Transcript Retention and Student Mental Health
Helping Distressed Students
{ Student Mental Health: How are our students feeling and what can we do to help?
• • •
State of student mental health today How we got to this point What we can do to help Student Mental Health
Historically, college student mental health was considered from a developmental view
• • Focused on transition issues of moving from high school to college Issues related to academics, homesickness, finances, dating relationships, extracurricular activities, parental issues, and racial and cultural issues
The World isn’t getting crazier; college is just getting more like the world around it.
H.E. Marano, 2002
Suicide is the 2nd leading cause of death among college students
• 80% of students who die by suicide have never been seen by campus mental health service providers.
• Only 29% of college students report receiving suicide prevention information from their schools. The good news, this is up from
14% in 2006.
• Over 1,100 students die each year from suicide, approximately 3 a day.
• • • •
Students at risk
Those with a pre-existing mental illness. Those that develop mental illnesses while in college. Those lacking coping and other life skills.
Those who stop their mental health related treatments while away from home.
Today
• • • • Students reporting a diagnosis of clinical depression increased from 10% in 2000 to 18% in 2008 (NCHA) Rate of depression is typically higher in college than in the general population (Pace & Trapp, 1995) o Women 21% Men 13% 80% of students with depression also have symptoms of anxiety and 60% have physical symptoms People with depression are at increased risk for co-occurring substance abuse, panic disorder, obsessive-compulsive disorder, and suicide
Today
Today
• • 92% of depressed students show signs of academic impairment o Heiligenstein, et al., 1996 70% of students seeking counseling center services reported that personal problems were affecting academic progress o Turner, 2000
Stress is the number one factor impeding college student success (ACHA, 2009)
Impediments to Academic Success
• • • • • • • 27.2% Stress 19.3% Sleep problems 18.2% Anxiety 15.4 % Cold/Flu/Sore Throat 13.1% Work 11.3% Concern for a troubled friend/family member 11.2% Depression (37 unique categories listed, the above were the 7 with a prevalence greater than 11%)
Today
Effects of Stress and Anxiety
Study by the John Hopkins Children’s Center (June 2010)
• 12% of college students studied stated they had thought about committing suicide at least once in the past year o 25% of these thought about suicide repeatedly o 7% of these made specific plans • Greatest risk factors • Depression and lack of social support • o Defined as feeling unappreciated, unloved and uninvolved with family and friends Childhood exposure to domestic violence and having a mother with depression also increased risk
Today
• • • The American Freshman: National Norms Fall 2010 The % of students rating their emotional health as below average rose to a record level o o Students rating their emotional health as above average fell to 52%, compared to 64% in 1985 Gender gap: women have a less positive view than men Students feeling frequently overwhelmed during their senior year of high school rose from 27% to 29% o Gender gap: 18% for men and 39% for women Contrast the above with 75% of students seeing themselves as above average in their “drive to achieve and their academic ability”
Today
A recent Michigan State study found the critical event having the most influence on whether students drop out of school is depression.
• Loss of financial aid was next in influence • • Other major influences include o Being recruited by an employer or another school, experiencing a large increase in tuition or cost of living, an unexpected bad grade, and roommate conflicts Students were less sensitive to events such as o Death of a family member, inability to enter their intended major, substance abuse, coming into a large sum of money, and becoming engaged or married
Today
Factors affecting retention and graduation at NDSU
1. Level of student commitment to earning a degree 2. Level of student motivation to success 3. Student study skills 4. Student educational aspirations and goals 5. Student personal coping skills 6. Student mental or emotional health issues 7. Amount of financial aid available to students 8. Level of emotional support from family, friends, etc. 9. Level of certainty about career goals
NDSU Survey
Used with permission from ACT n=3356, return rate of 25.4%
• • University of Michigan Public Health Study Students with depression are twice as likely to drop out of school Students with depression and/or anxiety have especially poor academic performance o If you compare students at the 50 th percentile of the GPA distribution to a student with depression, there is a 13% drop in GPA o If you add anxiety into the mix, the student drops to the 23 rd percentile (over 50% drop)
Today
•
University of Wisconsin-Stout Study
Concluded that students at risk for mental health concerns are more likely to be retained if they receive treatment for their concerns o o The more severe the distress, the more intervention is needed An example: Psychosis and Auditory Hallucinations Psychosis is a disorder in which a person has lost some contact with reality Bipolar disorder (2.6%), Schizophrenia (1.1%)
Today
• • • • Increased academic pressure, competitiveness, and sleep deprivation Fewer students take time off to stabilize after stress or mental health problems Students stop taking medications when they get to college o Worried about stigma; want to use alcohol/drugs Students using alcohol or drugs while on medications cause interactive problems
Why are students so anxious and distressed?
Why?
• • • Increased similarity between college population and general population o Greater availability of medications and counseling services allows individuals to attend school who would not have been able to in the past Less stigma attached to mental illness and the use of counseling Students already under care may stop when they get to college
Why?
• • • • Students believe their generation will be less successful than their parents, so there is more pressure to succeed Economy and parental unemployment “Hyper-enriched lives” with cell phones, computers, classes, jobs, sports, travel, volunteer work and more Lack of academic readiness: being awarded superior grades in high school without learning how to study
Facing the facts…
Death by Suicide and Psychiatric Disorders
Psychological autopsy studies done in various countries over almost 50 years report the same outcomes:
90% of people who die by suicide are suffering from one or more psychiatric disorders: • Depression • Especially when combined with alcohol and drug abuse • Bipolar disorder Alcohol abuse and dependence • • • Drug abuse and dependence Schizophrenia
Other psychiatric risk factors with potential to result in suicide
(account for significantly fewer suicides than Depression)
• Post Traumatic Stress Disorder (PTSD) • Eating disorders
Myths Versus Facts About Suicide
MYTH:
Suicide occurs in greater numbers around holidays in November and December.
FACT:
The highest rates of suicide are in April, while the lowest rates are in December.
Myths versus facts…
MYTH:
Sometimes a bad event can push a person to complete suicide.
FACT:
Suicide results from serious psychiatric disorders, not just a single event. One bad event will not normally push someone without a psychiatric disorder to commit suicide. One caveat, when dealing with youth and young adults, impulsiveness needs to be taken into consideration.
Myths versus facts…
MYTH:
Once a person attempts suicide the pain and shame will keep them from trying again.
FACT: The most common psychiatric illness that ends in suicide is Major Depression, a recurring illness. Every time an individual gets depressed, the risk of suicide returns.
Myths versus facts…
MYTH:
Asking a depressed person about suicide will push him/her to complete suicide.
FACT:
Studies have shown that individuals with depression often have suicidal thoughts and talking about them does not increase the risk of a person taking their own life.
Myths versus facts…
MYTH:
Males are more likely to be suicidal.
FACT:
Men COMPLETE suicide more often than women. However, women attempt suicide three times
more often than men.
Myths versus facts…
MYTH:
People who talk about suicide don’t complete suicide.
FACT:
Many people who die by suicide have given definite warnings to family and friends of their intentions. Always take any comment about suicide seriously.
Myths versus facts…
What do we know about the impulsiveness of youth suicide?
Among all 18-24 year olds who die by suicide: • 1 in 5 occur on the same day as an acute life crisis • 1 in 4 occur within 2 weeks • • Almost 50% are due to intimate partner problems Other reasons include: o Legal/criminal (20%) o Financial (12%) o Relationship problem with friend or family (13%) Due to the impulsiveness of youth, it is crucial to provide immediate help, develop means for students in crisis to cope, provide a safe haven, and ensure a support system is in place.
“The solution lies in being aware of it, intervening earlier and providing support with adequate and appropriate services.”
Nuran Bayram and Nazan Bilgel Uludag University, Bursa, Turkey
Bayram & Bilgel, 2008
Mental Health & Retention
The Bottom Line
• • • Students with social and emotional problems are at a higher risk for dropping out of school Students in counseling have a higher retention rate than those who are not Counseling helps students address their concerns and stay in school • It’s all about relationships!
Retention
Spectrum of Mental Health Interventions
Prevention Early Intervention Well Becoming Unwell Unwell Treatment Recovering
What can we do to help?
Distressed Behavior that causes us to feel alarmed, upset or worried (most common) Disruptive Behavior that interferes with or interrupts the educational process of other students or the normal business operations of the university Dangerous Behavior that leaves us feeling frightened and in fear for our personal safety or the safety of others
Distressed, Disruptive, or Dangerous
Be Aware of Warning Signs • • • • Depressed mood, social withdrawal, negative self-esteem, poor concentration Changes in weight or sleep patterns Loss of confidence, interest, and motivation Increased anxiety, obsessive worry • • • • • Productive vs. destructive anxiety Increased use of alcohol/drugs Excessive procrastination Too frequent of office visits (dependency) Crying
What can we do to help?
Be Aware of Warning Signs • • Decreased quality of work Listlessness, sleeping in class • • • • • • • • Marked changes in personal hygiene Threats to self or others Impaired speech or disjointed thoughts Marked changes in behavior Absence from class Under responding to academic notices Incongruous affect (smiling while crying) Lack of follow-through
What can we do to help?
If You See It
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Say It
When someone engages in risky, unhealthy, or suicidal behaviors here is a simple, caring, but assertive way to talk to them. • • • • • • • I care. Express your concern and care first.
I see. Describe what you see or have noticed.
I feel. Use a feeling word (e.g., worried, concerned).
I’m listening. What is going on for you? Have you been thinking of suicide, hurting yourself?
I want. I want you to talk with someone at the Counseling Center, involve your parents, etc. I will. I will help you make an appointment, give you a ride, go with you, call you tonight, etc.
Get help immediately if someone is actively suicidal, do not leave them alone. The Counseling Center or a local emergency room are your best options.
Intervention: Three Basic Steps 1. Show you care 2. Ask about suicide 3. Get help
You can help. . .
http://www.ndsu.edu/fileadmin/counsel ing/COUN_6542_Pamphlet.pdf
Counseling Center Web Site
Decision Making Tree
Mental Health First Aid is the help offered to a person developing a mental health problem or experiencing a mental health crisis. The first aid is given until appropriate treatment and support are received or until the crisis resolves.
Just as CPR training helps a layperson without medical training assist an individual following a heart attack, Mental Health First Aid training helps a layperson assist someone experiencing a mental health crisis.
8 hour training course.