Zoe RagouzeosStudent resiliency programs can be a valuable addition to college counseling services
It is well documented that mental health issues have reached crisis proportions in young people and on college campuses around the country.
The 2016 Centers for Disease Control and Prevention (CDC) Leading Causes of Death Report tells us that the suicide rate among young adults, ages 15–24, has tripled since the 1950s and suicide is currently the 2nd leading cause of death among college students. In addition to those students that die by suicide, 8.0% of full-time college students have had suicidal thoughts or have seriously considered suicide, 2.4% have made a suicide plan, and 0.9% has made a suicide attempt.
In the 2014 National Survey of College Counseling Centers, respondents reported that 52% of their students had severe psychological problems, an increase from 44% in 2013. A majority of respondents noted increases over the past 5 years of anxiety disorders, crises requiring immediate response, psychiatric medication issues and clinical depression.
The self-report of students isn’t much brighter.
In a 2016 survey of students by the American College Health Association, “52.7% of students surveyed reported feeling that things were hopeless and 39.1% reported feeling so depressed that it was difficult to function during the past 12 months.”
Mental health professionals, over the last 20 years have been working hard to decrease stigma and increase access to mental health services. We have been teaching young people to advocate for themselves, be good health consumers, educate themselves on mental health issues and ask for what they need.
The results? More and more young adults are increasingly comfortable sharing details of their mental health diagnoses, the treatment they’ve received historically, the medications they are taking and the services they expect from their colleges and universities — to help them cope.
Of course, the ability of students to cope with the inevitable challenges of college life has significant implications for both their well-being and academic success. Coping, or resilience, is the ability of students to manage and bounce back from the bumps of everyday life in safe and productive ways. Can a student effectively rebound from setbacks or do they become overwhelmed turning to unhealthy coping mechanisms, such as substance abuse, self-injury and/or disordered eating.
There are many theories which seek to explain why resilience is decreasing among young people. Some cite their helicopter or snowplow parents for not allowing them the opportunity to learn how to handle their own issues at a young age.
Some blame the current political climate where young people are bombarded with hate, violence, sexual misconduct and other issues in their schools and communities that make their learning environment overly stressful.
Others believe the high cost of college and the burden of student debt adds to students’ stress and anxiety. Another theory is that the pressures of 24/7 access to social media causes fragility among young people.
Regardless of the reasons, universities all over the country are struggling to help students cope. Most students believe that helping them cope involves access to the university counseling services whenever they need it.
The problem with this is that students’ appetite for one on one mental health support continues to grow with no end in sight. Are there other ways to work towards increasing resilience among students?
At NYU, we have created an opt-in “toolkit” program for students. Rather than call these experiences “therapy” which might alienate some students, they are called workshops that are specifically designed to help students develop new skills that enhance personal, academic, and social well-being.
Toolkits differ from clinical groups in that they are more focused on skill acquisition and are only one to four sessions in duration. Designed to resemble an academic class, the counselor is the instructor, there is a PowerPoint projected and chairs are arranged in rows as opposed to a group counseling circular format. Topics include stress and time management, life skills, managing anxiety, insomnia, living mindfully and using meditation for coping.
Students who are skeptical about counseling including underserved groups such as international students are drawn to our toolkit program which allows them to avoid an intake process and connect with a counselor in a way that feels safer.
These students are referred to our toolkits by their academic advisors, faculty, career services, athletic coaches and others who interact with them, detect an issue related to coping or resilience and believe this intervention will teach necessary skills that may prevent them from needing clinical interventions later. And for those who do, they have already met a counselor who now feels more safe an approachable.
The University at Buffalo takes the above concept one step further by actually requiring its low risk students, after triage with a counselor, to participate in a similar program prior to being able to make one on one counseling appointments.
The “Bouncing Back” program is 5 weeks in duration with one 90 minute session, once per week led by a counseling center clinician. There are 5-8 students per group. Curriculum includes modules on goal-setting and purpose, optimism, mindfulness, forming and nurturing relationships and belonging and engagement.
At the conclusion of the program, students complete an assessment which seeks to determine if they have gained targeted skills. Obvious benefits to the group format include the expansion of a students’ access to services/strategies and the opportunity to build support networks and campus connections with students going through similar issues. Benefits to the service include a decrease in students waiting for individual appointments.
A possible next step for both the NYU and Buffalo programs is to create an online format for the workshops using a platform such as Zoom, for example, which could significantly increase convenience for students.
College counseling services have historically been responsible for providing students with clinical interventions after they experience a mental health issue. We have often relied on our colleagues in Residential Education, Student Affairs, Academic Advising and other non-clinical units to teach students how to cope with college life. The mental health “crisis” is showing us that counseling services have a role to play in teaching resilience because we are the ones fielding feedback from our students, our colleagues, their parents and other stakeholders regarding intolerable wait times, restricted access due to our short-term model and whether our services generally are meeting the expectations of our students.
Zoe Ragouzeos is the Associate Vice President for Sexual Misconduct Support Services and Student Mental Health and the Executive Director of the Counseling and Wellness Services at New York University.
