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Mary Christie Quarterly A publication of the Mary Christie Foundation

Taking the Lead

Student groups aren’t waiting for change in college mental health policy—they’re driving it

p. 15

Issue 13 | Spring 2019

Schools That Make a Difference p. 27

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 Editor & Executive Director Program Manager Art and Layout Director

Marjorie Malpiede Dana Humphrey Ashira Morris

ARTISTS Cover Illustration

Haydn Symons

Spot Illustrations

Lily Strelich


John P. Howe, III


Marjorie Malpiede


Maryellen Pease


Frederick Chicos


Robert F. Meenan


Zoe Ragouzeos

Editor’s Desk


hank you for reading the Mary Christie Quarterly, our publication of ideas, opinions, news and research on the issues that affect the health, education and wellbeing of young adults. In our 13th issue, we feature a student-driven campus movement to secure stronger mental health services at colleges and universities. Through a combination of selfadvocacy and activism, student groups across the country are demanding that schools provide additional behavioral health services in more responsive and accessible ways. The motivation is personal, but it is far from self-centered. As the cover article describes, student-driven mental health activism reflects a collective concern for all who may be struggling and honors those who are no longer here to advocate for themselves. And while many of these groups may have formed after a tragedy, their main goal is to keep one another healthy and safe. As schools acknowledge the correlation between mental health and positive outcomes like strong academic performance, completion and flourishing, these student leaders have an important place at the table. Also in this issue is analysis, opinion and reflection from experts in the field; profiles of people and places with experiences to share; and a review of the latest research that helps drive practice in young adult health and wellbeing. Thanks again for supporting our work,

Marjorie Malpiede Editor

CONTE NTS 24 Q&A: Patricia Bellinger

The Chief of Staff to Harvard President Larry Bacow talked about the role of leadership at the country’s oldest university.

“Our approach is always to treat people’s issues and concerns with respect because that is a sign of a healthy democracy.”

26 Schools that Make a Difference Clark University President David Angel leads the charge for major impact.

“In many ways, we’re interested in the hardest problems,”

CONTE NTS 06 Q&A: Patricia Bellinger, Chief of Staff to Harvard President Larry Bacow 10 Opinion: Young Adult Substance Abuse Disorder 13 Needing to Know 18 Opinion: Help Them Cope 21 Taking the Lead 27 Schools That Make A Difference 34 Analysis: The Evolving Balance of Justice 37 National Collegiate Recovery Conference 39 Science Summary

Q&A: Patricia Bellinger The Chief of Staff to Harvard University President Larry Bacow on the state of higher education, inclusion, and leadership. Interviewed By Marjorie Malpiede

Throughout his inaugural address, Harvard’s new president, Larry Bacow, acknowledged the institution’s legacy of excellence. Not one for false modesty or euphemisms, the straightforward Bacow hopes to leverage Harvard’s outsized influence in the world to lead the university at a challenging time with people who have remarkable experience and perspective. One of those people is Patricia Bellinger, his Chief of Staff. Both cerebral and quick-thinking, Bellinger is, in many ways, the kind of professional you’d expect would sit across the hall from the president of Harvard. She is a graduate of the university and has a long career in both private industry and as head of the Harvard Kennedy School’s prestigious Center for Public Leadership. But as an African-American woman who was a first-generation college student, Bellinger defies the Hollywood version of the Harvard administrator, 06

which may be one of the reasons Bacow persuaded her to take the job. While recognizing that her role brings with it an enormous amount of influence, Bellinger seems undaunted by it. She views controversies as just part of the job of a higher education standard-bearer. In a candid interview in her office, Bellinger makes the connection between her life’s work in diversity and inclusion, her views on emotional health and wellness, and her own personal story to the task ahead. Here is an excerpt from our conversation: Mary Christie Quarterly: What was your first reaction when President Bacow offered you the job? Patricia Bellinger: Larry and I were friends. He was my inaugural leader in residence (of the Rita Hauser Leaders-in-Residence program) when I was at the Kennedy School, so he was part of the

community for the Center for Public Leadership. When he became president, I joked with him: “Why on earth would you say yes to this? – and by the way, what did your wife say?” When he asked me to come on as his chief of staff, I immediately said, “You need a much younger person with more energy,” and he said, “No, I need you. You’re the person I think can do this job.” I saw myself at the end of my career. Adding to that, I lost my husband 15 months ago, so I was in a very raw place emotionally. This was definitely not the sort of role I had on my radar. What I will tell you is the only reason that I was willing to consider this was because of Larry. He is not only one of the most impressive leaders I have ever worked with, he is also one of the kindest, most decent human beings that I know. When I agreed to take the job I said, “I don’t want to be the

chief of staff to the President of Harvard but I’ll be your chief of staff.” MCQ: What is it about the Bacow agenda that most appeals to you? PB: Larry’s mission and his own motivation for taking the job are why I’m here. Larry is one of the leading thought leaders and statesmen in higher education today and his leadership comes at a time when higher education is under a dramatic threat. There’s a sense, for the first time in my life, that people are questioning the value of a four-year education. Just take the notion of considering taxation of the higher education system. Larry often says, “talent is distributed equally but opportunity is not.” I believe that in a place like the United States, higher education is the way for society to remain competitive, but also for greater equality of opportunity and the fair and equitable distribution of life, liberty and the pursuit of happiness – all of that generally passes through having a good education. I care about those things. I’ve spent the majority of my career trying to open up opportunities for people through greater diversity and inclusion at an institutional level. This is something that is important in my life and to the history of my family. It is something that Larry and I share.

So we need higher education more than ever and, yet as a country, we’re investing in it less and less. When we think about engines of economic development and progress on virtually any dimension of society, it comes back to not just one’s individual education, but to the role in society of institutions of higher education. And yet, if you look at public institutions in particular, four out of five children in our country who will receive a college degree will go to a public university, yet funding to these critically important institutions has been dramatically cut. What has happened is the burden of the cost for higher education has been shifted to families and students though loans. And that burden is dramatic. Our society’s failure to boost investment in educationfor our people strikes me as terribly short-sighted. MCQ: What is Harvard’s role in addressing these issues? PB: There are many ways we think about Harvard’s contribution in this area, starting with the wide range of socio-economic backgrounds of the students who are able to come here. We are in a privileged position to offer need-blind aid. Over 60 percent of the undergraduates at Harvard College are on some form of financial aid.

Another way we are leading in this area is the work that is being done here in terms of income inequality, the opportunity gap, mass incarceration, the public education system. I think of it as concentric circles of contribution and good that an institution like this can do, from scholarship and teaching to the development of public leaders. Fifty-six graduates of Harvard are in Congress today. Our alumni are often recognized as titans of industry but they are also leaders of major non-profit organizations. MCQ: How important is the role of the president in bringing about societal change? PB: For better or worse, I think the President of Harvard is a leader in higher education worldwide. With that simple statement, there are places and ways that the President of Harvard can make enormous contributions. Another example is really trying to go after socioeconomic diversity in our class. Our goal is to identify young people who don’t even know they can get to college because of the challenge of affordability – let alone to a place like Harvard. And they may well have the talent to do so. One of the most important things Larry hopes to achieve is his goal to ensure that every


undergraduate who wants a public service internship will have the opportunity. Our demand today far outstrips our capacity to fund all of the students hoping for a public service experience, so this has become a really important objective we’re working on.

spect for your issues, to hear your point of view. It doesn’t mean you’re going to get what you’re asking for.” MCQ: What about other student affairs issues? Do you worry about students’ emotional and behavioral health?

In directing them through their first year, he is learning from them – what their struggles are, what they are interested in, and what is difficult for them.

We also think a lot about the special needs of diverse students. Inclusion and belongBut when the president lifts ing are heightened concerns PB: Absolutely. This is a very up public service and makes it for minority and first-gena cornerstone of his presiden- large community, so this is eration students. We have a cy, that can really help shine something we think about program, led by upper classa light for students and alums and talk about a lot. men first generation students, throughout w h e r e b y our commufirst-generanity. tion freshmen I’ve spent the majority of my career trying to come to camMCQ: Speakpus a week ing of stand- open up opportunities for people through greater before oriening up, what diversity and inclusion at an institutional level. tation. They has Presihave the opdent Bacow’s portunity to response discover the been to student activism at From our perspective, I think place through the eyes of it starts with making sure the Harvard? those who came before them resources and supports are in – students who understand PB: I think our campuses to- place. their dilemmas and their chalday are reflecting the mood lenges. of the nation and not just our We have a task force right students but also our faculty. now that’s examining men- Larry feels incredibly strongly What I love to see with Larry tal health on campus: What about free speech, but someis that as challenges arise, he are the factors? What are the times the actions of univeravailable resources? What meets them head on. sities can be misinterpreted more should we be doing? when it comes to these issues Literally, he will be going How might we contribute to a because our society is evolvsomewhere to give a speech culture of support and incluing. and will see students pro- sion? testing on a particular issue We try to think about safe and belonging, and he will stop and talk to Inclusion space and how we define them. Nobody stops and talks which was a focus of Presi- these. What does it feel like to students and thanks them dent Faust, is something Larry to be on a campus as a survifor their activism. But that cares deeply about and seeks vor of sexual assault? There doesn’t mean he agrees with to drive forward. He has car- is a good reason to take into ried on a tradition he has had them. account the social emotional from when he was President health of someone who has He leads with this approach of Tufts where he took on an experienced trauma. where: “I am here with re- advising role to six freshmen. 08

Photo by John Gillooly

Patricia Bellinger in her office in Cambridge.

We are undergoing a societal evolution. MCQ: Harvard has been in the news quite a bit since President Bacow’s inauguration, from external lawsuits to internal protests. How do you deal with this as a leadership team? PB: As far as controversies go, I’m not sure we’ve had more than our fair share but we always feel — and I know Larry does – that it’s important to grapple with issues. Our faculty and our student body are talented, engaged, and active and that means we

have to lead with authenticity. We have to think hard about issues. You don’t have to agree with what’s going on, but we try to engage. Our approach is always to treat peoples’ issues and concerns with respect because that is a sign of a healthy democracy. MCQ: How does that impact your job? Do you find it distracting? PB: My role, and for those in the president’s inner circle, is to be a sensor; to get out there and hear what’s going on and not become isolated. I don’t

see controversial issues as a distraction. I see them as part of my job. The challenge is to be sufficiently agile while not being defensive. Every day it’s: “This is what I need to manage right now – let’s think about how to act constructively. Let’s call in a meeting quickly.” You have to swing capacity in your schedule. You can’t just read and think and look at issues in advance, you have to respond with agility. And you have to be comfortable with ambiguity.


Opinion: Young Adult Substance Use Disorder The crisis within the crisis By Michael Botticelli

For a variety of reasons, some systemic, they are also less likely to address their addiction or maintain their recovery. The treatment gaps that exist for young people with addiction exacerbate the problem, creating a scenario where the population at highest risk for addiction is also the hardest to reach and treat, even as their recovery holds the most promise.

Michael Botticelli Director, Grayken Center for Addiction


he health epidemic that now kills more people than car accidents has taken a disproportionate toll on our nation’s youth. Young people between the ages of 16 and 26 are most likely to drink alcohol and use other drugs, most likely to engage in prescription opioid misuse and have the highest prevalence of heroin use.


Our response to these realities determines how well we protect and nurture some of our greatest assets and, in many ways, our most vulnerable citizens. There are hundreds of thousands of young people who, if properly treated and supported to recovery, will lead healthy, productive lives that include graduating from college and entering the work force. Given what’s at stake, we need a national strategy for addressing the unique chal-

lenges of young adult substance use which will involve the participation and perspective of all stakeholders, from health care providers and policymakers to community partners and education leaders. Neuroscientists have determined that young adult brains are particularly susceptible to addictive behaviors, making them prime targets for a confluence of factors, including the overprescribing that led to the opioid epidemic. In 2018 alone, almost 400,000 young adults aged 18 to 25 were diagnosed with an opioid use disorder. Heroin and the emergence of inexpensive, highly potent synthetic drugs like fentanyl add a heartbreaking level of severity to the problem. Even as we lose more young lives to drug overdose, our current treatment system is largely tailored to adults, and

therefore is ill-equipped to address the unique aspects of the disease in younger people. Unlike older people with addiction who often seek help because they have lost something to their disease – a relationship, employment or their physical health – young people may not have had as many consequences. They see themselves as invincible with little reason to ask for support to overcome a problem they feel they can handle.

Center for Addiction, despite the fact that medication made individuals more likely to engage in treatment long term, only 1 in 4 young people received medication within three months of a diagnosis of opioid use disorder. This underscores how critical it is that we find more effective ways to make these connections. Young adults with significant addiction problems may not be ready to engage in traditionally structured models of care. They need practitioners who understand their unique issues.

licate the strategies that are working. Outpatient treatment models have proven to be extremely effective for young people with SUD, particularly those that are integrated with primary care and take into account the many determinants of a young person’s overall health. There are some promising programs to learn from, including the Office-Based Addiction Treatment model at the Grayken Center at Boston Medical Center called CATALYST (Center for Addiction Treatment for AdoLescent/ Young adults who use SubsTances).

Connecting young people with substance use disorder (SUD) with treatment is In addition to an especialprimary care, ly important Even as we lose more young lives to drug overdose, CATALYST ofchallenge giv- our current treatment system is largely tailored fers recovery en that only a coaches and to adults. small portion licensed soof all people cial workers who need who provide help for addiction get it. Currently, there is a short- helpful guidance and support, age of treatment options for as well as nurses and other According to a study by Scott young adults. professionals who can adminHadland, MD, MPH, MS, an Assistant Professor of Pedi- Identifying the barriers to ister life-saving medications atrics and a physician at Bos- treatment for young people like Buprenorphine. ton Medical Center’s Grayken helps us improve on and rep- Because the patient’s addic11

tion treatment is part of the regular medical care they receive, CATALYST is able to build the kind of long-term relationships that foster retention in treatment. This is particularly important for young people, who have a harder time remaining in treatment than other age cohorts. This past November, national experts on young adult addiction gathered at a full-day symposium hosted by the Grayken Center aimed at creating principles of care for young adults with SUD. When finalized, these principles of care promise to serve as a much-needed roadmap to guide practitioners and policymakers working with young people. One organization that participated in November’s symposium was the Association of Recovery in Higher Education, (ARHE), an 12

advocacy organization that helps students with SUD stay in school. ARHE is one of many groups that are working to help colleges and universities better identify and support students with SUD – those in recovery who are beginning or re-entering college and those who are struggling with their addiction on campus. One certainty of the opioid epidemic is its extensive and indiscriminate reach. In a 2015 survey by the Hazelden Betty Ford Institute for Recovery Advocacy and the Mary Christie Foundation, 16 percent of the college-aged youth surveyed reported having used painkillers not prescribed to them, and more than 34 percent said these medications were easy to acquire.

The rise in study drug misuse, the popularity of other drugs like “Molly,” and the dangerous mixture of these substances with alcohol have become major concerns for college health professionals and administrators alike. From evidence-based prevention and education, to identification and referral, to active addiction response strategies, colleges and universities have a large role to play in fighting the addiction crisis in young people. As we define, improve and scale strategies and practices for this population, higher education has an important seat at the table in forging pathways to health and long-term recovery. Michael Botticelli is one of the nation’s leading addiction experts and served as the Director of National Drug Control Policy at the White House under President Obama. He is currently the Director of the Grayken Center for Addiction at Boston Medical Center in Boston.

Needing to Know Penn State’s Piazza Center will shine light on Greek Life By Marjorie Malpiede


t is fair to say that the current relationship between higher education and fraternities and sororities is strained. After a series of heartbreaking and high-profile hazing deaths, including that of Penn State freshman Timothy Piazza, stakeholders already concerned about the exclusion and abuses associated with these organizations are questioning their very existence. Once the iconic image of American college life, fraternities, in particular, have become polarizing litmus tests – are you for them or against them? In the aftermath of Piazza’s death, Penn State took an unusual stance on the issue by introducing a “third way” of looking at Greek life – through a research lens that the university hopes will lead to evidence-based practice and reform. With the gracious support of the Piazza family, the Timothy J. Piazza Center for Fraternity and Sorority Research and Reform is both a promising new institute aimed at meaningful change and, by its name, a

somber reminder of what remains at risk. The university has committed $2 million to an endowment for the center and has made a further commitment to match up to $3 million in additional funds. The man behind the Piazza Center is Penn State’s Vice President of Student Affairs, Dr. Damon Sims, who calls the Greek experience on college campuses “infinitely more complicated than people are aware.” “What we found after Tim’s tragic death, when all of our attention turned to fraternities and sororities, was that there wasn’t any evidence of proof for some of the theories we were operating within,” said Sims. “When you get into arguments about the impact of interventions, for example, schools make one claim and the national fraternities make another, and neither side has any hard evidence to support its position.” The Piazza Center hopes to provide that evidence through a number of initiatives, some

of which are extensions of the Center for Fraternity and Sorority Research (CFSR), which has been moved from Indiana University in Bloomington to the Piazza Center, where it is now more visible and better funded. Before coming to Penn State, Sims spent 33 years in Bloomington as both a student and an administrator and was aware of CFSR’s work. Its Executive Director, Dr. Stevan Veldkamp, is a long-time student affairs professional whose responsibilities include fraternities and sororities. He is now Sims’s special assistant and interim director of the Piazza Center. “There’s been a ton of work done on problem identification,” said VeldKamp. “But the Piazza Center will produce what everyone in this field is really clamoring for -- sound, professional practices.” Veldkamp says the center’s priority projects will be on student safety and high-risk behaviors. He sees the transfer of CFSR to Penn State as an


opportunity to fulfill the organization’s original mission to be a resource for colleges and universities as well as Greek organizations. Begun in 1975 with the backing of national fraternities and sororities, CFSR set out to identify gaps – both problems and opportunities – in the Greek life experience. But uncovering factors such as the undeniably strong correlation between fraternities and alcohol was not what the original funders hoped the center would pursue and publicize. Many of them withdrew their support. CFSR continued its work focusing primarily on one signature instrument – the Fraternity and Sorority Experience Survey (FSCS), designed to provide data to colleges and universities about what’s happening within their sororities and fraternities. The feedback is then used by schools to improve programing and provide some emerging best practices.

Another initiative the center will pursue is the national scorecard of fraternities and sororities. The brain child of Penn State President Eric Barron, the scorecard is a separate survey that gathers data from institutions around the country and gives stakeholders, including students and parents, a sense of how well these organizations are doing on a range of issues – from leadership opportunities to alcohol and sexual assault violations. Transparent in its desire to be pure of any influences, the center will provide research that supports positive educational outcomes, student safety and the reduction of highrisk behaviors. Sims hopes these efforts, together with sponsored research on other campuses, and national convenings, will shine light on an area that for too long has been in the shadows. “I think all of us would admit that for decades we were trying to influence outcomes in fraternities and sororities without a lot of evidence,” he said. “We need to understand

whether the actions we are taking, the tools we are using, are going to be effective based on what the research tells us.” Dr. Jeremiah Shinn provides an example. Shinn is a senior administrator at Boise State University and has been an expert advisor to fraternities and sororities for many years. “A lot of times what happens is when there is a student death – or a rash of alcohol transports – universities say to the organizations, ‘we’re going to make you defer recruitment until the second semester,’ which is a very common thing universities do. But there is no proof that joining a fraternity in the second semester creates more conditions for health and safety and there’s no information that says the opposite. Despite having no evidence, universities commonly make decisions so they can feel like they’re doing something.” Structural Issues

There are a number of reasons why Greek life is unThe Piazza Center will adder-examined, and why, deminister a new version of spite decades the survey to of trying, participating colleges and schools and u n i v e r s i t ies provide ag- We need to understand whether the actions we gregate data are taking are going to be effective based on what have had little influence that will allow the research tells us. —Dr. Damon Sims in preventing researchers Vice President of Student Affairs, Penn State tragedies like to examine Timothy Pitrends. 14

azza’s death. One of the main reasons lies in the loose relationship that exists between the schools and the organizations themselves. Fraternities and sororities are typically chapters of national organizations, independent and autonomous from the institutions they are associated with. In many cases, they are on private property, created by other entities with outside influencers like leadership boards and engaged alumni. This “arms-length” relationship has been both a plus and a minus for schools who hope to infuse positive practices into fraternities and sororities on their campuses while at the same time often distance themselves from them when something bad happens. Sims says that while schools often point to their independence in these cases for liability reasons, it matters little in the court of public opinion because the perception is that these entities are part of the university. Rethinking the school’s relationship with its fraternities and sororities was a key part of his strategy in creating the Piazza Center. “The argument I made after Tim’s death was that we needed not to distance ourselves more from these organizations but instead, to draw

Photo by Beyond My Ken

An Alpha Phi fraternity house.

them closer to us -- have more influence over them, and as a consequence, improve outcomes within these groups,” he said. Dr. Shinn shares the perspective that schools need to have a strong relationship with these organizations and notes that fraternities and sororities that have the best reputations are those that are most closely associated with their institutions. “My view is that fraternities and sororities can be enormously valuable for students to the extent they are aligned with the mission and purpose of the university they are partnered with.”

Student affairs professionals assigned to Greek life can play a significant role. Dan Wrona, a consultant and researcher in this area, recently wrote, “The campus fraternity/sorority professional does not exist to help Greeks do Greek life better; but to help members of fraternities and sororities better achieve the objectives of the institution.” Bring the Good – Leave the Bad Though not explicitly stated, the ultimate goal of the Piazza Center may well be to help retain what is beneficial about Greek life while preventing the negative outcomes that 15

have the entire system under siege.

ment and, perhaps, most important, a sense of belonging.

Kaye Schendel is the Chairman of CFSR’s Board and is the Director of Global Initiatives at the Delta Upsilon International Fraternity where she arranges service trips for members. She was a Tri Sigma at the University of Wisconsin and served as the sorority’s president for six years.

In a recent presentation at NASPA’s annual conference, Dr. Veldkamp revealed the results of the latest experience survey which showed that, among men, the number one reason to join a fraternity was friendship (74%); followed by social opportunities (49%) and leadership development (44%). Among women, friendship was also on top at 79%; followed by philanthropy and community services (43%); with leadership development and social opportunities tied at 38%.

“I believe that fraternity and sorority life, when done right, can be one of the most positive experiences a student can have,” she said. “The key is to emphasize and work on those positive aspects.” While invoking the “one bad apple” theory in defending the system, many proponents of Greek life point to life-long benefits that are not remotely similar to the shenanigans portrayed in “Animal House.” Role model organizations are engaged in student affairs programming within their chapters, from by-stander intervention training to mental health peer support. Both fraternities and sororities provide leadership and mentoring opportunities, community service engage16

Campus community groups – whether they be Greek organizations or learning communities – are viewed as a way to connect and draw comfort at a time when college students with mental health issues are presenting with greater frequency, severity and complexity (Benton, 2003; Gallagher, 2007). Isolation is the cause of particular stress with 55% of men and 62.8% of women reporting “feeling very lonely” in the past 12 months, according to the American College Health Association’s 2018 survey.

Dr. Shinn believes that the sense of “mattering and belonging” is the differentiator between the positive and negative behaviors associated with Greek life. “What we found (at Boise State) was that the extent to which members of a chapter feel like they matter and belong is what is most associated with pro-social behaviors,” he said. Sororities have a role to play as safe, supportive communities for women but are often “lumped in” with their male counterparts as part of the anti-Greek life argument. The recent Harvard lawsuit over the discouragement of single-gender houses argues that women’s groups are unjustly taking the fall for a ban aimed at the misogynistic attitudes of men’s “finals clubs.” But fraternities, too, are defensive, stating that most members are not “hazers,” and that the organizations provide institution-aligned benefits such as career and leadership development. With the proliferation of chapters for specific groups like Black and Latino or gay and transgender students, many believe that fraternities today are “not your father’s frat houses.” In a recent article, entitled “A Frat Boy and a Gentleman”,

researcher and author Alexandra Robbins argues that fraternities can help men develop “productive masculinity,” writing, “It is wrong to assume that every male group is toxic. I found many fraternities offering a comforting family away from home, a safe space for guys who worried that it would be hard to be themselves or find friends in college.” Sims agrees, to a point.

“There’s no question that these are strong, powerful communities that can have profound impacts that can be very positive, not just in college but throughout a person’s life,” Sims said. “We’ve accepted the notion that these things are possible. At the same time, there are certain assumptions about the positive aspects of them that early research has not proved to be true. Again, we need more information.”

To his earlier point, “Greek life is complicated,” and it is clear that higher education has much to learn from a thorough examination of its practices and outcomes. Ultimately, one of the most compelling reasons to study Greek life is that students continue to want to participate in it which makes the Piazza Center’s work so important and the Piazza family’s involvement so commendable.

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Opinion: Help Them Cope Student resiliency programs can be a valuable addition to college counseling services By Zoe Ragouzeos have had suicidal thoughts or have seriously considered suicide, 2.4% have made a suicide plan, and 0.9% has made a suicide attempt.

Zoe Ragouzeos, Executive Director of the Counseling and Wellness Services, New York University


t 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 second leading cause of death among college students. In addition to those students that die by suicide, 8.0% of full-time college students


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 five 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 ac-

cess 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.

health issue. We have often relied on our colleagues in Residential Education, Student Affairs, Academic Advising The University at Buffalo and other non-clinical units takes the above concept one to teach students how to cope step further by actually rewith college life. The mental quiring its low risk students, health “crisis” is showing us after triage with a counselor, that counseling services have to participate in a similar proa role to play in teaching resilgram prior to being able to ience because we are the ones make one on one counseling fielding feedback from our appointments. students, our colleagues, their A possible next step for both parents and other stakeholdThe “Bouncing Back” program the NYU and Buffalo programs is five weeks in duration with is to create an online format ers regarding intolerable wait times, restricted access due one 90-minto our shortute session, term model once per week led by a coun- The mental health crisis is showing us that and whether seling cen- counseling services have a role to play in teaching our services generally are ter clinician. resilience. meeting the There are expectations five to eight of our stustudents per dents. group. Curriculum includes for the workshops using a modules on goal-setting and platform such as Zoom, for Zoe Ragouzeos is the Associate purpose, optimism, mindful- example, which could signifi- Vice President for Sexual Misness, forming and nurturing cantly increase convenience conduct Support Services and relationships and belonging for students. Student Mental Health and the and engagement. Executive Director of the CounCollege counseling services seling and Wellness Services at At the conclusion of the pro- have historically been respongram, students complete an sible for providing students New York University. assessment which seeks to with clinical interventions determine if they have gained after they experience a mental


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.

Taking the Lead

Student groups aren’t just waiting for change in college mental health policy—they’re driving it By Nichole Bernier


ast summer, when Northwestern University junior Allison Zanolli was mourning the loss of a sorority sister who’d taken her own life on graduation day, she turned to Facebook with her grief. Then she turned her sights on the university. It was not doing enough to help students with their mental well-being, she wrote in a Facebook post. And when tragedy strikes—as it had four times that year— she felt the administration’s response to be inadequate and lacking in empathy. “When a death occurs at Northwestern, we receive one email about it,” Zanolli wrote in her post. “There is never a reference to the fact that Northwestern can be cold, can be lonely, can be a very big place to be scared and sad and feeling as though you have run out of options.” When she returned to cam-

pus in the fall, she founded #BeWellNU, a student mental health initiative. The group conducted a student survey and presented the administration with the data and recommendations: improved psychological services, increased staffing, and greater transparency in its decisions and communications. With #BeWellNU, a student initiative took fellow students’ isolated grief and consolidated it into action. “It’s really hard as students to create change on an institutional level if you don’t have one unified voice,” Zanolli told The Daily Northwestern. In the following months, the university president reached out to her, and the administration announced plans to hire two new counselors dedicated to emergent care and create a task force to address mental health on campus.

There have been nine suicides at Northwestern since 2013 and 14 at the University of Pennsylvania, figures that represent a snapshot of the growing crisis of mental health young adults in the U.S. Last year, a study by Brigham and Women’s Hospital in Boston concluded that one in five college students considers suicide. While colleges and universities struggle to implement policies and services, students are frustrated by the pace of change—and awakening to the power of their voice in the process. “Movements, social movements in general, are usually led by youth, so this isn’t a unique type of movement in that way,” says Laura Horne, director of college programs for Active minds, a nonprofit for student mental health. Active Minds was formed in 2003 as an organization to support 21

and guide student groups surrounding issues of wellness on campus, and now sponsors 550 chapters around the country. “We’ve seen firsthand the power of student-led efforts that have resulted in tremendous change in terms of campus climate and attitude toward mental health.” Student organizing has reached beyond campus climate and attitude to target tangible improvements, and groups are challenging administrations to make changes in a range of ways—from increasing counselors and reducing wait times for appointments to raising limits on the number of appointments allowed per year. At Cornell, a student-led M e n t a l Health Task Force delivered a report to the university president outlining proposed actions to improve Cornell’s mental health services. 22

Many schools—including the University of Michigan, Georgetown, and USC—saw the launch of peer-to-peer counseling to supplement what their classmates were (or weren’t) getting from CAPS. Students at UCLA established a physical location to focus peer-taught wellness and prevention—a mental health “toolbox”—including workshops on yoga and mindfulness in one of the student commons. And student governments at schools like Indiana State and University of Nevada are even asking for increases in health fees to subsidize extra counselors. Efforts to make initiatives like these come to fruition can be difficult to sustain; student leaders graduate out of rotation every four years, and momentum is naturally interrupted by the cycle of midterms, finals, semes-

ters abroad, internships, holidays and summers. Yet all it takes is the smallest spark to get it going, especially in the age of social media. At the University of Maryland-College Park, for example, the catalyst for student action was as complicated and simple as a perfunctory, overly formal email. When You Can’t Go Home Last April, University of Maryland junior Faye Barrett called 911 in the middle of the night. She was having a panic attack and concerned she might have taken her prescribed muscle relaxer incorrectly. She spent the rest of the night in the hospital calming down, preparing to be discharged and go back to her dorm for more restful sleep. Then an email from the school appeared on her phone. The letter from Residential Life informed Barrett that she wouldn’t be allowed to go to her room—or any other on-campus housing—until she had met with a university psychiatrist and a Resident Life case manager, and they

had “made a decision regarding [her] ability to return.” The letter specified that “finding alternative lodging off-campus will be required” until both meetings had been completed. “I have concerns about your ability to successfully manage living in a residence hall,” the letter read. As a freshman, Barrett had been treated for anxiety and depression, and more recently diagnosed with bipolar disorder. The cold formality of the letter hit her like a threat. “It takes strength and bravery to get help for a mood disorder,” she told the student paper, “and instead I was punished” for calling for help. Barrett spent a tearful night at a friend’s off-campus home and wasn’t cleared to access the clothes or food in her own apartment until a day later, after she’d completed the mandatory meetings. She shared the letter via social media and word spread on campus, where students

had already been lobbying for improved services at the psychological center. For more than a year, a group calling itself SPARC (Scholars Promoting and Revitalizing Care) had been trying to engage the administration in a dialogue. Founded by Anthony Sartori, a College Park Scholars senior, SPARC wanted to address the wait times at CAPS to receive psychological care—as much as 30 days. They’d launched a social media campaign (#30daystoolate) to collect input and experiences fellow students had had with CAPS, says Sartori, then sent a letter filled with suggestions widely throughout the administration and community, but didn’t get a response. So on Valentine’s Day, they delivered roses to the president with the letter. And the conversation began. When Barrett’s lockout experience gained attention, the conversation broadened: Can the university design communications with empathy in 23

mind, not just liability fears? Can the policy of re-entering the dorms be reassessed? And how about creating a counseling center on the North Campus—where the freshmen are, who often need it the most— as well as South Campus?

RAs have long been the soldiers on the front line of the mental health crisis in higher education. Living in the dorms 24/7, they are up close and personal with freshmen and privy to their sometimes-rocky transitions.

The door was open, but Sartori felt the conversation never really took hold. When the time came for the annual campus Do Good Challenge—an event where groups present projects that would benefit a social need—SPARC entered, and won $5,000 as one of the six finalists.

At Georgia Tech, junior Meghan Dietrich is an RA, and was so moved by the state of mental health on campus— two suicides in one week last year, and four attempts in five days (“and those were just the ones I knew about”)—that she made it the basis of her interdisciplinary project for her biology major.

“We donated half to Residential Life to train one of the new case managers in Mental Health First Aid, a national program with an eight-hour training about how to help someone in crisis,” says Sartori, who has now graduated and works in the Maryland mental health industry. “Because of that, they’ve gone on to train over 100 Resident Advisors.” Leading From Within


“We do have resources— counseling centers, hotlines, peer and online platforms. Why aren’t people using them if they’re in a state where they really need help?” she said. “We saw an interesting statistic. Tech students were asked in a survey if they felt they’d be perceived differently if they reached out for help, and about half said yes, there’d be a stigma. But only 10 percent said they’d look at someone

else differently for getting help.” These and other questions were on the agenda when Georgia Tech students founded, and hosted, the Intercollegiate Mental Health Conference in February. A gathering conceived and organized entirely by students, IMHC was held with students and administrators from other colleges, including Duke, the University of Michigan, UNC, UCLA, and Stanford. The event was the brainchild of Collin Spencer, a junior biology major who’d founded the Mental Health Student Coalition the year before, after he identified what he called a sense of “shared despair” in campus pressure and perfectionism. “Efforts tend to focus on developing and implementing internal solutions. As such, Tech has isolated itself from the local and national mental health community,” Spencer wrote in an article for the Atlanta Journal-Constitution in January.

“This mental health crisis is not unique to Tech, yet we have not collaborated extensively with outside experts or institutions. We are potentially reinventing the wheel while effective solutions may already exist at other institutions.” The main purpose of the conference was to collect and share best practices on mental health—what’s working, what isn’t, and why. One of the best secondary aspects of the conference, Dietrich recalls, was simply meeting with students and administrators at other schools where the pressure is likewise intense. “I went from being number one in my class to a college where everyone was first in their class. There are high expectations, and you want to be the best. Chasing that standard of excellence takes away from putting your own wellbeing first,” she said. “But you’re not going to be able to take care of yourself academically if you don’t take

care of yourself personally.” Under Pressure The call for self-care is nothing new, but it’s taken on added meaning and urgency in recent years: Between 2013 and 2016, depression diagnoses among those 18 to 34 increased by 47 percent, according to a report from the Blue Cross Blue Shield Foundation. But this is also a time period in which the conversation about mental health became far more open—diminishing the stigma, and increasing the likelihood of students seeking help. “We don’t know exactly what’s led to this place,” says Laura Horn of Active Minds. “But there’s a lot of data out there we can use to piece together a number of factors.” For starters, Horn notes, students with existing mental health issues are getting into college in higher rates than in the past—and thanks to advances in services and treatments, are able to attend. Then there’s technology—so-

cial media and smartphones put constant distractions and anxieties right in the palm of the hand, amplified and seemingly inescapable. It might be facile to blame parents, but helicoptering and snowplowing are proven to have detrimental impacts on the coping skills in young adults. And pressure; high school performance and college admissions are at more competitive levels than ever before, and grinding away with too many commitments and too little time for meals and sleep is a dark badge of honor. Throw in the reality that some students are dealing with food, housing, or job insecurity, and you have quite a cauldron of simmering anxiety. “When you look at basic necessities, the Maslow’s Hierarchy of Needs, you have food, shelter, clothing and sleep at the base of the pyramid. You have to address these things before you can move up to the levels of taking care of social relationships and mental health,” says Carly Stew-


art, a UCLA graduate student working toward dual master’s degrees in public health and social work, and a representative on the university’s Mental Health Committee. As part of her degree internship, she serves as a counselor in the community. “If you’re swamped and you can’t even sleep, how are you going to utilize self-care and take advantage of psychological services? Fellow students can appreciate that pretty well.” Partnership or Provocation?

things done, because their clock is always ticking, their semester calendar and time on campus both short, finite. Their help on the ground is undeniable. Initiatives like peer-support networks, RA training, campaigns to raise awareness, and mindfulness breaks are especially welcome when the demand for mental health services rises to a clamor at a school with 40,000 students. College counseling centers might well need to increase their staffing these days.

“You hear the rhetoric, ‘The administration isn’t doing anything,’ but that’s incorrect. On the Mental Health committee, you see they’re really trying,” says Stewart. “A lot of blame is put on the administration, but when you break it down, what does that really mean? Whose responsibility is it to make sure everyone’s ok? Students have a role in that too. There are complaints that there’s a lack of awareness about what services are offered and why they’re useful, and that’s on us, too.

“The whole communiWhile colleges and universities struggle to t y — f a c u l t y Student leaders at times implement policies and services, students are and administrators and play a provoc- frustrated by the pace of change. students. Our ative role responsibility on campus, is to spread pressing adinformation ministrators for change—more, further, But if the number of students about the help that is here, faster. Caution, costs, and lia- wanting frequent private and get people to use it.” bility tend not to be the issues counseling continues at this pace, schools will never be of their wheelhouse. able to meet the need. It’s not And yet their urgent energy a problem they can hire their fuels the motivation to get way out of.


Schools That Make A Difference Clark University’s impact journey By Marjorie Malpiede


hey say if you want to change the world, start in your own backyard. For Clark University, in Worcester, Massachusetts, this truism became the place-based planning strategy that would revitalize its neighborhood and improve its host city. By working side-by-side with its neighbors, Clark not only enhanced its campus environment, it set a precedent for anchor institutions involved in community development, and gained a reputation as a school that makes a difference. The story of how Clark helped transform its neighborhood and how that effort, in turn, helped transform Clark, lays the groundwork for its latest campaign: improving the behavioral health of adolescents and young adults, particularly boys and young men, through the Mosakowski Institute.

Once again, it will engage with the community. Clark’s president, David Angel, hopes the institute will shift the paradigm of practice around young adult mental health, reducing stigma and addressing root issues like trauma and racism. Instead of just identifying problems and examining best practices, Angel says, the Institute will change peoples’ lives. Such high impact is aspirational even by higher education standards. But Clark’s determination to develop a “new way” in adolescent and young adult behavioral health is rooted in its own history of change-making. From “Town and Gown” Tensions to Model Partnership Worcester is what is known in Massachusetts as a “Gateway City”— a traditional manufacturing town where large

employers provided an entrée to the middle class for generations of families and new Americans alike. During the latter part of the 19th century, these cities, like similar urban areas throughout the country, languished from the decline of traditional manufacturing, factories relocating to cheaper labor markets, and families fleeing to the suburbs. The resulting disinvestment, blight, and crime continues to impact the city to this day. But Worcester is making a comeback, buoyed by the state’s innovation economy that is bringing high-tech manufacturing to the city with follow-on investments in commercial and residential areas. Young people keen on urban life but wanting to avoid Boston’s exorbitant housing prices are moving in. The Boston Red Sox Triple-A affiliate, the Pawtucket Red Sox, is coming 27

to town with plans for an innovative downtown ball park. Worcester is also a college town, home to College of the Holy Cross as well as Clark University. While Holy Cross sits atop a hill overlooking the city, Clark is situated on Main Street in the heart of what was once the city’s most impoverished section. A liberal arts research institution of roughly 3,000 students, Clark’s otherwise highly-regarded profile was handicapped by its location. Parents of prospective students worried about safety, and staff were reluctant to live close by. From the late 1950s to the 1980s, the institution’s relationship with the city was well-understood: Clark students stayed on campus, and the neighborhood was not invited in.

to become a major player in the renovation of Main Street and its surrounding neighborhoods. At the start, the school purchased several properties adjacent to campus, which it renovated for its own use—including the president’s house, where all Clark CEOs are now required to reside. “Dick Traina made a courageous decision that we weren’t just going to stay in Worcester, we were going to link our future very directly to the success of the community in which we were a part,” said David Angel. But as inclusive as Traina hoped to be, the early days of neighborhood renovation were tough. Skeptical residents had yet to see what was in it for them, evoking what is known as the “town and gown” tension that many colleges experience when they purchase properties surrounding their campuses. “The neighbors were judging us all the time, so we needed to start small and follow through on our promise to become a real community partner,” said Jack Foley, Clark’s Vice President of Government and Community Relations, who has been the man leading the plan since the 1980s.

This “moat” approach began to change when Richard Traina became president in 1984 and committed Clark 28

Foley said small successes like planting trees, hosting barbecues, and inviting people onto campus helped. But it was the large-scale property renova-

tions, led by neighborhood stakeholders, that brought everyone to the table, and showed the community that Clark was serious about doing things differently. The school used what Foley calls an “alignment of enlightened self-interest” to engage local stakeholders in the planning process to purchase problem properties for re-use within the community. The vehicle for that approach was the Main South Community Development Corporation, created in part through a grant Clark received from the Ford Foundation for anchor institutions in underserved areas. Community Development Corporations, or CDC’s, are nonprofit, community-based organizations focused on revitalizing the areas in which they are located. The Main South CDC would be the primary planning instrument for the decades-long renovation of the area around Clark known as University Park. Clark took (and continues to take) just one seat on the CDC’s 15-person board. “Right from the beginning, we said this is a neighborhood-based partnership where there is shared decision-making,” said Foley. “That’s very different from most institutions who engage in this kind of work. Typically, they want to be in control of what’s going to happen in their community. We weren’t

Photo courtesy of Clark University

Clark President David Angel teaching a class.

going to control anything with one seat. People thought we were crazy.” Jay Ash agrees that Clark’s approach was unique. Ash, a Clark alumni who recently stepped down as the state’s Secretary of Economic Development and now heads the Massachusetts Competitive Partnership, has been involved in the redevelopment of underserved communities his entire career. “Clark’s community development activities in Main South and beyond have been the

source of significant effect and well-deserved admiration,” he said. “Frankly, too many institutions want to put up fences and turn inward, instead of opening up their gates and contributing outward.” Ash credits his early experiences in Worcester for deeply influencing his role as a public leader. “The basis of much of my work and evolving theory has been rooted in the very experiences I had as an undergraduate at Clark working in the Main South neighborhood and now

for decades watching, and occasionally contributing to, the way the university has interacted with and on behalf of those in need of a champion,” he said. The most tangible demonstration of Clark’s commitment to community-driven change came in 1995, when it launched the University Park Neighborhood Restoration Partnership, a strategic plan that focused on five areas identified by community members as their greatest concerns. It included the


physical rehabilitation of dilapidated properties owned by absentee landlords, as well as education, public safety, economic development, and social and recreational opportunities. According to the document, the vision for the plan was to “restore University Park to a vibrant community whose residents are committed to the neighborhood, to education, and to the safety of all.” The theory was to build equity in the neighborhood with a base of committed families and individuals willing to stay and rebuild their community. “Our efforts were successful because it was the opposite of gentrification,” said David Angel. “Instead of pushing low-income immigrant families out of the neighborhood, the reverse happened. A lot of families are moving into the neighborhood because of the housing and educational opportunities.” Clark received a transformational grant from HUD for $2.5 million to kick-off the effort—one of only five schools across the country to get the funding. The plan provided some immediate benefits like free tuition for neighborhood residents who are admitted to the university; significant incentives for faculty and staff to buy homes in the neighborhood; after-school programs on campus; professional de-


velopment for teachers in neighborhood schools; and the opening of the University Park Campus School—a 7 through 12 “innovation” high school jointly developed by Clark and Worcester Public Schools. The plan also called for the acquisition of key properties by the Main South CDC – a forward-thinking investment fueled by a vision and optimism. A Successful Blend Casey Starr was a middle schooler in New York City when Clark University issued its strategic plan. Nine years later, she began working at the Main South CDC just after she graduated from Clark, and received a Vista service grant in community development. Today, she is the Director of Community Initiatives and holds a graduate degree from Clark in community planning, which she earned tuition-free, thanks to her work with the CDC. “CDCs are a place-based thing,” said Starr, who lives in Worcester with her husband and young son. “The idea behind a CDC is to ensure that its residents and community members are identifying the priorities and driving the change in that neighborhood.” Starr stewards the work begun back in the 90s, when the CDC was aggressively acquiring problem properties and

renovating them for family housing. At the time, Clark provided unsecured equity for their projects, since they didn’t have any capital of their own. It would later issue a $1 million line of credit. The CDC receives federal subsidies and state tax credits to purchase properties, renovate them, and sell or rent at below-market rates to individuals or families at a certain income level. First-time home-owners of multi-family units are encouraged to buy properties, live in one of the units, and rent out the rest to other members of the community with some restrictions. Owners cannot resell their properties at market rates until they have lived in them for 15 years. For CDCs, stability is the end-goal. The organization has come a long way since its early days. The Main South CDC owns and manages its properties, generating a significant portion of operating costs itself and giving back more then $400,000 a year to the city in real estate taxes. It now has more than 340 new or renovated housing units in the neighborhood, including over 70 first-time home-owned properties. But to understand the real impact of the Main South CDC— the stuff that makes advocates like Casey Starr excited to go to work every day—you need to walk through the two-mile

University Park corridor and see how the “block-by-block” planning strategy is connecting the dots. In a series of large-track development projects that involved dozens of acres of burnedout buildings and abandoned factories, the CDC built new houses and rehabbed historic Victorians that now line clean, well-lit streets.

“What makes people feel safe is other people,” said Starr. Clark students are also using the park. “It is amazing to me to see Clark students playing basketball or joining in with the grandmothers for Zumba class. That would never have happened when I was an undergraduate,” she said.

1997, and now enrolls 250 students in grades 7 through 12. The award-winning public school is staffed almost exclusively by Clark graduates and is open, by lottery, to anyone who lives in the district. Its students are predominantly of color; 54 percent are Latino, 68 percent speak English as a second language, and 82 percent meet federal poverty guidelines. It is known as “The School with a Promise.”

Just up the road from Clark, the Dan St. Louis new state-ofClark’s determination to develop a “new way” is the school’s the-art Boys principal. and Girls Club in young adult behavioral health is rooted in its With educabuilding sits history of change-making. tion degrees adjacent to a from Clark, new profesSt. Louis has sional-grade been involved athletic field, with UPCS owned by Clark and used by In many ways, the rolling since he was first drawn to its green of University Park repthe Club. resents the bridge between unconventional style while As Starr will tell you, commu- the school and community, a student-teaching there as an nity development work is a relationship that has evolved undergraduate. lot more than fixing up prop- dramatically over the years. “I saw this place where the erties. Starr says that when residents kids and the teacher were have conversations about the “More and more, we have best things in their neighbor- on the floor, reading togethbeen focused on broad com- hood, Clark is always on the er and telling stories and laughing together, and I just munity programming, includ- list. thought, ‘Wow, that’s not how ing public spaces, engaging families, and working to ad- “Clark is probably the most I remember high school,’” he dress safety concerns,” she powerful institution in our said. said. community, but to the resi- St. Louis says the informal, dents, it’s just another part of engaging relationship UPCS One of her proudest achieve- the community,” she said. teachers have with their stuments is the “programs in the park” initiative, where a once- Just beyond the park is the Uni- dents sets them apart from feared and neglected space is versity Park Campus School more traditional high schools now home to farmers’ mar- (UPCS). Created through and motivates the students to kets, free concerts, and soccer Clark’s strategic plan, UPCS come to school every day. games for kids. started as a seventh grade in 31

It is a key part of a student-centered, active learning environment where heterogeneous classes with no tracked curricula help kids from poor backgrounds beat the odds year after year. “For us, the heterogeneity is absolutely huge,” said St. Louis. “We provide truly differentiated instruction that allows multiple types of learners to achieve a l o n g many entry points. We don’t have a lower class for kids to get bumped down to. Everyone deserves everything we are here to offer them.”

Students entering UPCS are typically two to four years behind the state average in reading and math. By using small steps called “scaffolding,” University Park students are well caught up by tenth grade, with St. Louis reporting that none have ever failed that grade’s

with the state’s average. It has a 100 percent graduation rate and a 97 percent college acceptance rate. “We started out hoping to establish one of the best public high schools in the state, and we now have one of the best schools in the country,” said Jack Foley.

The UPCS connection to Clark is no small factor in its success. Clark offers free college courses for the high school’s s o p h o mores, juniors, and seniors, free tuition for accepted graduates, and professional development A home undergoing renovations in Worcester, where Clark University s u p p o r t has been an integral part of the city’s revival. 55 for staff. A i m i n g The stuhigh is the dents spend school’s mantra. And college high-stakes English exam. much of their time on Clark’s preparation is its primary campus, using the gym, lifocus. For the teachers, this Overall, the school’s results brary, and other facilities as means going above and be- are remarkable. The percent- part of the college-going culyond for kids with significant ages of University Park stu- ture. dents passing the Advanced disadvantages. Placement exam is on par But Clark’s most powerful 32

influence on the school may be in the way its teachers teach. As Dan St. Louis says, “I was trained at Clark to take the kids that are here in our neighborhood and prepare them for college, whatever it takes. This is what we’re all about.” Part of the DNA Clark’s President David Angel is unapologetic that Clark’s 30-year journey to improve its section of Worcester began with self-interest. The transformation this effort has created within the institution was far less deliberate, but also of value, particularly to its brand. “What has happened is the notion of taking on really difficult problems in your own community, and the experience of actually moving the needle on that has become part of Clark’s DNA. It has actually come to define the mission of the university in a way that I think none of us anticipated.” For Jack Foley—who has, more than any individual, built Clark’s credibility with Worcester over the years— this means a commitment from trustees that every president from Dick Traina to David Angel to Angel’s successor will embrace the school’s ongoing work with the city. “It is now part of the job description,” he said, noting that

these kinds of campus/community partnerships often end when the president who started them leaves the post. The institution’s experience taking on real-world challenges motivated Angel to remake the foundation of Clark’s educational program. Its current framework, Liberal Education and Effective Practice, known as LEEP, seeks to graduate students that have highly-attuned skills in solving real-world problems. “So we’re not just developing liberal arts graduates in the classic sense, with great critical thinking and communication skills,” he said. “We’re putting knowledge into work in the world.” Part of that effort involved rethinking Clark’s scholarship and research work, which led to the new vision for the Mosakowski Institute. Established in 2009 through a $10 million endowment gift from Clark alumni William and Jane Mosakowski, the Institute supports research on major issues of social concern. After examining areas for which it could make a significant difference, Angel said they arrived at behavioral health of adolescents and young adults, particularly boys and young men. “In many ways, we’re interested in the hardest problems,” said Angel. “There is a large

group of young adults who never make it to college, who never complete high school, who end up in the criminal justice system or homeless, based, in large part, on their behavioral health. If we can figure out a way, a new paradigm, that addresses this issue, we will be making a major contribution.” Angel does not want the Institute to be thought of as a “think tank” where problems are addressed through examination or legislation. He envisions implementational work in one form or another where the measure of success will be changing young lives. A natural starting off point will be working within the neighborhood schools where the college already has a presence. “What we hope is that 10 years from now, behavioral health is thought of differently in our society, and its intersection with other challenges in society will be more broadly recognized,” he said. Angel has announced he will leave Clark in the spring of 2020 and says the Institute’s focus on behavioral health will be well underway by then. He is passionate about this initiative, but he is not worried that his departure will impact its success. In fact, he’s betting that the experiences Clark has had in changing its own backyard will be the foundation for bigger things to come.


Analysis: The Evolving Balance of Justice Title IX in the 2010s By Adam C. Powell, PhD

Adam C. Powell, President, Payer+Provider Syndicate


niversities have long enacted their own forms of justice under the auspices of the outside government. In the 16th Century, the University of Coimbra constructed an academic prison on its campus for the incarceration of students and faculty within its jurisdiction, in accordance with Portuguese law. While modern American universities do not operate prisons on their campuses, they nonetheless maintain inter-


nal grievance systems that operate somewhat differently from government-run courts. In addition to handling matters such as academic integrity violations, these systems are sometimes entrusted with addressing issues which would also be considered crimes outside the walls of the university, such as incidents of sexual assault.

criminal cases must meet the “beyond a reasonable doubt” standard. Plaintiffs must make a stronger case to satisfy the “beyond a reasonable doubt” standard than to satisfy the “preponderance of the evidence” standard. The configuration of a grievance system both determines what cases it will address and how it will make decisions.

There are a number of questions that every grievance system must address. Grievance systems must have a means of determining what is within their jurisdiction, and what is not, and must be addressed by a different system. For instance, some crimes are prosecuted locally, while others are prosecuted federally. Furthermore, they must determine their burden of proof. For example, in the United States, different standards of burden of proof are typically held for civil versus criminal cases. Civil cases must meet the “preponderance of the evidence” standard, while

One category of grievances that schools must address is grievances related to discrimination and other acts interfering with students’ education. Title IX, the Patsy T. Mink Equal Opportunity in Education Act, declares that, “No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving Federal financial assistance.” Title IX was originally passed in 1972, to fill gaps in the Civil Rights Act of 1964 pertaining to sex discrimination. While

it initially was operationalized to protect female rights in the context of employment and participation in sports, the law’s interpretations were extended during the 1990s, through a series of Supreme Court decisions which stated that part of universities’ Title IX obligations included protecting students from sexual harassment and sexual violence. In doing so, addressing such matters became within scope of the judiciary processes of American universities. Modifications to the scope of Title IX have often been made through “Dear Colleague” letters written by the U.S. Department of Education, which do not constitute changes in law, but do provide information on how an existing law will be interpreted and enforced going forward. Since these modifications in interpretation are made by appointed officials and do not constitute changes in the law, they can be quickly made to adjust policies so that they are in tune with the views of a presidential administration. As a result of the reliance on non-legislated letters to modify Title IX, it has been possible for both the Obama and Trump administrations to quickly enact changes to its implementation. The Obama Administration made a series of changes to Title IX that increased its scope and weighed school

grievance procedures more heavily towards plaintiffs. In 2010, a “Dear Colleague” letter outlined how Title IX would be interpreted as applying to multiple forms of harassment and bullying, including sexual harassment, gender-based harassment, and disability-based harassment. On a related note, a 2011 “Dear Colleague” letter was issued, specifying that when schools address matters involving sexual harassment, including sexual violence, they must use a “preponderance of the evidence” standard to evaluate complaints. The note further mentioned that at the time of writing, some schools were using a “clear and convincing” standard to evaluate cases, requiring there to be reasonable certainty that sexual harassment or violence occurred for the school to rule against the defendant. Finally, in 2016, a “Dear Colleague” letter was released, specifying that Title IX’s protections covered gender identity, and that transgender students must be allowed to use facilities and participate in activities consistent with their gender identities. Under the Trump Administra-

tion, Title IX has continued to evolve. While some Obamaera “Dear Colleague” letters have remained in effect, such as the guidance that charter schools have the same Federal civil rights obligations as non-charter schools, and the guidance for handling Ebola and measles outbreaks, a number of retractions have been made. Namely, the aforementioned 2011 “Dear Colleague” letter requiring a “preponderance of the evidence” burden of proof in grievance procedures, and the 2016 “Dear Colleague” letter covering gender identity, were retracted by the Department of Education. As a result of these changes, the Department of Education’s interpretation of Title IX reverted in these areas to what it was before the applicable “Dear Colleague” letters were issued. Taking a more formal approach than the use of “Dear Colleague” letters, on November 29, 2018, the Office of Civil Rights within the Department of Education entered a notice of proposed rulemaking into the Federal Register, with a public comment period extending until January 28, 2019. The proposed rules would “clarify and modify Title IX regulatory requirements


pertaining to the availability of remedies for violations, the effect of Constitutional protections, the designation of a coordinator to address sex discrimination issues, the dissemination of a nondiscrimination policy, the adoption of grievance procedures, and the process to claim a religious exemption,” in addition to specifying how covered schools must respond to sexual harassment. The rules proposal states the following intended aims: 1. Define the conduct constituting sexual harassment for Title IX purposes; 2. Specify the conditions that activate a recipient’s obligation to respond to allegations of sexual harassment and impose a general standard for the sufficiency of a recipient’s response; 3. Specify situations that require a recipient to initiate its grievance procedures; 4. Establish procedural safeguards that must be incorporated into a recipient’s grievance procedures to ensure a fair and reliable factual determination when a recipient investigates and adjudicates a sexual harassment complaint. 5. Clarify that in responding to any claim of sex discrimination under Title IX, recipients are not required 36

to deprive an individual of rights that would be otherwise guaranteed under the U.S. Constitution; 6. Prohibit the Department’s Office for Civil Rights from requiring a recipient to pay money damages as a remedy for a violation of any Title IX regulation; and 7. Eliminate the requirement that religious institutions submit a written statement to qualify for the Title IX religious exemption. The proposed rules specify that the definition of sexual harassment used for the purposes of Title IX shall be uniform and based upon the Supreme Court’s decisions in the Gebser and Davis cases. Furthermore, the rules establish safe harbors for schools to ensure that they are responding to formal complaints of sexual harassment in a Title IX-compliant fashion. The rules additionally work to define the jurisdiction of Title IX to incidents reported via a “formal complaint as to allegations of conduct with its [a school’s] educational program or activity.” The rules state, “nothing in the proposed regulations would prevent a recipient from initiating a student conduct proceeding or offering supportive measures to students who report sexual harassment that occurs outside the recipient’s education

program or activity,” while not requiring schools to initiating grievance procedures for incidents outside of their jurisdiction. Overall, the regulations proposed in 2018 narrow the obligations of schools, are protective of defendants, and increase the reporting requirements and burden of proof placed on plaintiffs. Means of academic discipline have been evolving for many years. While American universities do not operate independent prisons, as had once been done at the University of Coimbra, they do operate their own grievance systems, which are not uniform from campus to campus, but are nonetheless overseen by the Federal government. Protecting the civil rights of students on campus is a multigenerational project which has evolved alongside changes in outside society. In Greek mythology, the goddess of justice, Themis, is portrayed as holding a pair of scales. While justice always requires balancing the rights of defendants and plaintiffs, the scales that are used for determining the balance are recalibrated from time to time. Adam C. Powell, Ph.D., is President of Payer+Provider Syndicate. He holds a Doctorate and Master’s degree from the Wharton School of the University of Pennsylvania, where he studied Health Care Management and Economics.

A Decade of Growth in Recovery The National Collegiate Recovery Conference celebrates its 10th year By Marjorie Malpiede


his summer, students from across the country will convene at Boston University for a four-day conference on collegiate recovery – a phrase that describes the network of people and programs that support thousands of college students in recovery from substance use disorders. The National Collegiate Recovery Conference is in its 10th year and represents the strength and growth of the movement to make college a more welcoming and supportive experience for students in recovery. It is led and organized by the Association of Recovery in Higher Education, (ARHE), a non-profit organization that represents collegiate recovery programs on college campuses across the country. Tim Rabolt is its executive director. As a person in recovery who started his own program as an undergraduate, Rabolt is now in a position to expand the support system

to more and more students needing what was initially not available to him. “I got into recovery in high school,” he said. “When I went to college at George Washington University, I couldn’t find any recovery support, which was not unique,” he said, noting that eight years later, most schools still don’t have any kind of recovery programming. “It’s just not at the same level of support as other student groups like LGTB students, international students or veterans,” he said. Rabolt says that despite progress, people still have trouble talking about recovery and sobriety on campus, which makes it hard to target support.

well as their academic trajectory. “The goal in supporting students in recovery is so they don’t have to leave school in order to stay sober,” he said. Experts agree that collegiate recovery programs are a key part of a larger strategy to address substance use issues on campus. In a 2017 report by the Mary Christie Foundation, the Maryland School of Public Health and the Hazelden Betty Ford Foundation for Recovery Advocacy authors wrote, “Young people in recovery from substance use disorders should

Stigma is one of the challenges his association addresses as it works to build the campus by campus networks that can keep students in school and on track with their sobriety as


not have to choose between going to college and staying sober. Collegiate recovery programs eliminate the need for that difficult choice, helping students pursue their education and sustain their recovery simultaneously by creating an environment that is not abstinence-hostile and instead

validates and supports substance-free college life.” After starting GW’s first program, Rabolt stayed on for graduate school and interned in the Obama White House at the National Drug Control Policy office. He became involved in ARHE as a student board member.

After working as a consultant, he became part of its leadership team. Thanks to Rabolt and his colleagues, there are now over 200 schools that have student recovery programs ranging from 12-step meetings and sober housing to comprehensive recovery centers like that at Texas Tech. Of Texas Tech’s Center for Collegiate Recovery Communities, Rabolt says, “This is a massive program with over 120 students that is woven into the fabric of the school.” This year’s conference, which is in conjunction with the national conferences for the Association of Recovery Schools (ARS) and the Association of Alternative Peer Groups (AAPG), takes place from June 29th to July 2nd and will include nearly 1,000 attendees, most of whom are collegiate recovery staff, students in recovery, treatment providers, community members, families, and advocates. A special awards ceremony will take place at Fenway Park on Sunday, June 30th. For more information, go to


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


Government Report Finds High Rates of Food Insecurity Among College Students

A recent report from the Government Accountability Office (GAO), a nonpartisan congressional watchdog agency, cites widespread evidence of hunger on college campuses and urges officials to work with states and colleges to help more students get access to government food assistance. The GAO reviewed 31 studies of student access to food and found food insecurity rates ranged from 9% to more than 50%, with 22 studies estimating that more than 30% of students are food insecure. The data suggest that the problem is more prevalent among community college students than those at four-year colleges. According to the report, 57% of students from low-income backgrounds (nearly 2 million individuals) who were potentially eligible for the federal Supplemental Nutrition Assistance Program in 2016 did not receive the benefits. Confusion over eligibility often hinders access, as federal law bars many full-time college students from participating in the nutrition program. There are exceptions though, including parents with young children, participants in federal work-study programs, recipients of Temporary Assistance for Needy Families and students who work at least 20 hours a week. The report recommended the Agriculture Department’s Food and Nutrition Service clarify on its website who is eligible and share more information on state efforts to promote the program among college students. Many colleges have set up campus food pantries and taken other steps to combat hunger. The GAO found more than 650 colleges had pantries or were developing them.


According to a new report from the Jack Graduation Rates of Kent Cooke Foundation, Persistence: The Success of Students Who Transfer from Community College Community Colleges to Selective Four-Year Transfer Students Institutions, graduation rates of community-college transfers meet or exceed those of students who enroll at selective institutions as first-time freshman. Community-college transfers also graduate at higher rates than students who transfer from other four-year colleges, earning their degrees within two and a half years, on average. However, selective institutions are less likely to enroll community college students than other institutions. Community college students represent fewer than half of all transfer students at selective institutions and are underrepresented compared with students coming from high school or transferring from other four-year institutions.



The 2018 Center for Collegiate Mental Health (CCMH) Annual Report, which was released earlier this year, describes college students that seek mental health services at the college health center. The report found that college students seeking treatment continue to identify anxiety and depression as the most common concerns for seeking treatment. For the first time in five years, anxiety as assessed by clinicians did not increase in prevalence, whereas depression increased slightly again. Average rates of student self-reported anxiety and depression continue to increase while other areas of self-reported distress remain flat or are decreasing. Among students receiving mental health services, self-reported lifetime prevalence rates of “threat-to-self� characteristics (non-suicidal self-injury, 27.8%; serious suicidal ideation, 35.8%; and suicide attempts, 10.3%) increased for the eighth year in a row. However, only 8.2% of students seeking treatment report serious suicidality in the last month and clinicians report suicidality as a presenting concern for just under 10% of students. The rate of prior counseling (54.4%) demonstrated an upward trend for the third year in a row.

Center for Collegiate Mental Health Annual Report

This year, the report included a special section dedicated to examining the impact of counseling center policies on treatment outcomes. Using data from 118 college counseling centers in the United States, the researchers examined two common models of care: the access model, where students are assigned to counselors as soon as possible, even if the counselor had a full caseload, and the treatment model, in which students wait until therapists have an opening. Both models include immediate services for students who are suicidal. Researchers found that students at universities using a treatment model saw their therapist more often, waited fewer days between appointments, and had a greater reduction in symptoms. While an access model gets students into care for a first appointment sooner, counselors with too many patients often are unable to follow up with each of them regularly. Counseling centers are stretching to try to accommodate the growing demand for services and prioritizing rapid access to care, but this report highlights the negative impact these efforts can have.


According to a report published by Pell Grant Expansion to the Georgetown Law School’s Center on Poverty and Inequality and the Incarcerated Americans Would Vera Institute of Justice, expanding Create Economic Benefit access to Pell Grants for incarcerated people would create measurable economic benefits. since 1994,incarcerated Americans have been excluded from the federal Pell Grant program, the most widely used form of financial aid for low-income students. Among incarcerated people in federal and state prisons, 64% are academically eligible to enroll in a postsecondary education program. Access to postsecondary education in prison is limited; most existing programs are funded through the Second Chance Pell Experimental Sites Initiative, serving a maximum of 12,000 incarcerated students annually. The Vera Institute report estimates that if the ban were lifted, about 463,000 incarcerated people would be eligible for Pell Grants. The report also emphasizes that postsecondary ed-


ucation in prison increases employment and earnings for formerly incarcerated people. The report authors estimate that employment rates for incarcerated individuals participating in a postsecondary education program in prison will, on average, increase by nearly 10%. The report asserts that greater access to postsecondary education in prison will also reduce state prison spending. The economic benefits also extend beyond the incarcerated person; Businesses would have a larger pool of potential job applicants. According to the report, the ban on Pell Grants for people in prison has translated into fewer educational opportunities, contributing to the challenges they face on reentry and the cycle of poverty and recidivism.


The National Student Clearinghouse Research Center Signature Report found that, on averDegree Attainment Up; age, just 58% of students who started college Achievement Gaps Persist in the fall of 2012 had earned any degree six years later. These numbers are up overall, but experts say they’re still too low and vary widely depending on type of school. Four-year private schools usually graduate more students than their public counterparts, and two-year community colleges and for-profit four-year schools have average completion rates below 40%. The report showed increases in the overall completion rate for black and Hispanic students who started at four-year public institutions; the completion rate increased by 1.6 percentage points to 47.6% for black students and 1.7 percentage points to 57.4% for Hispanic students. These increases surpassed the growth observed for Asian and white students, whose completion rate grew approximately one percentage point from the fall 2011 to fall 2012 cohort. While these gains are promising, Asian and white students continue to have much higher completion rates than black and Hispanic students. A recent, separate report on race and ethnicity in higher education from the American Council on Education showed that while college-student populations are growing more diverse, achievement gaps persist among different racial groups. All students of color now make up more than 45% of the undergraduate population, compared with less than 30% two decades ago. Nearly one-third of graduate students are now people of color. Hispanic students have shown the most growth in college enrollment and completion. Black students represent a larger share of the student population than 20 years ago, and a larger share of the students who graduate. But the report showed that in addition to having the lowest six-year completion rate of any racial group, black students who began college in the fall of 2011 also owed 15% more than other students after graduation: an average of $34,010, compared with $29,669 for all students. One-third of black students accumulated more than $40,000 in debt after graduation, versus 18% of students over all. And after graduation, black graduates between the ages of 25 and 34 had lower salaries than other graduates of a similar age, and their unemployment rate was two-thirds higher, on average.


Profile for Mary Christie Quarterly

Mary Christie Quarterly Issue 13 | Spring 2019  

Mary Christie Quarterly Issue 13 | Spring 2019