student mental health... · and digital signage on sexual assault prevention, preventing harassment...
TRANSCRIPT
Board of Trustees
Committee on Academic and Student Affairs
May 30, 2018
Student Mental Health:The National Dilemma and Local Responses
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Nance Roy
The JED Foundation
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Sources: NAMI, SAMHSA, JED Harris Poll, 2017 County Health Rankings 6
Source: ACHA-NCHA Survey 2016
2016 – 17 Healthy Minds Survey DataN = 8000 first year students, 48 campuses
Positive
Negative
1/3 of first year students screened positive for depression
30%
56%
Positive fordepresssion
Negative fordepression
Students that strongly agreed they would persist to graduation:
94% reported that mental health difficulties had
impaired their academic performance over the
past month.
Of all first year students with diagnosed depression:
2005 – 08 Healthy Minds Survey Data
From the University of Michigan
Students with a depression diagnosis are at
2x the risk
of dropping out of college and not graduating than those who were not depressed
Depression and anxiety also have a negative impact on GPA.
Campus Capacity
• Average of 10% of students seen at campus services
• Many very symptomatic students do not see themselves as having “psychiatric problems” (less likely to seek treatment)
• Many in most serious risk do not present on their own
• 20% of campus suicides were seen at CC/80% no contact
We believe in a comprehensiveto
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Campus Reports on Innovations
Student Affairs Advisory Council (SAAC)
UMass AmherstUMatter at UMass
Core Concepts, Priorities and Outcomes
Spring 2018
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UMatter @ UMass
College Students Are Disconnected
at UMass Amherst
• 1:3 believe violence is a problem
• 1:5 observed or experienced violence in the
past year
• 1:3 know how to report an incident
• 1:4 ‘unlikely’ to report harassment/violence
• 55% had sleep or study interrupted by
others’ use of alcohol
• 28% have no cross-racial/ethnic friendships
• 18% have never had an important cross-
racial/ethnic conversation
Undergraduate Campus Climate Study
UMass Amherst Alcohol Survey Data
Core ConceptsCare • Community • Compassion • Connection • Inclusion
UMatter Key Purposes
• Reinforce UMass’ longstanding
commitment to inclusion, care, compassion
and collective action
• Reduce student isolation
• Increase feelings of connection and
belongingness
• Create a community of care and a culture
of active bystandership
College Students Are Increasingly
Disconnected - Nationally
• 86% feeling overwhelmed
• 59% lonely
• 54% overwhelming anxiety
• 42% hopeless
• 32% so depressed – difficult to function
• 8% considered suicide past 12 months
• 80% had not sought assistance from a
counseling center or other resource
• Suicide is second leading cause of
death for college students
AUCCCD Survey 2014, NASPA/ACHA Summary 2013
Suicide Prevention Resource Center – sprc.org
Key Practices
• Environmental Messaging
• Responsive Reporting
• Bystander Intervention
• Motivational Interviewing
• Targeted Education Programming
• Assessment & Data Collection
Climate Priorities – Aspirations
• Healthy Lifestyle and Wellness
• Belonging in Community
• Active Inclusion
• Respectful Relationships
• Mindfulness and Mental Health
• Digital Citizenship
Intervention Focus – Preventions
• Isolation
• Depression/Anxiety
• Alcohol/Drug Misuse
• Sexual Assault
• Hazing
• Bias/Hate Acts
• Bullying/Harassment
• Violence
UMatter Outcomes• 5,000 incoming undergraduate students are trained each year in active
bystandership to prevent and respond to incidents of bias, violence, sexual
assault, bullying, hazing, high-risk drinking and other community impacts
• 8,000 copies of the Maroon Folder to help staff and faculty recognize and
effectively respond to students in distress*
• Since 2013, UMatter at UMass has run messaging campaigns on local buses
and digital signage on sexual assault prevention, preventing harassment on
buses, and most recently, profiling bystander intervention strategies
• 10,000 UMatter at UMass guides are distributed to incoming students and
their families to increase early connection to campus support resources
• 26,000 students receive weekly and monthly messaging on connections,
self care, and campus resources
• 5,973 returning students had active bystander training in their residence halls
• 30+ support groups for distinct student populations
• Conference for Compassionate Leadership
*The UMass Amherst Maroon Folder framework is now used by 30+ colleges and universities across the U.S.
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UMass Boston:JED Self-Evaluation
UMass Boston
JED Self-Evaluation
Policy Systems & Strategic Planning
• Medical Leave/ Return Policy
• AOD Protocols
• Medical Amnesty Policy
Means Restriction
• Pill Collection
• Breakaway Closet Rods in Residence Hall
• Access Restriction
IdentifyStudents at Risk
• BIT and Care Teams
• Questions on Health Forms
• Outreach to Entire Student Body
• Maxient
Student Wellness
• Recovery at UMass Boston
• Engaging Faculty
• Residence Life Living Option
Developing Life Skills
• DBT Skills and Panic Coping Workshops
• KORU Mindfulness
• UMB-UR-Best Workshop and Coaching
Implementation Completed
Implementation In Progress
Policy Systems & Strategic
Planning
Means Restriction
IdentifyStudents at
Risk
Student Wellness
Developing Life Skills
UMass DartmouthBasic Needs InsecurityAn Impediment to Mental Health
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• Food insecurity is the limited or uncertain availability of nutritionally adequate
and safe foods, or the ability to acquire such foods in a socially acceptable
manner. The most extreme form is often accompanied with physiological
sensations of hunger.
• Housing insecurity is the inability to pay rent or utilities or the need to move
frequently.
• Homelessness means that a person is without a place to live, often residing in
a shelter, an automobile, an abandoned building or outside.
Basic Needs Definitions
Wisconsin Hope Lab Survey Report April, 2018
Basic Needs Insecurity
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Wisconsin Hope Lab Survey Report April, 2018
National UMassD
University students reporting
food insecurity in the last 30
days
36% 41%
University students reporting
housing insecurity in the last
year
36% 33%
University Students reporting
homelessness in the last year
9% 11%
Arnie’s Cupboard
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Food donations:
• Faculty/Staff donations
• "Food for Fines" program
• "The Cupboard is Bare" UMD Announce emails
• External donors such as Gold Medal Bakery
Monetary donations:
• Knights of Columbus
• UMassD Annual Fund (one-time or recurring
contributions)
• Trustee Maria D. Furman
Other support:
• Three work-study student positions
• Center for Religious & Spiritual Life Volunteer
Supervisor
Period Guests Visits lbs Volunteers
2016-2017 371 NA 2,731 NA
Summer 2017 22 47 448 29
2017-2018 389 742 5,396 202
UMass Lowell
Healthy Minds
Healthy River Hawks
A Community of Support at UMass Lowell
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Learning with Purpose
STUDENT STATES OF
MENTAL HEALTH
CRISIS
SEVERE DISTRESS
MEDIUM DISTRESS
MILD DISTRESS
POSITIVE WELLBEING
• Restrict Access to Potentially Lethal Means
• Follow Crisis Management Procedures
• Provide Mental Health & Substance Abuse Services
• Increase Help Seeking Behavior• Identify Students at Risk
• Promote Social Connectedness• Develop Life Skills
JED Foundation Model
Intervention
Prevention
Mental Health Continuum
www.mindyourheadyork.org/what-is-mental-health/
Learning with Purpose
CRISIS INTERVENTION
Learning with Purpose
COMPREHENSIVE
APPROACH TO
PREVENTION
Capes and Healthy Hawks
Student and Academic
Affairs Support Staff
Training
FYE Classroom
Presentations
Onboarding, Orientation
and First Year Experience
Facilitated Student Support Groups
Faculty and Staff
Onboarding and Resources Targeted
Prevention to Student Groups
Engaging Parent and
Family Partners
Leveraging Social Media
Role Modeling Healthy
Behavior
Sleep and Mindfulness
Planning: Financial, Life,
Future
Campus Ministry and Spirituality
STUDENTS
Developing Life Skills
Promoting Social Connectedness
UMass Medical SchoolUnique Issues Associated with Graduate and Medical Students
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Medical School Global Trends
• Burnout, depression and suicide are more prevalent in physicians and trainees as compared with the general population
• 300-400 physicians die by suicide each year1
• 1 in 4 medical students shows signs of depression globally2
• 11% of medical students experience suicidal ideation (SI) during medical school2
• 9.3% similar age general population experience SI during the same time
• Attention to mental health issues and wellness have not been embraced in the profession historically
• Cultural factors encourage suffering in silence; fear and shame predominate
1. Center C, Davis M, Detre T et al. Confronting Depression and Suicide in Physicians. A Consensus Statement. HAMA 2003;289(23):3161-3166. 2. Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical StudentsA Systematic Review and Meta-Analysis. JAMA. 2016;316(21):2214–2236.
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• Physician burnout is costly in the short and long term
– Measurable impact on patient care outcomes, patient safety and
measures of satisfaction and productivity
– National assessment of cost of physician turnover: as high as $500K-
$1.5M for a single physician
• Physician burnout impacts learners
– Learners observe and learn, watching their teachers
– Physician burnout mistreatment, the learning environment
– Burnout begins in medical school, grows in residency
Burnout/Suicide Garnering Increasing Attention
PubMed Search: “physician” and “burnout”
2016: 2752017: 3022018: 134
National Academy of Medicine: Action Collaborativehttps://nam.edu/initiatives/clinician-resilience-and-well-being/
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• Learning Communities: mentoring, coaching
• Curriculum
• Wellness Initiatives
• Student Counseling Services
The UMMS Model
Growing Challenges• Substantial increase in volume over past 5 years
Increased intakes
More complicated cases
Large percentage of students seen over tenure
• UMMS students are a unique population that require more nuanced care and
support.
• Medical and Nursing students are different due to current clinical duties
and future medical/nursing licensure concerns
• Graduate students generally are at a different stage of life
Sarah Ketchen Lipson
Healthy Minds Study
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Healthy Minds Study (HMS)
• Started in 2005
• Annual, web-based survey
• > 200 schools; > 200,000 students through 2018
• Random sample at each participating institution
• 20-25 minutes to complete
• After survey, informs students about mental health resources
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HMS Survey Topics
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How does mental health predict academic success?
Data: random sample of undergraduate and graduate students
Baseline
2-year follow-up
Outcomes: GPA, retention
Mental health: depression, anxiety, eating disorders
GPA
Within semester
Depression lower GPA
+15 points on PHQ-9 (“mild” (4) to “severe” (19) depression)
-0.2 in GPA
-0.4 drop in GPA if co-occurring anxiety
Over time
Negative associations: depression, panic disorder, generalized anxiety, eating disorders
Co-occurring anxiety-depression have an additional negative association
Retention
Drop-out rate at UM
25%: <3.0 GPA, screen positive for a mental health problem
9%: <3.0 GPA, no mental health problems
Each point on PHQ-9 +0.3% in drop out probability
+15 points on PHQ-9 +4.7% in drop out probability
Implications for Practice
Anticipating drop-out
Low GPA in previous semester
Positive screen for a mental health problem
Adding mental health criteria would increase drop out identification
On campuses with higher drop-out rates, screening would be more cost-effective (fewer “false positives”)
Economic Case for Mental Health Services
Return on Investment (ROI) Calculator
Parameters (customizable)
Student population (enrollment)
Percentage of students depressed
Institutional drop-out rate per year
Tuition
Cost of mental health providers
Outcomes
Number of drop-outs averted due to programs/services
Total additional revenue for institution
Total additional lifetime earning (productivity) for your graduates
Economic Case Illustrated
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Infographic from kognito.com, based on findings from Eisenberg, D., Golberstein, E., Hunt, J. (2009). Mental Health and Academic Success in College. B.E. Journal of Economic Analysis & Policy 9(1) (Contributions): Article 40.
Example: University of Michigan
Example: University of Michigan