Colleges Look to a Wider Network to Address Student Mental Health
Morell, Ricki, Newsweek
Byline: Ricki Morell
Universities are training everyone from college coaches to fraternity brothers on how to identify students who need help.
When Jennifer was a freshman at Western Kentucky University in Bowling Green, the pressure and the workload overwhelmed her. Though she had seen therapists in the past for anxiety, she had never been treated for depression. But at school, she sank into such despair that she tried to commit suicide by overdosing on pills. She ended up in the hospital, where she finally began to get the help she needed.
Now a senior, Jennifer, who asked to use a pseudonym to protect her privacy, depends on her weekly therapy sessions to stay on track. She also knows that resident advisers (RAs) and professors specifically trained in suicide prevention help keep an eye on her mental health; they will make sure she gets to the counseling center if they think she needs immediate help. "Now, it's a requirement for the RAs to get training," says Jennifer. "If I get into a bad situation, there's someone on my floor I can go to talk to."
It took a crisis to introduce Jennifer to Western Kentucky's campus counseling center, but these days the center is trying to prevent just that: it's looking to head off emergencies before they begin by reaching students like Jennifer where they spend most of their time--in classrooms and in dorm rooms. What's more, professors get involved too. "And if there's something in a class that is bothering me, I can go talk to my professor and ask them for a little lenience."
Ten years ago, a student with suicidal tendencies might have informally talked to a residence adviser or a favorite professor, who may not have recognized or told others about worrisome warning signs. But, today most college campuses have trained those advisers and teachers to recognize unusual behavior, so they know exactly how and where to report concerns. This strategy of using a formalized support network to prevent suicides and violence began trickling onto college campuses around 2005, when new federal funding for suicide prevention came into play. The method gained traction in 2007, after the Virginia Tech massacre caught the campus by surprise. By training a wider network of college community members--everyone from college coaches to fraternity brothers--schools are reaching outside the walls of the counseling office and into the everyday lives of students to offer help. But with this kind of attention comes heightened privacy concerns, as colleges walk the fine line between preventing harmful acts while preserving student confidentiality.
Universities are under more pressure to keep students mentally healthy and safe since the Virginia Tech shootings, in which a student, Seung Hui Cho, killed 32 people before fatally shooting himself. In 2008, another high-profile mass shooting occurred at Northern Illinois University in DeKalb, Ill. And in 2010, a rash of highly publicized suicides at Cornell University , as well as the suicide of Rutgers University student Tyler Clementi , have thrust campus mental-health issues back into the spotlight. "Following the Virginia Tech shootings, there was a push to put crisis funding into mental health so we could learn how to identify who might be at risk," says Brian Van Brunt, president of the American College Counseling Association , and Western Kentucky's director of counseling and testing. "We are trying to reach out to students who might never enter counseling."
Today, mental-health counselors must do more than sit in their offices and wait for students to come to them, says Van Brunt, who is Jennifer's counselor. Most counseling centers now run "gatekeeper" programs that train the community to act as the first responders to signs of trouble. People who see students every day--not just professors and RAs, but fraternity members, athletic teammates, and coaches--learn to watch for warning signs.
About 10 years ago, few if any campuses had such formalized programs, says Van Brunt. But, in 2004, Congress passed the Garrett Lee Smith Memorial Act, named after former Oregon senator Gordon Smith's son, who committed suicide at age 21. The act authorized $82 million over three years for youth suicide prevention, and campuses started instituting the gatekeeper programs. Since 2005, Western Kentucky faculty and students have been taught a popular method called QPR: question, persuade, and refer, which is designed to get troubled students into treatment as quickly as possible. Syracuse University has been using a similar program called Campus Connect since 2005. And in 2009, New York University
introduced Kognito's At Risk program, which used game technology to train faculty and students how to recognize and get help for students in mental distress, before switching to QPR last year, a university spokesman says.
In addition, since 2007, mental-health counselors on many campuses have been participating in "behavioral intervention teams," in which they talk with other members of the university's community and evaluate data about at-risk students. These teams, which generally meet weekly, are formal structures that universities have put in place to assess potential campus "threats," such as suicide or violence. Many keep data through a computer system to address pressing concerns and long-term problems. "One lesson from Virginia Tech is to look at not only immediate behaviors, but also address those times when at-risk students fall off our radar," says Van Brunt at Western Kentucky, which created a behavioral intervention team in 2008. By contrast, the gatekeeper programs are primarily focused on teaching campus members how to administer "mental health first aid." Often, gatekeepers feed information to the behavioral intervention teams.
"We take a much broader public-health approach than we used to," says Gregory Eells, director of counseling and psychological services at Cornell University, in Ithaca, N.Y., and a past president of the Association for University and College Counseling Center Directors (AUCCCD). Eells estimates that most colleges and universities have now adopted some kind of gatekeeper program. In addition, the AUCCCD annual directors survey showed that 80 percent of campus counseling centers had behavioral intervention teams in 2008, up from 77 percent in 2007, the first year the question was asked on the survey. Ten years ago, the AUCCCD didn't do a survey and most colleges didn't have formalized behavioral intervention teams, says Eells..
Of course, the "watch your neighbor" approach raises privacy concerns. Colleges have traditionally been reluctant to share mental-health concerns for fear of violating confidence with students. Brett Sokolow, the managing partner of the National Center for Higher Education Risk Management, advises school officials on how to set up teams without running afoul of confidentiality or privacy laws. Some schools require that patients sign a consent form that allows clinical staff to share information with the behavioral intervention team if there is a crisis. Others rely on state laws that require therapists to report to authorities any suspicions that a client will harm himself or others. Though therapists have always been required to report blatant threats, less obvious warning signs have often gone unreported in the past. "Some people fear that aggregating all this information about students is a bit Big-Brotherish," says Sokolow, "but on the whole there is a tremendous level of buy-in."
As high schools do a better job of serving teens with mental-health issues, which allows those students to go to college, campus counseling center services are now in greater demand. About 11 percent of college students seek counseling on their own, and about 38 percent are seen by trained mental-health counselors in other settings such as workshops, orientations, or classrooms, according to University of Pittsburgh professor Robert Gallagher, who conducted the 2010 national survey of counseling center directors.
The survey included 320 colleges and universities, representing 2.75 million students eligible for counseling at those institutions. Still, most students with mental-health issues don't receive any treatment through campus counseling centers. Of the 133 students who committed suicide last year at the institutions surveyed, only 13 percent were seen at the counseling center, though there's no way to know whether they were seeing private therapists, says Gallagher, who directed the University of Pittsburgh counseling center for 25 years.
The survey also found an increase in serious mental illnesses among students seeking counseling, with 24 percent taking some form of psychiatric medication, compared with only 9 percent in 1994. The 2009 AUCCD directors survey confirmed that impression, with 71 percent of the directors reporting they believe the number of students with severe psychological problems has increased in the past year. (Whether that's due to broader diagnosing from therapists is hard to tell.)
More than half of the students who use campus counseling centers seek help for depression and anxiety, says Van Brunt. The other major issues include problems adjusting to college life and relationship troubles.
At Western Kentucky, Jennifer credits her wide-ranging support system with helping her make it to her senior year. Her therapist, her RA, her professors, and even her fellow students are all armed with specific action plans if she exhibits signs of mental distress. She now dreams of graduate school and a career, instead of ways to end her life. " One of the things that is the worst for a student is feeling you have no one to talk to," she says. "That's no longer a problem on campus. Students are constantly being reached out to. It's been a big factor in my recovery."…
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Publication information: Article title: Colleges Look to a Wider Network to Address Student Mental Health. Contributors: Morell, Ricki - Author. Magazine title: Newsweek. Publication date: January 6, 2011. Page number: Not available. © 2009 Newsweek, Inc. All rights reserved. Any reuse, distribution or alteration without express written permission of Newsweek is prohibited. For permission: www.newsweek.com. COPYRIGHT 2011 Gale Group.