Helping Distressed Students

{

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

Today

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.

• 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

• 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

Today

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

Shaky Man

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 yearo 25% of these thought about suicide repeatedlyo 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 levelo Students rating their emotional health as above average

fell to 52%, compared to 64% in 1985o 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 aso 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

NDSU Survey

Factors affecting retention and graduation at NDSU1. Level of student commitment to earning a degree2. Level of student motivation to success3. Student study skills4. Student educational aspirations and goals5. Student personal coping skills6. Student mental or emotional health issues7. Amount of financial aid available to students8. Level of emotional support from family, friends, etc. 9. Level of certainty about career goals

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 performanceo If you compare students at the 50th 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 23rd 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 concernso The more severe the distress, the more

intervention is neededo 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 collegeo 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?

• Increased similarity between college population and general populationo 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

Why?

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

Myths versus facts…

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.


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.


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.


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.


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.


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.

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 BilgelUludag 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

What can we do to help?

Prevention

Early Intervention

Treatment

Well Becoming Unwell Recovering Unwell

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)• CryingWhat 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 – Say ItWhen 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.

You can help. . .

Intervention: Three Basic Steps1. Show you care2. Ask about suicide3. Get help

Decision Making Tree

http://www.ndsu.edu/fileadmin/counseling/COUN_6542_Pamphlet.pdf

Counseling Center Web Site





Mental Health First Aid

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.

Comments and Questions

Success

Documents

Helping Distressed Students