Transcript Wynaden LTC Mon 5 Aug 2013

Improving the university experience for students
who have a mental health problem
Dianne Wynaden PhD
Professor Mental Health –Curtin University, Perth, Western Australia - in
partnership with Fremantle MHS and WA State Forensic MHS
5th August 2013
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Aboriginal
Acknowledgment
Marian Barrett Address 21st July 2011 – University of Melbourne
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Dr Sean Murray
University student demographic data highlights:
a) a high level of cultural diversity and
b) an ‘at risk’ population for the development of ‘mental
health problems’.
Therefore, many students will commence a university
program managing problematic symptoms, behaviours or an
emerging or diagnosed MI.
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Mental ill health impacts negatively on both academic
performance and retention and completion rates with up to 86%
of students with MI in a US study failing to complete their
program.
Many students do not seek help for various reasons which
include not recognising the cause of their distress or stigma
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This project was supported by a Higher Education Equity
Support Program Grant and comprised three components:
1. Survey students to better understand the issues
2. To train University counselling staff in
3. Develop a Curtin Mental Health website
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The survey was open for one month and was supported by the
university Student Services.
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The term ‘mental health problem’ was used to capture:
1) Students who had diagnosed MI
2) Those who thought they might have a MI but had not
sought help
3) Students who perceived themselves as having a high
level of stress / distress and felt ‘at risk’ if their problem
became worse.
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Demographics
Over 2700 students accessed the survey and 1378 provided
complete data and the majority were: female (72%),
undergraduate (83.7%) full-time (76.7%) domestic students
(85.5%).
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All teaching faculties were represented
Health sciences (38.8%)
Humanities (22.9%)
Business (19.9%)
Science and engineering (16.9%)
Aboriginal Studies (0.4%)
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Analysis was divided into several stages:
1. Analysed through PASW ® Text Analysis for Surveys (SPSS
2009)
2. Manual review to eliminate misclassification of words or
terms
3. Creation of a custom MH library that referenced ICD 10
mental and behavioural disorders (F00-F69).
4. Reviewed by two researchers and then categories were
exported as coded multiple response variables in SPPS and
merged with demographic data.
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A decision frame was also used to categorise extracted data.
For example “Describe what you believe are your main MH
problems”. The criteria used were as follows:
Terms extracted that related to the diagnosis of, treatment
of, or medication for, a recognisable MI were accepted as
definitive and coded under that diagnostic category.
Symptom level terms were coded using five broad categories
(a) effect on emotions, (b) effects on thinking, (c) effects on
behaviour, (d) physical effects, (e) variation usually, but not
always, associated with cross-cultural differences.
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RESULTS - Mental health concerns
1378 respondents provided coded multiple response data set and of
those 83% provided recognisable labels for common mental disorders.
These included:
1. Bi-polar affective disorder, depressive disorders, manic and
depressive disorders, persistent mood disorders (n=594)
2. Neurotic and stress related disorders (phobic, anxiety, generalised
anxiety, OCD, adjustment disorders) (n=434)
3.
Eating disorders (n=38)
4. Hyperkinetic disorders (ADD &ADHD) (n=25)
5. Personality disorders (n=23)
6. Psychoactive substance use (n=16)
7. Psychotic disorders (n=14)
8. Other (Asperger’s syndrome, learning disability
(n=5)
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Of the 606 students who provided symptom
level information the most common problem
was the effect on thinking (n=209). This
included: self criticism, self blame, worry,
negative thinking, rumination, impaired
memory and concentration, indecisiveness
and confusion, thoughts of death and suicide
and wishing they were dead.
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151 reported effects on behaviour
which covered: increased sensitivity,
crying spells, withdrawal, neglect of
responsibilities, lack of interest in
personal appearance, loss of
motivation, self destructive
behaviours (cutting, punching oneself).
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143 reported effects on emotions included: sadness,
anxious feelings, guilt, anger, irritability, feelings of
apprehension or dread, mood swings, lack of emotional
responsiveness, helplessness and hopelessness.
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Physical effects (n=100) such as: chronic
fatigue, lack of energy, sleeping too
much or too little, overeating or loss of
appetite, constipation, weight loss or
gain, loss of sexual desire, unexplained
aches and pains.
Variations cluster (n=44) such as:
isolation and feelings of loneliness and
homesickness and shame. Most often
reported by international students or
domestic students who lived away from
home.
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A substantial percentage of students reported that stress
was impacting on their wellbeing (77.6%). These included:
unspecified stress (213), stress associated with
assignments, exams and deadlines (n=187), stress
associated with family and social relationships (n=172) and
employment (172), volume of work (n=171), problems with
time management (n=83), fear of failure and poor
academic results (n=72), financial stress (n=70).
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Health professional consultation and formal diagnosis
645 of the 1378 student had seen a health professional
GP- 29.6%
Psychologist 28.7%
Psychiatrist 18.5%
Counsellor 17.6%
Other health professional 5.6%
401 had received a formal diagnosis (62.2%). Most common
diagnosis was depressive disorder (72.7%) followed by
anxiety disorder (26.0%).
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August 2013
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4. Remaining % of students did not seek help because of
stigma, a lack of time, associated cost, service
availability, and the perceived capacity of health
professional to assist them.
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Discussion
Study useful to provide insights into the issues that this group
of students are experiencing particularly those just
commencing university and under 26 years of age.
Universities are communities and the wellbeing of all
members is important. There is a large emphasis on physical
disability and this study highlights the MH issue.
Better understanding of unmet needs to allow services to be
enhanced in this area.
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Stigma remains a factor for not seeking help.
It is also important to understand the
different belief systems that students have.
For example, family reputation may be more
important than seeking help.
Most “at risk group” were international male
students enrolled in Business or Science and
Engineering faculties
Access to confidential and safe pathways
to assistance is vitally important.
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MH First Aid: 140 staff have now completed the program
and 39 have completed a half day program. All nursing
students will now complete MH First Aid during their first
year
University website can also provide valuable information.
http://unilife.curtin.edu.au/health_wellbeing/MentalHealth.htm
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New study currently underway
1. Qualitative study between CQU and Curtin
to interview staff to see what resources and
training they require.
2. Survey of staff to measure stigma within the
university community
3. Survey of students who have experienced
being stigmatised due to their mental
health problem
5th August 2013
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CRICOS Provider Code 00301J
38th
International MHN Conference –Darwin Convention Centre
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3rd
–
5th
Thank you
October
2012 Dianne Wynaden
Professor
[email protected]
08 92662203