Addressing the Unique Mental Health Needs of College Students
~ Identify the scope of the mental health problem in college students
~ Identify the impact of mental health issues on learning and student retention
~ Learn about the connection between mental health issues and substance abuse
~ Explore unique issues faced by college students
~ Identify the components of a good campus mental health program and other strategies to reduce stressors
Scope of the Problem
~ According to a 2016 American College Health Association survey,
~ 37percent of students reported feeling so depressed within the last 12 months that it was difficult to function
~ 21 percent felt overwhelming anxiety
~ A survey of students seen for mental health services at 66 college counseling centers found that prior to college
~ 10 percent of these students had used psychiatric medications
~ 5 percent had been hospitalized for psychiatric reasons
~ 11 percent had seriously considered suicide
~ 5 percent had attempted suicide.
Scope of the Problem
~ The 2015 NSDUH shows that adults ages 18 or older with past year mental health issues were more likely than other adults in that age group to have used illicit drugs in the same period (32.1 vs 14.8%)
~ The risk of co-occurring disorders is pronounced among college students as they transition from adolescence to adulthood, an age when mental health issues often surface for the first time and in a new environment where substance use is common
~ Increased academic distress is associated with increased mental health issues including suicidal ideation
~ Misuse of drugs and alcohol is correlated with
~ Need to cope with the pressures of college life (6.4% of college students report nonmedicinal use of ADHD medications)
~ Campus culture of alcohol use

Why Do We Care?
~ The overall state of student’s health affects learning.
~ Mental health problems and harmful health behaviors such as substance abuse can impair the quality and quantity of learning.
~ They decrease students’ intellectual and emotional flexibility, weaken their creativity, and undermine their interest in new knowledge, ideas, and experiences.
~ Behavioral health issues such as binge drinking, drug use, cutting and other self-injurious behavior, eating disorders, pornography addiction, and problematic gambling can all be understood as maladaptive strategies to reduce stress and anxiety.
~ Several of those behaviors are reinforced and supported in the social culture of many colleges and universities. (Which behaviors are reinforced in your university?)

Why Do We Care?
~ Students may self-medicate by turning to substance use
~ Substance use is frequently associated with negative personal, social, and community consequences, from regretted actions while intoxicated to “hooking up.”
~ Students need access to care to cope with these events to prevent PTSD, depression and suicidal ideation.

Issues Students Face
~ Stressors
~ New freedoms and independence
~ New surroundings and experiences
~ New social networks
~ Separation from family and established friendships
~ New academic demands
~ Some students may be afraid to seek certain types of help or request accommodations for a mental health issue for fear of being viewed as incapable or being expelled.
~ However, without accommodations, their performance may be negatively affected
Developing Resilience
~ A key component of well-being is resilience—the ability to recognize, face, and manage or overcome problems and challenges, and to be strengthened, rather than defeated, in the process.
~ Resilient graduates better navigate today’s uncertain and volatile economic, employment, and career environments.
~ Challenges to health and well-being undermine resilience by making it more difficult for the student to deal with life on life’s terms
~ Less resilient students take fewer intellectual and creative risks and are poor partners in group learning situations

Developing Resilience
~ Hardiness (Commitment, control and challenge) is a strategy that can promote resilience
~ Hardy personality allows one to have confidence in one’s ability to handle change, increases belief in one’s general competence, and helps derive personal meaning from one's social activities
~ Learning experiences of all kinds, from academic courses to student employment, help students develop this ability
~ What experiences can we facilitate to help students? (What problems can we present, in what way, with what expected outcome?)
~ Providing culturally competent, trauma-informed services and active outreach to specific populations is vital

Developing Resilience
~ Where and how can outreach be done
~ Residence halls
~ Sports teams
~ Panhellenic council
~ Student Union
~ Email
~ Undergraduate courses
~ Where/how else…

Special Issues
~ Cultural factors may also inhibit help seeking
~ Race/ethnic beliefs about mental illness and help seeking
~ Gender
~ Group membership
~ Veterans
~ Many veterans face the challenges of injury, PTSD and TBI.
~ Adjustment from a military environment to the less formal campus culture can be quite difficult.
~ Providing mental and behavioral health services within a veterans’ center or focused programming for military learner support can improve their functioning and learning

Special Issues
~ Students with autism spectrum disorders, including Asperger’s syndrome, also have important needs.
~ Early identification, treatment, and effective accommodations before matriculation can prepare these students for the academic rigors of higher education.
~ Social skills deficits, however, are often problematic for students participating in the classroom, learning in groups, engaging in student organizations and activities, and living in residence halls.
~ Collaboration among several campus offices is necessary to respond to the needs of these students and promote their learning and retention

Components of Quality Programs
~ Strategies to strengthen learning outcomes for students of any age and in any context
~ Improving the quality of the learning environment.
~ Provide education, outreach and prevention services to help students manage unique stressors
~ Providing culturally responsive, trauma informed services to treat mental health and addiction issues
~ Ensure faculty, staff, administration and health personnel are aware of strategies to help students deal with stressors

Components of Quality Programs
~ The best way for colleges and universities to nurture resilience among students is to promote health and well-being, especially mental and behavioral health, at both
~ Individual
~ Organizational
~ Community levels (housing, employment, activities/engagement)

Components of Quality Programs
~ Publicity campaign to
~ Reduce the negativity associated with seeking help for mental health issues
~ Educate the campus community (students, residence hall staff, instructors) about
~ The warning signs of mental health issues
~ Stress management and wellness strategies
~ Demonstrate understanding of different ethnic/racial social norms and needs
~ Raise awareness of the resources on campus and in the surrounding community.

Components of Quality Programs
~ Screen students during orientation
~ Provide web-based screening that connects with the counseling center
~ Improve campus culture focusing on discrimination, trust, respect, dignity, sensitivity and cultural competency
~ Improve access to information focusing on the information needed and communication and dissemination practices
~ Make services available on campus… even if that is a clinician from the community

Components of Quality Programs
~ Manage expectations of campus mental health systems and changes to promote mental health and recovery on campus (How much can the center reasonably do?) focusing on…
~ Student control and choice
~ Mental health care expectations
~ Administrative expectations
~ Accommodations and policy
~ Community approaches

Components of Quality Programs
~ Other Services and Procedures
~ Access to mental and behavioral expertise for faculty, staff, families, and peers who are concerned about a student
~ Ability for self referral
~ Off campus referrals
~ Emergency services
~ Aftercare programs
~ Medical leave policies
~ Nonclinical student support networks
Components of Quality Programs
~ Onsite counseling centers with an interdisciplinary team that includes the primary health care providers, licensed social workers/counselors, life skills support staff, registered dietitians, peer support specialists
~ Onsite medical services and assistance with prescriptions
~ Student and administration leadership to promote mental health and suicide prevention (Athletes, Panhellenic, SOTA, minorities, unaffiliated students)
~ Life skills development
~ Social network promotion

Other Helping Strategies/Stress Points
~ Tutoring programs
~ Mentoring programs
~ Ensure sufficient parking and transportation
~ Hold all student groups on campus strictly accountable for underage alcohol use at their facilities and during functions that they sponsor.
~ Eliminate alcohol advertising in college publications.
~ Educate parents, instructors, and administrators about the secondhand effects of substance use that range from interference with studying to being the victim assault or date rape
Other Helping Strategies/Stress Points
~ Enlist administrative, community and student assistance in changing any culture that currently supports alcohol use by underage students or substance misuse.
~ Expand opportunities for students to make spontaneous social choices that do not include alcohol (e.g., by providing frequent alcohol-free, late night events; extending the hours of student centers and athletic facilities; and increasing public service opportunities

Campus Wide Emergency Plan
~ Emergency mental health-related situations that should be addressed in the plan include:
~ Managing suicidal and/or homicidal ideation.
~ Managing victims of sexual assault, with clarification regarding exemption from mandated reporting in this context.
~ Managing highly agitated or threatening behavior, acute psychosis (often involving hallucinations and/or delusions) or paranoia.
~ Managing acute delirium/confusional state.
~ Managing acute intoxication or drug overdose.
Campus Wide Emergency Plan
~ Written procedures for managing emergency mental health situations should, at a minimum:
~ Identify situations in which EMS should be immediately contacted.
~ Identify situations in which the individual responding should contact a trained on-call counselor, or the sexual assault center.
~ Identify trained on-call counselors who will be able to provide direct and consultative crisis intervention to the student to help stabilize the situation and recommend next steps for action.
~ Designate expectations for each stakeholder during a crisis
~ Specify steps to be taken by each stakeholder after an emergency situation has resolved to provide appropriate resources and follow-up care to the student.
~ Specify a procedure for reviewing preventive and emergency procedures after the resolution of the emergency situation

Special Issues for Student Athletes
~ Coaches should learn about the importance of being attentive and empathic in their interactions with student-athletes who are facing mental health challenges, while understanding that their role is not to manage the situation themselves.
~ Clearly delineate a transition of care plan for student-athletes who are leaving the college sport environment in the interest of continuing medical care and student-athlete welfare
~ Identify who is responsible for initiating transition of care and for facilitating the academic waiver process, should a waiver be needed
~ Develop plan for helping student-athletes who have been away from campus while seeking care for mental health issues transition back to campus and to sport participation

Special Issues for Student Athletes
~ Understand the institutional policies related to athletics financial awards and team engagement for student-athletes who are unable to continue sport participation, either temporarily or permanently, due to mental health considerations
~ Be aware of strategies for financial support of student-athletes in need of extended outpatient treatment or inpatient care
~ Consult campus disability services office on how to increase inclusive practices that may increase engagement of student-athletes

~ To thrive, students need access to services and programs of outreach, education, and prevention that:
~ Eliminate fragmentation and improving access to biopsychosocial services
~ Recognize patterns in campus life that suggest the presence of mental and behavioral health concerns among individual students, groups of students, or the campus environment itself
~ Provide outreach and consultation to prepare all members of the campus community to recognize and respond to students with mental or behavioral health concerns
~ Emphasize case-finding—using surveys, presentations, self-assessments, activities, and special events—to identify students whose lack of psychological well-being is interfering with their development, learning, and achievement

~ To thrive, students need access to services and programs of outreach, education, and prevention that:
~ Nurture a supportive tone and attitude about mental health in campus culture
~ Challenge stereotypes about mental health problems
~ Undermine prejudices and stigma about counseling
~ Provide encouragement to students to reflect on their own mental health and seek services when needed