College Student Mental Health E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Bildung
• Serie: J-B SS Single Issue Student Services
• Sprache: Englisch

Seitenzahl: 219

Veröffentlichungsjahr: 2017

Beschreibung

In recent years, there has been heightened attention paid to the mental health needs of college students, the range and scope of these issues, and the challenges related to providing mental health services. Counseling center data, changing legal mandates and anecdotal reports from senior practitioners all point to the growing complexity of managing these issues. This volume examines clinical issues for student affairs professionals beyond the counseling center- addressing how campuses can be prepared for and respond to mental health issues. It helps readers cultivate a community-centered understanding of and sense of shared responsibility for promoting mental health, knowledge about best practices for service provision, and strategies for dealing with mental health issues pertaining to specific student populations and issues within the environment. Topics covered include: * Contextual and foundational information related to current student mental health trends, * Mental health aspects of certain populations including military-connected students, students on the autism spectrum, and international student, * Bigger-picture, systemic issues related to mental health faced by colleges and universities, and * Future directions of mental health on campuses. This is the 156th volume of this Jossey-Bass higher education quarterly series. An indispensable resource for vice presidents of student affairs, deans of students, student counselors, and other student services professionals, New Directions for Student Services offers guidelines and programs for aiding students in their total development: emotional, social, physical, and intellectual.

Leseprobe

New Directions for Student Services

Susan R. Jones CO-EDITOR Sherry K. Watt CO-EDITOR

College Student Mental Health

Heidi Levine Susan R. Stock EDITORS

Number 156 • Winter 2016

Jossey-Bass

San Francisco

College Student Mental Health Heidi Levine, Susan R. Stock (eds.) New Directions for Student Services, no. 156

Co-Editors: Susan R.Jones and Sherry K. Watt

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CONTENTS

Editors’ Notes

References

1: Common Mental Health Issues

Overview of Common Mental Health Disorders

Roles of Nonmental Health Professionals

Strategies and Recommendations

References

2: Emerging Issues and Models in College Mental Health Services

Overview of Counseling Center Clients

Evolving Models and a Comprehensive Approach

Strategies and Recommendations

References

3: Mental Health Concerns of Students on the Autism Spectrum

Characteristics and Traits of Students with Autism Spectrum Disorder

Mental Health and ASD

Common Concerns: Challenges Facing Students with Autism

Student Affairs Offices: Sources of Support

Strategies and Recommendations

References

4: Mental Health and Military-Connected Students on Campus: Culture, Challenges, and Success

The Military-Connected Student, Campus Culture, and Resources

Diversity, Culture, and Experience

Administration and Policy

Dependents, Reserve, and National Guard

Mental Health Issues

Reintegration

Strategies and Recommendations

References

5: International Student Mental Health

Acculturation and Other Stressors

Considerations for Counseling Centers

Collaboration Across Campus

Strategies and Recommendations

References

6: Mental Health and Students at Risk

Who Are the Students At Risk?

Behavior Intervention Teams and the Office for Civil Rights

Risk Assessment and Threat Assessment

Strategies and Recommendations

References

7: Mental Health Aspects of Responding to Campus Crises

Response to Tragedy

Mental Health in the Aftermath of Tragedy

After the Tragedy: Responding to the Campus

Strategies and Recommendations

References

8: Promoting Resilience, Retention, and Mental Health

The Bigger Picture of Retention Efforts

Why Resilience and Mental Health Matter for Retention

Promising Programs and Initiatives

Strategies and Recommendations

References

9: Anticipating the Future of Mental Health Needs on Campus

Observations from the Field

Growing Awareness of Mental Health Issues

An Ethic of Care

Balancing Risk and Care

Strategies and Recommendations

References

Order Form

Advert

Index

End User License Agreement

List of Tables

Chapter 2

Table 2.1

Table 2.2

Table 2.3

Table 2.4

Guide

Cover

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Editors’ Notes

In recent years there has been heightened attention paid to the mental health needs of college students, the range and scope of these issues, and the challenges related to the provision of mental health services. Mental health generally refers to students’ psychological and emotional well-being and the conditions that affect their state of health, happiness, and security. Counseling center data, changing legal mandates, and anecdotal reports from senior practitioners all point to the growing complexity of managing these issues (e.g., Center for Collegiate Mental Health, 2016; Office of Civil Rights, 2010). Attend any meeting of senior student affairs officers and you are sure to hear discussion about how colleagues are handling such issues as managing students with inappropriate social behavior, challenges with special student populations, worries about suicidal or (potentially more worrisome) homicidal students, and simply keeping pace with rising needs in the face of limited resources. Barriers to effectively addressing student mental health issues may include a siloed approach that suggests these issues are the sole responsibility of the campus counseling professionals or a lack of knowledge about how licensed counselors and psychologist might effectively intervene in these situations. One of the goals of this volume is to suggest that student mental health is everyone's business—it certainly affects us all. Therefore, it is to both university student and employee benefit that campus administrators gain knowledge and skills that can directly and effectively address mental health issues on campus.

Throughout this volume we use the term “mental health” to speak in the broadest sense about students’ psychological and emotional well-being. In many of the chapters, the authors distinguish “mental health issues” (situations that may reflect some disruption in students’ optimal functioning) from “mental illness” or “disorders.” The latter terms are used in those specific situations in which an individuals’ functioning is sufficiently impaired as to constitute a condition in which some form of treatment or intervention may be appropriate.

Although a number of existing publications provide either skills focus for counselors-in-training or guidance for licensed counselors and psychologists working with college students, there are fewer resources for student affairs administrators interested in mental health issues. Reynolds’ (2008) Helping College Students is primarily a textbook for graduate students in higher education/student affairs, with a focus on teaching about helping skills. Kadison and DiGeronimo's (2005) College of the Overwhelmed provides an overview of the types of mental health issues students experience and ways in which colleges might meet their needs; however, Overwhelmed focuses on the provision of clinical services, and its primary target audience was students and their families. A 2006 NASPA publication, College Student Mental Health (Benton & Benton, 2006), had an intended audience of practitioners and addressed how programs and services across student affairs could support student mental health needs. These last two volumes, however, are each 10 or more years old. Since their publication, there have been significant changes in the legal landscape, prevalence of certain disorders and conditions, and campus approaches to service provision.

This volume is intended to examine mental health issues for the benefit of practitioners who are not trained and licensed counselors or psychologists—addressing how campuses can be prepared for and respond to these issues. Although some of the chapters address mental illnesses (i.e., specific diagnosed or diagnosable disorders), the broader focus is mental health writ large. For example, several chapters address the adjustment concerns that are commonly faced by some populations of students (such as international or military-connected students) or as the result of situational factors (such as campus crises). In developing this volume, we sought input from senior student affairs professionals about what mental health issues were most concerning or challenging on their campuses. Certainly, there are many issues and populations of students that are not covered within this book. As our society and campuses continuously evolve, there will be endless opportunities for colleagues to follow us in delving into new issues and approaches to addressing and fostering student mental health.

Our goal is to provide a resource for student affairs administrators who are seeking information and guidance on practices regarding emerging issues and challenges related to student mental health. We hope that this book helps readers cultivate a community-centered understanding of and sense of shared responsibility for promoting mental health, supporting those with mental disorders, increasing knowledge about best practices for service provision, and generating strategies for dealing with mental health issues pertaining to specific student populations and issues.

We have organized this book into three sections, reflecting some of the complexities and differences in content knowledge necessary to properly address mental health issues on campus. The first two chapters provide contextual and foundational information related to current student mental health trends. Chapter 1, by Susan Stock and Heidi Levine, opens the book by providing a layperson's overview of some of the more common mental health issues facing students, as well as strategies for effective intervention. In Chapter 2, Ben Locke, Jon Brunner, and David Wallace present overviews of counseling center data regarding student clients and clinical trends, as well as a review of evidence-based practices in the provision of counseling services.

The second section of chapters focus on populations of special interest. We recognize that many groups of students could warrant their own chapters regarding mental health needs, and in this volume, we have chosen three such groups that have received recent attention. In Chapter 3, Jane Thierfeld Brown, Lisa Meeks, and Michelle Rigler offer a primer on students on the autism spectrum, providing information on students with and without mental health challenges, as well as campus support strategies. Following in Chapter 4, Ted C. Bonar discusses the specific mental health needs of veterans and other military-affiliated students. Last in this section, Chapter 5, by Susan Prieto-Welch, explores the needs and challenges of and for international students.

The third section is composed of chapters that address bigger picture, systemic issues related to mental health faced by colleges and universities. Chapter 6, written by Alan Goodwin, focuses on students “at risk” threats toward self or others and the multiple legal, ethical, and cultural considerations that must be addressed within the campus environment. In Chapter 7, Micky Sharma and Christopher Flynn delineate goals, plans, and intervention strategies related to large-scale campus crises. Daniel Eisenberg, Sarah Ketchen Lipson, and Julie Posselt write about the connections between resilience, retention, and mental health in Chapter 8.

Our volume ends with a chapter by Robert Bonfiglio, long-time senior student affairs officer and leader in student affairs. Bob addresses the future of mental health on campuses by addressing two major forces on campus, which are at times in conflict: working from an ethic of care while attending to tenets of risk management.

We have both had the privilege to work, over the past 30 years, with many gifted colleagues in counseling centers and divisions of student affairs. Our knowledge of the issues presented in this volume is informed by their experience and wisdom. We hope that this book provides readers with some tools they will find useful in meeting the challenges presented by the changing face of student mental health needs and the campus environment.

Heidi LevineSusan R. Stock Editors

References

Benton, S. A., & Benton, S. L. (Eds.). (2006).

College student mental health

. Washington, DC: NASPA.

Center for Collegiate Mental Health. (2016, January).

2015 annual report

(Publication No. STA 15–108). University Park, PA: Author.

Kadison, R., & DiGeronimo, T. F. (2005).

College of the overwhelmed: The campus mental health crisis and what to do about it

. San Francisco, CA: Jossey-Bass.

Office of Civil Rights. (2010, December 16). Complaint No. 15-10-2098. [Letter to Spring Arbor University]. Cleveland, OH: U. S. Department of Education, Office for Civil Rights. Retrieved from

http://www.bazelon.org/LinkClick.aspx?fileticket=WGmoOxFqnto%3D&tabid=313

Reynolds, A. L. (2008).

Helping college students: Developing essential support skills for student affairs practice

. San Francisco, CA: Jossey-Bass.

Heidi Levine

is vice president for student development and planning at Simpson College; she is trained as a counseling psychologist and has prior experience directing college counseling and health services.

Susan R. Stock

is the executive director of student health and counseling services at Northeastern Illinois University. She is a counseling psychologist with experience in multiple student affairs departments.

1

This chapter provides an overview of common student mental health issues and approaches for student affairs practitioners who are working with students with mental illness, and ways to support the overall mental health of students on campus.

Common Mental Health Issues

Susan R. Stock, Heidi Levine

In this chapter, we provide an overview of mental health issues commonly found on college and university campuses. Our purpose is not to provide detailed diagnostic criteria (though we describe some of the characteristics found in current diagnostic manuals, such as the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5; American Psychiatric Association, 2013)), nor to allow or encourage those who are not licensed counselors or psychologists to diagnose mental disorders. Rather, our aim is to facilitate basic recognition of mental and emotional health issues and offer ideas for interventions and support that can be appropriately offered by staff beyond the counseling center.

Overview of Common Mental Health Disorders

While college students may experience the full range of mental health disorders found in the population at large, we focus on those disorders which most frequently affect students: anxiety, depression, alcohol and other drugs, trauma, and eating disorders. In this section, we describe some of the signs and characteristics of these disorders, particularly looking at how these issues may manifest among students or in a college setting.

Anxiety

In recent years, anxiety has overtaken depressive symptoms as the primary presenting issue at college counseling centers (Center for Collegiate Mental Health [CCMH], 2015) and as a significant issue on university campuses in general (American College Health Association [ACHA], 2014). There has also been a rise in anxiety in the general U.S. population (National Institute of Mental Health [NIMH], 2015). The term “anxiety” can cover a broad range of symptoms, some of which may warrant attention from a professional licensed counselor or psychologist and some not. Of course, all college students (and all people) experience anxiety at some point in their lives. Given the situational demands of university campuses—personal, academic, financial, and interpersonal stressors, many of which students may be facing in unique ways for the first time—it is no surprise that anxiety is a common concern.

Anxiety disorders are diagnosed when the worry or fear is so significant to the person that it affects her or his daily functioning, and has continued for a long period of time with the symptoms being present more days than not. Anxiety manifests in many ways. Sometimes the fear is very specific and/or limited to a particular situation. These specific fears are referred to as phobias. Given their limited scope, the fear-inducing stimuli may be relatively avoidable and therefore not significantly or consistently affect daily living. For example, a college student with a phobia of elevators may be able to climb stairs in her residence hall, her classroom buildings, and the gym and therefore avoid the fear-causing stimulus. However, if in the next semester, that same student is assigned to a classroom on the 30th floor of a high-rise building, she may not be able to attend class, which would have a significant impact on her daily experience.

Situational factors define other anxiety disorders as well. Someone with social anxiety disorder, for instance, may be a stellar student and produce excellent solo work, but be hampered in his ability to work on group projects, give oral presentations, and/or chat at networking events. The person with social anxiety disorder experiences overwhelming worry and self-consciousness about everyday social situations. The worry often centers on a fear of being judged by others, or behaving in a way that might cause embarrassment or lead to ridicule.

Panic disorder refers to situations in which feelings of terror occur suddenly and repeatedly, often without warning or an easily identifiable trigger. Sometimes people have panic attacks, which is a single instance of panic as described previously. Having panic attacks frequently and chronically can lead to a diagnosis of panic disorder. The person having a panic attack experiences not only the emotional component of fear but also intense physical symptoms such as sweating, chest pain, a rapid or irregular heartbeat, and/or the feeling that they are choking. It is not unusual for a person experiencing a panic attack to believe that they are having a heart attack.

Lastly, the broadest type of anxiety disorder is called generalized anxiety disorder. This features intense worry and concern regarding many aspects of one's life that does not match a more realistic appraisal of the situation(s). For example, someone with generalized anxiety disorder may find herself unable to stop worrying about school, family, finances, her health, and her school performance, despite the lack of any obvious reason to worry. People with generalized anxiety disorder tend to expect disaster and go about their daily lives anticipating the worst outcomes.

Depression

Following anxiety disorders, depression and other mood disorders are the most frequently occurring mental health issues among the general population and on college campuses. Depression is diagnosed in approximately 7% of the general population and 9% of college-aged adults; much less commonly, bipolar disorder occurs in approximately 2.6% of the population (NIMH, 2015). Responses to the 2014 National College Health Assessment (NCHA) indicate that 33% of participating students felt so depressed that it was difficult to function at least once in the prior year, and 62% reported feeling “very sad” at least once in the past year (ACHA, 2014).

The hallmark sign of depression is a persistently sad or low mood. However, sadness or feeling “depressed” is sometimes a normal response to life events, such as the ending of a relationship or disappointment. Two features that generally differentiate depression from normal sadness or “the blues” are the persistence and pervasiveness of the mood. One of the diagnostic criteria for depression is that this mood has lasted for a period of 2 weeks or longer and that during this time, the person has felt depressed more often than not. It is important to note that some events—particularly grieving the death of a close friend or family member—typically lead to feelings of sadness and loss that extend well beyond this period of time; with grief, however, the grieving person is often able to experience increasingly frequent periods of happiness or other emotions, whereas the depressed person often feels little or no lifting of the depressed mood. For example, students being sad and preoccupied and not feeling like engaging in normal social activities for a few weeks after the break-up of a romantic relationship are likely having a normal response to loss. If, however, students stop attending class and work, spend most of the day in bed, aren't eating or bathing regularly, and are avoiding contact with friends and family, there is a good likelihood that they have slipped into a period of depression.

Sometimes the person experiencing depression does not actually feel sad or down. Anger and irritability are also common emotional signs of depression. And especially in cases of more severe depression, the person may experience a kind of numbness, not really feeling any emotions at all. Part of this emotional numbing frequently includes a lack of ability to enjoy things that had previously been pleasurable. Students experiencing this sign of depression may talk about simply not finding anything fun or meaningful anymore; life just feels kind of flat, as if all the zest had been washed away.

Other signs of depression include difficulties with sleep (such as early morning wakening, excessive sleeping, not feeling rested or refreshed from sleep), change in appetite (sometimes an increase in appetite and eating, but more commonly loss of appetite), loss of motivation and ability to concentrate, social withdrawal and isolation, feelings of hopelessness, and thoughts of death and suicide (Chapter 6 addresses issues related to suicide and self-harm).

Although less commonly occurring, bipolar disorder typically first occurs in early adulthood, often (though not always) following prior periods of depression. Individuals with bipolar disorder fluctuate between states of depression and mania—periods marked by extraordinarily high levels of (often unproductive) activity, expansiveness and exaggeration of mood, and feelings of grandiosity that can lead to impaired judgment and risky behavior. Individuals with mania feel a decreased need for food and sleep, which are subtly different from the loss of appetite or ability to sleep soundly that depressed individuals often experience. As an example, a student who had previously been academically strong and interpersonally outgoing and easy to get along with but who suddenly becomes increasingly belligerent and harassing in their interactions with others, stops doing their academic work but stays up all night writing “creative” pieces that make little sense to readers, and damages others’ property may be demonstrating the signs of a manic episode.

Alcohol and Other Drug Use

Students’ use of alcohol (and, to a lesser extent, other drugs) has been a challenge throughout the history of higher education in the United States (Barber, 2011). Most students who use alcohol do so in relatively low-risk social and recreational ways but some slip into misuse, consuming alcohol as a way to cope with stress or manage emotions. At the far end of the spectrum, a small but still attention-worthy number of students develop substance abuse disorders or addictions.