Your health in their hands

Like most Canadian health services, HCDS faces funding and personnel challenges

Health Counselling Disability Services director Dr. Mike Condra says the HCDS serves 60,000 students every year.
Health Counselling Disability Services director Dr. Mike Condra says the HCDS serves 60,000 students every year.

Your student fees help pay for it. It holds a copy of your medical record. And it’s the primary organization responsible for your health at Queen’s.

Health, Counselling and Disability Services (HCDS) is a family doctor, psychiatrist, disability advisor and more for about 60,000 students, and it suffers from the same maladies as every other health provider in the country: the need for more personnel and resources.

HCDS is divided into three primary branches: Health Services, Counselling Services and Disability Services.

HCDS Director Mike Condra said Health Services exists to provide students with primary health care similar to what they would get from a family doctor.

“They can see a nurse or a family physician, have their health concerns assessed and have treatment or get a referral from there to a specialist if this a problem that requires a specialist,” he said, adding that Health Services uses both scheduled appointments and an “urgent care model” that allows students in more serious health situations to be assessed right away.

Health Services also has a division of psychiatry for students with mental health problems.

The Counselling Services branch of HCDS helps students deal with emotional or psychological problems.

“Students can receive professional counselling for ... any kind of personal concern or issue which could range all the way from homesickness at the beginning of the year right through significant mood problems, relationship issues, high levels of stress or eating disorders,” Condra said.

Counselling Services also has a cross-cultural counsellor who works on diversity issues and counsels students who may be dealing with cross-cultural adjustment.

The counselling service operates an intake system in which students are seen as soon as possible after they contact the service for a short appointment to determine the nature of the difficulty and the seriousness of the concern.

“We want to be sure … when students come in, that students who are in a great deal of difficulty get seen for ongoing counselling as quickly as possible,” Condra said. “For regular counselling appointments, sometimes the waiting period is longer because there is simply a higher demand for service.”

Counselling Services also operates the Learning Strategies Development program, which operates out of the LaSalle building and the Queen’s Learning Commons in Stauffer Library. Three of the service’s counsellors work with Learning Strategies Development.

Condra said the program is meant to assist students to become more efficient as students—how to take notes, how to organize study schedules, how to ensure they are studying effectively.

The third arm of HCDS is Disability Services, whose role it is to ensure that students with disabilities of any kind receive the accommodations they need in order to study effectively.

“It also has programs both in the LaSalle building and in the Learning Commons to assist students with learning disabilities as well as to provide students with access to adaptive technology,” he said.

Examples of this adaptive technology include screen enlarging or programs that read text documents aloud.

“If a student comes in, let’s say they’ve got a learning disability and they bring documentation into the Disability Services office and our advisor looks into it and says, ‘This student, on the basis of their disability, needs extra time’ … the advisor will then make sure the exams office gets that and the exams office will arrange the accommodation,” Condra said.

The University is responsible for classroom and examination accommodations, while some are covered by OSAP, Condra said.

Since she started working with Disability Service as an advisor in 1992, Barbara Roberts, said Disability Services has increased its full-time staff by 25 per cent, while the number of students the services work with has quadrupled.

Roberts said Disability Services meets with students to discuss what accommodations could be made to allow them to study better, and follows up as needed.

During September and October, Disability Services’ busiest time of year, it can take up to two weeks for a student to make an appointment.

“If people need to be seen, they’re able to be seen,” Roberts said. “If it’s urgent, obviously we move it up.”

Roberts said Accessibility Queen’s has also helped increase resources and awareness for Disability Services, most recently in the establishment of an endowment fund for students with disabilities who don’t qualify for other financial assistance.

In an ideal world, Roberts said, she would like to see Disability Services get a bigger students people with disabilities.

“That need is a never-ending goal to make the world more accessible, starting with the next external department from mine.”

Condra said there’s no limit to the amount a student can use Health or Disability Services. In the case of Counselling Services, students are recommended to have a maximum of eight sessions per academic year.

“If students have an ongoing difficulty that requires more, we will either continue with them or help them to find resources within the community,” Condra said. “Part of the difficulty that we have is if we were to have a more open-ended model, what has happened in the past … is that by the beginning or middle of November we don’t have any appointments available until January.

“We can’t have that because it’s absolutely vital that we get to see students as early as possible.”

“Mostly it’s self-referral,” he said. “You decide you have a difficulty and you come in … We have situations where we see housemates or roommates where they’re concerned, or they’re having some difficulties because the housemate or roommate appears to have an ongoing problem.

“They need some advice or support or consultation.”

Condra said Health Services is funded by students through student fees and billings, and by the University in that it doesn’t pay rent for its space.

“What [the student fee] ensures is that the Health Services has a high complement of nurses so that nurses are available for immunizations, they’re available for travel counselling and of course, they are the people, if you don’t have an appointment … they will see you initially and will then refer you to a physician.

“So we can assure you can be seen quickly.”

Queen’s funds Counselling Services, Condra said.

“The amount of money Counselling Services has received has gone up quite significantly over the last 15 years,” he said. “Overall, counselling has been well-funded by the University.”

The Ministry of Training, Colleges and Universities, which gives Queen’s money annually, primarily funds Disability Services.

Condra said this amount remains virtually the same from year to year.

“The government uses a formula and we get approximately the same amount unless the government chooses to increase it,” he said.

At press time, Condra didn’t have specific budget numbers for the Journal.

More than funding, Condra said the province-wide and countrywide doctor shortage makes it difficult for Health Services to provide care for a growing number of students.

“It’s just hard to find enough,” Condra said. “It’s difficult to find family physicians because the country as a whole has a shortage of them. We’re competing for the same family physicians who are being, if you like, lured by others. And that’s a problem.

“That’s a challenge year to year, and we are very fortunate we have great family physicians … We would like to have more of them. But there aren’t more around.”

There are eight family physicians at Health Services, each of whom works between one and four days a week, dividing their time between HCDS and other Kingston practices such as private practices or the correctional system, Condra said.

Health Services has the equivalent of five full-time nurses working.

“Relative to other universities we’re actually quite fortunate in the level of support we receive,” Condra said. “We have, by and large, enough resources.”

Condra said Counselling Services’ busiest times of year are from mid-November until about Dec. 15 and from the end of Reading Week to the end of April.

“It is sometimes difficult to get people in,” he said, adding that HCDS sometimes hires temporary staff to get through certain busy periods.

“We’re trying to work creatively with our budget,” he said.

Larry Mackey, ArtSci ’06, had a less positive experience with Health Services when he was sick earlier this semester, however: “I went there and I was very sick with a bad ’flu, and I knew this needed antibiotics,” he said. “It was just like, ‘Come back in three weeks.’”

Mackey said he eventually got better on his own, but said he thinks medication would have helped him recover sooner.

“I didn’t feel they were addressing my medical needs,” he said. “The wait was ridiculously long … There needs to be a change down there—it’s very inefficient.”

Condra said there Disability Services has a more stable workforce.

“We have three people in Disability Services who’ve been there more than a dozen years,” he said. “They’ve got quite longevity.”

In addition to paid staff, Condra said HCDS also has more than 200 student volunteers who fill such positions as peer health educators and peer learning assistants.

Carol Harris, HCDS associate director, said Counselling Services’ strengths include being able to see a large number of student and deal with a wide range of mental health issues.

“Over time, here, we’ve developed other systems of intake so that we can see students more quickly than we used to be able to in the past. The good stuff about that is that students can get in for the first appointment relatively quickly … the downside of that is that they often then will have to wait quite a while to get in for a follow-up appointment.

“It also makes us have to have less sessions per student, because we’re getting more and more students in.”

Harris said Counselling Services sees about 300 more students annually now than it did four years ago. This is thanks in part to a slight increase in the number of counsellors, including the addition of a crisis counsellor, but primarily because of the new intake system.

“We haven’t increased the number of counsellors to accommodate that number of people,” she said.

Right now, Counselling Services has the equivalent of 13 full-time counsellors.

“There’s not a lot of turnover,” Harris said. “People come and they’re here for quite a long time: Right now, we’ve got … nine people who’ve been here more than three years.”

In an ideal world, Harris said, she’d like to see Counselling Services have the equivalent 17 full-time counsellors.

Harris said Counselling Services hasn’t changed much over the years in the types of counselling it offers.

“We’ve got a variety of different models that counsellors use,” she said. “We’re more on a short-term counselling model just from the logistics of being able to see enough students.”

In the last six or seven years, however, Harris said she has seen students coming in with more severe mental health issues.

“I would say more students are coming now with major mental health problems,” she said. “A lot more students are coming with eating disorders … coming in with diagnosed depression or they’ve actually been in therapy for periods of time before they’ve ever come to Queen’s.”

Harris said she doesn’t know whether this is due to a greater occurrence of these problems, or if these problems are more often diagnosed than in the past.

“Probably the culture is changing out there,” she said. “It may be that more people are being diagnosed, they’re more willing to go and seek help earlier on, or their parents are more willing to go and seek help.

Harris added that counselling services at other universities in Ontario and in the rest of Canada are facing similar issues.

HCDS also works on promoting a healthy student lifestyle.

“We have had, for the last about 20 years, a really good health education program,” Condra said. “We’re always on the lookout for better, more effective ways to inform students about health and education.”

These strategies can range from awareness campaigns to workshops on different aspects of healthy living.

“We have a health education and promotion program which provides health education and health promotion information to students, which is provided in residence and other places across the campus,” he said.

Condra also mentioned that HCDS helps with stressbusters and offers a program called Food that Makes Cents, helping students eat nutritionally on a low budget.

Condra said he thinks students try to maintain healthy lifestyles for the most part, but this can be difficult at university.

“I think students listen, but there are times of the year when I think for students, the pressure of work [make it] very difficult to follow healthy choices all the time because students are under pressure around exam time, they have multiple assignments due, they’re wrapping up this, that and the other—sometimes it’s difficult,” he said. “We’re just in situations where we can’t always eat right or sleep enough.”

Kate McKenna, ConEd ’08, said she has always had positive experiences with HCDS.

“I found the doctors very knowledgeable and very willing to deal with students,” she said. “Any time I’ve needed a doctor’s appointment, if I’m sick enough the nurse referred me the same day.”

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