Mary Christie Quarterly Issue 15 | Fall 2019 by Mary Christie Quarterly

Mary Christie Quarterly A publication of the Mary Christie Foundation

The Parentsâ&#x20AC;&#x2122; View of mental health on campus

p. 18

Lonely But Not Alone:

Two recent college graduates discuss meaningful connections p. 27 Issue 15 | Fall 2019

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

STAFF President Editor & Executive Director Program Manager Art and Layout Director Editorial Assistant

John P. Howe III Marjorie Malpiede Dana Humphrey Ashira Morris Anna Goodwin

ARTISTS Cover Illustration

Daniel Chang Christensen

Spot Illustrations

Lily Strelich

BOARD OF DIRECTORS Chair

John P. Howe, III

Vice Chair

Mary Jane England

Secretary

Marjorie Malpiede

Treasurer

Maryellen Pease

Member

Frederick Chicos

Member

Lisa Kelly Croswell

Member

Robert F. Meenan

Member

Zoe Ragouzeos

Editor’s Desk

all is an exhilarating time for college administrators as the new academic year brings with it the promise of strategies launched and initiatives underway. For college presidents, this is a particularly busy time which is why we appreciated that 30 such leaders spent a day and a half at Georgetown University where they spoke specifically about their students’ behavioral health. Hosted by Georgetown president, John J. DeGioia, the “Presidents’ Convening on College Student Behavioral Health” brought national experts together with higher ed leaders to explore the data and the experiences that are impacting student wellbeing. The convening was the beginning of a larger effort involving another meeting in the spring of 2020 with provosts and student affairs deans who will take their own deep dive into these issues. At the convening, we released our new survey on college parents’ perspectives on behavioral health on campus. This “snapshot” adds to a growing conversation about the role of an important stakeholder group in college student mental health. Issues to watch for include miscommunication about capabilities and information; and high levels of concern about the problem overall. We hope you enjoy these stories and more as you continue your own work to improve the health and wellbeing of our next generation leaders. Sincerely,

Marjorie Malpiede Editor

CONTE NTS 06 Meeting of the Minds

Georgetown President John J. DeGioia at the Presidents’ Convening on College Student Behavioral Health.

“I am not sure there is another sector that could meet for a conversation such as today’s and emerge with this sense of promise. The hope is that we can set the standard for improved wellbeing for many others.”

14 Interesting People Doing Important Work Tamar Mendelson, Executive Director of the Center for Adolescent Health at the Bloomberg School of Public Health at Johns Hopkins University on leading a team of champions for disconnected youth.

“I was working with people in extreme poverty who had serious trauma histories, and I became very interested in prevention: how to reach people in the community before they are experiencing significant suffering.”

CONTE NTS 06 Meeting of the Minds 14 Interesting People Doing Important Work 18 The Parentsâ&#x20AC;&#x2122; View 22 Voices from the Survey: Parent Roundtable 27 Young Voices: Lonely But Not Alone 30 Analysis: The Federal Government and Higher Education 33 Science Summary

Meeting of the Minds Dispatches from the Presidents’ Convening on College Student Behavioral Health By Marjorie Malpiede Photos By Leslie Kossoff, Georgetown University

n September 23 and 24, 2019, Georgetown University and the Mary Christie Foundation hosted “The Presidents’ Convening on College Student Behavioral Health” at Georgetown’s Riggs Library. From the early planning stages, Georgetown President John J. DeGioia had a goal for the unique forum that drew from his own long-standing inquiry into the topic – to gain a deeper understanding of the role of higher education in the behavioral health and wellbeing of students. For the Mary Christie Foundation, DeGioia’s perspective matched its own mission to apply a broader, public health lens to the examination of young adult behavioral health. “We have a great opportunity to go beyond the news clips to understand and respond to the distress of our students

in a way that sets a precedent for future generations,” said John P. Howe III, MD, President of the Mary Christie Foundation. “Moving from crisis to structure within a new reality” became the tag line for the dinner and forum where 30 college and university leaders came together to talk exclusively about student behavioral health, the improvement of which has become one of their highest priorities. The presidents who attended the event (see list) committed to sending leading members of their teams to a follow on convening on March 2 and 3, also at Georgetown. The events began with a dinner on the 23rd where sociologist Corey Keyes opened the door to new thinking when he presented his work on flourishing. Keyes teaches the “Sociology of Happiness”

course at Emory University and is well known for his theory that the absence of mental illness does not translate into the presence of mental health. According to Keyes, colleges and universities should strive for students to “flourish”— meaning to exhibit high levels of emotional, psychological and social well-being. He told the audience of leaders and experts that not flourishing can be as negative as having a mental illness. Keyes suggests that many of today’s students may suffer from a sort of “flatness” that does not include positive stimuli like sense of purpose, self-acceptance, and good relationships with others. His theory dictates that just as illness can be prevented and treated, wellbeing can be taught and nurtured.

Top left: Speakers on the Experts Panel. Top right: Georgetown President John DeGioia and Mary Christie Foundation President John P. Howe III listen to speakers at the convening. Center: The convening was hosted at Georgetownâ&#x20AC;&#x2122;s Riggs Library. Bottom Left: Presidents discuss the health issues on their campus. 7

Presidents in Attendance Irma Becerra, PhD

Marymount University

Connie Ledoux Book, PhD

Elon University

Sylvia Burwell

American University

Robert Caret, PhD

University System of Maryland

Shirley Collado, MA, PhD

Ithaca College

Grant H. Cornwell, PhD

Rollins College

John DeGioia, PhD

Georgetown University

Peter M. Donohue, MA, MDiv, OSA, PhD

Villanova University

Marion Fedrick, MPA

Albany State University

Julio Frenk, MD, PhD

University of Miami

Philip A. Glotzbach, PhD

Skidmore College

John P. Howe, III, MD

University of Texas at San Antonio

Robert E. Johnson PhD

University of Massachusetts Dartmouth

David Leebron, JD

Rice University

Thomas LeBlanc, PhD

George Washington University

Brian F. Linnane, MA, PhD

Loyola University Maryland

Ronald Mason, Jr., JD

University of the District of Columbia

Martin Meehan, JD

University of Massachusetts System

Jacqueline Moloney, EdD

University of Massachusetts Lowell

Katherine Newman, PhD

University of Massachusetts Boston

Troy Paino, JD, PhD

University of Mary Washington

Mary A. Papazian, PhD

San Jose State University

Jo Ann Rooney, JD, LLM, EdD

Loyola University

Barbara R. Snyder, JD

Case Western Reserve University

Gabrielle Starr, PhD

Pomona College

Kumble R. Subbaswamy, PhD

University of Massachusetts Amherst

Kent Syverud, JD

Syracuse University

David Wippman, MA, JD

Hamilton University

The Practitioners’ View Keyes’ thought-provoking remarks permeated the next day’s discussion as the presidents gathered again at Riggs Library for a series of expert panels and facilitated discussions. President DeGioia described the forum as an opportunity to synthesize what institutions are experiencing, what experts are advising, and what the data is showing us to create new approaches to student behavioral health. The audience first heard from practitioners who provided insights from their work in college counseling and psychological services (CAPS). Paul Barreira, M.D., Director of Harvard University Health Services and Zoe Ragouzeos, Ph.D., Assistant Vice President and Director of Counseling & Wellness at New York University had an on-stage discussion where they exchanged their own ex-

periences and took questions from the presidents. When asked about national prevalence showing one in three students screening positive for depression and anxiety (American Psychological Association), Ragouzeos confirmed that these were the top two reasons for which students report seeking counseling on her campus. Both doctors said that demand has escalated, causing capacity problems even at the best-resourced schools. But when asked about how to address the escalating rate of symptoms and rising demand for services, their answers suggested a more complex problem with a range of considerations that extend far beyond the counseling center. “In looking at students coming to CAPS last fall, it was clear so many of them were

really seeking meaningful, empathetic conversations that they couldn’t find elsewhere,” said Barreira. “But that’s not a good use of resources.” Ragouzeos suggested that wellness programming, together with training for campus community members, can broaden capacity and allow CAPS to serve patients who are at higher risk. In the Q and A portion of the discussion, Ragouzeos responded to a question about the role of faculty. “Faculty intervention can be on a wide spectrum from noticing a problem and referring it to the Counseling Service to approaching students of concern directly. Regardless, it starts with thinking about their students as whole people,” she said. “This means if they are giving bad news (grades), being prepared with information about

Left: President Shirley Collado. Right: Dr. Paul Barreira and Dr. Zoe Ragouzeous. 9

resources; or sharing their own struggles with wellness which can have a significant influence on students in ways that the mental health professionals on campus alone cannot.”

students of different ethnic backgrounds who may be the first in their families to go to college, which can result in enormous pressure.

Dr. John Howe suggested that to craft smarter responses to student mental health, higher education leaders need to better understand the cause of the distress.

College behavioral health involves a complex set of stakeholders with potentially contradictory responsibilities and constraints.

While the evidence is inconclusive in this regard, both experts pointed to legitimate anxieties that have become the norm in a post-9/11, postrecession world with a 24/7 news cycle. “The world in which students live is different than when we were in their shoes,” said Ragouzeos. “They feel guilty about tuition. They have lived through active shooter trainings. And they are preoccupied with curating their lives for social media.” Barreira delivered one of the most memorable quotes of the meeting when he said, “What we are seeing is a crisis of the human spirit; many of our young people are unsure of who they are and where they want to go. And if this is a crisis of the human spirit then the whole community has a responsibility.” Both Ragouzeos and Barreira cited additional stressors on international students and 10

Stakeholder Priorities

Gabrielle Starr, President of Pomona College, led the next session which involved working in groups to think through the unique concerns of the different stakeholders, both internal and external. Starr prompted the discussion by asking “Who do students expect to care for them and how?” The presidents and experts identified stakeholders – from students and faculty to trustees and staff members – and weighed their varying concerns. They then took a “deep dive” into the perspectives of one stakeholder group as the Mary Christie Foundation presented its survey report on college student parents’ perspectives on mental health on campus. (See The Parents’ View, p. 16) The Presidents’ Panel If not already evident by the attendance in the room, the critical role that college presidents play in improving their

student’s behavioral health was acknowledged throughout the day – from setting tone and policy to sitting down with counseling staff to understand their challenges. President DeGioia moderated a panel of three college presidents: Sylvia Burwell from American University, Kent Syverud from Syracuse University and Barbara R. Snyder from Case Western Reserve University, each of whom shared challenges and inroads that resonated with their peers. Syverud’s opening remark spoke volumes about the gravity of the issue and its place among presidents’ priorities. “I am so grateful for a whole day to talk about an issue so important to us all. It is like water in the desert,” he said. Burwell concurred as she explained the motivation for her recent article for Foreign Affairs on student health and wellbeing. “I am on the Council of Foreign Relations and was asked: ‘What is the one thing we do not know about higher ed that we need to know?’ and the first thing that came to mind for me was the importance of mental health on campus,” she said. The response she received from this community and

Georgetown President John DeGioia moderated a panel of three college presidents: Sylvia Burwell from American University, Kent Syverud from Syracuse University and Barbara R. Snyder from Case Western Reserve University.

others, she said, was indicative of the ubiquity of the concern for these issues across the country. In seeking examples of new strategies, DeGioia asked Syverud and Snyder about initiatives at their respective campuses. Each has recently implemented major health facility improvements that make it easier for students to access services. Case Western Reserve University’s new health education campus integrates all of the university’s health schools as well as CAPS and student health into one location, which Snyder says reflects the school’s larger approach to health and wellness on campus.

The new Barnes Center at Syracuse is one integrated building in which CAPS, health, wellness, and recreation services are intermingled. Syverud says its location, on the main quad on campus, is both practical and symbolic. When DeGioia asked the panel: “Are things different today?” Snyder was optimistic and reminded the audience that a greater focus on health and wellness was good for colleges and that college itself has shown to be a protective factor in young adult mental health. But she also said there is far more work to be done in this area – particularly around creating connections for students – and noted this is

a bigger challenge at larger schools. She cited a new student success initiative at Case Western Reserve where students are assigned a guide for both academic and co-curricular activities throughout their four years on campus. In closing, DeGioia asked of everyone, “How might higher ed institutions, both individually and together, advance our understanding of these issues?” In a timely pivot to the next panel, the president of the University of Miami, Julio Frenk, MD, PhD. said, “Universities are criticized for preaching change but not enacting change ourselves. We have an opportunity to apply the knowledge we produce through our scholarship and 11

insight and update our policies and practices simultaneously.” Turning Research into Practice As a world-renowned public health expert, Frenk was the appropriate lead conversant for a discussion on how to use data to address – and anticipate – student behavioral health issues. “Looking at this from a public health perspective, if we take populations and identify patterns, we can devise anticipatory solutions,” he said. The panel was made up of national experts in college student behavioral health whose data is cited and utilized frequently by colleges throughout the country: Sarah Ketchen Lipson, Ph.D., Ed.M., Assistant Professor, Health Law, Policy & Management, School of Public Health, Boston University and Associate Director of Healthy Minds Network; Nance Roy, Ed.D., Chief Clinical Officer, The JED Foundation; Amelia Arria, Ph.D., Professor, Department of Behavioral and Community Health, University of Maryland School of Public Health; and Ben Locke, Ph.D., Executive Director, Center for Collegiate Mental Health, Penn State University Ben Locke opened the discussion by describing his dual

roles at Penn State where he is both the director of counseling and psychological services and the director of the Center for Collegiate Mental Health (CCMH). The center combines counseling center data from 600 institutions, reaching 1.25 million students in higher education. Its sought-after reports provide counselors throughout the country population-level data that tell them what works and what doesn’t. “Treatment works,” he said, “when it is available.” Locke said that students seeking services at CAPS are not just the “walking wounded,” with many experiencing serious mental health concerns. Meeting the needs of these students is the focal point of the center’s work. Locke is currently working on a clinical load index that compares 500 institutions and their staffing levels as it relates to the number of students served. He says the index will eventually become a web-based tool that allows schools to understand what it would take to serve their number of students. Sarah Ketchen Lipson said her work at the Healthy Minds Network is complementary to Locke’s in that it provides colleges and universities with population-level

data, generated by students themselves. The Healthy Minds Survey is used at over 300 schools and by 300,000 students, both graduate and undergraduate, to provide insight into a range of issues, from prevalence and risk to sexual assault, substance use and help-seeking behavior. Lipson says the Network’s mission includes translating this data into useful tools for practitioners. As example, she cited the Healthy Minds’ return on investment (ROI) calculator that helps schools understand what mental health investments would equate to in terms of retained tuition. Amelia Arria, who is a national expert on untreated mental health and substance use among college students, talked about the importance of recognizing that academic issues can be rooted in mental health and related substance use. “If your bottom line is academic retention and success, then you should be concerned about drug use and mental health,” she told the presidents, citing data that show that 43% of frequent marijuana users are skipping class regularly making them academically disengaged. The foundation of Arria’s work is the College Life Study,

a large prospective study of more than 1,200 individuals who were originally assessed as first-year college students and followed up into adulthood. That study has made significant contributions to the scientific literature regarding the mental health needs of young adults and the risk factors and consequences of substance use among college students. In her opening statement, JED Foundation Chief Clinical Officer Nance Roy said, “Without a public health approach, in conjunction with your (the presidents’) support, it will not be possible to effect any longterm, systemic change.”

Much of the experts’ advice underscored the practitioners’ experience that identifying and understanding student need helps provide the right supports to the right students. “We need to hold up our end of the bargain,” said Locke. If they come, we must serve. But it is important to remember that distress is normal and not everyone requires professional help. This will help navigate the true need for CAPS.”

She spoke of the highly acclaimed JED Campus program, which provides an evidence-based framework that assesses schools’ policies, programs, services and systems and develops a strategic plan to improve campus climates to better support student mental health.

Roy agreed. “We need to create caring, compassionate communities on campus where everyone has a role to play and there is no wrong door for a student to walk through for support. We may avert a crisis if folks across campus reach out and provide support when a student may be just beginning to struggle. Of course we also need to ensure that everyone knows where the professional resources are to manage acute situations.

She said the foundation collaborates with the Healthy Minds Network to measure the impact of the JED Campus program on student outcomes.

In the Q and A portion of the discussion, the presidents were eager to learn more from the experts about a host of issues from evidence on environmental interventions

to how to comply with potentially unrealistic mandates. Arria reiterated that leadership is critical, as is more cohesion between academic affairs and student affairs. All agreed that continuing to bring experts together with policy and decision-makers will lead to progress. Onward and Upward The last hour of the day focused on preparing for the second convening to be held in March 2020 involving provosts and student affairs leads from these same institutions. Georgetown’s Vice President for Strategy, Eugenie Dieck, led an exercise where presidents reflected on their time at the convening, and identified topics they wanted their leaders to address at the March meetings. Dr. Howe and President DeGioia expressed their gratitude to the presidents for their engagement and participation amidst schedules filled with competing priorities. In his closing remarks, DeGioia said, “I am not sure there is another sector that could meet for a conversation such as today’s and emerge with this sense of promise. The hope is that we can set the standard for improved wellbeing for many others.”

Interesting People Doing Important Work By Marjorie Malpiede

Tamar Mendelson, PhD.

Photo by John Gillooly

he Center for Adolescent Health is a Prevention Research Center that is funded by the Centers for Disease Control and Prevention (CDC) and housed at the Bloomberg School of Public Health at Johns Hopkins University in Baltimore. Tamar Mendelson is its executive director.

The Center’s mission is to promote health equity and thriving for urban youth. It’s location within a school of public health in the heart of a large urban area is a reflection of its approach – and Mendelson’s vision. The Center draws on the city for both its research and its transla-

tion, doing trainings, working in the schools, and dealing directly with young people to promote youth thriving. “If we find something in our research, we don’t just publish in scientific journals,” she said. “We think about ways of getting the information into the community.”

As part of the Bloomberg American Health Initiative, the center is leading work on “disconnected youth” – a term that defines young people ages 16-24 who are disconnected from both school and employment. They are often called “opportunity youth,” as the promise of their engagement has significant societal benefits.

It is the promise of reaching youth at risk for disconnection early on that Mendelson finds most hopeful about the Center’s work – that, and the focus on the structural factors that lead to the large disparities in who becomes disconnected.

Mendelson is a strong proponent of viewing the issue of youth disconnection, and the significant disparities associated with it, as a public health problem, meriting large-scale, population-based strategies focused on prevention as well as reengagement.

In 2016, nearly 12% of teenagers and young adults aged 16 -24 in the United States were both out of school and out of work. According to a recent report, authored by Mendelson and her colleague, Kristin Mmari, these young people have a disproportionate share of problems as they age. These include chronic unemployment, poverty, mental health disorders, criminal behaviors, incarceration, poor health, and early mortality. (Opportunity Youth: Insights and Opportunities for a Public Health Approach to Reengage Disconnected Teenagers and Young Adults)

Mendelson says she came to a public health perspective only after having been trained as a clinical psychologist where her work focused on treatment rather than prevention. It was when she was interning at a public hospital in San Francisco that she began to learn about the social determinants of mental health.

Simmering Under the Surface

17.2% of Black, and 25.8% of American Indian/Alaska Native young people. While reengagement programs – many focusing on linkages to skills training – are a critical part of the solution, Mendelson takes a broader view. “Most disconnected youth grew up in impoverished households and are the victims of schools, child welfare programs, and other systems that failed to meet their needs. Their poor emotional and behavioral health outcomes are therefore not surprising.” Mendelson and her team advocate for using the tools of public health – data, funding, population engagement and evaluation – to augment the work that is being done in reengagement. She also believes that early “engagement” with caring adults can make an enormous difference. “What we know more generally as psychologists, and as people who are invested in positive youth development, is that relationships with caring adults are a huge part of being connected,” she said.

The disparities within this “I was working with people populations are striking. Acin extreme poverty who had cording to the report, youth serious trauma histories, and disconnection occurred in I became very interested in 6.6% of Asian American, 9.7% prevention: how to reach of White, 13.7% of Latino, people in the community before they are experi“If we find something in our research, we don’t just encing signif- publish in scientific journals. We think about ways icant sufferof getting the information into the community.” ing.”

Putting it to Work Mendelson’s team works directly in Baltimore City, 15

learning from youth and community partners, and then scaling the knowledge throughout the country. Programs include school-based interventions that promote positive mental health in young people. One trauma-informed initiative, called Project POWER (Promoting Options for Wellness and Emotion Regulation), works with 8th graders on mindfulness, coping abilities and resiliency to ensure a smoother transition into high school. It is clear that Mendelson is particularly excited about the YAB – a Youth Advisory Board of 25 or so young people, one member just ten years old, who hold trust in the community and help the center focus its work. One of their latest ideas was the “Granny Project.” To address widespread food insecurity among young people, the YAB interviewed grandmothers in the community (grandfathers, too) in order to teach younger people how to cook and prepare larger meals for block parties and community events. “It is phenomenal to see the resilience, talent and joy that these young people bring,” said Mendelson. “Many have made it through a lot of hardship, and they have so much to offer.” Opportunity indeed.

Alan Schlechter, MD

ive minutes with Alan Schlechter and you can see why students at NYU line up to take his class. He is funny, irreverent and not afraid of showing his vulnerability. Schlechter is a child psychiatrist at Bellevue Hospital in New York City and an associate professor at NYU’s Langone Medical Center. With his friend and collaborator, Dan Lerner, he teaches the “The Science of Happiness,” class -- the most popular elective at the school. Since 2012, Schlechter and Lerner have taught tens of thousands of NYU students that focusing on their wellbeing, including positive emotions, will not only make them happier, it will make them more successful, whatever their definition. Their curriculum became the foundation for the book they co-authored called U Thrive: How to Succeed in College (and Life.) “Let’s face it, college is stressful and we’re never going to make it not stressful,” he said. “But we can make it easier for students by increasing their wellbeing.”

Schlechter started the course after a tragic year at NYU where several students died by suicide. In the aftermath, the school launched a number of mental health initiatives including a new area of studycalled the child and adolescent mental health studies (CAMS), meant to increase people’s awareness of mental illness and mental wellbeing. As part of CAMS, “Happiness” examines the state of college-student mental health and wellness on a personal and systems level. But what started as an antidote of sorts for poor mental health has become a forum for joy, meaning and self-expression. The key to the professors’ success in this area may well be their delivery. “We are constantly trying to connect with students and that means submerging serious topics with material that will actually grip them,” Schlechter said. “If we said, ‘let’s talk about anxiety,’ most of our students would be like ‘No thanks, that makes me uncomfortable.’ If we called the course ‘The Science of Depression,’ no one is

taking the class.” Sharing his story Schechter says the Science of Happiness is the course he wished he had taken in college.

challenges. This includes learning about cognitive behavioral therapy – one of the few evidence-based strategies that can reduce the course of depression and anxiety. About 65 to 70% of the class is about raising students’ own level of wellbeing. For the high-performing students at NYU, this means teaching them that there are ways of doing better without studying more. Again, Schlechter draws from his own experience.

Schlechter believes that, as a success-obsessed country, we have the equation all wrong. Happiness does not come from success but success can come from happiness, he said.

Like sociologist Corey Keyes and other experts he admires, Schlechter laments that mental illness is rarely viewed from a prevention perspective as physical health is. He believes that like lowering your blood pressure to Schlechter received therapy protect against stroke, focusbut terminated it as soon as ing on the posihe was tive and purposefeeling can vaccinate better. “Let’s face it, college is stressful and we’re never ful against worsenIt wasn’t going to make it not stressful. But we can make it ing anxiety and until easier for students by increasing their wellbeing.” depression. he was 27 that “U Thrive” is he said Schlechter and he re“I didn’t go out much in colLerner’s effort to scale what ally took care of his mental lege,” he said. “Partly because they teach and what they’ve health. Confronting issues of my social anxiety and learned to more students early on is a strategy he partly because I thought I throughout the country. Used purports in his lectures, as is would have less stress if I was at many colleges as part of understanding that wellness ahead with my work. So I’d orientation, the book prois a life-long journey, not an go to the library and watch vides practical advice on evend it itself. my closest friend go off to a erything from finding meanparty, literally through the ing in careers to nutrition, “I am now 43 years old and glass, and think ‘Ha, I’m getmindfulness, and sleep. Their I’m still working on myself.” ting ahead.’ Not true.” criteria: If the material is not In their class, Schlechter engaging to undergraduates, Schlechter said his best and Lerner use a definition they don’t include it. friend graduated with some of wellbeing called PERMA of the highest honors in the Schlechter said, “I used to – positive emotions, engageschool because he made postalk about cholesterol in the ment, relationship, meaning itive relationships and emoclass and Dan was like, ‘What and accomplishments to tions a priority. are you doing? They don’t teach students how to betcare about cholesterol.’ We ter care for their wellbeing. “Meanwhile, I’d go home don’t talk about cholesterol Schlechter says that about every night and be like ‘Why anymore. Even though my 30 – 35% of the class is about don’t I have a girlfriend?’” cholesterol is really importovercoming mental health ant to me, I’m not bringing it up.” “I come from a long line of anxious people and my junior year in college my anxiety surfaced in a way that put a full halt on my ability to function,” he said.

The Parents’ View

New survey of parents on college student mental health By Marjorie Malpiede

tewarding the emotional and behavioral health of America’s college students involves a number of stakeholders, including their parents. Parents, particularly those of students at four-year, residential colleges and universities, more often than not participate in their children’s admission choices, pay their tuition, and help them navigate what is often their first time away from home. Like it or not, many of today’s college student parents are highly engaged with their students while they are away at school, which can make them important partners in supporting student mental health. Yet despite their outsize role, parents have been an under-examined constituent group in this area, leading to misinformation, misun-

derstand and perhaps, lost opportunity. To get a better understanding of the attitudes, awareness and expectations of college student parents as it relates to mental health on their students’ campuses, the Mary Christie Foundation, with funding from Anthem Blue Cross and Blue Shield, commissioned a poll of over 1,000 parents of students between the ages of 18 -25 at residential colleges throughout the country. “Supporting Student Mental Health: Parents’ Perspectives,” provides a glimpse into how much parents know, and want to know, about their students’ mental health while at college; how aware they are of their campus’ mental health resources; and how concerned they are about the issue overall. “As we seek to more fully

engage the challenges facing our young people and better support their emotional and behavioral health, understanding the perspective of parents is a critical factor,” said Georgetown President John J. DeGioia. “Our students are with us at a unique moment in their lives and we recognize there is a distinctive role for colleges and universities to continue and contribute to this important work, strengthening the pool of resources available, and building campus communities that support their ability to flourish.” The report was released following a national convening, co-hosted by the Mary Christie Foundation and Georgetown University, where 30 college and university presidents came together to engage with topics and policies related to student behavioral health.

Concern and an Unclear Picture The nationally representative survey, conducted by the MassINC Polling Group, found that engaged parents have significant levels of concern but may have misconceptions about key factors in college student mental health regarding disclosure, accountability, and campus resources. 77% of parents called mental health a very or somewhat serious problem on college campuses and a majority said that access to mental health services was an important factor in the college selection process. Over half of parents (52%) say that access to mental health resources were important when choosing a school, with 24% saying it was very important. This is a particular

priority for parents of children with mental health conditions, 70% of whom say access to mental health resources was important – 37% saying “very important.” Like their students, college student parents are increasingly more diverse with differing perspectives that were reflected in the variances within the report. Parents of color, parents of students with a recognized diagnosis and parents of students from lower income levels have unique concerns that translate into valuable knowledge for those on campus who seek to support all of our students. The survey found that 50 percent of parents with children who have a mental health condition rate their child’s mental health as more concerning than any other category

listed including their GPA, how much they enjoyed school and alcohol use on campus. Concern is also as high or higher among parents of students of color, though their worries about mental health are rivaled by their concern about race relations on campus. For parents of Black students, 67% say they see mental health as a problem while 69% say they are very or somewhat concerned about race relations on campus. Parents of all students frequently are under the impression that a robust set of resources are already in place on college campuses. The reality is many schools are engaging with a complex set of challenges, including issues of funding and staffing, to adequately address the full range of student mental health concerns. “Schools vary significantly in the array and volume of mental health services they are able to provide to 20

students yet often parents assume that their students will receive the help they need,” said Dr. John Howe, President of the Mary Christie Foundation. “This is often not the case, certainly when it comes to accessing counseling services on campus.” Close Ties and High Expectations Parents describe close relationships with their students with a significant majority of them saying they know more or the same about their child’s mental health since they went to college, indicating they are on top of these concerns even after their children have left home. 87% say they know at least a fair amount about their children’s mental health since starting school. On average, 70% of parents polled agreed that when it

comes to mental health, it is important to be informed of their child’s wellbeing – of those with children with a current mental health condition, 95% believe so. Only 23% of parents say that it is important for students to have their privacy protected. Variances exist by school size, with 72% of parents with students attending small schools wanting information about their student’s mental health in all cases – compared to 32% of parents whose children attend the largest schools. As the report points out, these expectations do not match up with the current law. The Family Educational Rights and Privacy Act (FERPA) prohibits schools from revealing confidential information about students, except in certain cases, making navigating how and when

“In many cases, parents can be instrumental partners in their students’ mental health but our first responsibility is to the students in distress and we must abide by their choices.” – Dr. Zoe Ragouzeous, Executive Director, Counseling and Wellness Services at New York University. to involve parents difficult for administrators. Students have an option to waive these restrictions and many schools encourage parents to talk to their students about this option. “The college years present a challenging developmental stage for both students and parents,” said Dr. Zoe Ragouzeous, Executive Director of the Counseling and Wellness Services at New York University. “In many cases, parents can be instrumental partners in their student’s mental health but our first responsibility is to the students in distress and we must abide by their choices.”

The poll also reflects ambiguity about who is responsible for monitoring and reporting mental health issues. According to the report, 68% of parents say they are most responsible for monitoring and reporting their student’s mental health, indicating they see themselves as the first line of defense. But around 1/3 of parents expect that other groups of university employees are taking on some level of responsibility for student mental health, including faculty. “What this poll tells us is that a substantial portion of parents see responsibility extending to campus staff in a way that carries the potential

to cause misunderstanding or conflict,” said Steve Koczela, author of the report and president of the MassINC Polling Group. Communication and Clarity

“Supporting Student Mental Health: Parents’ Perspectives” gives us a snapshot of an increasingly important set of stakeholders. Some key takeaways for colleges and universities include providing ample, clear communication between school and home about mental health services and access to them; making sure parents and students are aware of the laws and opportunities around health care disclosure; and engaging more campus community members in the school’s effort to support student behavioral health and wellbeing.

Voices from the Survey

After we received the results of our parents’ survey on student mental health, we wanted to talk to parents further about their concerns and their expectations. Using videoconference software, we gathered five parents of current college students — diverse by geography, ethnicity, and gender orientation — in a virtual roundtable discussion, for a Brady Bunch-like block of six squares onscreen. What we found gave voices (and faces) to the survey findings: Parents are very concerned about mental health on campus — not just for their own students, but the ones their children will befriend, study with, and live with. And while the parents have opinions about the support structures that should be in place, they’re uncertain about the way they’re put in practice, campus by campus. NB: The number of students who say they’ve experience a mental health issue in college has risen dramatically in recent years, and schools are struggling to keep up

with the requests for counseling services. Where is this coming from, in your opinion? What’s different and more psychologically difficult about being a college student today than when we were in school? JN (mother of three, including twin first-year daughters): Social media, for one. Students with Twitter and Instagram and Snapchat can see what everyone else is doing and they have tremendous FOMO (Fear Of Missing Out). Everyone else seems to be having so much fun, so many friends, the picture-perfect adjustment. LT (mother of three, including twin first-year boys): There’s reality, and then there’s Instagram reality, and they can’t always tell the difference. JN: Right. And they have trouble doing the steps it takes to build relationships from scratch. They’re more used to texting than real-life communicating, so the things they need to do to meet peo-

ple and make new friends on campus are out of their comfort zone. Sticking your neck out, making small talk, sitting down and eating with people you don’t know very well. It’s more comfortable to have your headphones on or your face in your screen if you’re alone around campus. But that’s exactly the opposite of what you need to be doing. KC (mother of three, including a college senior daughter and sophomore son): I read an article by a child psychologist recently that said something to the effect of, Today’s kids are ill-equipped with the skills they need to interact as social beings in the world. They’ve grown up with their time organized for them and playdates arranged and activities scheduled. And in addition to not being used to unscheduled time, they’re not as comfortable making conversation to meet people and asking, “How are you?” or “Where are you from?” – the things we used to call icebreakers. When we were little kids, [our gener-

ation] worked out problems with friends in the neighborhood by standing in the street and hashing it out. That’s how you figure out the rules of engagement, and how to function in groups when other people aren’t telling you exactly what to do all the time. NB (interviewer and mother of five, including a first-year son): And for a lot of kids, that kind of play seems old-school and drama-filled, very “Sandlot” or “Little Rascals.” With unsupervised kids getting lost or into trouble all the time. AH (mother of three, including a first-year daughter, and twin boys who are seniors in

high school): Now there’s just a different kind of trouble. Being a teen is just so hard with technology. Friend dynamics are different, dating is different, the bullying is different, the isolation is more obvious… It’s no wonder they are stressed and anxious and depressed.

LT: It all affects their mental health! I’m just glad this is being talked about now and taken seriously and addressed by schools. We have what’s practically a suicide epidemic among young people, and

we have to find better ways to support them. Whether they’re having trouble making friends, or the environment feels foreign and family feels far away, or the population seems really different. AH: And it can be really different. Schools today are much more diverse, and by design. There’s an intentionality about diversity that’s a very good thing. But it can also make it a bit harder, walking into a room where on the surface it might look like you have nothing in common with people, or there’s a cultural difference or language barrier. It takes more work and effort to get past that and to a place where you find the things you have in common. Which 23

is good, but it’s also one more hurdle and one more step out of your comfort zone, when we’re talking about kids who might already be lacking in that spontaneous social aptitude. NB: Who is watching out for them, and what’s the first line of defense for students when they are falling off-kilter? Did the school lay that out for you as parents during orientation? AH: I honestly have no idea. My daughter just started as a freshman, and we had about 10 assigned minutes to practically drop her off curbside. LT: My twin boys are freshmen and the school was very good about explaining campus resources from the first visit, the channels of help open to students. Our ears were sort of open for it from the beginning, because both boys are gay and one has battled anorexia. They’ve found the community to be very welcoming, and they’re finding their people. They don’t have trouble making

friends. In fact, they often end up being a resource for other people because they know where to get answers and support. And with a mother who’s a GYN, they get all kinds of questions from women friends looking for information they don’t want to ask the RA. KC: The classic model was always Resident Advisors as the first line of a support system in the dorms keeping an eye on things and being there to talk. But when you’re talking about recognizing when students are approaching crisis mode, that’s a lot of pressure on student RAs. And honestly, on roommates, too. JN: I think it should be a multi-tiered approach — not every situation means a student needs to be marched down for counseling. A peerto-peer approach to talking things out can go a long way for things like academic

stress and social problems. There are a lot of peer support networks out there. And resident advisors, and head residents. There are people moving up in age and responsibility who are either on site or on call in the dorms. One of my twin girls is a freshman, and they had a very thorough overview for students and parents about the support network in place. My other twin is at a big city school [laughs], so yeah, not a lot of handholding there. KK (mother of three, including a first-year daughter): I’m a dean of student life at a very small arts college in Philadelphia, and I can tell you there are a lot of times when it’s a faculty member seeing a student is in trouble. Someone who’s trying to be independent but is falling behind, and either is afraid to tell anyone or doesn’t know what to do, goes to their

teacher and says, “I couldn’t get this assignment done because there’s so much and I don’t understand and I’m really overwhelmed.” And the teacher may or may not be equipped to help them psychologically, so we tell the faculty to urge the student to come in to the counseling center. But this also depends on the student being willing and able to speak up to the professor. KC: My son has a friend at school in Ohio who just stopped going to classes for a month, it was all too much for him. And no one noticed. How would an RA notice that? NB: In an ideal world, the parents would be the ones noticing that something was off, and realizing the pressure was building up. For students, where’s the pressure coming from? Themselves, wanting to be perfect? LT: From parents! KK: I have better communication with my daughter now

that she’s across the country than I did when she was in high school. JN: Agreed. AH: We’re not always talking all the time, but we’re texting at least every day. That’s the upside of technology, it’s like a constant open conversation. It’s not like when we were in college, and I’d call my parents once a week. JN: On Sunday nights, because the rates were cheaper. AH: From the hall phone! [laughter from all six faces on screen] KK: But back to where’s the pressure coming from? It’s because the stakes feel higher for everything. They worked so hard to get in, and it costs so much, and an undergraduate degree doesn’t even get you very far these days. So you’re looking at more grades to get into more schools for more money, crazy amounts of money, and loans. LT: They don’t want to disappoint the parents or look embarrassed to other people at

home. So they might not want to admit it’s not going well. They might believe they can work it out in the end before it gets to be a big problem, and then get themselves into a hole, but they don’t want anyone to know. NB: And you do hear that issue, too, the issue of privacy versus a parent’s right to know. There’s the parent frustration that they didn’t know their student was in so much distress until there’s a serious cry for help. KK: But your hands are tied as an institution if the student is a legal adult. I had a situation where my friend’s daughter was attending my school. She’d had a lot of problems in the past, and my friend asked me to keep an eye on her. Well, I had some suspicions that things weren’t going well, but she kept saying everything was fine whenever I checked in. How much can you do in that situation? If they don’t want to confide, and don’t want to seek help, there’s only so

much you can do when someone is over 18. She ended up leaving school. LT: There are confidentiality issues with HIPPA. KC: And it’s both with the school, and medically with the state, too. But there are forms you can sign with the school and your student, giving consent under certain circumstances. It differs by school, and there are steps with each state, but they do exist. JN: I think if the parents suspect their child isn’t ready for school, then they need to think hard about whether to send them yet. It doesn’t help anyone if the student isn’t emotionally equipped or academically prepared to be away at school. A gap year can be a beautiful thing. KK: But there’s this pressure to know where you’re going, know what you’re doing, have your perfect future all lined up. At my kids’ school they have “commitment day” March 1, and everyone wears the sweatshirt of the college 26

they’ve decided on. But that’s so early and creates anxiety for kids who aren’t sure, or still have too many balls in the air. For my daughter, the financial pieces hadn’t fallen into place yet. Her biological father is African, so she had some potentially good opportunities, but we didn’t know yet what was going to come through. She wanted to go to school in L.A. where she’d find more diversity — all my kids get labeled the “beautiful exotics” [air quotes], and she just wanted to go to school where there’d be more people who looked like her. So she’s got that on her mind, plus the financial piece, with a mother saying, ‘Come to my college,’ and there’s a lot of pressure about making the right choice. NB: At least transferring has become more common if they feel like they didn’t make the right choice. KC: My daughter was dead set on going to a city school. We’d be driving through some beautiful countryside on the way to a city, and

there’s a bucolic campus right there and she was like — [turns head away from looking into camera] Nope, no. So she went to a big city school, which was great because I was on the medical faculty there. But she hated it. When she came home for the holidays she’d lined up all the transcripts she had to have sent, and these places she wanted to see, all the things she was supposed to do the first time around. She ended up at small New England school and she loves it, and she figured it all out herself. What started as a mistake turned into a huge growth experience. KK: But is it really a mistake? Isn’t picking themselves up what we want them to learn? They did what we’re always wanting them to do — make a choice, learn from it, change course, find a better situation. When it’s looked at as a mistake, it adds to the unhappiness. AH: Hear, hear.

Young Voices: Lonely but Not Alone Thoughts on creating meaningful connections from two recent college graduates By Rory Kelly and Jennifer Melcher

“

Hey! Haven’t seen you in forever!”

“I know! Good to see you! How’ve you been?” “Good! Really stressed, but good! You?” “Alright. We should get a meal. Do you have time this week?” “Um, no, I’m super swamped with midterms and a lecture event I’m organizing. Maybe like, in two weeks, well, that’s the week of the lecture, haha, maybe like three weeks from now? I’m so sorry, I’m the worst.” “No! You are so busy and doing really important things like that lecture. Is there a Facebook event for it?” “Not yet, on my to do list that I never finish! But

there will be one soon.” “Cool, I’ll be on the lookout for it. Well, good luck with everything.” “Thanks, yeah, you, too. Bye!” *** Sound familiar? You hear it every day. There’s a roar of conversation in every dining hall and a chorus of whispers even in the silent sections of the library, linking us on the surface but failing to connect us in authentic and meaningful ways. Living in close quarters with hundreds. Sitting next to people in classes, in the library, at the dining hall, on the spin bike. More connected than ever-Snapchat, Instagram, Outlook email, Find My Friends, Facebook.

And yet, the irony is that amidst all of this activity, there is a loneliness epidemic on college campuses. Students crave close, dependable friendships, but despite the constant contact with others, both digitally and in-person, they are not finding them. Real friendships take time and energy, two resources that are hard to spare when you’re completing assignments for four or five classes, working a part time job, making summer plans, keeping up with sports and extracurriculars, and trying to take care of yourself all at the same time. Small exchanges are cornered into the time it takes to pass someone between classes, while standing in the cafeteria line, or in the few moments before a professor begins class. A twenty-minute lunch in a crowded cafeteria does not feel like the right 27

when one is not used to it is like walking barefoot after a long winter: the thawing ground may still sting and the sensitive soft skin feels the sharp edges of a small stone in a gravel drive or the quick tickle of a young blade of grass. As one continues to accept vulnerability, the skin toughens just as it did when you went barefoot all summer.

Photo by John Gillooly

Jennifer Melcher and Rory Kelly are recent graduates of Middlebury College. time to broach a serious topic, but sometimes that’s the only free time to do so. But it’s not just time that keeps us from truly connecting. Meaningful conversations require a level of vulnerability and a willingness to talk about uncomfortable topics, like feeling alone. It’s hard to talk about loneliness when you’re surrounded by people and resources and it seems like you shouldn’t feel lonely. But when nobody talks about it, people often think that they’re going through it alone. 28

They are not. 62.8% of college students report feeling lonely within the last 12 months, and 27.1% reported loneliness in the past two weeks (American College Health Association-- National College Health Assessment Spring 2018 Reference). Students, administrators, faculty, and staff at colleges and universities struggle to bridge this loneliness gap despite the wealth of potential allies and tools available. Leaning into vulnerability could be a step in the right direction. Being vulnerable

Perhaps even more important, one’s willingness to be open creates space for others to be vulnerable and that’s when real connections can take root. Perhaps a cultural shift driven by vulnerability could build bridges to connect students’ islands of loneliness and to do so, we must be intentional. Putting vulnerability into action means breaking through simple small talk and digging deeper. Asking someone how their weekend was can feel like an easy way to be nice and courteous, but if that is where the conversation ends, no meaningful connection is being made. Authentic conversations requires that one enter the conversation with an “open up, follow up” approach. Even in small moments after class or in the lunch line you can start a conversation to get to know someone on a deeper level. The student takes responsibility to share while also taking

responsibility to circle back with their friend about one of their interests, difficulties, or feelings. This may mean following-up on something they’ve said in the past, or asking deeper questions about how school is going, how their family is doing, or about a detail like a book you noticed they were reading. Breaking out of “did you have a good weekend?” is a good first step on the path of establishing a deeper connection with someone. While your phone may be frequently buzzing with

texts, snaps, DMs, and other conversations, it is okay to let those notifications go unread for a little while to prioritize face-to-face interactions. Social media can be a great place to start conversations to be continued face-to-face. Moving away from screens and back to fully engaged real conversation can make you feel more heard and more valued and deepen the quality of the conversation. Keep in mind that unlike on social media, there is no character limit to expressing yourself through speech.

Like any new activity, giving thought and care to each interaction you have is taxing at first. Start slow. Commit to finding a meaningful connection with one person. While you may always hear a buzz of empty conversations in the dining hall, creating your meaningful connections will help to dull the noise and keep loneliness at bay. Rory Kelly and Jennifer Melcher are recent graduates of Middlebury College and current employees of Christie Campus Health.

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Analysis: The Federal Government & Higher Education From loco parentis to the Higher Education Mental Health Act By Adam C. Powell, PhD increasing rates of mental illness experienced by students in higher education. This is a consequence of both efforts by higher education to be more accommodating of students facing a wider range of challenges, and by the increasing prevalence of mental illness among young adults. Thus, there are growing mental health needs that colleges and universities potentially must address.

In loco parentis

Concurrently, there is evidence that there have been

After the Civil Rights Movement, colleges and universi-

he role of the college or university in ensuring the mental health of its students is a matter of perennial debate. The issue has become more complex in recent years, as the student population has become less tied to the campus environment. A single university may maintain campuses in multiple states and nations, and serve both campus-based and online students simultaneously locally and internationally.

As the teaching environment evolves, the legal expectations of colleges and universities in maintaining the mental health of their students is being transformed as well. In the early 20th Century, colleges and universities were expected to act in loco parentis â&#x20AC;&#x201C; to act in the manner that they perceived to be in the best interest of students, but were not held responsible for student injuries.

ties were no longer expected to act in loco parentis, but were held accountable for injuries that students experienced. The situation has grown quite complex, as colleges and universities have simultaneous obligations to protect the privacy and civil liberties of their students, while also protecting students from experiencing harm. FERPA Students have legal protections under the Family Educational Rights and Privacy Act (FERPA), which impacts the way information may be shared about a studentâ&#x20AC;&#x2122;s mental health. FERPA allows for information about a specific to be shared between faculty, staff, and administrators, if they are concerned about the welfare of the student or the community. However, there are confidentiality obligations that limit communications between professionals within the insti-

tution and people outside the institution (such as parents), unless consent has been received from the student. The extent to which information may be shared is also governed by the Health Insurance Portability and Accountability Act (HIPAA) in situations in which FERPA does not apply. The ADA Additional protections are afforded to students experiencing mental illnesses through the Americans with Disabilities Act (ADA). Under the ADA, individuals having difficulty completing one or more life activities due to a disability, such as a mental illness, are entitled to academic accommodations and reasonable modifications of institutional policies. While colleges and universities are required to accommodate students with disabilities, they are not required to make changes that would alter their operations, waive essential requirements, or cause heavy financial burden. Thus, colleges and universities are required to make a reasonable effort to ensure that they offer a welcoming environment to

students with disabilities – both mental and physical. Despite the degree of protection that students already have at colleges and universities, tragedies persist, and there are definite opportunities for further improvement. The solutions to the issues that students face are still a work in progress. Proposed Legislation: Higher Education Mental Health Act In order to gain a better understanding of the issue and potential solutions, the Higher Education Mental Health Act was introduced by Senator Robert Casey and Representative David Trone. The Act (S. 1204 / H.R. 3489) highlights the fact that over three-quarters of mental illnesses begin before the age of 24, that over a quarter of students between the ages of 18 to 24 report having a mental health concern, and that over half of students of those ages report having a severe psychological problem. In order to address these issues, the Act has two aims: 1. “To ensure States and institutions of higher education are provided with

accurate information on the mental health concerns facing students. 2. To provide detailed recommendations that institutions of higher education, States, and the Federal Government can take to improve the mental health services available to students and properly treat the rising number of students with mental health issues.” The Act works to achieve its aims by having the Secretary of Education form the Advisory Commission on Serving and Supporting Students with Mental Health Disabilities in Institutions of Higher Education to study four areas: A. “the services available to students with mental health disabilities in institutions of higher education and their effectiveness in supporting these students; B. the impact of policies and procedures that help or hinder the goal of providing equal opportunity for students with mental health disabilities, such as reasonable accommodation policies, mandatory and voluntary leave

policies, and disciplinary policies; C. the use of protected health information of students with mental health disabilities by institutions of higher education, including the extent to which campus-based mental health providers share this information with college or university officials without student consent; and D. the impact of providing mental health services on a studentâ&#x20AC;&#x2122;s academic performance, well-being, and ability to complete college.â&#x20AC;? Once the areas have been studied, the Commission is to draw conclusions on the challenges that students with mental health disabilities are facing within colleges and universities, and to pose a series of recommendations for improving the education, retention, and graduation of this group of students, to ensure that they have access to education equal to their 32

non-disabled peers. The Commission would terminate after the submission of its final report. In addition to requiring the Commission to write a report covering these topics, the Act additionally requires the Comptroller General of the Government Accountability Office to submit a report to Congress covering a similar set of topics. The Higher Education Mental Health Act has received widespread support from college and university leaders; it has the potential to provide useful information while not requiring leaders in higher education to take any specific actions at this juncture. A petition to gather support for the bill from college and university leaders was launched by Furman University. It has gathered over 200 signatories, including the President of Penn State, Eric Barron; the President of Tufts, Anthony Monaco; the President of George Washington Univer-

sity, Thomas LeBlanc; the President of Cornell University, Martha Pollack; and the President of the University of Wisconsin System, Raymond Cross. This support suggests that there is a hunger for more information on the services that are currently available to students and the impact that these services are having. The government has played a role in determining how the mental health of students is protected by colleges and universities. The widespread support that the Higher Education Mental Health Act has received from leaders in higher education suggests that the question regarding how student needs may best be addressed still requires further exploration, and that opportunities for peer learning exist. If passed, the Act will not solve todayâ&#x20AC;&#x2122;s growing student mental health challenges but will potentially provide a roadmap that can be used to work towards doing so. The Act would represent one of multiple efforts to ensure that students with mental illnesses are able to have successful experiences obtaining a higher education.

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

Student Mental Health Becoming a Greater Priority for Presidents

A survey of more than 400 college presidents by the American Council on Education showed that students’ mental health has become more of a priority for colleges, which are allocating more resources to address it. More than 80 percent of the presidents surveyed say that mental health is more of a priority on campus than it was three years ago.

of presidents agreed or strongly agreed that their staff is spending more time addressing these concerns than they did three years ago. And a majority of presidents also agreed or strongly agreed that faculty on their campus were spending more time addressing student mental health concerns than three years ago (82 percent).

One president wrote, “Mental health has become a major issue for retention and the general well-being of our students...This is in my top three areas of improvement for my college.” The presidents reported that anxiety and depression were the most common mental health issues they were aware of. Seventy-two percent of the presidents indicated they had allocated more funding to mental health initiatives than they did three years ago. According to the report, ninety percent

Notably, presidents were more likely to strongly agree (60 percent) that staff is spending more time addressing these issues than faculty (32 percent). One president reported, “The issues facing students have become more complex and time-consuming for faculty and staff to address. It also involves multiple staff (student services, counseling, security, external resources, safety, legal) to develop a comprehensive plan to address.”

Millennial and Gen Z Mental Health

A new study published in the Journal of Adolescent Health found that suicidal thinking, severe depression, and rates of self-injury among U.S. college students more than doubled over less than a decade. Looking at data from two large annual surveys of college undergraduates from 2007 to 2018, researchers Mary E. Duffy, Jean M. Twenge, Ph.D., and Thomas E. Joiner, Ph.D. found a worsening of mental health indicators including depression overall, anxiety, anger, low flourishing, and suicidal planning and attempts, particularly in the second half of the study period. Another recent study, also co-authored by Twenge, reports that Gen Z (or iGen) out-

Historically Black Colleges and Universities as Engines of Social Mobility

According to a study from the Rutgers Center for Minority Serving Institutions, historically black colleges and universities have far smaller endowments and a far larger share of low-income students than predominantly white institutions, but raise students up the ladder of economic success at rates comparable to white colleges. A report on the study compared the trajectories of students who attended 50 HBCUs against those who went to mostly white institutions in the same regions. Two-thirds of HBCU students from low-income families, meaning those with household incomes of roughly $25,000 or less, ended up earning at least middle-class incomes by

paces all older generations in stress, with 9 in 10 Gen Zs between the ages of 18 and 21 reporting stress in the last month, compared to around 75 percent of their elders. Drawing from the National Survey on Drug Use and Health, a nationally representative survey of U.S. adolescents and adults, researchers observed a steady rise in mood disorder and suicide-related outcomes between cohorts born from the early 1980s (Millennials) to the late 1990s (iGen). The study identifies the rise of electronic communication and digital media and decline in sleep duration as cultural trends that may explain the increase in mood disorders and suicidal thoughts and behaviors since the mid-2000s.

their early to mid-30s. Seventy percent of low-income students at mostly white colleges reached the middle class or higher by that age, according to the report, “Moving Upward and Onward: Income Mobility at Historically Black Colleges and Universities.” This report comes on the heels of another recent report from the United Negro College Fund (UNCF), “HBCUs Punching Above Their Weight,” that showed that while historically black colleges accounted for less than 10% of all four-year institutions across 21 states and territories in 2016, they enrolled and graduated about onefourth of all black undergraduates.

Substance Use Trends

University of Michigan’s annual Monitoring the Future Panel study showed a 35-year high in marijuana use by college students. According to the study, which is funded by a grant from the National Institute on Drug Abuse, in 2018, 43 percent of full-time college students said they used marijuana at least once in the previous year, while one in four said they had used it in the last month. About 6 percent of students said they used marijuana daily, which was defined in the survey as having used it 20 or more times in the last 30 days. The study also found that the use of vaping products to vape marijuana as well as nicotine doubled between 2017 and 2018. Among the college students, roughly 11 percent reported that in 2018, they had vaped marijuana within 30 days of taking the survey. More than 15 percent of the students indicated they had vaped nicotine in the last month. The vaping trend is particularly concerning to researchers, because students often perceive vaping to be a safer alternative to smoking

cigarettes. The national survey also showed that binge drinking and other types of illicit drug use had decreased among college students. A recent analysis of CDC data by the non-profit Trust for America’s Health and Well Being shows that over the past decade, young adults have been more likely than any other age group to die from drugs, alcohol and suicide. According to the authors, the data underscore the despair Millennials face. Drug-related deaths among people 18 to 34 soared 108% between 2007 and 2017, while alcohol deaths were up 69% and suicides increased 35%. The increases for these three so-called “deaths of despair” combined were higher than for Baby Boomers and senior citizens. “There is a critical need for targeted programs that address Millennials’ health, well-being and economic opportunity,” says John Auerbach, CEO of the Trust for America’s Health and Massachusetts’ former health secretary.

Gender Minority Mental Health

A new study published in the American Journal of Preventative Medicine found that transgender, gender-nonconforming, and gender-nonbinary college students suffer two to four times more than their cisgender classmates from mental-health problems, including depression, anxiety, eating disorders, self-injury, and suicidality. In Gender Minority Mental Health in the U.S.: Results of a National Survey on College Campuses, researchers Sarah Ketchen Lipson, Ph.D., Julia Raifman, Sc.D., Sara Abelson, M.P.H., and Sari

L. Reisner, Sc.D., indicate that about 78 percent of gender-minority students met the criteria for one or more mental health problems compared to 45 percent of cisgender students. The study relied on data from the Healthy Minds Study. The article authors write that the findings indicate the importance of recognizing and addressing the mental health burdens and needs of gender minority students by providing services such as mental health screenings and gender-affirming services.