcohol, drugs, or current stressors. Relational and Social Factors: nature of the relationships, social connectedness, and environment.

Question 41

Discuss the circle of mental health care.

Answer 41

Typically university students with a mental health concern should reach out for help on campus or through their local family practice. Less commonly, students may be referred to specialized psychological therapy or psychiatric consultation Psychiatry: well-suited for assessing and treating moderate to severe mental health conditions that require a combined psychological and pharmacological treatment. Psychological: well-suited to help with and support young people with emotional, social, and mental health problems, typically of moderate severity. Primary Care Provider: central to coordinating health and mental health care. They are a first line for assessment of a mental health concern and provide continuity. Counselling: short-term and problem-focused, addressing healthy coping during periods of stress, strengthening problem-solving skills, and managing emotional responses to an identified stressor. Peer support: talk to other students who are going through similar experiences. Student volunteers can help by empathizing, sharing information and resources, and sharing their own experiences. Self-help: using available resources, such as books, websites, or apps, to work through a problem or difficulty. It can be very effective for many different types of problem and is accessible and convenient to work through at a time and pace that suits you.

Question 42

What is stepped care?

Answer 42

A stepped care approach aims to match patients to the level of service indicated based on intensity of need and is often visualized using a pyramid. Each step in the pyramid represents a progressive increase in the level or intensity of treatment and expertise. Generalized: entry level services for the lowest intensity care required to meet the individual’s needs (campus-based health promotion, self-guided resources). Next: student mental health care teams or family medicine, Next: speciality mental health services located in the community, Specialized: hospital-based service such as emergency and urgent care services. Effective care must provide: 1) the level matches the clinical need. 2) the steps represent evidence-based effective treatment. 3) each level is convenient, accessible, and has flexibility. This is a way to rationalize and economize healthcare resources that are often limited. We want individuals to have the proper indicated level of treatment but not more than they need.

Question 43

Who provides mental health support?

Answer 43

Occupational Therapists: regulated healthcare professionals who specialize in assessment and intervention focused on helping people resume or maintain participation in a variety of activities. Counsellors: have variable training, which may include a graduate degree. Counselling is often short-term and problem-focused to support healthy coping, emotional and behavioural regulation, and healthy lifestyle choices, as well as achieving a good study-life balance. It is free of charge and has limited sessions. Psychotherapists: licensed healthcare professionals with training in group and individual psychological talking therapies. Psychotherapy services are well-suited to support individuals with emotional, social, and mental health problems of mild to moderate severity. Clinical Psychologists: registered healthcare professionals regulated by the College of Psychologists of Ontario, requiring a PhD in a graduate program, but it is also possible for Master’s degree level psychologists to transfer from other provinces and apply to practice in Ontario. Psychologists receive extensive training in psychological, cognitive, and psychoeducational assessment, and in providing manualized group and individual therapeutic approaches to help with a variety of mental health problems and conditions. They are well-suited to provide psychological support and treatment for mild to moderate mental health problems and to work as part of a multidisciplinary team supporting patients with more moderate to severe mental disorders. Psychiatrists: medical doctors with extensive speciality training in the diagnosis and treatment of mental disorders, integrating pharmacological treatment with other aspects of educational, psychological, and social and family care. Psychiatric assessment takes into account developmental and family history, psychosocial context, early adversity, onset and clinical course and nature of symptoms, and any contributing risk factors. As medical specialists, access to psychiatric consultation occurs through a referral from a responsible family doctor.

Question 44

What would be the ideal mental health system model?

Answer 44

An ideal model would start with a welcoming clinic visit to determine each student’s support need, followed by referrals to the appropriate level of service and support. Ideally there would also be a seamless flow between levels of service and between community-based and campus-based services. The idea is to bring all of these services and resources together under a cohesive system of coordinated and complimentary, effective, and student-friendly mental health services. 1) It seems important to have a single point of entry for all help-seeking students where triage should be delivered by seasoned mental health professionals who are empathetic, reassure students, and can immediately point them to what's needed 2) From there, students would be matched to the level of care or service required which could be housed on-campus or in community-based speciality services 3) Welcoming students back to the umbrella of student health services when they are well enough and have received the appropriate level of care that they needed.

Question 45

What are some resources at Queen's?

Answer 45

Queen's Student Health and Wellness Services: supports the personal, academic, and social health development by providing a range of programs and services, including physical and mental healthcare. Queen’s Student Wellness Services & Queen’s Student Accessibility Services: supports the personal and mental health of students, and their academic success through providing a range of resources and services. Psychology Clinic: provides psychological assessments, treatment, and consultation for, operating on a sliding scale fee-for-service model.

Question 46

What are community based services for mental health care?

Answer 46

Hospital-Based Services: include emergency or urgent care and various subspecialty programs which typically have defined criteria for admission. Publicly Funded Community-Based Services: high demand and limited funding means that publicly funded community-based services have long waitlists and prioritize the most ill people. Private and Fee-for-Service Options: many people have to rely on private and fee-for-service options. Some insurance companies offer coverage, and for those under 25 years you might qualify under your parents’ coverage, but in many cases this coverage is limited.

Question 47

What are some barriers to accessing mental health support?

Answer 47

Stigma: fear of being evaluated negatively presents a significant barrier in accessing mental health services and supports. Only one third of students entering university with a mental health condition actually intend to disclose it. The Canadian Mental Health Association is working to combat mental health stigma by educating the public of outdated terms and encouraging person-first language. Attitudinal: people invalidate their own mental health concerns as there is not a clear diagnosable test to provide objective proof and validation of a disorder. Some people may feel that they should just “try harder” or that they can “get over things” independently. Practical: - Long Wait Times: high demand plus limited funding for resources often means that there are long wait times for accessing services. - Financial Barriers: limit access to specialized services. - Challenges Navigating the System: it can be difficult to know what level of services you need and where you can access those services.

Question 48

How are symptoms categorized?

Answer 48

None: prevention and health promotion Mild: targeted self-Help Mild - Moderate: social or psychological approaches Moderate - Severe: pharmacological and psychological approaches

Question 49

What are self-help resources?

Answer 49

There are a variety of self-help resources for people experiencing mild mental health symptoms or problems. In particular, workbooks and apps that allow for self-directed treatment can be useful for managing symptoms.

Question 50

What are social mental health resources?

Answer 50

Mild mental health symptoms may benefit from social approaches, including social skills workshops, interest groups or clubs, health promotion, and support groups. Social prescribing improves getting out in nature, spending time with others, investing in interests, and taking part in recreation activities that all support your well-being and mental health.

Question 51

What are psychological approaches to mental health support?

Answer 51

If mental health symptoms persist or worsen then this might indicate the need for additional support. Psychological approaches and treatment can reduce and manage moderate symptoms of anxiety, depression, and sleep problems. They can be delivered individually or in a group setting, and may include a variety of therapy modalities. Mindfulness-Based Stress Reduction: useful for being mentally present, focused, and relaxed. Behavioural Activation: an evidence-based treatment based on increasing your activity level, especially in pleasurable activities. Psychodynamic Therapy: focuses on unpacking our thoughts and feelings. Interpersonal Psychotherapy (IPT): focuses on relieving symptoms by improving interpersonal functioning through understanding and strengthening your relationship with yourself and others. Cognitive Behavioural Therapy (CBT): effective in treating mild-moderate sleep problems, anxiety, and depression. Cognitive Processing Therapy (CPT): focuses on evaluating and changing upsetting thoughts to reduce PTSD.

Question 52

What is CBT?

Answer 52

CBT is an evidence-based therapy that involves addressing and changing maladaptive thinking patterns as well as modifying behaviour. CBT can be effective for a variety of mental health disorders, including anxiety, depression, eating disorders, and trauma. As mental health disorders become more severe, CBT is often useful when combined with other psychosocial and educational approaches including medication.

Question 53

What is mindfulness?

Answer 53

Practicing mindfulness has positive effects on student well-being and resilience to stress. Students who participated in an 8-week mindfulness course had improved well-being and distress tolerance, especially during stressful exam time. These effects lasted for at least a year. - Focus on an object - Focus on breathing

Question 54

What are medical approaches to mental health support?

Answer 54

A medical approach is an important component of assessment and treatment. Family doctors and psychiatrists are trained to assess the whole person in the psychosocial, family, and medical context of the individual. Alternative Medical Explanation: consider whether there might be a medical explanation for symptoms (thyroid problems can cause depression-like symptoms). In addition, family history is an important lens to understand emerging symptoms with other risk factors. Medication: can be an important, and central part of treatment for specific disorders and severity of disorders. Family doctors often work in collaboration with psychiatrists to identify when medication is required and to assess the tolerability and treatment response. Physical and Mental Health Interaction: consider the interaction between physical and mental health. Often physical illnesses are associated with mental health problems and vice versa.

Question 55

Define well-being and mental health.

Answer 55

Well-being: an overall state or feeling comfortable, healthy, and happy. Well-being is made up of many components, one of which is mental health. Mental Health: includes psychological, emotional, and social aspects of thinking, feeling, and behaving. Mental health is a prerequisite to realizing potential, being able to cope, and being productive. These exist on a continuum where you can have positive of one and negative of another.

Question 56

What is the biopsychosocial model of mental health?

Answer 56

Determinants of mental health can be thought of in three domains: * Biological: genetic determinants, and brain development * Psychological: thoughts, behaviour, self-concept, and self-awareness * Social: connectedness, context, and maltreatment. These determinants are not mutually exclusive and interact with one another. The combination of these factors determines the level of well-being and mental health.

Question 57

What are important mental health definitions?

Answer 57

Risk Factor: A biological, psychological, or sociological characteristic or exposure which is associated with a higher likelihood of a negative outcome. Protective Factor: A characteristic or exposure that lowers the likelihood of negative outcomes. Distal: An early exposure or factor Proximal: A factor that represents a more immediate exposure or vulnerability.

Question 58

What are some risk and protective factors?

Answer 58

Distal Risk Factors: * Trauma, abuse, neglect, bullying * A chaotic, unsafe, or insecure home * Poor early attachment relationships or loss * Poor quality of nutrition, sleep, recreation * Family history of mental disorders Proximal Risk Factors: * Social isolation * Non-supportive or abusive relationships * Alcohol binging * Substance misuse * Poor quality sleep * Non-regular exercise * Poor self-regulation * Symptoms of anxiety, worry, or depression * Chronic stress Distal Protective Factors: * Secure attachments * Compassionate relationships growing up * Safe and secure home environment Proximal Protective Factors: * Healthy coping strategies * Social support and a sense of belonging * Security and stability * Good sleep hygiene * No substance misuse * Healthy study-life balance

Question 59

What are the three S's?

Answer 59

Stress: a state of emotional strain or unease, and is a normal response to the demanding situations or pressures experienced in day-to-day life. Sleep: a state of the mind and body characterized by altered or reduced consciousness. Good quality sleep plays a crucial role in both physical and mental health. Self-Regulation: control over behaviour, thoughts, and emotion which can interact with each other.

Question 60

What is the impact of substance use on the developing brain?

Answer 60

During brain development, with synaptic pruning and myelination, the brain improves speed, efficiency, and complexity of cognitive functioning. The brain during this time of development is exquisitely sensitive and plastic which can support incredible learning and positive growth in the right environment or in a risky environment, can lead to significant well-being, mental health, and academic problems. Using too much alcohol, inappropriate or excessive use of stimulants, regular cannabis use, and use of other illicit drugs can impair and derail brian development.

Question 61

What is the importance of being emotionally aware?

Answer 61

By being more emotionally aware of how you are feeling and what your mind and body need, without judgment, you will be able to find the right balance, feel competent, happy, and fulfilled. A healthy and optimally functioning mind and body will support you to realize your full potential in your studies, interests, ambitions, and relationships, while also helping you through the difficult times.

Question 62

What are indicators of mental health concerns?

Answer 62

Not everyone who experiences an indicator has a mental health problem. However, if you are experiencing some of these feelings, it may be helpful to receive additional follow-up from a mental health professional. Changes in Feelings: * Irritable, sad, and/or anxious mood * Experiencing mood shifts or swings * Feeling lonely even when not alone * Feeling more sensitive and easily hurt or angry * Decreased hope, lack of caring, or dread Changes in Behaviour: * Stop attending classes * Give up hobbies * Withdraw from social events * Poor sleep * Arguments with friends * Unhealthy ways of coping Changes in Thinking: * Poor concentration * Self-criticsim * Over-worry * Pessimism * Thoughts of self-harm Sustained Change: * Feelings interfere with friendships or school * Difficult feelings do not go away * Others who know you notice a change

Question 63

What are services available to those seeking support?

Answer 63

Online Well-being Resources: guided and unguided therapeutic resources for managing stress, mild anxiety, and depressive symptoms. Counselling: call or walk-in same day appointments for the support of stress, mild to moderate anxiety, and depressive symptoms in non-urgent or emergency situations. Family Doctor: discuss and assess your mental health and develop a treatment plan in non-emergency or life threatening situations. 24-Hour Hotlines: available anytime you want support or need advice about your mental health. Addiction & Mental Health Services: a hotline you can call 24 hours a day, 7 days a week: Hospital Urgent Care: suitable if you have thoughts of self-harm and are concerned that you would act on these thoughts, if you cannot take care of yourself, or if you friends/family are very concerned about you and your safety. Ongoing Support Services: a psychologist or psychotherapist in the community, can provide ongoing support for relationship problems, healthy coping, or various psychological approaches to treat mild to moderate anxiety and/or depressive symptoms.

Question 64

What are downfalls of clinical services in the community?

Answer 64

Clinical services in the community are not organized to respond to the needs of university students in areas such as being proactive or in providing tailored prevention, responding in a timely way given condensed learning terms, managing students who travel between terms/holidays, and being set up to deal with the onset of symptoms, rather than chronic debilitating disorders.

Question 65

What contributes to the increasing demand for student mental health resources?

Answer 65

* The brain is undergoing accelerated growth and is sensitive to what it is exposed to. * Many students are experiencing a number of changes. * Stigma related to reporting mental health problems is decreasing * Adjusting to new circumstances or life events

Question 66

What characteristics are important for university mental health services?

Answer 66

University mental health services must be: * Proactive and preventative * Health promotion-focused * Engaging * Student-friendly and accessible * Compassionate * Helpful from first contact * Tailored to meet the individual student need University mental health services must include: * A safe and inclusive learning community * Stepped care model offering care at different levels of intensity based on need * Single accessible point of entry to all services * First contact that is therapeutic and supportive rather than administrative * Universities need to partner with students to co-create and develop student wellness services