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Op-ed: For mental health, callous attitudes contribute to preventable deaths

SHANNA HUNTER/THE VARSITY

Op-ed: For mental health, callous attitudes contribute to preventable deaths

Reviewing the development process of the university-mandated leave of absence policy

Content warning: discussion of suicide.

Earlier this week, a U of T student died by suicide at the Bahen Centre for Information Technology. Just last June, another student died under similar circumstances.

Around that time, the University of Toronto Governing Council approved the University-Mandated Leave of Absence Policy (UMLAP). The UMLAP is intended to help students in distress — like our peer who died recently. As stated in the UMLAP, if a student’s behaviour “poses a risk of harm to self or others,” it can be used to place the student on a non-punitive leave of absence and to provide them with additional resources and accommodations.

With that said, in the first quarter of 2019, there have already been two suicides on campus. With the UMLAP in place and the media attention it has received, students should be reaching out and considering it as an option. However, recent comments from students show clear disagreements with the policy. We need to ask ourselves what impact the UMLAP has really had on campus since its implementation.

Something went wrong

Somewhere along the UMLAP’s development process, something went wrong. I was a member of the University Affairs Board (UAB) of Governing Council when the idea of a leave of absence policy was first introduced in May 2017. At the time, Vice-Provost Students Sandy Welsh described it as “a welcome Policy” that would provide a “transparent, non-disciplinary and compassionate” process for students to engage in leaves of absence. I distinctly recall the broad support from across the board — myself included.

We understood the need for a policy, both to provide front-line administrators with direction on mental health issues, resources, and accommodations, and to provide students with a voluntary, compassionate leave option when no option existed in their division or program.

It was not until the following academic year at the October 2017 UAB meeting, after my term had ended, that the terms of the proposed leave of absence policy were made public. Students and faculty raised grave concerns with its contents. They included the risk that a student in crisis could be denied access to essential services at their time of greatest need, the fact that individuals with no expertise in mental health could make unilateral judgements on what could be considered ‘relevant information’ when a student was pleading their case, the lack of involvement from regulated health professionals throughout the process, and much, much more.

Within a month of the UMLAP’s release, students self-organized a grassroots Facebook group with over 200 members to coordinate their opposition. Several took the initiative to meet privately with the central administration to discuss their concerns.

In response, the central administration revised the UMLAP and put forth a new version for final approval by the Governing Council’s boards in January 2018. Some issues were addressed. The revised version made clear commitments to the Personal Health Information Protection Act, prohibited the placement of any notation on academic transcripts regarding the leave, and added equity officers as an additional source of support for students subject to the UMLAP. But given that the fundamental concerns raised by students, like the threat of being denied services during a time of need, were not addressed to students’ satisfaction, they continued to raise vocal opposition.

The university and the Ontario Human Rights Commission

Less than 24 hours before the revised version of the UMLAP was slated for recommendation at the January 30, 2018 UAB meeting, Renu Mandhane, Chief Commissioner of the Ontario Human Rights Commission (OHRC), sent an unprecedented letter to Ms. Claire Kennedy, Chair of the Governing Council. Mandhane communicated major concerns with the UMLAP. The OHRC recommended that “the Policy not be approved in its current form.”

The letter also referenced a meeting between staff from the Office of the Vice-President and Provost (OVPP) and the OHRC on December 13, 2017. In fact, documents obtained by The Varsity showed that correspondence with the OHRC began as early as December 6, 2017. After the December 13 meeting, the OHRC had stated that it “[looked] forward to receiving a copy of the next draft of the Policy before it enters the governance path for approval.” In response, the OVPP stated that “we will share that we have met informally with OHRC staff about the proposed policy when we meet with student groups in the weeks to come.”

As the OVPP never specified which student groups they intended to share their conversations with, it’s difficult to determine whether they kept their promise. Nonetheless, a comment from Mathias Memmel, President of the University of Toronto Students’ Union (UTSU) at the time, was telling: the UTSU “didn’t know that the OHRC was involved until the [January 30, 2018] UAB meeting.” For context, during this time, the UTSU had met extensively with the Office of the Vice-Provost, Students and several student groups regarding the UMLAP. The fact that the UTSU was not aware of the OHRC’s involvement at the time is concerning.

But perhaps more concerning was the central administration’s behaviour toward the OHRC’s request and at the January 25, 2018 meeting of the Academic Board (AB) of Governing Council. Like the UAB, the AB must also recommend draft policies that impact certain issues before the policy can proceed in the governance path. The OVPP appeared to have declined the OHRC’s request to provide a draft policy prior to the UMLAP’s entry into the governance path.

In response to a direct question regarding the OHRC’s request from The Varsity to Elizabeth Church, Interim Director of Media Relations at the time, Church stated, “I can tell you that the draft policy was made publicly available to everyone to review before it went through governance.” This statement is technically true: a draft policy was made publicly available just prior to the October 2017 UAB meeting, but the January 2018 version of the UMLAP that was made public on the AB meeting agenda was different. By placing the updated UMLAP on the AB agenda, this previously unseen version of the UMLAP had entered the governance path for approval.

Consequently, if the central administration had not provided this updated version of the UMLAP to the OHRC prior to placing it on the AB agenda, it would seem that the central administration declined the OHRC’s request to review the UMLAP “before it [entered] the governance path for approval.”

Based on reports from The Varsity, it appears that the OHRC and the central administration did not have any correspondence between December 15, 2017, when the OVPP responded to the OHRC’s email, and January 29, 2018, when the letter from the OHRC to the Governing Council was sent. If the central administration truly did not send the OHRC a draft of the UMLAP before placing the policy on the AB agenda, the onus of the OHRC’s letter of concerns lies with the university even more. Had the OVPP complied with the OHRC’s request for a draft, changes could have been made and the notice avoided. Also, nothing prevented the central administration from delaying approval of the UMLAP until a later meeting.

Furthermore, the central administration appears to have failed to disclose the OHRC’s concerns to the AB at their January 25, 2018 meeting. An official, detailed record of the meeting shows no mention of any correspondence between the OHRC and the university.

In corporate governance structures like the AB, there is an expectation that management — in this case, the OVPP — provide relevant information that could contribute to the decision-making process of the respective board. This is part of a legal ‘fiduciary duty’ — something of a shared interest toward a common goal among the board members, who oversee the corporation, the management, who deal with day-to-day operations, and the members or shareholders of the corporation. Because management is the source of a significant amount of information about the corporation and its affairs, board members must be able to implicitly trust the information that management provides them to be able to perform effective oversight.

Failing to disclose relevant information can jeopardize the diligent review of information each member of the board is required to perform when making decisions.

Thus, I find the central administration’s failure to disclose the OHRC’s concerns to the AB to be an outrageous, unconscionable, and indefensible act. In light of potential legal liabilities identified by the OHRC, they ought to have done so. I have no doubt that, had the OHRC’s concerns been fairly presented to the members of the AB, the UMLAP would have been met with significant opposition. But these concerns were not presented, so it is no surprise that the AB approved the UMLAP. Just five of the 65 members present, including two named faculty members from the U of T Faculty of Nursing and the Department of Applied Psychology and Human Development at the Ontario Institute for Studies in Education, dissented.

Tokenistic public consultation or sunk-cost fallacy?

Let’s fast-forward to spring 2018. By now, the draft UMLAP had officially been published twice in Governing Council documents. For the first time since the initial draft, the central administration began soliciting public comments from any student, faculty member, or staff on a third, not-yet-official revision. Like the policy development process for the Policy on Sexual Violence and Sexual Harassment passed in December 2016, an online form was provided as part of the public consultation process.

To my knowledge, responses to the form were never released, so it’s hard to know exactly how many submissions were delivered. At the very least, we can assess how the consultation process changed the UMLAP by comparing the third version to the version ultimately approved at the May 2018 UAB meeting.

The similarities between the third version and the final version are striking. If you took each copy and laid them out side-by-side, you would find that the pages and clauses line up almost perfectly. All but three of the 79 clauses are identical, and two of the amended clauses had little impact to the practices prescribed by the UMLAP.

The third and arguably most substantive change involved section 40, which discusses the discretion that the Vice-Provost Students may exercise when placing a student on a University-Mandated Leave of Absence (UMLA). Language was added such that the Vice-Provost, Students “will consult with an appropriate regulated health professional” when considering a UMLA. Previously, there was no requirement for the Vice-Provost Students to consult health professionals. Students had consistently raised concerns at prior UAB meetings regarding the lack of involvement of health professionals and the potential for decisions to be made by administrators with no expertise in mental health. The same concern was also identified in the OHRC’s letter.

Some might allege that the lack of substantive change following public consultation was a reflection of a broader consultation process rife with tokenism. However, I propose an alternative explanation, albeit one that is not mutually exclusive. The central administration had already received suggestions for the UMLAP based on “initial consultations with registrars, academic administrators, deans of students and health & wellness staff” as early as May 2017. The UMLAP was then placed on the governance path for approval in January 2018, where the AB recommended it.

Following the OHRC’s letter, it is reasonable to assume that the central administration sought further legal advice — at great expense — to ensure that the UMLAP complied with the Ontario Human Rights Code. Substantial resources had already been committed to the UMLAP. While just as insidious as a tokenistic public consultation, perhaps the central administration felt that it was not worth turning back at this point. Maybe they felt pressure to proceed, despite ongoing concerns, from the burden of sunk costs.

Regardless, there was a clear disconnection between the concerns raised by students and the changes made after public consultation. And it’s frankly not that surprising. Public consultation is a poor way to solicit comments on a policy that has already been written; it’s unreasonable to expect members of the public to provide usable feedback when a nuanced understanding of the policy’s provisions is required. Public consultation can be extremely useful at the earliest stages of policy development, as potential issues can be identified, discussed, and mitigated before they become cemented in language. However, that time had long since passed.

Instead of a late public consultation process, I suggest that striking working groups composed of members familiar with the UMLAP would have provided more substantive and effective changes.

Good intentions, poor execution

My intention here is not to accuse the university’s central administration of impropriety. Rather, I believe that its actions after the October 2017 UAB meeting reflect a disappointingly callous disposition toward students’ mental health. There were countless opportunities for the university to take more appropriate actions. They should have done better to understand the real consequences and impacts of their decisions. Annual campus police reports show that there have been 12 suicides or suicide attempts on campus between 2014 and 2017. Especially in light of these incidents that came prior to the UMLAP’s enactment, the risk that poor decision-making could contribute to preventable deaths should have been a salient and disturbing thought.

Had the university listened closely to students, they would have heard about the numerous issues that plague our campus today. Their original focus might not have been on redirecting students from disciplinary provisions, but rather on how best to implement a voluntary leave of absence program that could accommodate all students regardless of “harm to self or others.” Despite reassurances, students now worry that disclosing severe mental health issues could lead to denial from campus services.

When you take a closer look at the issues that students discuss in conversation about mental health, they inevitably identify a range of contributing factors. Some students face long commute times, which reduces their time available to study and leads to stress. Others might live closer to campus but take on part-time jobs to help make ends meet — meaning they are similarly affected and are further impacted by financial stress. Students also report stress due to anxiety about their futures and academic pressure.

These and other factors should be described as the determinants of health and mental health, a term used in public health to emphasize the contexts in which individual and population health is experienced. Any campus mental health strategy needs to consider the impact of such determinants and the role that the university plays in mitigating or exacerbating ongoing issues.

Earlier this week, when a member of our community died by suicide this year, students rose. The next day, a grassroots movement drew media attention to a “silent protest” outside Simcoe Hall, where Governing Council and its boards meet a reflection of the unspeakable trauma within the U of T community. Their silence stands in stark contrast with the previously deafening chorus of students who had relentlessly expressed their concerns with mental health on campus. What’s left to say?

Nathan Chan is a graduate student at the Centre for Addiction and Mental Health and the University of Toronto’s Institute of Medical Science. He was a 20162017 member of the University Affairs Board of the Governing Council, 20172018 Associate President at the University of Toronto Students’ Union, and 20172018 Course Union Representative on the General Council of the University of Toronto Graduate Students’ Union.

Disclosure: Chan was The Varsity’s 20162017 Photo Editor.


If you or someone you know is in distress, you can call:

  • Canada Suicide Prevention Service phone available 24/7 at 1-833-456-4566
  • Good 2 Talk Student Helpline at 1-866-925-5454
  • Ontario Mental Health Helpline at 1-866-531-2600
  • Gerstein Centre Crisis Line at 416-929-5200
  • U of T Health & Wellness Centre at 416-978-8030.

Warning signs of suicide include:

  • Talking about wanting to die
  • Looking for a way to kill oneself
  • Talking about feeling hopeless or having no purpose
  • Talking about feeling trapped or being in unbearable pain
  • Talking about being a burden to others
  • Increasing use of alcohol or drugs
  • Acting anxious, agitated, or recklessly
  • Sleeping too little or too much
  • Withdrawing or feeling isolated
  • Showing rage or talking about seeking revenge
  • Displaying extreme mood swings

The more of these signs a person shows, the greater the risk. If you suspect someone you know may be contemplating suicide, you should talk to them, according to the Canadian Association for Suicide Prevention.

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