Addressing the Unique Mental Health Needs of College Students

This episode was pre recorded as part of a live continuing education webinar on demand. CEUs are still available for this presentation through all CEUs. Register@allceus.com Counselortoolbox I'd like to welcome everybody to today's presentation on addressing the unique mental health needs of college students. I am Dr. Donnelly Snipes. Today we're going to 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 some of the unique issues faced by college students, and finally, identify the components of a good campus mental health program and other strategies that universities and colleges might be able to use to reduce stressors. According to a 2016American College Health association survey, 37% of students reported feeling so depressed within the last 12 months that it was difficult to function. Just let that sink in for a second. That's more than one in three students. If you are teaching a class of 30 students, 11 of them roughly would have felt in the past 12 months so depressed that it was difficult to function. That is mind boggling, astounding, and really depressing. 21% also felt overwhelming anxiety. A survey of students seen from mental health services at 66 college counseling centers found that prior to college, 10% of these students had used psychiatric medications. Now 37% feel clinically depressed. Only 10% had a prior history of psychopharmacology, 5% had been hospitalized for psychiatric reasons, 11% had seriously considered suicide, and 5% had attempted suicide. Wow. Okay, let that sink in again when we're looking at our classes. I was a professor in a face to face classroom for many, many years and I would have classes of anywhere from 30 when I taught graduate school to 75 or 80 when I was teaching undergraduate classes. So that means that 8 of the students, or 9 of the students 8 point something had prior to college either seriously considered suicide and or been on psychiatric medications. Now, some of these numbers are overlapping so people can be in each one of the groups, but it's still a very eye opening number. However, I want to highlight again, that's a small number compared to 37% who felt clinically depressed over the past 12 months. Which means that we've got some people who are at risk when they come, or more at risk when they come. But there's also another 25%, 27% that had no notable history of psychiatric issues. What's going here? The 2015 survey 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 time period. The NSDUH survey is the National Survey on Drug Use and Health. This is not specifically to college students. However, it does highlight the risk factors for the development of addictive issues or the use of illicit drugs in people that have a mental health issue, whether it's diagnosed or not. If they have a mental health issue, they may they probably are at more risk. The risk of co occurring disorders, mental health and addictive 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. Remember our brain, especially that prefrontal cortex where we've got impulse control and higher order reasoning and all that kind of stuff that doesn't finish developing until we're about 24 college students. You start at 18, you graduate at 22. Even when you graduate well, assuming you go straight through for four years, even when you graduate, your brain is still developing in those areas. Youth, if you look at Erickson's model at that age, are going through that stage of identity development which is full of so much turmoil for so many people. You know, I think the majority of people go through a period of turmoil, whether it's figuring out their identity as a person, figuring out what career they're going to pursue. There's a lot of choices that need to be made. And I talked about this last week. My daughter is struggling right now because she feels no matter how much I tell her that people are going to change their majors, you don't have to know exactly what you're going to do the day you walk into college. She feels she needs to know and she's just dead set on that. And that puts a lot of stress on her. When she goes to classes and she's like, oh, you know what, maybe I don't really like this. Maybe this isn't such a good fit. And it's important for us as parents as well as professors and college counselors and whomever else to validate students feelings and help them recognize that they do have choices. Just because they declared a major doesn't mean they're necessarily stuck. They're not in a tunnel where there's nowhere to turn. They're on a path and they can choose a different arc if they want to. But there are a lot of things that are going on developmentally. This is also a time when students are often engaging, especially now. It seems engaging in some of their first more serious relationships. I've seen a trend in the people that are my kids age that they are not getting into their serious relationships in general until somewhat later. They're not doing the individual dating and things. Which is I think an interesting difference between our age groups. There's increased academic distress which is associated with increased mental health issues, including suicidal ideation. It's challenging. You know, when in high school you turned in a paper, you got a paper back, there was a grade, yada yada. And in high school there was also a lot of times the ability to either redo the assignment or get extra credit. That's not necessarily true in college. And in college I've seen a trend among my colleagues when I was teaching and definitely seeing it in my daughter's professors where they don't, they take in assignments but then don't give them back. So students are going, I have no idea what my grade is. Which increases anxiety tenfold for a lot of students. They want to be able to know where they stand. Do I have a C right now or do I have an A? I don't know, I don't have any grades. And it's almost the midterm. From a mental health standpoint and from an advocacy standpoint, we really need to encourage the instructors at the collegiate level to make sure that they're helping students develop great anchor points so they can plan and they can understand where they are. A lot of students, their funding, their financial aid is contingent upon their grade point average. So if they don't know what their GPA is and they have no idea what their grade is, it's going to increase stress. Misuse of drugs and alcohol is correlated with a need to cope with the pressures of college life. 6.4% of college students report non medicinal use of stimulant medications. A lot of times this is to help them study and help them focus on. We talked last week about the fact that learning in college is very different and what you have to do in college is very different in many cases than what you had to do in high school. It's not as much spoon fed to you and there's more to do and requires more self discipline, which a lot of people don't develop in their first semester or two. That second semester, second year, it starts to develop, it seems, which means in these earlier years students may be putting things off and then having to cram at the last minute pulling all nighters. And we know that just sets them up for circadian rhythm. Dysfunction, which creates a higher risk of depression and all kinds of other things. And misuse of drugs is also correlated with campus culture of alcohol and drug use. Even if you're on a dry campus, people are using alcohol. You know, don't fool yourself to think that, well, this is a dry campus. So, you know, nobody that goes here is drinking. Well, they may not drink on campus, they probably are, but they may not. They're drinking somewhere. It's important to recognize that there is a pressure to drink. And again, look at the age range 18 to 22. You've got a lot of people who, you know, let's just assume they didn't start drinking until they were legal. Well, they get legal in their junior ish year. And there is definitely a pressure or I don't know if I want to use the word pressure, but a lot of people when they turn 21 feel like, especially if they haven't consumed alcohol up until then, like they should try it out. You know, I'm legal now, look what I can do. Why do we care? Well, hopefully we care for, because we care about people. However, if we're talking about a college, why does a college care about students mental health? Well, the overall state of students health affects learning, their physical health and their mental health. If they're depressed, they ain't going to learn too good. They're probably not going to go to classes, which means they may flunk out. We know that colleges brag about their graduation rates. If we want students to graduate, we need to have them relatively happy and healthy. Mental health problems and harmful health behaviors such as substance use can impair the quality and quantity of learning. If they are hungover, they're going to have more difficulty learning. If they're not able to learn, they're not able to pass their test. If they're not able to pass their test, they're going to flunk out, yada yada. Mental health problems also decrease students intellectual and emotional flexibility, weaken their creativity, undermine their interest in new knowledge, ideas and experiences. Think about clients that you've worked with or yourself if you've ever struggled with major depressive disorder or generalized anxiety. How much intellectual, how much psychological flexibility did you have when you were in the midst of that emotional turmoil? How creative were you? How interested were you and eager were you to learn new things? Not so much. You were just trying to get through the day. Is that really a quality of life? We want our students to have behavioral health issues such as binge drinking, drug use, cutting and other self injurious. Behavior, eating, eating disorders, pornography, addiction, and problematic gambling can all be understood as maladaptive strategies to reduce stress and anxiety. Sometimes people start because of peer pressure, they start drinking because of peer pressure, they begin trying to diet and lose weight and start developing pathological eating habits because of peer pressure. But it can morph, if you will, into something that a student uses in order to cope with stress and anxiety. It can also just start out as a stress and anxiety coping tool. Eating disorders, especially binge eating, people get stressed out, they're not eating right, they binge, then they purge, and you know, we can start setting up a bulimic cycle really easily. Several of the behaviors are reinforced and supported in the social culture of many colleges and universities. Think about your own college or university that you went to. Which of those behaviors do you know was relatively prominent? I know at the university I went to, eating disorders were huge and they were supported. They were actually encouraged in certain sororities. I don't know about the fraternities. I wasn't in a fraternity. Binge drinking, I know was encouraged in some of the fraternities and other self injurious behavior. I didn't see much of that. Not saying it didn't happen, but I can look at all of these things and I can say, yeah, I saw that on my campus. I saw that on my campus. And these are ways that look at the behavior and ask, what is this behavior trying to communicate? What is the function of this behavior and what's maintaining it? Instead of judging it as making a bad choice, look at it as, you know, well, this person wants to survive. This behavior is obviously rewarding in some way. Let's figure out why it's becoming a priority. Why is it? Why are they choosing that over the this? A lot of times it's because that helps them escape, that may help them feel better. That you know, when we're talking about addictions and self injurious behaviors, there's a benefit to it. Academic studies, they may feel helpless, they may feel powerless. And sometimes it doesn't even have to do with academics. Sometimes it's homesickness or relationship issues that they don't have the skills and tools to deal with. So they turn to something else to help them avoid escape or numb. Students may self medicate by turning to substance use, which 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. Sometimes we make bad choices. Whether you were under the influence of something or not, Whatever you did, you did. And instead of creating a victim blaming culture, we need to make sure that we help support the person to be a survivor, to recognize that in the case of, you know, unwanted sexual activity, just because you were drunk doesn't mean you asked for it. You know, you're not to blame here. You're not, you know, you're not the, you're not to blame here. And let's help you figure out how to deal with it. Students face unique stressors as opposed to those of us who have, you know, graduated or choose a different path. There are new freedoms and independence. A lot of times in college, you know, if you remember your college schedule, I remember mine, it was beautiful. I could have classes on Monday, Wednesday, Friday for like four hours each day. And then the rest of the time was supposed to be homework, but it was, it was open. There was so much flexibility. There wasn't somebody telling me I had to make the bus. There wasn't somebody taking attendance in my classes. There was a lot of freedom and independence that I had to learn how to manage and not take advantage of. There are new surroundings and experiences which can be stressful. Being exposed to different cultures, different people. Just being in this environment, learning, figuring out how to manage your own finances and your financial aid and there's lots of stuff. New social networks can be stressors. Whether it's in your residence hall, the people that you live with, the people that you share a dorm room with, your fraternity, your sorority, your cohort, in your college. There are a lot of different social networks that people make when they're at college. Sometimes they blend together beautifully, sometimes they don't. And encouraging people to figure out how they feel and how they're going to navigate those relationships, their separation from family and established friendships. The people that you went to high school with for four years or however long you were there, they're probably not there now with online universities, with the upsurge in people taking classes online, there is a little less of this in those students because a lot of times they're still living at home. However, that doesn't mean that it doesn't still apply to all those students who go away to college. You know, my daughter's chomping at the bit to be able to move and experience her independence. And she doesn't want to be too far away, wants to be able to come home on the weekends, but she is looking forward to a little bit of separation, a little bit of individuation and we talked about 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 if students are struggling. I know a lot of people who didn't get diagnosed with learning disabilities, with dyslexia, for example, until they were in college. And there are a lot of people that are afraid to ask for help because they're fearful of being seen as lying or trying to manipulate the system. We want to make sure people have access to resources. This will prevent them from having a negative outcome because they weren't able to access accommodations that they were entitled to. We need to help students, all students, whether they're online students or face to face students, develop resilience. A key component of well being is resilience, which is the ability to recognize, face, and manage or overcome problems and challenges and to be strengthened rather than defeated in the process. We want people to be kind of like a bouncy ball that, you know, just. It may hit an obstacle, but it bounces back. And if you ever have had one of those super bouncy balls, we can't have those anymore because in my house, because the dogs try to eat them, but every time they bounce, they seem to bounce even higher. And this is what we want to do with resilience. Resilient graduates better navigate today's uncertain and volatile economic, employment, and career environments. We want. Part of what we need to do as professors and college counselors and family is to help students develop resilience so when they graduate and they face that, you know, cold, cruel world, sometimes they have the ability to take it in stride. There are challenges to health and well being that undermine resilience by making it more difficult for the student to deal with life on life's terms. We want to encourage them, when they have these challenges, to view that challenge, view that situation as a challenge instead of an obstacle and say, okay, what can we do here? Less resilient students take fewer intellectual and creative risks and tend to be poor partners in group learning situations. Well, we already talked about how mental health issues can impair a student's ability to learn and may lead to them dropping out. Mental health problems can also impair other students because the person with the mental health problem may not be participating as effectively in group projects, which puts a lot more stress on the rest of the group. Hardiness. Y' all know, this is one of my favorite concepts. The idea of commitment, control, and challenge is one strategy that can promote resilience a hearty personality, allows people to have confidence in their ability to handle change, increases belief in one's general competence, and helps derive personal meaning from one's social activities. Commitment. We want people to be committed to doing things that help them live a happy, healthy, rich life as they define it, which means recognizing that school or academics is one part of their life. But we want them to be committed to every part of their life, because sometimes one part is going to go a little wonky. Keeping that commitment going, recognizing their commitment to all those other areas, realizing there's more to them than, you know, getting into medical school or, or whatever it is, is really important to helping them with hardiness. The control part is that cognitive behavior will help them identify the parts of situations they can and cannot control and recognize those areas in their life where they do have control. Not everybody is a control freak, but all of us like to have a certain feeling of a certain amount of control, whatever that person needs. And we want to help students and people view things as a challenge. When something goes wonky, you know, for lack of a clinical term, encourage them instead of seeing it as, oh my gosh, this is a catastrophe. See it as a challenge or a puzzle or something that can be solved. It's like, okay, this happened. Now what are my options to deal with this situation? To either, you know, go over it, around it, under it, as the case may be. Learning experiences of all kinds, from academic courses to student employment help students develop resilience. So think about what experiences can we facilitate to help students with. One thing I see and okay, soapbox warning here. One thing I see in the college classes right now that just frustrates me is teachers not holding students accountable for anything. If they, they'll start out the semester saying, if you're late, you're going to so many times you're going to lose a letter grade. If you miss so many classes, you're going to lose a letter grade. If you don't turn your assignments in on time, I'm not going to accept them. Yada, yada, yada. You know, the same stuff we heard when we were in college. But then they don't hold them to task. Assignments get turned in late, if at all, and teachers keep giving second, third, fourth chances. It's like, okay, well, you didn't, you didn't get your assignment in when it was due by midnight, so get it to me by midnight two days from now. Oh, well, you couldn't do that. Well, get it to me by midnight Sunday night. And it's just continually moving that bar. In reality, in jobs, most employers are not going to continue moving that bar going, oh, well, okay, you didn't meet the deadline. Let me move the deadline for you. I see that as handicapping students significantly because it doesn't prepare them for the real world, it doesn't prepare them for careers, and it also does not teach them how to manage their time and be responsible. We want to provide culturally competent trauma informed services and active outreach to specific populations. And those specific populations can be pretty varied. Obviously, we're going to talk about some. However, there are so many different cultures and communities and populations on a college campus. It's important to make sure that we are targeting the different groups as much as possible. How can outreach be done in the residence halls? I was a resident assistant for a couple of years and every semester we had a certain number of programs that we had to put on for our. The students that were living on our floor. This was one of those mandatory things. And this is how we did outreach. And we figured out that you offer food, people will come. Sports teams can. You can reach out to sports teams and do outreach. Going to a practice, showing up at, you know, their training sessions and doing a little spiel ahead of time. Encouraging sports, sports teams to also model healthy behavior. People go to, you know, I'm a Florida Gator. People go to Florida Gator games. While people are there, you know, let's provide them a little bit of information about resilience. And obviously you have to do it in a way that they're going to receive it because they're not really wanting to, you know, take a mental health class when they're at a Gator football game. But there are a lot of ways that you can do it. Going back to modeling, if you think of Tim Tebow and Danny Werfel, they did a lot of modeling of resilience. And obviously they were very prominent public figures. But even on campus they were involved in a lot of activities and a lot of groups and they did model method of coping with distress. Whether it's a method that everybody chooses. Yeah, no. But they did model some of that and it served to help people think, okay, well, for lack of a better term, the cool people are doing it. Must be something cool to do. Pan Helenic Council, you can reach out to the fraternities and sororities, encouraging the pledge class presidents and the sorority and fraternity presidents to provide resilience information, to provide programming at their meetings. You know, we had, as a pledge class, we had weekly meetings as you know, a big sorority, they weren't so often, but there's a lot of stuff that can be done because fraternities and sororities, people that are members do tend to congregate together on almost a daily basis. So it's really easy to reach those people. The student union is a place where you can start reaching people who may not live on campus and maybe students over traditional age and all kinds of other people having information handouts, booths, screening places, all kinds of things can help students start developing resilience. Emails sent out to students with a tip of the day or even a text message, a tip of the day on how to deal with stress. Undergraduate courses. One of my favorite ones that I taught when I was working on my dissertation was undergraduate stress and anxiety management. And then also there was a wellness class that I taught at a different university. Those are great courses. They teach resilience. They teach health behaviors. It's one of those classes that qualifies for one of the required courses under. I think it fell under humanities. Either way, it provided really useful skills and tools for the students that took it. So, you know, it's a win win. They get a good grade in a relatively easy class and. And we help them enhance their mental and physical health. There are many, many other ways that you can probably reach out to students and help them develop resilience. Part of it depends on the culture of your university. Where my daughter is right now, the Entire University has 2,000 people. So that's a much different culture than the University of Florida where we had like 75,000. My son goes to yet a different college, but he does all his classes online. So how do we reach out to online students? Cultural factors may also inhibit help seeking. Race or ethnic beliefs about mental illness and help seeking can influence things. If it is culturally seen as shameful or not okay to have a mental illness, then people may not reach out. We want to figure out how can we connect with those cultural groups, if nothing else, but to provide prevention information. These are skills and tools that you can use to help you be more successful. We don't have to say, okay, when you get depressed, come see us. No, let's be proactive instead of reactive. Let's get out there. Lgbtqi, two different genders. Obviously, group membership may also inhibit help seeking. Athletes may not want to reach out for help. People of sororities may not want to reach out for help. I don't know. It depends on the culture of that group. If that sorority or fraternity or sports team or whatever the group is has negative attitudes. ROTC is another one. Has negative attitudes about seeking mental health help. Then they may not reach out. Veterans. Many veterans face the challenges of injury, PTSD and traumatic brain injury. There are a lot of people who go to school on the GI Bill. They may have been in the military for a short period of time. They're not career military people, and they're going to school now, and they're in college. This is way different than when they were in the military, which was way different than when they were in high school. So it's still a huge transition. Adjustment from a military environment to the less formal campus culture can be quite difficult and frustrating for people who are used to a paramilitary structure providing mental and behavioral health services within a veterans center or focused programming for the military. Learner support can improve their functioning and learning. Often it helps with all of these groups to get. Please get feedback from those groups. Actually pull in people who are willing, you know, not involuntarily, but consult with people in those groups and say, okay, hey, this is what we want to do. This is why we want to do it. How can we make these services more accessible and more palatable to your group? Students with autism spectrum disorders, including Asperger's syndrome, may also have important needs. There are people with autism don't necessarily have impaired iq. We do want to remember that. And they very well may be part of the university. Actually, I'm sure they are. There are people with somewhere on the spectrum disorder. There are students at probably every university out there. Early identification treatment and effective accommodations before matriculation, before getting into college can prepare these students for the academic rigors of higher education. They may need additional supports and assistance dealing with this new environment because change. For a lot of people with autism, change is extraordinarily stressful. Social skills deficits are often problematic for students. Participating in the classroom, learning in groups, and engaging in student organizations and activities and living in residence halls. A lot of people on the spectrum have experienced some of these challenges when they were in high school and, you know, before that. That's not all that new. However, the living and residence halls can be more challenging because they're just immersed and they don't have the buffer that they may have had when they were living at home. To be able to go home to this, to a safe space. They may not have as much of a safe space anymore. We want to make sure that they can have a safe space. That may mean for a lot of people with autism, but not all of them, they may need or prefer to be in a single room dormitory so that they're the only person in there. They're not having to share with four other people and four other people's mess. That may be too overstimulating. In addition to all the academics, it's an individualized thing. No two people with autism are the same. Collaboration among several campus offices is necessary to respond to the needs of people with autism and promote their learning and retention. It's important for instructors to understand that people with autism may have different learning needs than the rest of their class. If you're a good instructor, you recognize that almost everybody has unique learning needs. We do want to educate instructors more about how to better help people that are on the spectrum. Components of quality Programs this is what you've been waiting for. Strategies to strengthen learning outcomes for students of any age and in any context include improving the quality of the learning environment. Look around. Are students comfortable? When I was in graduate school, all of our courses were in the basement of the hospital and it was so stinking cold during the summer and during the winter it was so stinking hot that we were constantly having to dress in layers and put on and pull off in order to even be able to focus in class. That of the learning problems or environmental problems, you know, you can kind of deal with that one. But we do want to pay attention. Students with ADHD are going to have difficulty in classrooms where there's a lot, there are a lot of distractions where people are coming in and out all the time. Improve the quality of the learning environment by holding people accountable for getting to class on time and staying in class the whole time, ideally not getting up and going to the bathroom and taking phone calls and this and that and the other. Other ways you can improve the quality of the learning environment, including making sure that there's not too much distraction on the walls and that kind of thing. And make it a comfortable environment where students aren't, you know, switching in their seats because they're uncomfortable and they're at some little, you know, fold out table when at all possible. For students who are home learners, you know, they're taking classes online, we want to make sure that they are in an environment that is ergonomically correct, that has enough lighting. And for the another soapbox here. For our people who take 100% online courses, making sure that they get daylight, that they set their circadian rhythms and they don't get into this habit of kind of being in a cave all the time, they will start to get Depressed. We want to make sure that they, you know, get up, get dressed, take a shower, all that kind of stuff like you would do if you were going to a brick and mortar classroom. Provide education, outreach and prevention services to help students manage unique stressors. Provide culturally responsive trauma informed services to treat mental health and addiction issues. Not all colleges have the ability to have their own counseling center. That's okay. Connect with or liaise with. Develop memorandums of understanding with whatever you want to say. Community mental health centers that will see the students sometimes. Again we talked about this last week. Sometimes. Sometimes you can use part of the university will choose to use part of the student activity fee to contract with a provider, sort of like a capitated situation, to provide mental health services for their students. Other times it's just here are some referral sources in the community that you can go to. Recognizing that a lot of students are still on their parents insurance and will be able to access those resources. Ensure faculty, staff, administration and health personnel are aware of strategies to help students deal with stressors regardless of their ability or disability. Making sure that professors and residence hall staff and etc. Are schooled in techniques like psychological flexibility and and different cognitive behavioral interventions and grounding techniques. Distress tolerance skills to help students deal. You know, if a student gets a paperback and they've got an F on it, they may become very, very upset. We need to help them use their distress tolerance skills to get back into that wise mind before they're even going to hear anything we say. In terms of Patricia, question about are professors informed of students that have special needs and is training provide provided by the colleges? If the student has requested accommodations, then professors are notified. If the student has not requested accommodations, then we have no way of knowing. So if we have a student who is being seen for depression, you know, they may not be requesting any accommodation. So we may not know. If we have a student that has autism, but it doesn't impair their academic abilities and they're not requesting accommodations, then we may not know. It's important. In my mind as a professor, I would always tell students ahead of time if you have any issues or concerns or anything you want to talk to me about or if there's some way I can help you learn better, please come talk to me. You know, here are my office hours, here's my email. Let's meet and make ourselves available. We can't force people to tell us, however, we can make it easier for them. 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 the individual, organizational and community levels. The individual level we've been talking about a lot. We can send them text messages about tips for mental health, tips for physical health in the student union. You know, just like when you go to the doctor's office and they have that channel that just plays all the health tips while you're sitting in the waiting room, seemingly forever. We can have that available. We can have posters up, we can. There's lots of different ways we can engage students. We can have videos on the health center page of the university's website that students can access from the privacy of their own home. There are a lot of different ways we can reach out to the individual. From the organizational standpoint, we need to promote health and well being by creating an organization that's healthy. Creating an organization where you don't have a teacher going in to class the first day going, I don't want to be here any more than you do, but I was told I'm teaching this class so we're going to try to make the best of it. What kind of message does that send? Or spending the first 75 minutes telling them that basically they have no rights and no opinions. But again, soapbox. You also have other teachers that walk in and they're just thrilled to be there. They're so excited. And that's what we want. We want to create a culture that nurtures and encourages people. And when we see them struggling, floundering, withdrawing, we reach out and we go, hey, I notice that you haven't been to class or you seem to be distracted in class lately. Anything I can help you with? It's not that hard. It doesn't mean I have to have the skills and tools to do means I can help people connect with the right resources. And at the community level, we want to make sure students have access to affordable, safe housing, employment and activities and engagement not only on campus, but in the community. Where can students go? What can they do that they enjoy? You know, bowling, movies, parks, Making sure that they're aware of the fact that there is life beyond campus. Which is something I didn't even really realize for the first year, two years that I was at UF because there was so much to do on campus, I hardly ever left campus except for to get groceries. And yes, one way we could really helps students is making sure that they are aware of the different financial aid options that are available to them and how to apply for them. Some universities do have a mentor that Students are assigned to. Not all do. I know my son has a mentor assigned to him that helps him navigate his financial aid. She doesn't help with anything else. It's just making sure that he's doing what he needs to do to keep his scholarships and applying to graduate school. Choosing a major, there's a lot of stuff. Some universities have career counselors that will help students navigate these things. It would be wonderful if some of this were made a little bit more prominent so students knew that, hey, I could go here and get help choosing a major. And I never knew that service existed when I was going to the university. And now one of my students actually runs that particular department. And so I was like, oh, okay, who knew? We can publicly campaign to reduce negativity associated with seeking help for mental health issues. If it's depression, if it's stress, if it's whatever it is, let's not make this, oh, my gosh, you know, you have to go over to the counseling center or get freaked out about it. Encourage students to, you know, go seek help. Encourage students to be open, as open as they feel comfortable about what's going on with them. Educate the campus community, the students, the residence hall staff, and instructors about the warning signs of mental health issues and stress management and wellness strategies. First mental health, first aid is great. It would be wonderful if everybody had to go through that for a 2 hour abbreviated version of that for orientation. Demonstrate understanding of different ethnic and racial social norms and needs, and raise awareness of the resources on campus and in the surrounding community. This is done a lot better now than it was in my day because, you know, we have computers but. And the Internet, which didn't exist back then. However, I still think we can do more. I still think we can do better to make sure students know about the array of resources that are available to them. We can screen students during orientation, provide web based screenings that connect with the counseling center. So if a student takes online screening for depression and they score in the, you know, concern category, then they are automatically redirected to the counseling center where they can choose to make an appointment or not. And that screening that they do online is anonymous. They're not risking anything, but that helps them get that appointment set up. A lot of students are not going to pick up the phone and call, go, well, I think I'm depressed. I might need to set up an appointment with a counselor. In this day and age, they want to be able to make their appointments online. Improve campus culture. Focusing on discrimination, trust, respect, dignity, sensitivity and cultural competency. That's a whole class, well, set of classes in and of itself. Improve access to information, focusing on the information needed and communication and dissemination practices. We want to make sure that we figure out, okay, what is it that these students actually need to know. A lot of times I find we assume wrongly that they know a whole lot more than they actually really know already or they have a lot of bad information. Which is why it's important to figure out what is it that these students actually need and how can we communicate to them and get it to them in a way that is meaningful and digestible? And in today's culture, meaningful and digestible comes in very small chunks. We don't want to make them sit through a two hour class. A five minute video at tops one to five minutes closer to the one minute section is usually better digested and retained than something that's, you know, a two hour seminar that people have to sit in. Make services available on campus, even that if that's a clinician from the community. Some campuses will open up an office where clinicians from the community can come in and volunteer to provide pro bono services one day a month. And if you have, obviously if you have five clinicians that alternate, then every Friday you know, there's going to be a pro bono clinician on campus. Manage expectations of campus mental health systems and changes to promote mental health and recovery on campus. How much can these centers reasonably do with their budget? The student mental health center on UF at UF is beautiful. It's big, but it's not big enough to accommodate 75,000 plus students. What can they do and what ways can they, you know, maybe switching to groups as opposed to as many individuals? How can they use their time more effectively? How can they improve student control and choice? Some students don't want to go to group. Okay, what are your options? Mental health care expectations. What is the student mental health center expected to be able to handle? What are the administrative expectations of the mental health center? Doesn't do any good to have a mental health counseling center and have all the clinicians so stressed out that they can't see straight. Doesn't work. What kind of accommodations and policies exist in the campus mental health system? Who qualifies for services? How much does it cost? How might that work? And what are some community approaches going back to finding people in the community? A lot of clinicians and I don't know about y', all, but I know there are a lot of clinicians out there who would be willing to hold one, maybe two Pro bono slots open for, you know, a university student or for, you know, particular group. So a community can create a network. Even if the college can't afford a mental health counseling center, clinicians, doctors, whomever can come in and do educational seminars on campus or even do webinars that can be rebroadcast, they don't ever have to even leave their office. Community approaches go past just providing mental health services though. We want to make sure that the community has resources to support students and their families if they have, you know, significant others and children, etc. With child care, financial services, employment, safe housing, all that kind of stuff. The university is not this bubble in the middle of a town that doesn't influence the town and get influenced by the town. We need to recognize that we influence each other reciprocally. So we want to involve the community in making sure that students are healthy and happy. It's going to benefit them. It's going to benefit the business owners and, and the landlords and everything else. If these students love this community and want to stick around other services and procedures, access to mental and behavioral expertise. For faculty, staff, families and peers who are concerned about a student, they can call up a hotline and go, you know what? I have this concern about Jim Bob in my second period class. What should I do? A lot of professors just don't have that kind of background. That's okay. Give them somewhere they can reach out. Make sure students have the ability for self referral and off campus referrals. Not all students want to be seen on campus. They may associate too much stigma with that. There should be the availability of some type of emergency services, whether it's through the university or through the community after care programs, medical leave policies and non clinical student support networks. Medical leave would be if a student is traumatized and has ptsd, needs to take three months off. That was one case that I dealt with. Or they have clinical depression or something else. What is the policy for them leaving the university and coming back without having to reapply on site counseling centers with an interdisciplinary team that includes primary health care providers, licensed social workers and counselors, life skills support staff, registered dietitians and peer support specialists. And in these situations, yes, it may not be ideal. If you have rotating clinicians coming in, you may not see the same clinician two weeks in a row. That's why good noting is important. However, it's better to have some services than no services. And that's what we're talking about here. We're not necessarily talking about the ideal you know, that can be really expensive. What can these universities, who only have 15002000 students, do in order to support their students on site? Medical services and assistance with prescriptions can be helpful. That gets really expensive. But if it's possible, that is something that people can consider. Student and administration leadership to promote mental health and suicide prevention. Going out to talk with the athletes, the Panhellenic Council, other groups and unafflicted students. Those who are not struggling with mental health or depression issues or depression or suicidal ideation right now. Just because they're not struggling with it right now, or they've never struggled with it, doesn't mean they won't. We want to be able to reach out to everybody. Life skills development is so important. Adulting classes are becoming more popular. How do I pay bills? How do I balance a checkbook? What's the difference between a debit and a credit card? All of those things that students may have difficulty with. How do I do laundry? How do I cook meals? How do I find an apartment to rent? All of those questions. Those of us who've been doing it for 30 some odd years, you know, don't think twice about it. But it is something that can be daunting for a lot of students. Tutoring programs are really important. And tutoring can be done by graduate students. They can be done by people who volunteer to help. You'd be surprised at how many people would be are willing to volunteer to help their peers out if you have a tutoring center. Mentoring programs, super helpful if you've got an older mentor that is helping new students along. Somebody who gets assigned to a freshman to help them navigate their first semester. Somebody who is available as a mentor, not necessarily on a daily basis, but somebody who basically like our old school counselors, where you can go to them and say, okay, I need to pick a major. I have no idea where to start. You know what resources are available. And the mentor can help the person navigate whatever system they need to navigate, ensure sufficient parking and transportation. That is a big stressor for a lot of students trying to figure out how they're actually going to get their happy butt to class because there is no parking or they have to drive around for an hour to find a space. Hold all student groups on campus strictly accountable for underage alcohol use at their facilities and during functions that they sponsor, even off campus. Eliminate alcohol advertising in college publications. And educate parents, instructors and administrators about the secondhand effects of substance use that range from interference with studying to being the victim of assault or date rape. Enlist administrative, community and student assistance in changing any culture that currently supports alcohol use or unhelpful behaviors by students and expand opportunities for students to make spontaneous social choices that do not include alcohol. Have different activities at UF now. We just went back not too long ago, but the student union has expanded so much and they've got places you can go. You can go bowling, you can go play pool, there's movies, there's all kinds of stuff that students can choose to do that's paid for with their activity fees, that is in a dry environment and work with the community to increase public service opportunities. Again, a lot of people, if there's an opportunity to volunteer or engage in public service, would actually probably do it. Have a campus wide emergency plan for mental health related situations that should be addressed, including managing suicidal or homicidal ideation, managing victims of sexual assault, managing highly agitated or threatening behavior and acute psychosis which can happen when people take certain drugs, managing acute delirium or managing acute intoxication or drug overdose. There should be written procedures for managing emergency mental health situations which should 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. Designate expectations for each stakeholder during a crisis Specify steps to be taken by each stakeholder after an emergency situation to make sure appropriate resources and follow up have been provided and specify a procedure for reviewing preventative and emergency procedures and after the resolution of the emergency situation that should be in every standard operating procedure. Coaches should learn about the importance of being attentive and empathetic in their interactions with student athletes who are facing mental health challenges while understanding that their role is not to manage the situation themselves to help them. Connect to people who can 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. You know what's going to happen to their scholarship, what's going to happen to their housing. Identify who is responsible for initiating transition of care and for facilitating the academic waiver process if a waiver is needed and develop a plan for helping student athletes who have been away from campus while seeking care to transition back to campus and possibly to sports participation. Understand the institutional policies related to athletics, financial awards and team engagement for student athletes who are unable to continue sport participation either temporarily because of an injury or illness or permanently. Be aware of strategies for financial support of student athletes in need of extended outpatient treatment or inpatient care and consult campus disability services 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 improve access to a variety of services. We need to recognize patterns in campus life that suggest the presence of mental and behavioral health concerns among students, groups of students, or on the campus environment itself. We want to provide outreach and consultation to prepare all members of the community, students, staff, faculty to recognize and respond to students with mental or behavioral health concerns and emphasize case finding, using surveys, presentations, self assessments, activities, and special events to identify students who may be in trouble. To thrive, students also need to nurture a supportive tone and attitude about mental health in campus culture, and this culture needs to challenge stereotypes about mental health problems, undermine prejudices and stimulus stigma about counseling, and provide encouragement to students to reflect on their own mental health and seek services when needed. If this podcast helps you help your clients or yourself, please support us by purchasing your ceus@allce.com or getting your agency to sponsor an episode. 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