Mental Health, Top of Mind

Student affairs officials discussed behavioral intervention teams, suicide prevention programs and other sobering realities at annual convention Monday.
March 29, 2011

BALTIMORE -- Two Old Dominion University student affairs officials who are reviewing the past 10 years of college counseling literature -- that is, documents related to research, theories and practices -- have found that the theme of "student counseling and mental health needs" appears near the top in most every category of literature; it spans student development, student health, counseling psychology and professional counseling.

That this set of concerns dominates the minds of people in the field was reinforced by the large number of sessions on these topics Monday at the annual convention of the American College Personnel Association. Presentation subjects ranged from behavioral intervention teams and suicide prevention to using positive psychology to help students succeed.

Alan M. Schwitzer and Dana Burnett, professors in counseling and human services and education and leadership, respectively, studied their own university's students to see whether those who are referred to counseling -- and who actually go -- perform better academically and are more likely to graduate than their peers who decline counseling. When they found that the answer is yes -- at least, on that campus -- it raised the question of whether research has found the link elsewhere as well.

The search for an answer led to the review and annotation of 750 articles published in about a dozen leading journals from 1998-2008, and an organization of that research into a website-database that its creators hope will serve as a valuable resource to student affairs professionals. "We would like to stimulate research in areas where it doesn't exist, or doesn't very much exist," Burnett said. "We need to identify where it's coming from and where it's not." For instance, after the Virginia Tech shootings in 2007, Burnett found, surprisingly little of the literature about students in crisis came from college counselors.

Counseling journals are publishing on other topics, though. In addition to student counseling and mental health needs, other subjects that surfaced most often during the 10-year period include serving specialized campus populations; attachment theory (commonly referred to as "helicopter parenting") and self-efficacy; and professional issues and trends.

Another theme that came up -- and that, as one attendee pointed out, is of particular interest as colleges look for ways to cut costs -- is the value of counseling centers. While Burnett said the research does demonstrate their value, he suggested that with the help of those in the audience who might review the website and offer feedback on the project, they could recommend further research on the topic. "We really want this to be a group effort," he said. "We really need to be planning for the next 10 years, and maybe we could influence the way people do their research."

In literature discussing concerns of students, one sub-theme that Schwitzer and Burnett identified as getting significant scholarly attention was that of depression and suicide, which Donn Marshall, associate dean of students at the University of Puget Sound, addressed in another session Monday.

"In the case of suicide prevention, what I think of as a moral imperative," Marshall said, "is that we're really talking about life and death here. That if we're choosing suicide prevention programs, we're really talking about choosing things that are effective in saving lives." To aid colleges in making those tough decisions, Marshall summarized the suicide prevention landscape, identifying programs that are proven to work, as well as those that are unproven but may be a good fit for a given campus. (The complete list is available on the ACPA website, where programs can be categorized under early identification, referral and follow-up; clinical; policy; or case management.)

There are a number of factors that colleges should take into account when implementing a suicide prevention program, including cost and the demographics of the student body. And, he observed, an institution's officials must consider whom they're dealing with: programs can address the entire student body through an educational campaign, or one student who attempted suicide and is at risk of a relapse. The key is knowing your campus, Marshall said.

At Puget Sound, there hasn't been a death by suicide in eight years and 18 days (Marshall keeps track). But that doesn't mean the college found the perfect prevention methods and hasn't changed since. Quite the opposite, actually; both Marshall and student affairs officials in the audience noted that, because humans lose interest in the familiar, it's often more difficult to sustain a program that works than to start an entirely new one.

Marshall noted a few standouts. At the University of Illinois, suicide deaths have plummeted 50 percent since the institution started mandating more than 20 years ago that students who considered or attempted suicide undergo four psychological assessment sessions. While there's no empirical evidence from other colleges using the strategy, its success at Illinois has garnered attention.

A newer method that is backed up by empirical evidence is an online screening program, where counseling centers reach out via e-mail to their student population to offer an online test to measure how they're faring personally, and follow up with feedback about resources and options if a student's response indicates he or she is having problems. The American Foundation for Suicide Prevention has suggested online tests are a "pretty effective" way of reaching students who wouldn't otherwise have sought therapy, Marshall said.

One method that inspired conversation at the session was that of medical leave. Puget Sound allows at-risk students to voluntarily take time off, but convention attendees were more interested in involuntary medical leave, after one person in the audience mentioned Pima Community College, which suspended Jared Lee Loughner; after leaving the college, he carried out the shooting spree in Tucson. The man who posed his question to Marshall asked whether any colleges as a policy assume risk for involuntary student medical leaves.

Marshall said he didn't know of any, but he, like many other student affairs officials, defended Pima's actions. He noted that the college actually sent officers to Loughner's parents to convey their concerns (which illustrates another point Marshall made: communication with parents can be critical). "That's more than my school's policy would do, would require of us," he said. "I'm unaware of any place that does anything more than what they did, and my hat is really off to them."

Behavioral Intervention and Positive Psychology

Another measure Pima has in place is a behavioral intervention team. Such teams exist at many colleges, and student affairs officials from Montgomery College, in Maryland, described the concept in a later convention session. They said that while such teams are not a new idea in higher education, recent shootings and the growth of counseling complexities and diversity in student bodies have caused many colleges to modify or upgrade their own systems.

Behavioral intervention teams are meant to identify and address worrisome student behaviors based on early signs of danger. They are not, the presenters stressed, emergency first-response teams. Rather, they can serve as reporting systems and draw attention to troubled students before they act out. "We see BIT as a process that assists students in being successful," said Monica Brown, dean of student development at Montgomery. "It is important that if students are dealing with mental health issues, or dealing with behaviors of concern, that they get the help they need so they can continue."

Montgomery's behavioral intervention operates through a seven-step process. First, it responds to a student referral from a faculty or staff member. It conducts a preliminary investigation to determine whether it should respond, as opposed to referring the student to another resource if an intervention is not necessary. If the team moves forward, it will then initiate a threat assessment and develop an action plan, which is based on a model that's used consistently for all students (of course, each case is unique and certain details will depend on the student). It makes a recommendation to the dean of students. If the recommendation is green-lighted, the team implements its intervention, or response.

"That can take very different shapes and forms, depending on your case," said Helen Brewer, associate dean of student development at Montgomery. The last step is "wrap-around services," or following up with everyone involved -- including the student, his or her parents, and the person who made the referral in the first place.

One convention presenter explored ways to avoid a referral situation altogether. In her session, Jamie Matthews, community director of university housing at Southern Illinois University at Edwardsville, applied the principles of positive psychology to higher education.

Positive psychology is also an identification method, but rather than the clinical method of pointing out what's going wrong and trying to fix it, it identifies what's going right and tries to replicate it. Matthews said that in the last 10 or 15 years, positive psychology has gained popularity, but it's still mostly anecdotal at colleges. "I think it's growing," she said. "They're dabbling with it."

At a college, the psychologist would discuss with the student his or her strengths to help facilitate growth and learning in both academics and other parts of college life. A major component is helping students understand how they got to college and what role their past experiences should play in their present lives, which is intended to help them figure out where they'll go from here. This can assist the students -- and staff -- in identifying what's important to them and what defines success.

There are various positive psychology models that can apply to higher education, but all of them emphasize understanding students. Other benefits that Matthews pointed to are personal and professional growth for the practitioners, as well as quantitative research opportunities.

It's important, Matthews said, to balance out the clinical methods with positive psychology strategies. "You can have positive motion at the same time as negative motion," she said. But it's what you do with it, and how you move forward with your students, that counts.


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