
A new set of clinical practice recommendations published in the Canadian Medical Association Journal (CMAJ) aim to help health-care providers support students experiencing a mental health crisis. The research represents a collaborative effort between London Health Sciences Centre Research Institute (LHSCRI), McGill University and the Douglas Mental Health University Institute and are designed to address the growing need for mental health care among youth, which Statistics Canada reports has doubled between 2019 and 2023.
“This quick guide helps reframe how we view mental health crises — moving beyond a diagnostic focus and calling for a response that is proportionate to the context, so we can provide care that’s more personalized and effective,” says Dr. Lena Palaniyappan former medical director for LHSC’s Prevention and Early Intervention Program for Psychosis (PEPP) and the senior author of the study.
Most crises are a reaction to life circumstances
The authors of the published research explain that most mental health crises stem from challenges such as academic stress, peer pressure, family conflict, and financial difficulties. An effective approach involves validating these life circumstances and identifying the contributing factors in a compassionate way.
“Youth struggling with mental health need validation and understanding, which our paper highlights. What they don’t really like is a diagnostic label,” explains Irnes Zeljkovic, Clinical Navigator for the Prevention and Early Intervention Program for Psychoses (PEPP) at London Health Sciences Centre (LHSC) and an author on the paper.
Lifestyle and support from community matters
Early collaborative planning with individuals like family members, teachers, or employers plays a vital role in reducing stigma, maintaining engagement, and preventing further negative outcomes, like dropping out of school. The authors comment on how factors such as sleep, physical activity, nutrition and social media use can significantly impact a person’s mental health.
Preventing further mental health crises is crucial
The paper highlights the critical need to focus on prevention and sustained support in student mental health care. One key recommendation is to ensure continuity by having students see the same provider for follow-up appointments. This consistency fosters trust and strengthens the connection between the student and clinician.
They also emphasize the role of prevention. Students should learn to recognize behaviours that could lead them to a mental health crisis such as lack of social connection, increase in sedentary behaviour or a significant use of social media and seek help if they are struggling.
“There is power in being vulnerable,” explains Zeljkovic. “In my opinion, I think it makes people much stronger when they’re more open and honest about some of the things that they’re struggling with because it makes them more authentic. By keeping things inside, it not only contributes to the stigma, but it also takes away that person’s authenticity,” Zeljkovic adds.
Cultural humility of clinicians can enhance outcomes
The authors share the importance of recognizing that power dynamics and cultural differences between the health-care provider and the patient may exist. They note that using open-ended questions, showing genuine interest, and seeking feedback are a few strategies that can be used to build rapport during therapy.
“I hope this research helps clinicians enhance the care they provide and ultimately, I hope that it leads to better outcomes for students who face a mental health crisis,” says Zeljkovic.