Recommendation Progress

• The University should facilitate a wellness and mental health analysis when new academic programming is proposed.
• The University should develop a mental health framework for use when writing new, or reviewing existing, policies and procedures.

Progress status: In progress

Progress update: The CoSMH support team has had preliminary discussions about this recommendation with the President and Provost.

Equip AccessAbility Services with the capacity to review mental health-related accommodation requests on campus, while maintaining the confidentiality of the student.

Progress status: Complete

Progress update:

• A working group has been struck to address the Verification of Illness Form at UWaterloo. This recommendation has been included in their terms of reference. Once finalized, the revised process will educate and inform faculty of difference between considerations and accommodations and provide more options for students who require temporary support.
• AccessAbility Services (AAS) employs regulated health professionals with the expertise required to review mental health-related accommodation requests while maintaining the confidentiality of the student.
• AAS has procedural mechainsms in place to manage academic accommodation disputes, outlined in the Student Academic Accommodations Guidelines.

Develop a centralized physical and online system for submitting Verification of Illness Forms that notifies all students’ instructors while maintaining confidentiality of students’ medical conditions and history.

Progress status: In progress

Progress update: A working group has been struck to address the Verification of Illness Form at UWaterloo. This recommendation has been included in their terms of reference.

The University should develop proper recourse mechanisms for students who allege staff or faculty have violated an approved accommodation request related to mental health.

Progress status: Complete

Progress update: Student Academic Accommodation Guidelines were published on the Secretariat's site, outlining the informal and formal dispute processes for alleged violations of approved accommodation requests. These guidelines were developed to align with and redirect to Policy 33 - Ethical Behaviour, which addresses mechanisms for alleged violations of principles outlined in the Ontario Human Rights Code, and Policy 70 - Student Petitions and Grievances.

Strike a working group that recommends implementable best practices around exam and evaluations with a wellness viewpoint in mind. This includes but is not limited to:

• Final exam schedules and availability of the exam schedule during the course enrollment period.
• Weighting and overall number and type of evaluation/assessment in courses.
• A more efficient system for deferred exams.
• Confidentiality around communication of grades to students to ensure practices aren’t promoting an unhealthy competitive environment (e.g. rankings).

Progress status: Complete

Progress details: A working group was struck, consisting of all CoSMH faculty representatives and two students. This group is in the process of developing the following:

• a best practices document to assist units in making formal arrangements to meet and compare course syllabi for potential scheduling conflicts or overloads with regards to mid-term exams or other significant assessments
• a best practices guideline for managing deferred exams, with timely access to a rewrite as a core best practice

The faculty of Engineering will be moving away from providing rankings, and all faculties will work towards a standardized definition of the dean's list.

Academic programs should review for unnecessary stress those sequences in which students acquire their first co-op position in the second term. The PAC-SMH recommends that a committee be struck to investigate how to reduce the stress levels associated with this sequence.

Progress status: Complete

Progress details: A collaborative group of Co-operative and Experiential Education and Engineering Faculty have been meeting, chaired by the Associate Dean, Undergraduate. This committee is in the process of reviewing activities associated with co-op and engineering students going on their first work term after their first four months on campus. This committee has collected employment data and feedback from students to better understand stressors and pressure points. To respond to those, CEE has provided more opportunities for flexible pathways, adjusted the tone and focus of communications, enhanced the interview conflict and relief process, and made embedded counselors available to co-op students. This committee is also considering alternatives to a work term for students in the stream described above.

• Consider universal instructional design as a valuable perspective that can be used to improve course delivery. Consider a collaborative effort between CTE and faculties to include universal instructional design in existing and new courses.
• Develop an online resource to record good practices for embedding universal instructional design and mental wellness into teaching.

Progress status: Complete

Progress details: The Centre for Teaching Excellence provides an array of programs and supports encouraging instructors to embed universal instructional design into curriculum, such as Teaching Excellence Academy, New Faculty core workshops, and online resources such as the teaching tips and accessibility resources webpages.

Openly communicate the process the University undertakes when communicating about student deaths on campus.

Progress status: Complete

Progress details: The protocol in the event of the death of a student was announced to the university on July 26, 2018. It is accessible for review on the Secretariat’s site.

Develop a protocol to include community partners when communicating adverse events that involve a member of the community, while ensuring that support services are available to those impacted by the event.

Progress status: Complete

Progress details: Counselling Services has a detailed protocol in place to communicate adverse events with key people, Campus Wellness, senior administration, deans and associate deans, students, and other campus partners, with different pathways depending on how they were informed and who is involved. When a tragedy impacts students on campus, counselors from the Canadian Mental Health Association (CMHA) come almost immediately to debrief and provide drop-in support, and are available during the week of the event to manage crisis appointments. When staff and faculty are impacted, Counselling Services will reach out to the Employee Family Assistance Program (EFAP) to arrange a debrief.

• All academic programs and student service departments should include peer mentorship activities in the delivery of their mission for the purpose of:
  • Improving the frequency of connection and collaboration between students, faculty and staff.
  • Developing a greater sense of belonging and community at Waterloo for all students.
  • Increasing cross-campus support and advocacy for student wellness.

Progress status: Complete

Progress details: The CoSMH support team and faculty representatives have worked together to build an inventory of peer mentorship groups and activities embedded in each faculty and student service department. The dean of each faculty has committed to supporting the enhancement of existing groups and activities, and development of new resources to address student-identified gaps.

Peer Mentorship Program Inventory

A committee should be struck to develop and implement a cultural competency strategy for the University regarding health promotion and student wellness. The committee would review campus policies, procedures and practices in consideration of race, ethnicity, faith, gender, sexual orientation, gender identity, and socioeconomic status.

Progress status: Complete

Progress details: The Provost's Advisory Committee on Equity's (PACE) focus and mandate meets the spirit and intent of this recommendation. To support this recommendation, CoSMH provided a list of people for inclusion in the appropriate PACE working groups. Nominees for membership on PACE working groups include a CoSMH member, previous members of the PAC-SMH panels, and other interested campus partners with mental health experience.

Expand the range of options for students who are having challenges in interactions with their supervisors or instructors. For example, consider the model of an ombudsperson employed at some institutions with functions such as support, advocacy, and tracking data/patterns.

Progress status: In progress

Progress details:

• Jeff Casello, Associate Vice-President, Graudate Studies and Postdoctoral Affairs, presented on the existing hierarchy of support for students experiencing challenges with their supervisors or instructors.
• The Waterloo Undergraduate Student Association's Centre for Academic Policy Support also provides student advocacy.
• Beth Jewkes, Chair of the Policy 33 Drafting Committee, presented on the Policy 33 revisions, which are currently with the staff and faculty relations committees for their consideration.
• Jeremy de Boer, Senior Case Consultant Conflict Management Human Rights, presented on the informal and formal supports the Conflict Management and Human Rights Office provides to students, staff, and faculty on campus.

• Open a continuous dialogue with students, staff, faculty, and the wider community about mental health and well-being, including online forums for discussion of:
  • Prevention of mental health issues and promotion of mental health-care strategies.
  • Suicide prevention.
  • Impact of trauma and sexual violence.
  • Effects of racial injustice.
  • Effects of transphobia.
  • Harm reduction approaches to substance use.

Progress status: Complete

Progress details:

• Student Mental Health Forum (2019), and the University of Waterloo Virtual Conference on Student Mental Health Research (2020) included student, faculty, staff, and community partners in research and discussions on these six subject areas.
• CoSMH has created a definition of a dialogue that is detailed in the final report.
• Campus Wellness will oversee dialogues on these subject areas on an ongoing basis. Various university entities have also been identified as leaders that specialize in these topic areas.
• UWaterloo received the Bell Let's Talk Post-Secondary Fund Kickoff Grant. As part of the grant, the Mental Health Commission of Canada Canadian Standards Association “National Standard of Canada for Mental Health and Well-Being for Post-Secondary Students” will be used as a mechanism to oversee continuous dialogues.

Suggestions for dialogues at UWaterloo

Encourage faculty to integrate curriculum focused on mental health, resilience, and support resources and to develop courses in ways that promote mental wellness.

Progress status: Complete

Progress details:

• The Course Evaluation Project Team is integrating a question about supportive learning environments into the student course evaluations
• The Centre for Teaching Excellence (CTE) provides a workshop and resources to support integration of mental health, resilience, and support resources into curriculum and course development
• Deans, chairs and directors will be asked to share messaging on CTE's offerings related to mental health in faculty council, department and school meetings, and with sessional instructors.

• Support the professional development of faculty, including the following:
  • Explore ways to share existing best practices between instructors on an ongoing basis, particularly in an online format.
  • Encourage faculty involvement in teaching-related professional development by recognizing these efforts in their merit reviews. Go beyond numbers generated by the student survey. Acknowledge and value up-to-date course assessments, participation in CTE workshops, and pedagogical conferences.

Progress status: Complete

Progress status:

• The Centre for Teaching Excellence (CTE) has developed online Teaching Tip Sheets and a webinar series of instructors sharing best practices.
• CTE offers a 2-day graduate supervision series, including scenarios about graduate student mental health and wellbeing to help new faculty achieve Approved Doctoral Dissertation Supervisor (ADDS) status sooner. This training is available to all faculty, and the later modules have important content on supporting graduate student mental health in a mentor/mentee relationship.
• Teaching-related professional development is included in merit reviews.
• The Complementary Teaching Assessment Project Team (CTAPT) provided an initial report in 2020 on teaching dossiers and peer review, and will be continuing its work in the second quarter of 2021 to consider how to implement at UWaterloo.

The Sexual Violence Response Coordinator should provide training related to sexual violence to other healthcare workers on campus.

Progress status: Complete

Progress details: The Sexual Violence Response Coordinator provides sessions for campus staff members, including healthcare workers, to create a train-the-trainer model for Responding to Disclosure (a module developed by the Centre for Research and Education on Violence Against Women and Children).

• Make information and resources about mental health easy to find, including but not limited to the following:
  • Implement one platform to access services and supports.
  • Develop a comprehensive list of peer supports on campus and provide opportunities for knowledge sharing.
  • Enhance existing peer support resources.
  • Clearly describe available mental health resources in the Region.

Progress status: Complete

Progress details: Comprehensive wellness resources and services have been compiled on the Campus Wellness site, and are accessible through a services database. The Student Success Office continues to offer training and and is working toward coordinating a peer support network. CoSMH's regional partners have informed the committee of additional community resources, which have been added to the Campus Wellness services database.

• Develop a campus-wide training program in resiliency.
  • Ensure that a common definition of resiliency is used across all program delivery platforms and training providers.

Progress status: Complete

Progress details:

• Health Promotion and Evaluation Specialist Robbyn Hesch led a working group in the development of a resiliency definition based on a number of literature reviews and consultation with campus stakeholders and experts
• UWaterloo offered Surviving to Thriving train-the-trainer sessions
• An environmental scan was conducted, and the working group is determining activities that can satisfy the gaps
• The definition and findings have been presented to staff and various departments across campus, and will be brought to Leadership Forum, Wellness Collaborative, and published in the Daily Bulletin
• A resiliency module will be embedded in the Mental Health Literacy Certificate

Assess the current level of coordination of peer support networks. Create a mechanism for coordination and knowledge sharing.

Progress status: Complete

Progress details: Student Leadership Program Coordinator and Peer Mentorship and Student Leadership Program Coordinator conducted an environmental scan of peer programs and coordination across campus. Based on their findings, they are launching three major initiatives - a peer program community of practice, centralized resource bank and website updates, and the Foundational training Program for Peer Leaders (FTP).

• University of Waterloo should join the Canadian Centre on Substance Use and Addiction Postsecondary Education Partnership — Alcohol Harms, a partnership that other universities across Canada have joined. It focuses on:
  • Reducing harm associated with drugs and alcohol.
  • Developing an institutional implementation and measurement plan based off the framework.

Progress status: Complete

Progress details:

• Substance abuse framework is being developed by a local collaborative of post-secondary institutions
• As noted in recommendation #14, a cannabis working group is preparing for the impact of legalization
• University of Waterloo joined this partnership after receiving approval from the Provost on Jan 15 2020

• Develop new training programs in the following areas:
  • How parents can support their students.
  • Strategies to prevent sexual violence.
  • Bystander intervention training in orientation leader training.

Progress status: Complete

Progress details:

• The Student Success Office offers online programming and resource pages for parent supporters, and has developed a robust parent calendar with important dates, actionable strategies, and linking to the Parent Toolbox.
• Campus Wellness has developed and updated resources for parents, including the Supporting Your Student handbook.
• Since 2018, the Sexual Violence Prevention Response Office (SVPRO) has offered responding to disclosure training. Sexual Violence Awareness, Prevention and Response training is available through LEARN for all students, staff and faculty. There are also 7 training modules on responding to disclosure available to staff and faculty online.
• SVPRO has provided content and presented on bystander intervention for orientation leaders during training. The bystander intervention information covers the steps/processes to move from being a bystander to taking action, including intervention skills and examples relevant to the prevention of sexual violence.

• Review staffing practices and plans in Counselling Services, with an emphasis on the following:
  • An external review to determine whether a recent reorganization, as well as the existing on-call system, has achieved its purpose.
  • Investigate the utility of embedding counsellors within each faculty and residence.
  • Within cost constraints, implement the recommended ratio of 1 counsellor/psychologist FTE for every 1,000 students (36.67 FTE), taking into account counsellor leave and other absences. Further, ensure there are additional resources to meet increased demand during peak periods (e.g. exam time).

Progress status: Complete

Progress details:

• Additional staff have been hired exceed the ratio to the 1:1000
• Protocol has been developed with Here24/7 to address high impact and off-hours service needs
• All faculties have at least one embedded counsellor, or have a counsellor designated to see its students. Counselling Services is examining utility by evaluating data and feedback from students, faculties, and clinicians.
• External review with Credence Co. conducted December 2018

• Invest in training and research for underserved/ disproportionately affected populations.
  • Ensure counsellor training is kept up to date and relevant to student needs (with a specific focus on cultural competence).
  • Conduct a climate survey on the experience and perception of supports specifically designed to meet needs of international students.

Progress status: Complete

Progress details:

• Human Rights, Equity and Inclusion office offers a variety of trainings on a termly basis, including anti-racism workshops and LGBTQIA2S+ training
• CoSMH agreed to bundle the research portion of this recommendation with recommendation 35, which is focused on student mental health and wellness research
• Campus Wellness conducted a situational assessment regarding international student use of mental health services and is currently reviewing recommendations.
• Counsellors receive funding for professional development, and are currently engaged in cultural competency training
• Campus Wellness psychologist with a research background in cultural diversity developed a training package that has been distributed to current wellness staff, and will be integrated into new staff onboarding
• CoSMH support staff is examining potential existing data sources for information on the experience and perception of supports for international students, as creating a new survey would increase burden on students, possibly without getting much variation in results. Rather than create a new survey, UW could seek to engage international students in other ways, including adding items dealing with unmeasured domains of importance to international students

• Update and promote available funding for mental health services on and off campus.
  • In light of the recent government change in funding of prescription drugs, use any surplus from the Student Health Plan toward mental health (including off-campus services).
  • Inform students about the funding and services available to receive mental health services off-campus.
  • Review the feasibility of funding a 24/7 service providing counselling by telephone, video-counselling, or internet-based counselling.
  • Review the need for expanding services on campus relating to substance abuse.

Progress status: Complete

Progress details:

• As the new government reversed the policy decision referenced in this recommendation, there is no longer a change in funding of prescription drugs, and this portion of the recommendation is no longer applicable.
• The Student Health Plan Committee has doubled mental health coverage to $800/year, and Counselling Services is working with community practitioners to determine support packages within the $800 cap
• The Student Health Plan Committee procured a 24/7 counselling service, Empower Me, which will be integrated with Counselling Services on campus. This committee is also working with a provider to get a rerouting service so students can access this service outside of North America
• Campus Wellness and Co-operative and Experiential Education are working on a significant initiative that will be announced soon
• Information about funding through the student health plan, OHIP and UHIP, and local clinis with sliding scales will be posted on various UW and student association websites
• Substance abuse services review:
  • Five clinicians in Counselling Services have a background working with multiple addictions
  • Per recommendation 25, UWaterloo has joined the Canadian Centre on Substance Use and Addiction Postsecondary Education Partnership - Alcohol Harms
  • Empower Me offers addictions counselling services
  • Alcoholics Anonymous group is available for students, staff, and faculty on campus
  • Campus Wellness co-leads the Post-secondary Collaborative to Prevent Substance-Related Harms (PSC), which inlcudes membership from Wilfrid Laurier and Conestoga College. This group also discusses new ideas for intervention in this area
  • The Peer Health Education Substance Use Team partners with DrinkSmart and Leave the Pack Behind to educate students and increase the occurence of safer substance use practices on campus
  • Campus Wellness is currently conducting a substance use survey, and has plans to implement a standardized assessment that will be able to provide more granular data in the future
  • Uptake on harm reduction group counselling has been very low in the past, but may be worth providing a group counselling option that is not faith-based

Mental health supports and resources for student’s off-campus (e.g. international placements, co-op placements) should be developed and the level of support available should be clearly communicated.

Progress status: Complete

Progress details: Co-operative and Experiential Education (CEE) department has created Student Mental Health Advisor roles, and is working with Campus Wellness to develop a comprehensive mental health training plan for those staff. Additional out-of-Province and Country resources are posted on the Co-op Mental Health webpage. There are now two embedded counselors as part of a partnership between Co-op and Campus Wellness. These have all been promoted on the Co-operative Education website, through CEE Instagram and Facebook posts, in the Daily Bulletin, through the UWaterloo Central Facebook account, and on the Campus Wellness website.

Campus Wellness also promotes Good2Talk, Here24/7, and Empower Me. If students call UWaterloo Counselling Services, staff will help them find local supports in their area. A mental health widget has been added to Learn, and students can access a list of mental health resources through there. There is more information about Empower Me on the Co-op, Campus Wellness, WUSA, and GSA websites.

• Tailor the level of mental and physical health care provision to the needs of the individual.
  • Continue to develop a complex care team to respond to students with more complex mental health issues.
• Continue to develop and implement a stepped-care approach within Health Services and Counselling Services.

Progress status: Complete

Progress details:

• Complex Care team (CCT) description has been developed
• CCT has been formed, including a Clinical Case Manager
• Stepped care approach is in place in Campus Wellness with multiple levels of a continuum being offered

Literature Review Summary

• A committee should be established to oversee implementation of the recommendations of this report, as well as to provide consistent feedback and advice regarding the strengths and limitations of the University response to the mental health and wellness of students. In the Implementation Committee's early deliberations, the PAC-SMH recommends that the committee determine priorities and classify proposed actions based on what is needed from the University (e.g. statement of commitment, financial commitment, human resources, standing committee, or working group) to move forward.
• Make the full collection of recommendations, strategies, and ideas brought forward through the PAC-SMH process to the implementation committee for ongoing consideration.

Progress status: Complete

Progress details: The Committee on Student Mental Health (CoSMH) has been struck, and members have engaged in a two-stage process to prioritize all recommendations for action. CoSMH is systematically addressing each recommendation through the formation of smaller working groups and collaboration with other groups on campus.

Undertake a full adoption and promotion of the Charter. A significant transition for the University will be the movement from a perspective in which mental health and wellness is the responsibility of a few professionals to an environment in which a healthy campus becomes the business of all stakeholders. The Okanagan Charter affords an opportunity to support this transition.

Progress status: Complete

Progress details: The University of Waterloo is officially the 16th Canadian institution to adopt the Okanagan Charter. Specific commitments are published on the CoSMH website.

Further exploration of the development of a research institute or speciality area in student mental health and wellness. It was evident that there is a strong base of expertise relevant to the topic of student mental health in our institution, including researchers in Applied Health Sciences faculty and the Centre for Mental Health Research (Psychology). There are some examples of institutions that have marshalled this expertise to create a research institute dedicated to addressing questions that are, so far, difficult to answer. These might relate to our population of students, to the range of service options, or the most effective promotion, prevention and intervention options.

Progress status: Complete

Progress details: This recommendation has been brought forward to the Health Initiatives Task Force for consideration. CoSMH is hosting the University of Waterloo's inaugural Virtual Conference on Student Mental Health Research on November 5th, 2020, as part of Thrive Week. The goal of this event is to bring together members of the Waterloo community to share knowledge, connect researchers, and promote mental wellness through 10-minute oral presentations and pre-recorded poster presentations with an emphasis on the themes listed in recommendation 14. By highlighting multidisciplinary faculty and students conducting research in emerging adult and post-secondary mental health and wellness, CoSMH aims to create connections that will serve as a base for the development of a UWaterloo research network on mental health modeled after the Network for Aging Research.

The PAC-SMH recommends University of Waterloo endorse and actively advocate to the provincial government, using its government affairs/relations apparatus, to implement the 26 recommendations in the In It Together report. The report and its recommendations outline sector-wide consensus of the role of the provincial government has to play in order to address mental health concerns in post-secondary campuses.

Progress status: Complete

Progress details: A letter was sent to the Minister of Training, Universities and Colleges and local MPPs advocating for the implementation of the In It Together report released in 2020, and offering to meet to share UWaterloo's experience with student mental health initiatives. This letter received input and approval from CoSMH, the CoSMH executive sub-committee, WUSA, GSA, Government Relations, the Provost and President.