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Mary Christie Quarterly A publication of the Mary Christie Foundation

Student Veterans A group worth fighting for p. 16

Q&A with Emerson College President Lee Pelton p. 04

Issue 11 | Third Quarter | 2018

Mary Christie Quarterly The Mary Christie Quarterly is a publication of the Mary Christie Foundation, a thought leadership and philanthropic organization dedicated to the health and wellness of young adults.

STAFF Publisher & President Editor & Executive Director Program Manager Art and Layout Director

Robert F. Meenan Marjorie Malpiede Dana Humphrey Ashira Morris


Robert Caret

Vice Chair

John P. Howe, III


Robert F. Meenan


Marjorie Malpiede


Maryellen Pease


Frederick Chicos


Zoe Ragouzeos

CONTE NTS 04 Q&A: Lee Pelton 07 Opinion: A Critical Balancing Act 11 World Mental Health College Student Initiative 16 Student Veterans: A Group Worth Fighting For 21 Opinion: Yes, You Can Recover From Depression 24 Q&A: Dr. Mary K. Grant 28 Pursuing the Triple Aim in a Higher Education Setting 32 Science Summary

Cover art by Jia Sung Spot illustrations by Fran Murphy

Q&A: Lee Pelton The president of Emerson College on creative approaches to a more equitable campus. Interviewed By Marjorie Malpiede Emerson College is fully integrated into its host city, recognized by large purple banners hanging from several buildings lining Boston Common, including three restored iconic theaters. As an institution devoted to communication, the arts, and the liberal arts, Emerson has a vibrant culture of innovation carefully stewarded by its current president, Lee Pelton. Pelton considers Emerson’s creative environment a key advantage in a global economy that requires innovation in every discipline. But having come from traditional liberal arts institutions (Harvard and Dartmouth), Pelton says the student experience at Emerson can sometimes be, well, different, when individuals prone to marching to the beat of their own drums come together to form a community. Pelton shares his current students’ talent for communication as he speaks eloquently about the mental health dangers of a “heads down” digital


world. He outlined the steps Emerson is taking to better support students’ emotional and behavioral health given the correlation between wellness and academic success – a key takeaway he says he received from the Mary Christie Foundation Presidents’ Colloquium on the subject, which he attended in 2016. Pelton has launched a number of forward-thinking, student-centered initiatives at Emerson, including opening a physical campus for undergraduate students in LA and “Global Portals” – an initiative that will establish international degree programs in Paris, Switzerland, Barcelona, Sydney, and Hong Kong, making Emerson a borderless campus. But for these and other innovations to work, he believes higher education will need to operate less vertically to match the horizontal environments of today’s students. Asked how well Emerson is doing on “flattening,” Pelton says he’s “working on it.”

Here is an excerpt from our conversation. Mary Christie Quarterly: It sounds like our MCF Presidents’ Colloquium on student health and wellness had an impact on your work in this area. How so? Lee Pelton: Yes, very much so. Speaking with my peers around the country about this topic, it was clear that colleges and universities have a responsibility to invest in services that support students’ learning, which, by extension, means those services that ensure that students are mentally healthy and engaging with their community in a healthy way. At Emerson, we’ve prioritized student emotional and behavioral health as a necessary component for academic excellence and success. So we always need to make sure we’re on the look-out. I have been spending a lot of time talking to students, and you can learn so much just by asking them.

MCQ: What kinds of improvements have you made? LP: Just since that meeting, we’ve added three new psychologists, a new case manager, and a post-doctoral fellow to support our counseling services. Now, we make sure the students have around-theclock, ubiquitous access to support. We created an office of care and support with a director who works closely with counseling and psychological services. This office makes sure students are getting the support they need, particularly around persistence and retention. Recognizing that there are a number of factors that impact a student’s retention, one of them is obviously their financial well-being, but emotional security is equally important. There’s another piece here that I’ve long wanted and finally have gotten and that is we now have a full-time chaplain, a director of spiritual life. He is a Buddhist, and he provides training for students in mindfulness and meditation. The response from the students has been wonderful, which is terrific because I really believe it contributes to their capacity to learn. MCQ: Are you optimistic that these changes will address student behavioral health concerns at Emerson? LP: One of the most important considerations to be given

Excellence is not about being, but rather, about becoming. in this area is to understand that the issue of health and wellness is not something to be fixed. People think, “I will fix this and then I won’t have to attend to it anymore.” Excellence is not about being, but rather, about becoming. Excellence is a process of continuous improvement. Two years from now, we may be in a completely different place, doing different things, learning from best practices because this is a continuous, unfinished project. And it’s important for students to know that we will continue to work on this. MCQ: What are some of your biggest concerns for your students? LP: Our students, like most of the country, are living in a digital world. And the digital world is a heads-down world where you are connected to your phone (except it is not a phone, it is a disintermediation machine with a phone app, which is probably the most anachronistic of all the apps on it). So, we spend the majority of our time in the heads-down, digital world, which I worry is overwhelming the heads-up

analog world of conversation and thoughtful engagement, which leads to understanding, empathy and imagination. This analog world is threatened and diminished by our slavish devotion to our digital devices. I don’t have a solution for this but I do recognize it as a problem – a mental health problem – because it creates and sustains a level of tension and stress like I’ve never seen before. Being in a tumult of this digital world, this highly uncurated environment, where content is coming at you at a rapid rate, you don’t have an opportunity to distinguish facts from fiction. It destabilizes truth. We are having conversations here about how we can create a center that can at first recognize this issue, provide some research around it, and also provide encouragement for analog conversations. MCQ: What other initiatives related to student development are you working on? LP: At Emerson, we are engaged in developing four capacities in students, all beginning with the letter C:


creativity, critical thinking, collaboration, and communication. My view is that these capacities are critical to success in the 21st century, not just for people in the arts. However, they are not very well reflected in the structure of higher ed. The world of the modern-day student is a flat world. Young people move across multiple media platforms horizontally. One of the problems with higher ed is that it’s not horizontal, but vertical. Departments are silos that keep people from interdisciplinary collaboration.

have to be – they are working in groups, collaboratively. I think all of this makes Emerson a really vibrant, exciting place to be. Innovation is not something we have to manufacture here. MCQ: What are some of the innovations you are working on?

Photo by John Gillooly

Emerson College President Lee Pelton in his office in Boston.

We still need departments, but we need to make them more porous. And we need to flatten them out because that is the experience students seek. MCQ: What is the typical profile of the Emerson student? How does this factor into the student experience here? LP: Our students are part of 06

the creative class so in high school, they tend not to be in the dominant circle. They are not the football captains or

the student government presidents. They sit on the periphery, like most artists do. They see the world through a different lens, their own particular, idiosyncratic lens. Our students tend to be a little less communal and more individualistic. Their tendency as artists is to be singular and to march to the beat of their own drum. That said, they are very supportive of one another because they

LP: We’re opening campuses in Paris in 2019, Switzerland in 2020, and then in Hong Kong and Sydney in 2022. These are not study abroad programs but campuses where students without US passports can matriculate and received Emerson degrees.

We are calling them “global portals” and no other college of our size will have our breadth of global engagement. MCQ: What is your motivation behind this big effort? LP: To be global – that’s where the future is. Despite the fact that, as a country, we are closing ourselves off, the future will be a borderless world with a borderless economy. We want to be at the forefront of that. We build bridges, not walls.

Opinion: A Critical Balancing Act What the recent MIT ruling tells us about protecting the mental health of students By Adam C. Powell, Ph.D.

academia. Immediately afterwards, the student leaped from a building.

Adam C. Powell, Ph.D, President, Payer+Provider Syndicate

In 2009, a doctoral student at the MIT Sloan School of Management died by suicide shortly after his doctoral program director confronted him about an email that he had sent which was considered offensive. During the confrontation, the professor offered to assist him in crafting future emails and suggested that he consider a career outside of

Although the professor was aware of the student’s pre-existing mental health issues to the extent that they related to exam anxiety – and had even provided him with an extended period of time to take his exams – he felt it was necessary to address the offensive email, which had been sent to a colleague. Having earned a doctorate and worked as a university lecturer, I have come to appreciate the moral tension that all universities today face, not to mention the angst that this doctoral program director no doubt experienced. Having had instances of cheating in my courses, I have had to balance the university’s need to uphold academic integrity with the potential impact that such actions may have on the mental health of students.

I likewise recall my time as a doctoral student, during which I witnessed a number of my colleagues get dismissed from their programs due to inadequate academic performance. While the department sought to uphold a set of standards, its efforts to do so placed profound stress on a number of people – in some cases, forcing them to pursue entirely different careers. These situations have caused me to contemplate the extent to which universities must protect the mental health of their students, when fulfilling the academic mission of the university is sometimes at odds with doing so. In 2018, the Massachusetts Supreme Judicial Court was asked to ponder the duties of the university in protecting students from suicide, in the context of the 2009 incident at MIT. 07

The judge presiding over the case arrived at a multifaceted conclusion, and ultimately found the university and professors to be innocent. He started by defining the university-student relationship: “We conclude that a university has a special relationship with a student and a corresponding duty to take reasonable measures to prevent his or her suicide in the following circumstances. Where a university has actual knowledge of a student’s suicide attempt that occurred while enrolled at the university or recently before matriculation, or of a student’s stated plans or intentions to commit suicide, the university has a duty to take reasonable measures under the circumstances to protect the student from self-harm.” (Note: This case was made more complex by the doctoral student’s status as both a student and an employee. The doctoral advisor plays a mentor/employer role, and the doctoral student in part learns through working. When a doctoral student behaves offensively, it can be simultaneously student misconduct and employee misconduct.


The doctoral advisor is in a challenging situation, as discipline is sometimes necessary to maintain a proper workplace environment, while the academic community has a charge to enhance the lives of students.) The judge tempered his remarks by clarifying the limitations of a university’s duties to prevent suicide: “It is definitely not a generalized duty to prevent suicide. Non-clinicians are also not expected to discern suicidal tendencies where the student has not stated his or her plans or intentions to commit suicide. Even a student’s generalized statements about suicidal thoughts or ideation are not enough, given their prevalence in the university community. The duty is not triggered merely by a university’s knowledge of a student’s suicidal ideation without any stated plans or intentions to act on such thoughts.” The judge concluded by specifying what he believed to be the responsibilities of the university, and how he believed that they needed to be executed:

“Reasonable measures by the university to satisfy a triggered duty will include initiating its suicide prevention protocol if the university has developed such a protocol. In the absence of such a protocol, reasonable measures will require the university employee who learns of the student’s suicide attempt or stated plans or intentions to commit suicide to contact the appropriate officials at the university empowered to assist the student in obtaining clinical care from medical professionals or, if the student refuses such care, to notify the student’s emergency contact. In emergency situations, reasonable measures obviously would include contacting police, fire, or emergency medical personnel. By taking the reasonable measures under the circumstances presented, a university satisfies its duty.” The professors involved in the case were cleared because they were unaware of the doctoral student’s intention to commit suicide, as well as of his prior suicide attempts. While MIT and the professors were found to have behaved appropriately in accordance with their duties, in order to

provide guidance to resolve future situations, the judge provided clarity around the duties of universities. Nonetheless, one lawyer has pointed out that there are still areas of ambiguity in the standard to which universities will be held. While additional duties are triggered to protect students with suicide attempts “recently before matriculation,” the word “recently” was not defined. The student in the MIT case made a suicide attempt about a year and a half before enrolling at MIT; it is unclear whether this was deemed recent by the case, as it was not the deciding factor. Furthermore, the ruling did not provide clarity around the timeline for when a university has fully fulfilled its duties to take reasonable measures to prevent suicide.

ed to be able to discern unarticulated suicidal intentions, they are expected to act as the university’s eyes and ears, and to ensure that the appropriate protocol is initiated once they learn that a student is suicidal. In order to meet this obligation, universities may wish to train their faculty and staff about the protocol that should be followed in the event that they are informed of a student’s suicidal intentions. The spirit of the training could be similar to that used to inform personnel about other emergency situations, such as fires or active shooters.

As a result of the case, it is now clear that Massachusetts universities and their personnel have an obligation to initiate suicide prevention protocols in the event that it is learned that a student intends or is planning to commit suicide.

Some organizations are already following these practices. For instance, one organization operating a call center unrelated to mental health has a protocol in place for addressing incidents in which callers discuss suicide. Employees are expected to review the protocol on an annual basis, and are assessed on their comprehension of it.

While non-clinicians within the university are not expect-

The tragedy at MIT helped clarify the responsibilities of

university personnel in Massachusetts. It is a relief to hear that non-clinicians, like myself, will not be held accountable for assessing whether the students we meet are facing potential mental illness. Likewise, theoretical potential for mental health consequences does not appear to be a barrier to maintaining the decorum of life within the university, be it in a classroom or workplace setting. Having non-clinician instructors intuit the mental state of students would be an increasingly herculean task, as instruction moves to online platforms where it is less possible to assess the presentation of students. The verdict is empowering to academia, as it provides a definition of what constitutes a reasonable response to being informed by a student of suicidal intentions. By defining a reasonable response to a suicidal student, the verdict acts as a call to action for universities. The verdict makes it clear that there is an obligation to pro09

vide appropriate responses, and that universities should be proactive in ensuring that appropriate responses are delivered. Just as the call center has done, universities may wish to institute training programs to ensure that all personnel are prepared. While many universities have already programs in place to help troubled students, it is important for universities to

ensure that everyone affiliated with the university, regardless of role, is familiar with the programs and proactively refers students to them when necessary. Adam C. Powell, Ph.D., is President of Payer+Provider Syndicate. He is a healthcare economist known for his expertise in healthcare finance, healthcare technology adoption, and op-

erationally-oriented problem solving. Dr. Powell holds a Doctorate and Master’s degree from the Wharton School of the University of Pennsylvania, where he studied Health Care Management and Economics. Note: Dr. Powell is a healthcare economist, not a lawyer. This article should not be treated as legal or compliance advice.

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The Mary Christie Foundation’s weekly roundup of news and research on the health and wellness of young adults



World Mental Health College Student Initiative The World Health Organization’s program shows new thinking aimed at the campus behavioral health crisis By Marjorie Malpiede A recent study published by the American Psychological Association found that one-third of freshmen from 19 colleges in eight countries report symptoms consistent with a diagnosable psychological disorder. The concerning “1 out of 3” statistic was widely reported in the news media as further evidence of a global mental health epidemic among college students. The study, however, is only part of a much larger effort to apply data analytics and precision medicine to identify students at risk and provide the time-sensitive interventions that, in some cases, may save their lives. The new findings are from the World Mental Health International College Student Initiative, (WMH-ICS) a longitudinal study with an innovative twist led by the World Health Organization (WHO). Its primary instrument is a web-based self-report student

questionnaire that has been administered in surveys to young people in over 25 countries on five continents since it was first introduced six years ago. The questionnaire evaluates a number of common mental disorders, such as major depression, generalized anxiety disorder and panic disorder among college students. The initiative is led by Dr. Randy P. Auerbach, an Associate Professor at Columbia University, along with an international team of collaborators. In addition to providing prevalence data, Auerbach and his team analyze the large datasets of the participating universities in ways to help schools identify the profiles of students with a wide range of behavioral health problems (e.g., insomnia, substance use, eating disorders). As the effort has evolved, the researchers have begun to introduce an online intervention in the

form of I-CBT (Internet-based, cognitive behavioral therapy) to survey respondents screening positive for clinically significant mental disorders. In addition to embedding a randomized treatment effectiveness trial into their surveys, the WMH-ICS collaborators are developing statistical models based on artificial intelligence methods to help clinicians decide which students are most likely to be helped by I-CBT. Such “precision treatment” models might well change the status quo in college behavioral health and help solve the campus behavioral health crisis in the process. These models are based on recognition of the fact shown in much previous mental health treatment research that not all treatment paths are right for all patients; as well as the hypothesis that systematic predictors of such 11

differences can help select the right treatment for the right patient right away. If this hypothesis turns out to be true, as it is proving to be in a number of other areas of medicine where precision treatment models are being developed, the results could help colleges and universities reduce the trial and error approach that characterizes much current mental disorder treatment planning. This, in turn, will increase the efficiency of treatment and reduce the number of students who drop out of treatments that are not right for them. WHO is behind this The WMH-ICS is the “brain child” of Dr. Ronald C. Kessler, an epidemiologist and the McNeil Family Professor of Health Care Policy at Harvard Medical School. The initiative’s population-based approach to mental health is a familiar concept, sourced in the philosophy of its originator, the World Health Organization. What is novel about this work is its application to college students within the


campus ecosystem. The backdrop for the WMH-ICS came from another WHO program, the World Mental Health Survey Initiative which brought together a dream team of investigators from around the world including Dr. Kessler. Kessler’s work studying the social determinants of mental illness was instrumental in the cross-national study that involved face to face interviews over a span of twenty years. The study, which continues today, helped determine treatment efficacy by factors such as population group and culture and is credited with raising global awareness of mental illness and its cost on the world economy. “There is no illness category that has as high a cost to society, as high a cost effectiveness of treatment, but as low a level of investment in terms of funding from the government as mental disorders,” said Kessler. One of the factors that Kessler and the WMH-ICS investigators studied in their research on the societal costs of untreat-

ed mental disorders was education level. They found that mental disorders, which are much more likely than chronic physical disorders to begin in childhood or adolescence, are powerful risk factors for low educational attainment. This is especially important in poorer countries, where the percentages were low and the expectations on the student were very high. “Only a tiny proportion of young people in many low and middle income countries go to college,” said Kessler. “Most of these kids are first-generation college students who face enormous pressures for success from their extended families. But the schools have little in the way of resources to help students cope with these pressures and the emotional problems they often create.” In 2010, Kessler met Auerbach, who, at the time, was a junior faculty member at Harvard Medical School with a research focus on adolescent disorders and suicide. Auerbach was particularly interested in college student mental health and believed

there was a gap in analysis and methodology in this area given the importance of the population group. Auerbach took on the significant hours and effort to get the initial grant for the initiative from the World Mental Health Survey to create the instrument and begin recruiting schools. Follow-on grants have subsequently come from a variety of sources including participating countries. Also joining the team was Stephanie Pinder-Amaker, Director of McLean’s College Mental Health Program and the former Associate Dean of Students and Chair of the Mental Health Work Group

at the University of Michigan. Pinder-Amaker is a key link to the colleges and provided a bridge to early adopters like Harvard and Boston University. ICSI was soon off the ground with a web site stating its purposes: “The Initiative is designed to: generate accurate epidemiological data on unmet need for treatment of mental, substance, and behavioral disorders among college students worldwide; implement and evaluate webbased interventions for both the prevention and treatment of these disorders; and disseminate the evidence-based interventions found to be ef-

fective.” A Critical Point in Time Just as Kessler, Auerbach and Pinder-Amaker began recruiting schools for the WMHICS, the rise in the demand for mental health resources on college campuses skyrocketed. According to the Center for Collegiate Mental Health 2016 report, while college enrollment has increased by just 5 percent over the past five years, the number of students seeking behavioral health services has risen by 29.6 percent or six times enrollment. “When we started doing the first waves of this study, we


were seeing that rates were alarmingly high, treatment access was relatively low, and universities were coming to us saying, ‘What do we do?’ said Auerbach. The team focused on data analytics as their primary contribution to their participating schools. The initiative began in Belgium and now has 20 schools collecting data, including more than 10 in the United States. But as Auerbach says, it is the messages within the data that can help schools address their unmet service needs. “Our thinking was, if we are going to study these really large populations, can we start to develop predictive algorithms to identify these potential risk groups in order to help universities provide more targeted care?” he said. As they continued to work on identifying risk groups, they considered how an intervention, triggered by certain scores on the survey, could provide an immediate response for students who might be suffering while also 14

helping schools with their capacity problems. Currently, most college counseling centers provide some number of traditional therapy sessions, a model that can become unsustainable, given the increase in, and inconsistency of, the demand. “Counseling centers are able to fill only so many mental health requests by mid-semester, and invariably, a wait list begins to form,” said Au-

With the goal of providing students the care they need in as timely a way as possible, the team met with experts in e-health about college-specific tools that can be accessed online. The first innovation is a product called “ICare,” developed in Germany, that provides online cognitive behavioral therapy designed specifically for college students. The seven-week course includes intermittent coaching to help keep students stay engaged. When students report a certain level of distress on the behavioral health assessment, they can receive a message saying “because you reported some elevated levels of depressive symptoms, you might benefit from this online treatment. If you’re interested, click here.”

erbach. “The people who are less severe, wait in line, much like an emergency room. The problem is the people who are experiencing what we call ‘sub-threshold symptoms’ are often impaired enough that it is affecting their quality of life and their ability to perform at school.”

One of the strongest arguments for these online tools is their potential to reach students who are not likely to show up at the counseling center. According to the WMH-ICS data, only about 15 to 20 percent of students who need treatment actually receive it on campus. Their ev-

idence shows stress manthat for many agement, students, general worOne of the strongest arguments for these online particularry, perfecly those who tools is their potential to reach students who are tionism, and are impacted not likely to show up at the counseling center. sleep manby stigma, or agement. feel so deMeanwhile, pressed they they are become powfeeling good erless, online tools can help, stand risk for disorders and about their initial results and suicidal behaviors in young hoping that through a combieven as a first step. people and to guide processes nation of precision medicine, “For hundreds of years, we that help determine which in- data analytics and technology, have been doing one to one, terventions work best for cer- they may even prevent some face to face counseling and tain patients. students from dying by suithat is effective for a lot of Auerbach, Kessler and their cide – now the second leading people, but we also know from cause of death among college recent analysis, that online in- colleagues from WMH-ICS students. terventions, in certain circum- are continuing to publish stances, can be comparatively their prevalence findings “We’re trying to use complex and chronicling the ongoing effective,” said Auerbach who precision medicine models notes this is particularly true worldwide crisis in college to help increase our ability of young people whose native student mental health. They to select treatments that are language involves technology. are also looking at a range of optimal for a meaningful subnew technologies and online set of students and make sure tools; anything, Kessler says, those students get those treatThe way of the future that “adds to a coordinated Randy Auerbach recently system where you can pro- ments,” said Kessler. “This moved to New York where vide the right stuff to the right will inevitably be an iterative process, but we’re in it for the he continues to co-lead the people in the right way.” long haul and our goal is to WMH-ICS effort while in his Their exploration spans both keep working until we find new roles at Columbia University and the Sackler Institute ends of the behavioral health helpful treatments for every for Developmental Neurosci- spectrum. The group is inter- student with a meaningful ence. There, Auerbach runs a ested in developing a broad- emotional problem.” research lab to better under- based tool kit for issues like 15

Student Veterans

A group worth fighting for By Mansie Hough As colleges and universities consider how to target re-

sources towards student success, one group that should not be overlooked is student veterans. Not only do those who serve deserve respect and support, they arrive on campus


with distinct profiles and perspectives that need to be acknowledged. For many young men and women, the path to college begins with military service – either as a way to afford the high cost of tuition or as an opportunity to try something different before settling into school. This

makes student veterans older and, in many cases, wiser than their recent high school graduate peers. Student veterans bring with them unique experiences, most of which add texture and depth to the academic community;

but they can also bring challenges in terms of health and wellness. According to the Substance Abuse and Mental Health Services Administration, just under 20 percent of service members returning from Iraq or Afghanistan have post-traumatic stress disorder (PTSD) or depression. Around the same amount reported having experienced a traumatic brain injury during deployment, which can lead to behavioral health conditions later in life. Barriers to access, stigma and lack of effective outreach or education can often impede student veterans from seeking treatment. And sometimes, even when they do ask for help, faculty, staff, and even counselors are not properly trained to assist student veterans and understand the challenges they face.

A recent study by The National Center for Veterans Studies at the University of Utah found that most colleges and universities have a long way to go in understanding and supporting the mental health needs of student veterans, and not just those who have experienced combat. Of the 14,673 college and university faculty and staff surveyed, about 70 percent said they did not feel adequately prepared to recognize when a student veteran is exhibiting signs of psychological distress. 75 percent said they do not feel prepared to approach student veterans to discuss their concern.

professors or staff who are used to very young adults. Most student veterans are often past the point of transitioning into adulthood by the time they start college, which can make it difficult for campus community members to help them navigate their college experience, let alone any struggles they may have along the way. “We’re finding that, because other staffers haven’t served in the military or in a

According to Craig J. Bryan, Psy.D., assistant professor of clinical psychology at the University of Utah and executive director of the National Center for Veterans Studies, part of the problem is the disconnect between student veterans and 17

Federal service role in general, they don’t know how to talk to them about the issues they face,” Dr. Bryan said.

More than 95 percent of the faculty and staff surveyed in Dr. Bryan’s study said that it is part of their duty to assist and support student veterans and to connect them to mental health services should the need arise.

“They’re used to working with 18- to 19-year-old kids who go to parties and hang at frat houses. Student veterans are 23 or 24 when they start school, and many of them have alFor so many young men and women, ready served in leadership college begins with military service. positions. “They’ve been responsible for multimillion-dollar budgets, and they’ve managed other people.” According to the study, higher ed leaders recognize the value that veterans can bring to the classroom, yet they often feel ill-equipped to tap into their experiences. The good news in all of this is that there is a strong desire to learn how to better connect and support student veterans on campus. 18

Almost 94 percent said people in their positions should take a course on military competency and veteran mental health. “What we’ve found is that a lot of administrative staff and faculty members very much want to be able to help student veterans in need,” said Dr. Bryan. “The majority of them are saying, ‘I don’t know what to do about that. If there were a

student veteran in need, I’m not necessarily confident I would be prepared to support them in the best way possible.’ They’re telling us that providing that training would be beneficial to the higher education system.” Another component of addressing this issue is the path to changing people’s misperception of student veterans, which experts believe adds to the alienation. If there is a sense among campus community members that veterans are universally “broken” or “suffering” when they return from service, then there is a hesitancy to connect. “There’s a whole notion of veterans being broken or angry with mental health problems and PTSD,” said Dr. Bryan. “Faculty members make assumptions. The stereotypes

we might have about military members might serve as a barrier for faculty members to fully engage and assist student veterans. Everyone is well-intentioned, but they think of the veteran with the head clutched in their hands crying. But, it’s more appropriate to approach this issue with duty, integrity, and honor – to speak the language of veterans’ culture.”

Campuses should ensure there is at least one licensed mental health professional available who is ready to provide support and services tailored to student veterans.

Part of training for faculty and staff could include how best to speak that language. How can you engage student veterans in a respectful way? What’s the best way to relate to them and make them feel heard? How can you promote inclusivity and understanding in and out of the classroom?

Schools can address this problem by bringing those services to campus, so an appointment with a therapist who understands what the student is going through is a walk across campus rather than a drive across town.

In addition to better preparing faculty and staff, the report suggests colleges should provide more dedicated support to help student veterans who are struggling academically or need help handling the mental health challenges that sometimes accompany integrating into an academic environment after serving.

This way, veterans don’t necessarily have to go to the local VA to receive this type of specialized care. The VA often is inconveniently located or has hours that coincide with class.

Establishing support centers for student veterans can be another important way of helping them succeed and improve their overall wellbeing. Many campuses have support centers for

other minority populations such as LGBTQ+ students. Incorporating veterans into this approach of multiculturalism by offering the same dedicated systems of care and resources can often make a big difference, Dr. Bryan suggested. The Mary Christie Quarterly recently interviewed Admiral James Stavridis, the former Dean of The Fletcher School of Law and Diplomacy at Tufts University which has a large number of military personnel and veterans. When asked about providing adequate mental health services for this group of graduate students, he said having an open environment for discussion on campus is of great importance. “The first thing we do is identify those who are having problems,” said Adm. Stavridis.


“Second is to talk broadly about it. When we bring in all the students for indoctrination, we have mental health professionals come and communicate to the students that it’s okay to not be okay.” Having open communication and forming peer relationships are helpful strategies for student veterans but feeling like a part of the community can be difficult for any student not participating in the traditional four-year college path.

Connecting these students to opportunities for social engagement and lasting relationships is crucial to supporting them in their college experience – particularly if they are undergoing behavioral health issues, which can be assuaged by the presence of meaningful relationships and a supportive social circle. When she was Chancellor of the University of North Carolina (Asheville), Dr. Mary Grant worked with campus leaders to create a space specifically

Higher ed leaders recognize the value that veterans can bring to the classroom, yet they often feel ill-equipped to tap into their experiences.

According to the VA website, just 15 percent of student veterans are traditionally college-aged (ages 18 to 22), 47 percent of student veterans have children, and 47.3 percent are married.


designated for returning veterans. The living/study area that Veteran leaders helped design and furnish became a go-to spot for student veterans who

were often campus.



“In addition to academic support and disability accommodations, there are social connections for veterans that schools need to be thinking about. It’s about feeling like they are welcome on campus and being able to talk with someone who has shared their experiences.” Training, outreach, communication and community are all important elements of a targeted strategy to better support student veterans. Considering the cost of college and the benefits of serving first, the schools that adopt these strategies will be better and stronger for doing so.

Opinion: Yes, You Can Recover From Depression I know because I did. By Alexandra Hayes

Alexandra Hayes, Audience Engagement Editor, Thrive Global

For about 10 years follow-

ing my initial diagnosis of depression, I was mired in a cycle of sadness and the unbridled, reckless actions that helped me cope with what I was feeling. Some of my impulsive tendencies could be blamed on my young age (I was 12 when I was first diagnosed), but I learned the hard way that the habits you develop early — especially the ones disguised

as coping mechanisms — can easily become perennial. For years, I felt like my mental illness and my identity were one in the same, that another person couldn’t really know me unless they knew about the things I was going through, or had been through. If you asked 20-year-old me to tell you about who I was, my mental illness would be at the forefront of my answer. But today, at 25, my answer is different.

physical illness, like having a cold.

While my past experiences inform my perspective on the world, I am not depressed. And saying so is a radical act, because for a decade, I wasn’t sure if those words would ever be true. The idea of fully recovering from mental illness is one we don’t hear about often, but it’s one that’s deeply important to discuss.

I was the body incapable of fighting off the cold, the body that struggled to cope with what life threw at her. So as a means of staying afloat, I developed symptoms — like self-harming in high school and an eating disorder in college — that temporarily anesthetized my pain. Without them, I’d be left alone to confront the roots of my depression, which was a more frightening and difficult prospect than dealing with the behaviors layered on top of it.

Part of recovering from a mental illness is learning to understand what it is, and I’ve come to understand that my depression was a lot like a

When you have a cold, there are symptoms — a runny nose, lethargy, sometimes a fever. Healthy bodies are able to fight off the cold with some rest and TLC, but there are other bodies that for whatever reason are unable to get better without more help. Their symptoms may take on a life of their own, and in extreme cases, can become dire.


But eventually (and if we’re being honest, only after something deeply important was taken from me), I found the mindset required to heal. My grandmother had always dreamed of taking me to Paris. We finally booked the trip for April of my sophomore year of college, but April came, and the doctor who was treating me for bulimia recommended that we cancel because it would be too dangerous for me to go. Having to cancel our trip broke my grandmother’s heart. And it was grueling for me to see how my illness was affecting the people I love. The silver lining is that I realized I wanted to value my life and the lives of the people I cared about. And doing so meant I needed to get my actions under control.

With the help of my therapist, I regained control of how I responded to my feelings. This was a key revelation for me — the notion that I’d never be able to control my feelings, but I could control how I responded to and worked through them. I started to take my medication consistently (this may seem obvious, but when I was depressed, I tried to sabotage myself by skipping days of my meds, which I never really saw as self-sabotage until my therapist said to me, “You don’t skip days of your birth control, do you?”). I went to therapy four times a week for three years, without exception. If I had to miss a session one week, I’d make it up the next, meaning there were some weeks where I’d go to therapy literally every day.

Being committed to my healing meant having to make incredibly hard and confusing choices, ones that felt selfish and selfless simultaneously, like the summer I chose to stay in Ann Arbor by myself instead of going home to my family in Boston so that I could continue my treatment. It meant having to talk about things that made me cry, like my relationship with my dad, or talking about things that made me feel uncomfortable, like sleeping with someone I shouldn’t have. But in doing those things, in taking my recovery seriously and putting it above all else, I healed. And because I know firsthand what an accomplishment it is to commit to and then maintain recovery, I can’t help but notice the lack of coverage about people who thrive after getting help for a mental illness. In a recent article in Perspectives on Psychological Science, psychologists at University of South Florida and George Mason University write about “the curious neglect of high functioning after psychopathology” — specifically, depression.


For all the existing research on depression, there’s not much out there about how common it is to thrive after treatment. Although researchers sometimes follow people through their recovery, the authors note that it’s often only for a short while. “We know little about what happens next, particularly to those with who have a sustained recovery that is accompanied by good functioning,” they write. I agree. And I strongly believe that if those who are in a position to talk about mental health (doctors, psychologists, publishers, celebrities or regular individuals with personal experiences to share) were to talk about how they sustained recovery, it could be the impetus that gets people to commit to their own. If stories of healing were shared more often and in more detail, those suffering would know it’s possible to recover, while also having realistic expectations of what it may take to get there. Today, I’ve been off my medication for two years and haven’t been to therapy in three, though I‘ve been considering going back — not because I

need it, but because I miss the aspect of self-discovery.

life is ever going to get better, I want you to know that it can.

And I celebrate my happiness often, as I believe I should. I celebrate with loved ones when they tell me how proud they are of me and how wonderful I look (like many others with mental illness, mine was visible and worn all over my body).

It’s not the same for everyone. Healing is a process, sometimes a lifelong one.

And then there are the subtle, more private celebrations, where I’m alone or resting with my partner and my happiness moves me to tears. These are tears of astonishment that I actually live the life I live; that I haven’t missed an obligation or a deadline since college (I’d oversleep and miss class all the time), that when I start to encounter what would have previously been intolerable feelings, I tolerate them, without harming myself; that I’ve found a partner who cares for me as much as I’ve learned to care for myself — one who doesn’t try to fix me, but to better understand me.

Because you, like me, may land at a place where you feel healed. Where you cry happy tears about the way you feel right now, and what you feel is glorious.

I cry because for years, I never thought I’d experience anything close to what I do now.

This piece originally appeared on Thrive Global.

Your healing may feel uncomfortable and inconvenient and at times unbearable, but I want you to know it’s worth it. Put in the work.

Alexandra is the Audience Engagement Editor at Thrive Global. She comes to Thrive from Teach For America where she was awarded the Sue Lehmann Teaching & Learning Fellowship—an honor that recognizes two teachers who exemplify the program’s core values. She studied Creative Writing & Photojournalism at the University of Michigan and has a masters in education from Relay Graduate School of Education.

If you’re reading this, wondering like I once did if your


Q&A: Dr. Mary K. Grant A conversation with the President of the Edward M. Kennedy Institute for the United States Senate, Chancellor Emeritus of the University of North Carolina Asheville, and President Emeritus of the Massachusetts College of Liberal Arts Interviewed By Marjorie Malpiede

A primary focus of the Edward M. Kennedy Institute is to encourage productive civil discourse, a notion that may seem more nostalgic than realistic in this vitriolic political climate. But not according to the Institute’s new president, Dr. Mary K. Grant, who believes that today’s young people are eager to work collaboratively and listen to opposing views, if given the right experiences and opportunities. A former college president and university chancellor, Grant speaks passionately about how to better support college students in their journeys toward global citizenship and why this effort is more important than ever. She hopes that education about how democracy works will motivate young people to participate in it and will enhance the value of public service. Like early childhood education, she says, the sooner we teach students why government matters, the more likely they are to become active citizens.


Inspired by the late Senator Edward M. Kennedy from Massachusetts, the Kennedy Institute provides educational programming on the legislative process that simulates real Senate debate within a remarkable replica of the United States Senate chamber.

in critical thinking, listening, problem-solving, and empathy. Freedom of speech is a key issue in both realms. In our interview she said, “I believe a liberal arts education and the Kennedy Institute will change the world.” She did not appear to be joking.

Housed between the John F. Kennedy Presidential Library and Museum, the University of Massachusetts Boston, and the Massachusetts Archives and Commonwealth Museum on Columbia Point on Boston Harbor, the spectacular building welcomes visitors for engaging forums and interactive tours, and convenes opinion leaders from around the world and from varying perspectives.

Here is an excerpt from our conversation.

As Grant says, it is both a place and an idea. There are parallels to be drawn from Grant’s current position and her previous work at liberal arts institutions, starting with the fact that both involve young adults and the development of skills

Mary Christie Quarterly: Let’s start with your days as a college president and chancellor. What are some of your takeaways for supporting students’ personal development and wellbeing? MKG: In smaller schools (like UNC Asheville and MCLA) you get to know students in very important ways. The size and scale of these institutions allowed us to be able to engage directly with our students and talk to them about what was going on. Being able to offer that environment influenced the college selection process in many ways.

Our students were looking to be part of a community and, for their families, there was a sense that students were not going to get lost. But beyond size, community and space play a large role in how students feel and stay connected. The student experience has come such a long way. From the dining hall experience to the resident hall experience to the range of activities that happen on campus – the important thing was for students to feel connected. At UNC Asheville, we found that students who had high retention rates were often students who took part in programs outside the classroom, like our theater program. Working together on something they were passionate about, like rehearsing for a production or building a set, often late into the evening, built deeper connections and stronger relationships. Our student athletes also had

Photo by John Gillooly

Mary K. Grant, President of the Edward M. Kennedy Institute for the United States Senate.

high rates of retention, spending many hours studying and practicing together. MCQ: How does a liberal arts education come into play? MKG: In my opinion, the liberal arts are essential.

The foundational pieces of liberal arts – critical thinking, working in teams, understanding the perspective of someone who is different from you, being able to convey knowledge – are relevant to anything you do in life. Good liberal arts schools


have programs in the sciences, business, and engineering that infuse critical and creative thinking within the professional programs and disciplines. Pulling apart a problem, curiosity, asking good questions – that’s what science is all about – it’s inquiry.

United States Senate; the importance of the deliberative work of that body, and the place it holds in our government.

How do you take an idea and bring it along and then make that into something that can improve the common good?

And what he was equally passionate about was bringing people together to listen to one another, to be engaged and be informed.

That’s liberal arts. It teaches you how to think. MCQ: Are there synergies with your previous roles and the work you are doing now with the Kennedy Institute?

Sometimes, to get to the grand solution, it takes many

We have in this country an enormous divide. People are worried and anxious about the future. And when that happens we tend to look around and think, “who can I hold responsible?” It’s too easy to dissolve into name-calling and shutting the process down. Once we leave the table, our opportunity for making a difference lessens.

A big part of the breakdown we’re having in civil discourse is we are just not listening.

MKG: Yes. An example of that is when we have groups in and they’re working on a piece of legislation and they have to listen to one another, work with one another, take on another’s perspective, and hone that sense of empathy. Senator Kennedy was passionate about the role of the


We want people to understand that, particularly when the legislative process appears to be broken down.

tening. And if we are listening, it’s only in small soundbites to which we have a tendency to overreact.

steps along the way. Just because something may not work exactly as envisioned in that first step doesn’t mean you don’t get back in and work to the second step and the third step. A big part of the breakdown we’re having now in civil discourse is we are just not lis-

One of the ways of getting around that is to sit down with people who think differently than you do and find out what’s driving them.

We have to seek common ground. That’s a key part of what we do here. MCQ: Are you hopeful we will achieve this? MKG: What we’re finding in our programs is that people are hungering for conversation. It’s similar to the concept of creating spaces on college

campuses where you can intentionally connect with people. At the Institute, we convene diverse perspectives through daily educational and visitor programs where you can talk with and listen to others who might be troubled or curious about the same things you are. I am so impressed with this generation of young people because they are genuinely paying attention to the wider world. There is a shift on college campuses; students really want to make a difference. We need to encourage this as a society and underscore the value of public service. We’ve witnessed some bruising and nasty political campaigns and it can be a turn off from getting involved. What we need to do is educate people. Remind them that public service is important and exciting and that they really can make a difference. I think we’re seeing a resurgence in that with young people. MCQ: What is your opinion on freedom of speech on campus?

MKG: Colleges need to be places of competing and contrasting ideas. During my time as chancellor, I had students ask me if I would restrict certain speakers on campus. I have maintained that unless there is a threat to public safety, we have to allow conversations that make us uncomfortable. If we don’t, we are not doing our jobs as educators. Shutting down the speech doesn’t shut down the issue. You’ve got to continue to talk. MCQ: What are some of the Institute’s goals for the future?

similar things but may have a different perspective. We want to strengthen and deepen our partnerships and expand our role as a convener on important issues facing our communities. We are not experts in all things, but we certainly know how to bring people together to engage, to listen, to debate and to work toward solving complicated problems.

MKG: Our next frontier is really to figure out how to take what we are doing at the Institute and transport it beyond these walls, working in partnership with other organizations in the city, across the Commonwealth and the country. We want to connect with those who are working on


Pursuing the Triple Aim in a Higher Education Setting A learning and action collaborative By Marjorie Malpiede There’s something big going on in higher education. This month, eight schools will begin participating in a twoyear learning and action collaborative based on improvement science and focused on “the Triple Aim” – a term well known in health care policy and delivery but not yet widely applied to the health and wellbeing of college students. The Triple Aim is the simultaneous pursuit of three goals: best possible health outcomes; best experience of care; and lowest cost. This seemingly simple formula has been proven to improve the health of individuals and population groups around the globe, and through ways that extend far beyond traditional health care. The Triple Aim was developed by the Institute for Healthcare Improvement, (IHI), an international organization focused on transforming health and health 28

care. With origins in process improvement, IHI’s paradigm-shifting methodologies are not for the small-minded or those that like to stay in their lane. It is exactly this kind of “out of the box” thinking that leaders of the new collaborative hope will infiltrate higher education. “What would it look like for an entire college or university to say we hold ourselves accountable for the health and wellbeing of students?” said Ninon Lewis, Head of Content Portfolios for IHI, leader of the Triple Aim initiative, and advisor to the collaborative. “These are the kinds of questions we will be asking.” Ninon acknowledges that IHI has never worked explicitly on the health of students as a population of focus until approached by New York University (NYU), the convener of the collaborative and the backbone for the Network for Improvement and Innovation

in College Health (the Network), within which the effort is organized. NYU downplays its leadership role, deferring instead to the distributed leadership model adopted by the Network. But in many ways, NYU is the ideal leading laboratory for the Triple Aim. While the learning can be applied to any school of any size or resource capacity, NYU has a lot of infrastructure to work with. It has a large student health center in New York with a well-staffed counseling arm and specialty services like onsite optometry, physical therapy and health promotion. It provides health, health promotion, and counseling services to students at the dozen or so NYU campuses around the world. NYU also has forward-thinking leadership in Associate Vice President of Student

Healthcare, Dr. Carlo Ciotoli, and Allison Smith, the Assistant Director of Population Health. Together, they have worked on a number of initiatives aimed at creating a culture of health at the school, including a university-wide, population health framework called LiveWellNYU.

Network and led to the Triple Aim. These inter-institutional initiatives, which included four collaboratives on improving depression outcomes and two on improving immunization rates, involved up to 40 schools at a time and utilized the “breakthrough series model,” also created by IHI.

that helped the schools take evidence and apply it to their systems in sustainable ways. “At the end, the hope is you have a breakthrough improvement, that you have radically redesigned those underlying systems that are contributing to your outcomes,” she said.

When the five-year strategic plan that created Live“First is to WellNYU was improve the coming to a health, wellclose, Ciotoli being and and Smith health equity wanted to do of the 50,000 something students at even more NYU;” she ambitious said, “and we that would also have an also involve opportunity a consortium to catalyze of schools. change in They were this area for Washington Square Park near New York University’s campus. drawn to the the 20 milTriple Aim lion college for a variAccording to Smith, the work ety of reasons, starting with students in this country.” of the previous collaboratives the fact that it represented It was Ciotoli and Smith’s brought together multiple an open frontier, as opposed work with previous collabo- sites focused on a common to just the application of eviratives that established the aim and provided a structure denced-based practices. One Smith sees her role as both local and national.


of the big distinctions between IHI’s two change theories is that the breakthrough series methodology is usually around issues that have a high degree of evidence, a strong belief in what works, whereas the Triple Aim is about innovating and testing new approaches. For NYU, the key word in Triple Aim’s simultaneous pursuit of three goals is simultaneous. “We want better outcomes, we want better conditions and service experience, and we need to begin to mitigate the rise in cost because adding more and more staff and space is not sustainable and won’t meet all of our students’ needs,” said Ciotoli, who sees mental health and health disparities as key areas to explore. Smith saw the Triple Aim and the partnership with IHI as a way to catalyze systemic change in higher education. It met her vision for putting the student at the center and working to identify all of the components in the system that 30

are influencing student health and wellbeing. But enlisting IHI meant convincing the institute that college students were a population worthy of this kind of examination. If Ninon Lewis had any doubts about whether this population met the criteria, she has since become a convert. Initially drawn to the fact that college students were an under-examined population in public health, Lewis was also intrigued by the opportunities for improvement in college health and healthcare given the fact there was not a significant amount of regulation in the field, particularly around quality improvement. The other dynamic that Lewis identified was the opportunity to take a more holistic view for managing the health of students beyond the traditional walls of the college health center. “There is a whole ecosystem within an institution to think about health and wellbeing and I think currently there is a lot of trapped potential in the system.”

Addressing cost seemed to be an obvious opportunity, and not just from the standpoint of what is reflected in student insurance claims. Hidden costs related to student health, particularly emotional and behavioral health, show up in other parts of the system such as graduation rates, retention, and admissions competitiveness. The experience dimension of the Triple Aim is something Lewis believes will be particularly interesting to study, given its interplay with the others. “Most of the programs and services students access are controlled and driven by what the institution has put in place,” said Lewis. “That’s not the same for other populations. We have never worked with a population segment for which the experience dimension has a disproportionate effect on the other two dynamics.” The impetus for this work, together with their confidence in NYU, convinced IHI that utilizing the Triple Aim in higher

education settings held enormous promise. They hope the combined effort will produce a major shift in the mental model of student health in a way that will move the field forward. “When this Collaborative is over,” she said. “We hope people will say ‘something happened here that changed the way things moved,’” she said. With IHI behind them, the Network began recruiting schools earlier this year seeking a numerical sweet spot of participants. Too big a group diminishes the ability to coach through change; too small means you won’t have enough different experiences to learn from. Recruitment materials stated the impetus for the Collaborative to be “the need to develop new paradigms and approaches for how institutions of higher education address the increasingly complex and costly health issues on our campuses that are impacting students’ wellbeing, learning, degree attainment, and overall success.”

These are themes that resonate with all campus stakeholders in all schools across the country but for the Collaborative conveners, engaging schools, in which college student wellbeing is a shared institutional value and there is a commitment to innovation and transformational change, was a priority. Getting the commitment of the Vice President of Student Affairs, or equivalent, was a requirement of the application process. If sustainable change in student health stems from an examination of all its determinants, then it must be a university-wide priority. Ciotoli says he was delighted with the eventual mix. Starting in October 2018, the collaborative kicks off with eight partner institutions including Case Western Reserve University, Cornell University, New York University, Rochester Institute of Technology, Stanford University, Texas A&M University, University at Albany – State University of New York, and University of California – Los Angeles. The two-year commitment

includes four face to face sessions, a series of web conferencing sessions, and action periods, which, in the Triple Aim world, is where the real work is accomplished. The partner institutions’ first challenge will be learning the Triple Aim methodology and then will focus on testing the application in their own settings, exploring what works, in which settings and why. By the end of the two-year process, the goal is for each partner institution to make significant progress in building their infrastructure, capability, and capacity to lead and sustain impactful change within their own spheres of influence, ultimately transforming their institutions’ approaches to improving student health and wellbeing.


Science Summary A recap of research worth noting. By Dana Humphrey


A new study published in the Journal of Abnormal Psychology examines the prevalence of major depression, anxiety disorders, mania, panic disorders, and substance use among college freshmen around the world. Researchers analyzed data from the World Health Organization’s World Mental Health International College Student Initiative, which surveyed almost 14,000 students from 19 colleges in eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States). They found that 35 percent of the respondents reported symptoms consistent with at least one mental health disorder at some point in their lives, while 31 percent reported challenges within the 12-month period prior to taking the survey. Major depressive disorder was the most common, followed by generalized anxiety disorder. The high level of need for mental health services implied by these results represents a major challenge to higher education institutions and governments. According to lead author Randy Auerbach, “While effective care is important, the number of students who need treatment for these disorders far exceeds the resources of most counseling centers, resulting in a substantial unmet need for mental health treatment among college students.” Previous research suggests that only 15 to 20 percent of students seek services at their college’s counseling center, which, in many cases, are already overtaxed. Auerbach suggests that students seek out internet resources, saying, “Internet-based clinical tools may be helpful in providing treatment to students who are less inclined to pursue services on campus or are waiting to be seen.”

High Level of Need for Mental Health Services Globally


A new study published in the Journal of the American Academy of Child and Adolescent Psychiatry Mental Health Clubs found that campus chapters of Active Minds, a naReduce Stigma tional student-peer mental health organization, are associated with increased awareness of mental-health issues, reduced stigma and a rise in “helping behaviors.” In what they describe as the largest study of its kind, researchers ranked students’ engagement with Active Minds on their campus – from low to medium to high – for more than 1,000 students at 12 California colleges. Researchers also measured students’ knowledge about and attitudes toward mental health and experiences with psychological difficulties. At the end of the academic year, students who were in the low- and medium-engagement groups that became more involved with Active Minds had better knowledge of mental health issues and were less likely to believe stigmas about them. They were also more likely to engage in helping behaviors with other students who were experiencing a mental health crisis (e.g. providing emotional support, or connecting others to services). Researchers suggested that organizations like Active Minds can complement more traditional programs and play an important role in improving the campus climate. 32


New research shows minority college students are less likely than white students to seek menDisparities in Mental Health tal health services or have their Treatment Seeking problems diagnosed and treated. In a new study published in the Journal of Adolescent Health, Boston University School of Public Health researchers found significant disparities in mental health treatment across race and ethnicity. The researchers used data from 43,375 undergraduate and graduate students at 60 institutions that participated in the Healthy Minds Study survey from 2012 to 2015. The participants included 13,412 students of color who self-identified as African American, Latinx, Asian/Asian American, Arab/ Arab American, or multiracial. The study found that among college students with clinically significant mental health problems, half of white students received treatment in the past year, compared to only one-quarter of African American and Asian students, and one-third of Latinx students. Only 21 percent of African American students with a mental health problem had received a diagnosis, compared with 48 percent of their white peers. Researchers found that attitudes related to mental health treatment vary significantly and help to explain the study’s primary findings. According to the study, many students of color deny they need help or opt to deal with the issues themselves. Asian/Asian Americans had the lowest levels of perceived need for mental health treatment, with only 47 of those with a mental health problem believing they needed help. And 23 percent of Asian/Asian Americans and 35 percent of Asian international students reported stigma towards mental health. According to the study, while Arab and Arab-American students reported the highest prevalence of mental health issues (53 percent vs. 42 percent overall), they had the lowest levels of knowledge about mental health. Only 52 percent of Arab/Arab American students reported that they knew where to go for mental health services, compared to 70 percent for white students. Lead author Sarah Lipson noted that students of color face many barriers to college persistence and have lower graduation rates than white students. “Understanding and addressing the mental health needs of racially diverse students is essential to supporting their success and creating equity in other dimensions, including persistence and retention,� Lipson says. To that end, a new component of the Healthy Minds Study was launched this year, measuring issues related to diversity, equity, inclusion, discrimination, sense of belonging, and identity formation.


According to a new study by researchers at Oregon State University, Oregon Post-Legalization Increases in college students, including those under Marijuana Legalization 21, were much more likely to use marijuana after recreational use became legal. Researchers analyzed data from the American College Health Association National College Health Assessment survey, and found that most of the increase in the post-legalization period was among students who reported using marijuana one to five times a month, not among heavy users. 33


A recent report sponsored by Hopelab and Well Being Trust examines young people’s use of online health information and digital health tools, and the association between their use of social media and mental wellbeing. The survey of more than 1,300 U.S. teens and young adults ages 14 to 22 showed that young people experiencing mental health issues are turning to the internet for help, including researching mental health issues online (90 percent), accessing other people’s health stories through blogs, podcasts, and videos (75 percent), using mobile apps related to well-being (38 percent), and connecting with health providers through digital tools, such as texting and video chat (32 percent). Young women are more likely than men to go online for information about anxiety (55 percent vs. 29 percent) or depression (49 percent vs. 27 percent). LGBTQ youth are even more likely to look for mental health information online; 76 percent have looked online for information about depression, compared to 32 percent of straight youth; 75 have looked for information about anxiety, compared to 36 percent of their straight peers; and 68 percent have looked for information on stress, compared to 40 percent of straight youth.

The Mental Health Effects of Teen and Young Adult Use of Digital Health Tools and Social Media

Many young people reported that social media helps them find connection, support, and inspiration during times of depression, stress, or anxiety. Respondents who reported moderate to severe symptoms of depression were nearly twice as likely as those with no symptoms to say that social media helps connect them to useful support and advice when they feel depressed, stressed or anxious (25 percent vs. 13 percent). And among those with symptoms of depression, 30 percent said social media is “very” important to them for feeling less alone, compared to 7 percent of those without depression. Of the 33 percent of young people who connected with health peers online, 91 percent of them said the experience was helpful. However, there are mixed reactions among young people using social media for support. Respondents were only slightly more likely to say that when they are feeling depressed, stressed, or anxious, using social media makes them feel better (30 percent) than they are to say it makes them feel worse (22 percent). And while 65 percent of all teens and young adults say they “hardly ever” or “never” feel left out when using social media, about a third (34 percent) say they often or sometimes do. And young people with moderate to severe depressive symptoms are more likely than those without to say that when they use social media, they often feel left out (18 percent vs. 1 percent) or that others are doing better than they are (32 percent vs. 7 percent). While the survey highlights the potential of online tools for positively engaging young people, it also raises some concerns about young adult social media use.



British researchers recently investigated the impact of academic and non-academic stressors on mental health in university students, focusing on the role of social connectedness in protecting against mental distress. They found that while university-related stressors are moderate predictors of experiencing depression, general life stressors have been identified as more significant determinants of depressive symptoms. The evidence shows that relationship stressors are the most common source of stress reported by university students, and loneliness was the strongest overall predictor of poor mental health. Other stressors included: students having high expectations of themselves, and lacking important coping resources like time, sleep, support, and money. The researchers also found that identification with social groups in the university setting was protective against distress; social groups decrease feelings of loneliness, thereby decreasing the symptoms of depression, anxiety, and paranoia. The study highlights the benefits of establishing strong social connections while in college, and the importance of minimizing stress.

Social Connectedness as Factor in Stress and Mental Wellbeing


A new study has quantified the damage that lack of sleep has on academic success among college The Damage of Sleep students, finding that it is as detrimental as binge Problems drinking or doing drugs. Using a data set of over 55,000 college students, researchers found that for every extra day a student experienced sleep problems, they were 10 percent more likely to drop a course, and their GPA declined by 0.02. The study also found that sleep disturbances had a greater effect on GPA than being diagnosed with depression or anxiety, and a greater effect on dropping a course than having a learning disability. Other factors like stress, binge drinking, marijuana and other illicit drug use, which typically receive more attention, were shown to have similar or smaller negative associations with academic success as compared to disturbed sleep. Approximately three quarters of students surveyed reported never having received information about sleep from their university.


MCQ Issue 11 | Fall 2018  

The Mary Christie Quarterly is a publication of the Mary Christie Foundation, a thought leadership and philanthropic organization dedicated...

MCQ Issue 11 | Fall 2018  

The Mary Christie Quarterly is a publication of the Mary Christie Foundation, a thought leadership and philanthropic organization dedicated...