Supporting Student Wellness
Dr. Dawn-Elise Snipes, Director AllCEUs.com
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Objectives
~ General guidelines for supporting student mental health
~ Specific information regarding student athletes
~ Explore some information relevant to students regarding alcohol and drug use and disordered eating
~ Identify the basics for early crisis intervention

~ One in every 12 U.S. college students makes a suicide plan, according to National Data on Campus Suicide and Depression.
~ One in four adults experience mental illness in a given year, according to the National Alliance on Mental Illness.
~ In 2015 students were asked if they worried their food would run out before they had money to buy more. Nearly a quarter (22 percent) of undergraduate students answered yes to this question
~ 32 percent of female students reported experiencing sexual assault within their lifetime Association of American Universities survey
~ CDC finds sharp increases in three sexually transmitted diseases, and young adults account for a majority of these cases. (11/3/2016)
~ 30–70% of those seeking treatment for an eating disorder receive medical treatment for weight loss, indicating that individuals with eating disorders are much more likely to receive treatment for a perceived weight problem than mental health treatment for an eating disorder.
~ 4.4–5.9% of teens enter college with a pre–existing, untreated eating disorder

General
~ Find a “champion” who will support the student well-being initiative
~ Promote positive behaviors and benefits of health promotion
~ Demonstrate a genuine interest in student success (academics, extracurricular, athletics etc)
~ Engage athletic trainers, directors of residence life and resident assistants, house moms/dads, professors and apartment managers
General
~ Communicate about the consequences of not seeking help and the benefits of early intervention
~ Normalize/destigmatize mental health issues
~ Due to strong cohesion of certain groups, understanding and addressing group (athletics, sorority/fraternity) norms about health and safety behavior an important educational strategy
~ Train peer health educators
~ Be aware of high stress times: Rush, Try-outs, midterms, finals, before breaks, after breaks
~ Be alert to signs of hazing and have a clear policy and procedure for handling hazing reports

Student Athletes
~ Just because student-athletes are generally a healthy population does not mean that they are immune to mental health issues.
~ Because of this perception, student-athletes may be even more reluctant than a non-athlete student to seek help.
~ Pressures related to scholarships, academic and athletic performance and being in the spotlight (good and bad attention), reaction to injury, overtraining add to student athlete’s stressors.
~ Key people influencing student-athlete decision-making are coaches, teammates, and parents.

Student Athletes
~ Programing for student-athletes must consider timing issues, such as differences in alcohol use, dieting, workout schedule, and time availability in the off-season compared to the competitive season
~ Student-athletes may experience an increase in anxiety when exposed to a new coaching style and/or team
~ Coaches need to be particularly responsive and careful with depressed student-athletes as they may interpret interactions and communication more negatively than intended
~ Establish a practice of following up with student-athletes who suffer career-ending injury or otherwise are disconnected from the team

Alcohol Awareness
~ Alcohol use inhibits absorption of nutrients and diminishes protein synthesis, resulting in decreased muscle growth.
~ Alcohol causes dehydration and slows down the body’s ability to heal.
~ Alcohol negatively impacts sleep, which can result in decreasing the body’s natural production of human growth hormone (HGH) and may compromise muscle repair and growth.
~ Decreased sleep also hampers memory and information retention.
~ Alcohol produces a substance that is directly toxic to testosterone.
Alcohol Awareness
~ Alcohol use depletes energy sources, can disrupt water balance in cells and alter their ability to provide fuel for muscles to contract.
~ Alcohol use inhibits the ability to learn new information and form memories
~ Consuming five or more alcoholic beverages in one night can affect brain and body activities for up to three days.
~ Two consecutive nights of drinking five or more alcoholic beverages can affect brain and body activities for up to five days.

Drug Awareness
~ Marijuana
~ Can slow reaction time, impair both motor and eye-hand coordination, impair learning and memory, increase anxiety and in some cases cause psychoses, and lead to frequent respiratory infections.
~ Stimulants
~ Abuse of stimulant-type substances such as amphetamines, cocaine, ephedrine, and medication for ADHD can cause people to become nervous or jittery, increase heart rate, blood pressure, heat production, and body temperature

Strategies for Group Leaders: Drugs & Alcohol
~ Be aware of the symptoms of substance abuse.
~ Understand reporting protocol for students who are violating substance use policies, and for referrals of students seeking assistance with substance use issues.
~ Encourage help seeking for all mental health concerns, including substance abuse.
~ Communicate with group members about the consequences of substance abuse.
~ Establish clear expectations about the role that all group members play in keeping each other healthy and in preventing substance abuse.
~ Be aware of how their own substance use behaviors and attitudes are modeled for students.

Disordered Eating
~ Risk Factors
~ Misperceptions about weight and performance
~ Emphasis on BMI vs. overall health and body fat %
~ “Image” standard set by the group or media
~ Upcoming Spring Break or formal season
~ “Freshman 15”
Disordered Eating
~ Consequences
~ Restricting carbohydrates forces the body to convert protein into a less efficient form of energy and increases the risk of injury.
~ Intense dieting can negatively affect VO2 max and running speed
~ Anxiety, depression, decreased concentration, emotional dysregulation and obsessions with eating, food, and weight.
~ Vomiting, excessive exercise, and restricting calories often lead to
~ Dehydration, which can compromise performance
~ Electrolyte imbalances which can impair performance and lead to heart failure
~ Stress fractures
~ Male and female students who are inadequately fueling their bodies may experience hormonal disruptions that lead to compromised bone density and increased risk of bone injuries, including stress fractures.

Advice for Group Leaders
~ Be aware of the symptoms of disordered eating (lanugo, Russell’s sign, sudden drop in weight, puffy face, dehydration, refusing to eat in front of others…)
~ Seek out services of a registered dietician
~ Know what services are available to students with disordered eating
~ De-emphasize weight. Focus on increasing performance and status of the organization
~ Remember that body composition and training for optimal health differ between people
~ Involve other stakeholders
Services for EDs
~ Educational events, programs and workshops e.g. Body image workshops, participation in National Eating Disorders Awareness Week, etc.
~ On-campus screenings for eating disorders
~ Counseling services with staff practitioners who have a specialty in eating disorders
~ Academic classes, research and programs for formal education and training in eating disorders for students or staff.
~ Residence life programs and peer advisors who are trained to identify and offer referrals for disordered eating.
~ Athletic department services to prevent, screen for and refer student athletes with eating disturbances
~ Informational resources for students including articles, web sites, pamphlets and library collections specifically on eating disorders
~ Availability of dietician, physician and counselors

Disordered or Lack of Sleep
~ Risk factors in the sport environment
~ Athletic scheduling. Timing of practices, travel, and competition can interfere with regular sleep patterns.
~ Intense exercise in the evening can interfere with sleep.
~ Post-game socializing. Sleep after a practice or game is critical for consolidating benefits from the effort and repairing the body. A “work hard, play hard” mentality.
~ General Risk Factors
~ Time demands (job, clubs, school, friends) decrease sleep opportunity.
~ Poor time management
~ Homesickness
~ Poor nutrition

Consequences of Disorders Sleep
~ Diminished reaction time.
~ Diminished cognitive function, which can result in greater difficulty learning and remembering
~ Compromised hormones, including diminished testosterone.
~ Changes to the athlete’s metabolism, which can make it challenging to stay at an optimal body composition
~ Individuals who are sleep deprived are more likely to overeat.
~ Decreased ability to regulate emotions, which can result in greater irritability and impulsivity.
~ Decreased energy

Best Practices
~ All coaches, faculty and group leaders receive information annually about:
~ Signs and symptoms of mental health disorders.
~ Programming for first response to emergency situations.
~ The importance of, and how to, create a positive culture that promotes personal growth, autonomy and positive relationships.
~ Information about sexual assault, interpersonal violence and hazing.
~ How to encourage and support diverse students who are facing mental health challenges to seek appropriate management and referrals
~ The specific referral process that staff should follow if they are concerned about a student’s mental health.
~ The importance of understanding and minimizing the possible anxiety about adverse consequences for seeking mental health care.

Best Practices
~ Students should annually receive education about:
~ Signs and symptoms of mental health disorders and how to obtain mental health guidance from licensed practitioners
~ Programming about preventing and responding to sexual assault, interpersonal violence and hazing.
~ Programming about peer intervention in the event of student mental health distress.

~ How can we do this?

Crisis Intervention Protocol
~ Ensure a written policy for when student’s family members will be notified of a mental health emergency
~ Develop a clear policy indicating who is responsible for what in the event of emergency all the way through academic reintegration
~ Ensure that individuals in a crisis are not turned away
~ Ensure interveners have a comprehensive understanding of the crisis.
~ Provide timely access to supports and services in the least restrictive environment
~ Spend adequate time with the individual in crisis.
~ Ensure individuals with appropriate training and demonstrable competence to evaluate and effectively intervene with the problems being presented provide crisis services. (Unique issues for athletes, SOTA, DV in married housing, athletes, EDs, LGBT issues etc.)

Crisis Intervention Protocol
~ Help the individual to regain a sense of control.
~ Attend to issues of culture, gender, race, age, sexual orientation, health literacy and communication needs of the individual being served.
~ Respect individual rights.
~ Ensure services are trauma-informed.
~ Take meaningful measures to reduce the likelihood of future emergencies
~ Ensure peer support is available.
~ Note recurring crises and consider whether they signal problems in assessment or care.
~ Annually review incidents to identify areas for improvement and prevention

Summary
~ University students are not a homogenous group
~ Supporting student mental health has some fundamental aspects, but different groups also have unique needs
~ Supporting student mental health requires the multidisciplinary interaction of students, teachers, counseling, housing and financial aid staff, coaches, parents and the administration.
~ Schools need to have protocols in place for prevention, intervention and referral of students with mental health issues
~ Services need to be available, welcoming and normalized.