UP Teaching & Learning Community Blog

mental health

By

Intersections? How diversity, mental health, and teaching might mix

an aerial view of 2 intersecting footpathsAnyone paying attention to higher education in recent years is well aware of two pressing issues on regular repeat: changing perceptions of student mental health needs, and the need to better attend to diversity and inclusion. But how might those two issues intersect? How might an equity lens inform the way academics, and academic institutions, think about student mental health?

Several organizations working collaboratively on those issues (including the JED Foundation and the Steve Fund) recently produced an “Equity in Mental Health Framework” that highlights needs and offers ten specific “recommendations for colleges and universities to support the emotional well-being and mental health of students of color.” The full report is available on-line, and while it is a bit more oriented towards administrative policy than classroom practice it is worth a browse for the curious. For this teaching and learning blog, however, here are a few quick takeaways that might inform faculty and academic staff at UP.

First, the report notes that there are good empirical reasons (beyond the obvious ethical reasons) to pay attention to equity in mental health. In two national studies involving thousands of racially diverse college students Harris Poll research found, among other things, that:

  • “First-year college students of color are significantly less likely than white students to rate their overall college experience as ‘excellent’ or ‘good’ (69% to 80%)”
  • “Students of color are significantly less likely than white students to rate their campus climate as ‘excellent’ or ‘good’ (61% to 79%)”
  • “Students of color are significantly less likely to describe their campus as inclusive (28% to 45%)”

These types of statistics do not by themselves suggest that students of color are necessarily more or less likely to confront mental health issues – in fact, mental health concerns are a relatively equal opportunity reality (with some interesting and important demographic differences). But they do suggest that college and university environments may have a different social and emotional climate for students from diverse backgrounds.

So what can be done to promote a social and emotional climate that is supportive and inclusive for all students? Many of the recommendations in the ‘Equity in Mental Health Framework’ are structural (including, for example, promoting “the mental health and well-being of students of color as a campus-wide priority” and to “actively recruit, train and retain a diverse and culturally competent faculty and professional staff”). There are also several that might be worth thinking about for our work with students in and around the classroom.

Recommendation #4, for example, involves creating “opportunities to engage around national and international issues/events” including cultural movements such as Black Lives Matter and #MeToo. This seems like a natural fit for many educational contexts – both in and out of classrooms. It is not always easy to create constructive spaces that are genuinely educational to discuss current events that are complex and evolving, but it is worth remembering that doing so thoughtfully can matter to students who otherwise feel disconnected and marginalized.

Recommendation #7, as a second example, involves offering “a range of supportive programs and services in varied formats” that might include discussion groups and workshops allowing students from diverse backgrounds to connect and engage with developing identity issues. This recommendation makes me think of the many positive experiences I know UP students have had with groups such as the Hawai’i Club, the Black Student Union, the Feminist Discussion Group, Active Minds, and many others that are student-driven but thrive with faculty and staff support.

Working toward “equity in mental health” at colleges and universities is a big project that goes well beyond just what academics do with teaching and learning. But we faculty and academic staff can do our part by recognizing the ways teaching and learning can create further intersections for both equity and mental health.

Featured Image: Photo by Mike Enerio on Unsplash

By

Who; What; Where; When; Why: A Quick Primer-Reminder on Mental Health Services for Students at UP

Orrico hall, home of U P health and counseling servicesI always find the Spring semester much harder to start than the Fall. The days tend to be cold, rainy, and short. The bubbling enthusiasm of a new academic year has faded into a less inspiring feeling of being right in the middle of things. I realize, yet again, that I planned too much for the break and accomplished too little. And I have the sense that many students find the early part of the Spring semester equally challenging.

So to start a new semester’s effort to integrate thinking about student mental health with thinking about effective teaching and learning, I thought it might be worth a quick primer (or, more hopefully, a reminder) about what is available through UP’s counseling services to students who seem to be struggling in our classes for reasons other than academic skills.

WHO: The UP Health and Counseling Center offers both primary care and counseling services to students, with the counseling side of things comprising four full-time professional psychologists and two practicum students (usually third year doctoral students who spend 2.5 days a week on campus seeing students and organizing groups for one academic year). The director of UP’s Health and Counseling Center, Carol Dell’Oliver, is also a clinical psychologist who occasionally sees students amidst her busy administrative schedule.

As of this 2017-2018 academic year, the Health and Counseling Center has also contracted with ProtoCall to make after-hours phone counseling available – students can reach licensed clinicians any time of day for ‘specialty telephonic behavioral health services’ by calling the main UP Health and Counseling phone number (503 943 7134) and taking option ‘3’ after hours.

It is also worth remembering that UP’s Early Alert system has been expanded in recent years to offer a useful first point of contact and referral when faculty are concerned about student mental health.

WHAT: As was described in my last TLC blog post, “the Health and Counseling Center reserves two appointment slots every work day for emergency needs – ensuring that students experiencing acute mental health concerns can get same day help. They also have nine daily appointments for 20 minute initial consultations with one of the counseling staff, ensuring that most any student with non-emergency concerns can talk to a professional within a few days.”

After initial consultations, UP’s counseling services focuses on short-term therapeutic work – ranging from a few 50 minute sessions to a few months’ worth of sessions. If students need more intensive longer-term therapy they are referred outside the University. As with college counseling services nationally, the most common issues students want to discuss in counseling are anxiety and depression – but it is also common to have students discuss relationships, adjustment to college, identity issues, and more. In prior years about 16% of UP students have utilized counseling services – which is slightly, but not dramatically, higher than the national average.

The primary care side of the Health and Counseling Center can also help students with medication prescriptions when needs are mild to moderate, though when students have more serious medication needs those are often managed by outside providers.

WHERE: The Health and Counseling Center is on the top floor of Orrico Hall – above the Career Center, snuggled in-between the physical plant building and Mehling Hall. Information is also available at: https://www.up.edu/healthcenter/index.html

WHEN: The Health and Counseling Center is open Monday-Friday, 8:30 a.m. to 4:30 p.m. They close daily from 12:00 p.m.- 1:00 p.m.. As noted above, they also make after hours phone counseling available by calling the main line at 503 943 7134 and selecting option 3.

WHY: There are lots of reasons for faculty to pay attention to student mental health – starting with the fact that any person in distress needs others to show they care. It is also both intuitively and empirically evident that students struggling with mental health concerns also often (though not always) struggle with their academic work.

But it is also important for faculty and academic staff to remember that our job is not to become para-professional counselors in addition to professors – our job is to pay attention to, and care about, our students by helping them find the help they may sometimes need. So, as we approach the rainy early months of the Spring semester, I hope it is helpful to remember the ways UP makes such help available for students (including many parts of the University outside of the Health and Counseling Center).

By

Student Athlete Mental Health Part II: What do we do at UP?

Two weeks ago I wrote a bit here on the TL blog about whether there is anything particular about student-athletes with mental health concerns compared with other students. The short answer is yes and no; student-athletes may feel particular pressures to ‘tough out’ mental health challenges due to sports culture, but a proportion will always experience the same types of mental health concerns all our students can sometimes experience.

So should faculty and academic staff treat the student-athletes we come across in academic contexts any differently when we suspect mental health concerns? Again, the short answer is probably yes and no. The NCAA nationally has developed extensive resources specific to working with college student-athlete mental health concerns (see the NCAA resource hub). And it is true that student-athletes may have different social networks than other students, including intensive relationships with coaches and athletic department staff who closely track their well-being. Because of concerns about access and stigma in sports culture, there have been points when the UP athletic department sets up counseling and consultation opportunities specifically for student-athletes.

For the most part, however, the athletic department works in the same mental health support structure as the rest of the University. That means that when faculty and academic staff have concerns about a student-athlete, it often makes most sense to start with using the general Early Alert system. Early Alert can then work with the athletic department, along with other campus resources, to plan what are most appropriate next steps – should, for example, coaches be involved or would that have the potential to unnecessarily complicate matters? Alison Knoedler, the Director of Academic and Student Athlete Development at UP, is notified of any early alert for a student athlete and works collaboratively to identify best steps for each particular situation.

The athletic department at UP is also actively making efforts to connect with other campus services: they invite UP’s professional counselors from the Health and Counseling Center to attend a staff meeting once a year, to introduce themselves to the athletic department’s compliance team, to speak with the HPE 108: Life Skills for Student Athletes (required) course each Fall, and to meet incoming student athletes in the summer to talk to new first year athletes and transfers about services on campus.

In addition, the athletic department has a ‘sports performance’ staff that primarily attends to student athlete’s physical health – but through that work also has natural access to a broader sense of student-athlete well-being. This type of work is tricky anywhere with athletes because the application of psychology in sports settings takes two very different forms: one is often termed ‘mental coaching’ and is focused largely on using psychological tools towards performance enhancement; the other is more conventional counseling psychology for athletes dealing with personal issues distinct from their athletic performance.

Sometimes these two areas overlap – student athletes can have performance issues that relate closely to personal issues. But often they are distinct – performance issues such as a lack of athletic motivation or sport-specific concentration are different from personal issues such as anxiety and depression. Each particular case might require a distinct type of intervention, and a distinct type of professional help – most ‘mental coaches’ are not trained in counseling psychology, and most counseling psychologists are not trained in mental coaching.

Ultimately, however, these should all work collaboratively: the UP athletic department tries to create a network of support and referral that works closely with the Health and Counseling Center. Coaches, assistant coaches, trainers, sports performance staff, academic support staff, and administrators in the athletic department all work to identify and refer student athletes. Ideally, and for the good of all our students – athletes or not, we faculty and academic staff outside the athletic department can best serve as an additional complimentary and supplementary layer in that network of support and referral.

By

Student Athlete Mental Health: Are Sports Special?

a basketball hoop seen from below and behindDo student-athletes tend to have more mental health problems than the general student population, fewer mental health problems, or similar mental health problems? Last Spring, when introducing a speaker talking to UP student-athletes about the particular dynamics of mental health for athletes, I asked a version of this question to our UP varsity athletes. The question is one I also discuss in my PSY/SOC 453 class on ‘Psychosocial Aspects of Sport and Physical Activity’ and it turns out to be surprisingly difficult to answer with research.

Most basic data finds athletes report fewer mental health concerns than comparable non-athlete populations, but researchers generally assume that athletes underreport mental health concerns because of sports culture – high-level athletes are often socialized to be tough, competitive, and averse to admitting what could be perceived as a ‘weakness.’ Though sport culture is changing some, we are still much more likely to hear about famous athletes taking time off for physical injuries than for psychological ones.

So I was both surprised, and somewhat impressed, when a large proportion of the UP student-athletes I surveyed by show of hands last Spring thought athletes were more likely to experience mental health concerns than the general population. I was impressed because our athletes were willing to admit that the pressures and cultures of sport are not always as healthy as we might hope – and that the path of athletic excellence can indeed involve significant mental health challenges.

I was reminded of this experience recently while reading a 2017 book by ESPN journalist Kate Fagan titled What Made Maddy Run: The Secret Struggles and Tragic Death of an All-American Teen. The book tells that story of Madison Holleran – a student-athlete at the University of Pennsylvania who tragically took her life as a 19 year old first-year college student despite many external appearances of ‘having it all.’ The book, and a thoughtful long-form article on the ESPN web-site titled ‘Split Image’, discuss ways Holleran devoted so much of herself to excellence in athletics, academics, and with friends (at least partially through a carefully cultivated social media presence) that when she achieved her dream of becoming an Ivy League athlete she decompensated in isolation. She made tentative efforts to reach out to friends, family, counseling services, and coaches – but mostly she started to feel as though her inner turmoil and despair were unredeemable failures. To an outsider it seemed she was good at almost everything she did, but inside she didn’t feel good enough.

Madison’s Holleran’s story is not just about sports, but it does say important things about the relationship between sports culture and mental health. Student-athletes often invest massive amounts of their selves and their identities in being good at sports. Those who succeed get many benefits from that investment, but they also experience costs – they often feel a constant pressure to get better and be the best, they sometimes lack the autonomy to make their own decisions and change directions in their lives, and they don’t always have opportunities to explore identities outside of sports that might actually balance their development into healthy adults.

Over the last few years at UP I’ve learned about several ways our athletic department tries to care for the mental health of student athletes who may have concerns; I hope to discuss some of those ways in a follow-up post soon. For now, however, it is worth emphasizing to UP faculty and academic staff who interact with student athletes that mental health concerns can affect even those who seem the strongest. Student athletes often have to fight against the stigma in sports culture against openly acknowledging mental health concerns, but many should and do take up that fight.

*/ Featured Image by MontyLov /*

By

Kids These Days: The Media (and Social Media) on Student Mental Health

young man looking at smartphone

In recent weeks several major feature articles have perpetuated a growing trend to portray today’s students – particularly those in high school and college – as unusually fragile and disposed to mental health problems. First, in a September article in The Atlantic provocatively titled “Have Smartphones Destroyed a Generation?” psychologist Jean Twenge suggested we are on “the brink of a mental health crisis” among adolescents.  Then, in the October 11th issue of the New York Times Sunday Magazine journalist Benoit Benizet-Lewis wrote from the titular question “Why Are More American Teenagers Than Ever Suffering from Severe Anxiety?”

These articles clearly touched a nerve – as I write the latter article has been atop the New York Times most popular list for nearly a full week. And both are worth reading. As long as you don’t get caught up in the moral panic that seems to be pervading discussions of student mental health.

In the Twenge Atlantic article, she presents some interesting data suggesting that technology may be enabling teens to do less real socializing and more virtual socializing – she notes, for example, that “only about 56 percent of high-school seniors in 2015 went out on dates; for Boomers and Gen Xers, the number was about 85 percent.” She also has interesting data about the need to be constantly connected leading to serious sleep problems, and makes a reasonable case that excessive technology usage associates with unhappiness. She does not, however, provide as much tangible data for her claim that “iGen” is “on the brink of the worst-mental health crisis in decades.”

Likewise, the Benizet-Lewis New York Times article presents compelling case studies of intensely anxious students and cites surveys such as those by the Higher Education Research Institute at U.C.L.A. (surveys that UP students participate in) showing that in 1985 about 18% of college freshmen “felt overwhelmed by all I had to do” compared with 41% in 2016. The Times article also fingers social media as a major culprit, while also nodding to broader parenting and cultural pressures. Importantly, Benizet-Lewis also discusses ways in which excessive accommodations to student anxiety – and a concomitant lack of developing resilience – may exacerbate the problem. And ways that confronting anxieties, recognizing the inevitability of imperfection, can help alleviate anxiety’s grip.

Clearly something is going on around student mental health – there is an intense, and sometimes frightening, awareness of the needs of the kids these days. But that awareness, and its rapid dissemination through the very social media technologies that many finger as root problems, may also be a more optimistic part of what is going on. The recognition of student mental health needs means less stigma, and that by itself may be a more hopeful reason we seem to hear so much more about mental health crises. The hopeful side of this story would be that students who used to suffer in silence, or not attend college at all, are reaching out, getting help, talking about what they need, and persevering.

A version of this more hopeful side of the story was available here at UP during our faculty development day keynote address on mental health in 2016. My clinical psychology colleague Andrew Downs presented data suggesting that while we may be more aware of mental health concerns now than we were in past decades, the actual base rates of psychological distress have probably not changed all that much. Some students have always suffered; a significant part of what has changed is how we recognize and address that suffering.

The former director of UP counseling services Will Meek then followed up with descriptions of what UP offers – quick consultations and assessments (including through early alert) that increasingly help students identify their needs – along with encouragement to faculty to help students by directing them to appropriate resources and by maintaining expectations and boundaries. Part of being a college student is learning to meet new expectations in an environment where your performance in a class does not define your value as a person.

In the popular media, my favorite counterpoint to the profligate ‘mental health crisis’ literature is a Science of Us piece by Jesse Singal on ‘The Myth of the Ever-More-Fragile College Student.’  Part of what Singal points out is that some of the shift is in higher education more broadly – colleges didn’t used to provide full-service mental health facilities because that was the role of community mental health services (which have been significantly de-funded in recent decades). Ultimately, Singal provides a useful alternative spin on why the prominence of social media matters to the story of student mental health:

“What separates present-day moral panics about college students from past ones is that we live in a golden age for confirmation bias. We have greater, more intimate access to scenes from campus life than ever before, which makes it easier than ever before to slip into the trap of “I’m sure this thing is happening because I see evidence it’s happening.” But prior to YouTube and Twitter and the morass of think pieces choking the internet anew every morning, there were also campus-politics freak-outs, there were also nervous breakdowns in counseling centers, there were also tragedies involving students and their mental health — and there were also adults proffering cultural theories for why everything was falling apart.”

For faculty and academic staff it may be worth recognizing that the attention we devote to the very real concerns of students with mental health concerns doesn’t necessarily mean we are in the midst of a what the media likes to frame as a crisis. It may instead mean we are ourselves learning new ways to address old, ongoing, and really important problems.