A quick reference guide to mental health on university campus: a brief rhetorical analysis of fear

Abstract

I was teaching rhetoric at the University of Victoria when I received the ‘Quick Reference Guide: Assisting Students in Distress’, part of the university’s initiative to address the increasing problem of mental illness on university campuses. I immediately read a rhetoric that presented mental health as Madness, as something to be feared, a threat to the university, class and the individual. This short article is a brief rhetorical analysis of this Guide, and suggests that we must move beyond fear if we are to begin to address the mental health crisis on university campuses.

Keywords:

• Mental health crisis
• rhetoric of fear
• Mad Studies
• depression
• madness

I received the ‘Quick Reference Guide: Assisting Students in Distress’ at the end of 2014 (University of Victoria 2014b). This was a much-needed resource. Every faculty member was given one as part of a three-year initiative (2014–2017): the University of Victoria (UVic) Student Mental Health Strategy, a ‘framework that provides direction for the Division of Student Affairs and the broader university community for a holistic and comprehensive approach to student mental health’ (University of Victoria 2014a). The somewhat vague wording of this UVic initiative seemed to reflect the uncertainty that continues over issues of mental health on campus, and beyond – a once-tabooed topic, stigmatised (still stigmatised), a subject to be awkward and unsure about, even fear. The Strategy also reflected any number of similar initiatives across university campuses in North America and Europe, which are struggling to deal with a rising incidence of mental health problems among students. It was good to see an attempt to address student mental health. The most common diagnosis for students is depression. Richard Kadison and Theresa DiGeronimo call this a ‘Mental Health Crisis’ on campus, claiming that depression affects 50% of students at some point during their time at university (Kadison and DiGeronimo 2004). And it appears to be a growing problem, reported widely in the media: in Canada, from rising suicide rates amongst students in 2013 (Kennedy 2013) to the ‘struggle for campuses to provide students mental health care’ in 2017 (Goffin 2017); while in the United Kingdom, The Telegraph reports research that suggests suicide rates amongst university students have risen 56% between 2007 and 2016 (Rudgard 2018). The Office for National Statistics data published shortly after The Telegraph story suggest university student suicide rates are in fact lower than those of the same age from the general population, but statistics highlight a worryingly high suicide rate more generally among young people (‘New data’ 2018). Uncertainty continues to define this crisis and response: why this increase in mental health problems; why depression; are students under more stress than ever before; is there an over-diagnosis; and what should be the response? As Rachel Demery, Kathryn Thirlaway, and Jenny Mercer’s study suggests, little had been done to examine the experiences of students diagnosed with mood disorders, and in looking to rectify this they also conclude that little information is offered on campus to help these students (Demery et al. 2012). Those with such ‘invisible disabilities’ face the challenge on campus of ‘negative social attitudes’ and a ‘general lack of understanding’ (Mullins and Preyde 2013, 153). With these various uncertainties around mental illness comes fear; and the four glossy pages of the UVic Reference Guide seemed appropriately timed to allay some of that fear and offer a resource that might be helpful to both faculty and students.

I was teaching rhetoric during the semester I received the Guide and immediately saw the possibilities of writing a rhetorical analysis of its format and content. Over three years later, the same Guide is still in use and can be found as a pdf online (https://www.uvic.ca/studentaffairs/assets/docs/SMHS_reference-folder.pdf). What intrigued – and concerned – me was a conflict in the rhetoric of the Guide that nicely reflects a historical dichotomy of care and fear that has long governed our uncertain response to mental illness. A simple resource of information for faculty suggests awareness and care for those with mental health issues (and for this, institution and resource should be praised); but this sense of care, and arguably the resource itself, is undermined by a recourse to fear, so that not mental illness but rather Madness is glimpsed on the page – Madness which has traditionally been seen and represented as a threat that must be contained. In the remainder of this article, I conduct a brief rhetorical analysis of the UVic Guide to ‘Assisting Students in Distress’, to highlight the continuing sense of fear that surrounds issues of mental illness and troubles a university response to the crisis on campus. My aim is not to simply criticise the resource; rather, I seek to generate discussion that will help us further improve services and resources for students, staff and faculty. At the same time, this article also looks to contribute to the field of Mad Studies, a growing movement of scholarship and activism that questions social constructions of mental illness in search of a more humane and imaginative way of defining, representing and treating mental illness.

On its cover, the Guide sets out a passive, non-confrontational visual and written rhetoric to represent a sensitive issue: an appeal to pathos, to an emotional calm; yet it suffers from being too passive, so appearing to avoid rather than clearly address its topic. A neutral purple and yellow colour scheme sets the tone on the cover, with a stock computer image of three light-green centric circles at its centre; within these sit three purple flowers and three purple leaves. The image reassures – its simplicity and ‘threes’ offer balance and symmetry, reminiscent of a zen pool with floating blossom; in other words, this Guide is a calm response to the ‘distress’ of the student highlighted in the title. But what is this distress? A student stuck up a mountain, drowning at sea? The title is unclear, its logos poor. Subtitles introduce the ‘Mental Health Initiative’, clarifying focus a little, and then the resource offers, on the first inside page, lists of ‘Possible Signs of Student Distress’ and then ‘Tips for Assisting a Student in Need’ – again, in vagaries of description. Like any public service piece, the information suffers from having to be brief, so oversimplifying, and from offering almost banal advice, such as if a student seems to have a problem, then talk to him/her (logos issues, again). The signs of distress as listed also remain rather vague, and include signs of social withdrawal, alcohol and drug use, expressions of violence and feelings of hopelessness – not necessarily signs of mental illness; some are, perhaps, signs of an over-partying student. We remain uncertain as to what it is we are dealing with here – mental health is not mentioned, and although alluded to (‘hopelessness’), depression is conspicuous by its absence, considering it is the main mental health issue on campus right now. The careful, thoughtful passivity ultimately says less than it should (a failure in logos, in information), trying to avoid a topic it is perhaps uncomfortable addressing, instead creating further uncertainty – referring to something that cannot be named, misdirecting its pathetic appeal and even creating a subtle sense of fear.

This fear is more pronounced on page three, entitled ‘Recognising Concerning Student Behaviour’. This flow diagram can be seen in Figure 1. Three options are given to the reader: (1) observe, ‘Uncharacteristic Behaviour’ and respond, ‘Gather Information and Seek Advice’; (2) observe, ‘Disruptive or Distressed’ behaviour and respond, ‘Timely Consultation Required’ (but with whom?); and (3) observe, ‘Dangerous, Threatening or Violent Behaviour’ and respond, ‘Immediately Report’. The choices are (necessarily?) reductive, and speak to a tradition of psychiatry that reduces complex individual experiences to symptoms, rather than – as advocated by Mad Studies – consider the various social contexts of the individual (Menzies, LeFrançois, and Reaume 2013, 2).

Figure 1. A visual and written rhetoric of fear.

More troubling is the visual rhetoric of the page, particularly option 3: ‘Dangerous, Threatening or Violent Behaviour’, which is positioned central to a two-page spread and coloured red. Red for danger. This dominates the inside pages – this is where your eyes immediately go when you open the Guide. The diagram seems to highlight information relating to the threat the student poses, not the help we might provide – the focus seems wrong. An arrow then points from ‘Immediately Report’ to telephone numbers for emergency services and campus security. Indeed, the 9-1-1 number for emergency services is given six times in the Guide, four times on page three alone. Campus Security, however, is the most cited number at seven times, far more than the number for Counselling Services (twice) and Health Services (twice). Why do we require these numbers so many times? Again, the emphasis highlights ‘threat’ and not ‘help’. Like Figure 1, Figure 2 highlights the emphasis on these ‘phone numbers of fear’. ‘Tips for Assisting a Student in Need’ are overshadowed by fear of the Mad, ‘Dangerous, Threatening or Violent’ student. The lesser threats of options 1 and 2 on the diagram connect to the more useful telephone numbers of Counselling and Health Services, but this list entitled ‘See Something, Say Something’ offers a rhetoric reminiscent of war-time safety propaganda or the signs that adorn London railway stations, that remind us to be vigilant for terrorist threats. Is this an unintentional emotional appeal to fear due to the poor wording of information; Is it a logical appeal cloaked in pathos to emphasise the importance of this information (but why this information)? Or does the writer really want to instil fear of mental illness into the reader? The Guide then positions – unwittingly or not? – the distressed student as a threat, akin to a terrorist or bomb that might explode at any moment on campus. This student is dangerous, so be prepared!

Figure 2. ‘Phone numbers of fear’.

Ultimately, the Guide portrays student ‘distress’ (mental illness) as a threat to class, campus and more immediately to the member of faculty dealing with the student/threat. The drive to care, which can be read in the production of this Guide and its intent to offer helpful information, is overpowered by a stigma of fear long attached to mental illness. Considering that depression is the main concern on campus – an illness not generally associated with violent outburst and attacks (in fact, most common mental illnesses are not) – the rhetoric (its logos and pathos) of the Guide appears misfocused. In our drive to aid those with mental illness, and be more mindful of the stresses faced by university students, it seems that we still cannot escape a reading of Madness. What, then, is the effect of the Guide on the reader? What response to a student with mental illness does it encourage from the faculty or staff member? Perhaps the reader is unconsciously just a little more unsympathetic, a little more tense, fearful, when ‘confronted’ by a student with mental health problems, and left wondering which telephone number is best to call. Madness, here, breaks free of its medical redefinition as mental illness, escaping through the vagaries of ‘distress’ and a fear for personal safety, remaining something that we do not understand. The Guide reminds us that we need to look closely at how we read and represent mental illness on university campus; we must leave behind a rhetoric of fear (so ingrained that it manifests unintentionally?), if the mental health crisis is to be looked at, not only in a more caring, compassionate manner, but in – perhaps more importantly – an original and creative (indeed, dare I write, critical) way, so that we might at least begin to understand the crisis on campus.

Disclosure statement

No potential conflict of interest was reported by the author.