Mary Christie Quarterly A publication of the Mary Christie Foundation
UVM Sees the Future of Student Wellness Inside the WEvolution p. 14
Q&A: Tufts University President Anthony Monaco p. 08
Issue 8 | Fourth Quarter | 2017
Mary Christie Quarterly The Mary Christie Quarterly is a publication of the Mary Christie Foundation, a thought leadership and philanthropic organization dedicated to the health and wellness of young adults.
STAFF Publisher & President Editor & Executive Director Program Manager Art and Layout Director
Robert Meenan Marjorie Malpiede Dana Humphrey Ashira Morris
BOARD OF DIRECTORS Chair
John P. Howe, III
Robert F. Meenan
CONTE NTS 04 Mary Christie Foundation & Hazelden Betty Ford Foundation Presidents’ Colloquium on Substance Use 08 Q&A: Tufts University President Anthony Monaco 12 Opinion: Counselor Self-Care Critical to Quality Care for All 14 The University of Vermont’s WEvolution 20 Young Voices: Kyle Bodge 23 New Framework Supports Students of Color 28 Survey: College Administrators See Rise in Marijuana Issues 31 Science Summary
Cover art by Daniel Chang Christensen Spot illustrations by Jia Sung
Mary Christie Foundation Presidents’ Colloquiu By Adam Powell Photos by Rick Reinhard On Oct. 17th, 2017, the University of Maryland hosted Substance Use on College Campuses: New Approaches to a Perennial Problem. The event, jointly sponsored by the Mary Christie Foundation and Hazelden Betty Ford, was held to foster a dialogue on campus-based substance use between university presidents and leading experts on the issue. The event began with a warm welcome by Robert Caret, Chancellor of the University of Maryland, and William Moyers, Vice President of Public Affairs and Community Relations for the Hazelden Betty Ford Foundation, symbolizing its joint purpose of convening leaders within the worlds of academia and recovery.
In the opening session, Jason Kilmer, PhD, Associate Professor of Psychiatry at the University of Washington’s Center for the Study of Health and Risk Behaviors, highlighted trends and challenges in substance abuse prevention, and treatment, particularly those related to marijuana. His home state, Washington, legalized marijuana, which led to escalated use. As marijuana use causes cognitive declines which can last for 24 hours and attention issues which can persist for 28 days, it can interfere with the academic mission of colleges and universities. W h i l e concerns a b o u t marijuana have existed for decades, the prob-
lem has become particularly pronounced because average potency tripled between 1985 and 2014. Kilmer concluded by recommending that universities support and identify those struggling with substance use, enforce laws and policies, respond to testimonials and address unwanted affects with science, share norms, involve parents, and address marijuana in addition to alcohol. Kilmer’s remarks brought an urgency to the following discussions. W h i l e marijuana has long been present on campuses, it is becoming both stronger and more readily obtainable.
n and Hazelden Betty Ford um on Substance Use After Kilmer’s call to action, NASPA president Kevin Kruger led the Presidents’ Panel, a discussion between Presidents Gregory Crawford of Miami University of Ohio; Wayne A.I. Frederick of Howard University; Marty Meehan of the University of Massachusetts; Kim Schatzel of Towson University; and Tom Sullivan of the University of Vermont.
President Wayne A.I. Frederick Howard University President Frederick spoke passionately about how he has worked to help students realize that mental health issues could impact them. “A lot of times we think about the issues as, ‘This is a student issue,’ or, ‘It’s somebody else’s issue.’ But the reality is, we all have personal experiences that we could probably relate to.” While he was filming a video on the importance of addressing mental health issues, he decided to talk about how he lost his father to suicide during his childhood.
President Kim Schatzel Towson University President Schatzel reminded the audience that it was important to take a segmented approach rather than a unified approach to addressing potential issues on campus. “I think we have a tendency to treat all student groups the same and really not take a look at segments and demographics differently. For student athletes, there’s no reason why we should believe that behavioral health issues are even less present within their population. We recently applied for an NCAA grant that we received to be able to provide for increased counseling through our student athletes, to be able to make sure that we’re responding to them and their particular needs.”
President Marty Meehan University of Massachusetts system President Meehan implored the audience to realize that tragedies that had befallen other campuses could repeat themselves anywhere. “I know we don’t think this would ever happen at our university, but it could.”
Speaking from a liability perspective, he then remarked, “I think, to the extent that you can look at why universities get into trouble...it’s really an important teaching moment. I take whatever advantages I can in terms of getting those moments across to folks.”
President Gregory Crawford Miami University of Ohio Miami University of Ohio recently partnered with Haven at College, a program offering recovery housing, Women Helping Women, a confidential reporting mechanism, and TriHealth, a provider of acute care. “We’re trying to do as much partnership work as we can.”
President Tom Sullivan University of Vermont President Sullivan stressed the importance of involving stakeholders and using data. “I commissioned a president’s committee on alcohol, marijuana, and misuse of drugs, and it’s made up of faculty, staff, students, and parents. It’s some 60 people. We’ve had some great success in a relatively short period of time, lowering the use of alcohol in five years by 30 percent, lowering the use of marijuana, lowering the use of detox by 30 percent in five years.”
The day conclud“We are beginning ed with a panel of to have better data experts moderated on opioid use, and I by William Moyers. think although that Panelists included is still in the minoriAmelia Arria, PhD, ty of what people Director of the Cenuse on campus, it is, ter on Young Adult as we know, a growHealth and Develing epidemic in our opment at the Unisociety,” said Young. versity of Maryland “It will not be long School of Public before it becomes a Health, and an Asmore prevalent isThe Jed Foundation’s Nance Roy speaks at the sociate Professor with- conference. sue on our campuses... in the Department of Students frequently Behavioral and Community Health; Timothy underestimate or are ignorant of the interacRabolt, Collegiate Recovery Advisor for Alta- tion effects between alcohol and opioids.” rum, and Director of Community Relations Throughout the colloquium, a message & Strategic Advancement for the Association of Recovery in Higher Education; Nance Roy, emerged with a common strain: Substance Ed.D., Chief Clinical Officer, Jed Foundation; abuse may be a perennial problem on camand Nancy Young, PhD, Vice President for puses, but the increased availability of stronStudent Affairs, University of Maryland-Balti- ger substances makes the problem more immore County. Each shared perspectives on the portant to address now than ever before. risks facing today’s students. The Presidents’ Panel: from left to right, Presidents Sullivan, Schatzel, Meehan, Frederick, and Crawford.
William Moyers, Vice President of Public Affairs and Community Relations for the Hazelden Betty Ford Foundation, moderated the Experts Panel.
Kevin Kruger, President of NASPA, moderated the Presidents’ Panel. 07
Q&A: Dr. Anthony Monaco The president of Tufts University on student mental health, from his Task Force and beyond Interviewed By Marjorie Malpiede
Anthony Monaco is a medical doctor and a Ph.D as well as a distinguished geneticist whose doctoral work led to landmark discoveries recognized throughout the world. His role as President of Tufts University, where he presides over the often-unpredictable behaviors of young adults, has taken him in less methodical directions. But Monaco is an adept listener whose penchant for observation and problem-solving extends to every facet of university life, particularly student success. In 2012, after students brought concerns about the way the university was handling sexual assault claims, Monaco put the school’s entire leadership team behind it. The sexual misconduct prevention task force, now a steering committee, brought major changes in education, resources, and reporting, which increased the number of people who have come forward. In the fall of last year, Monaco announced another task 08
force after seeing trends indicating sharp increases in usage at the school’s counseling center. He appointed renowned psychiatrist Paul Summergrad to serve as his co-chair in the effort to examine the university’s infrastructure around student emotional and behavioral health, including its policies, practices, and culture. As the Mental Health Task Force enters the final phase of its effort, we spoke with President Monaco about what motivated such a sweeping effort and what the university hopes to gain from it. We also learned more about the students themselves — “Jumbos,” as they are called, after their elephant mascot. Mary Christie Quarterly: What motivated you to take on a comprehensive effort like the Mental Health Task Force? Dr. Anthony Monaco: About four years ago, we started to document increasing numbers of students visiting our
Counseling and Mental Health Service. And that has gone unabated. We had a 25 percent increase last year in students accessing our mental health services; currently about 25 percent of our undergraduate students utilize our mental health services. We conduct a survey of students every two years called the Healthy Minds Survey (out of the University of Michigan), and that data was also indicating increased need. It was clear from the survey work that a large percentage of students say that their academics are impaired by mental health issues. The biggest two are anxiety and depression. They make up 50 percent of the cases we see. Either of those can impair academic performance in the short or long term. That’s why I think this is our issue to solve — because our main educational mission is to ensure that students are successful, that they are educated while they’re here,
and graduate to successful careers. If mental health or substance use issues prevent them from being successful, we must provide a network of support in various avenues so that students can try to overcome those challenges. MCQ: Beyond eliminating barriers to success, why is this something colleges should care about? AM: Intellectual development of students is only one part of our mission. Students’ personal and social development are also a big part of the college experience. College students are still developing on a range of fronts. One of the best parts of my job is watching how students arrive here at age 18 or 19 and how they’ve changed and matured by the time they graduate. It’s not just what happens in the classroom. They benefit from residential life and the entire community experience — all the clubs and co-curricular activities in which they’re involved. Mental health issues, substance abuse, and sexual misconduct are risks that exist in this environment, so we need to make sure that we are providing the right support to reduce those risks. MCQ: What has the Task Force been working on? Did you identify specific areas of focus? AM: We’ve tried to frame
this by looking at three areas: our policies and practices; our services and resources; and then education, outreach, and health promotion. We’ve had a several different working groups. One focused on undergraduates and, for the first time, we’ve been looking comprehensively at graduate and professional students. (Tufts has eight graduate schools.) We know from our data that although the largest area of growth in utilization was in undergraduates, 20 percent of the clients served at the mental health counseling center on our Medford/Somerville campus are graduate students. And we’ve had evidence from our professional schools of significant numbers of students having to take leave for mental health issues, so it’s really important that we support this group. We are now completing the first university-wide survey of graduate and professional students. MCQ: How is the Task Force going about this work?
AM: The work of the task force is very data-driven in terms of understanding how our services work, the resources we’re putting in, and how they’re being managed, given the more acute cases we’re seeing as well as the rising volume of cases. We’re also comparing data across the country to understand Tufts’ experience relative to other schools. Our surveys and focus groups are showing how people perceive the services, how they perceive the supportive environment, and ways in which they think we could provide better outcomes for students. We are also talking to other schools and attending national conferences. MCQ: What are you looking at specifically in terms of models of care and policy? AM: Right now, we have a traditional short-term care model within the counseling center. We’re examining how that is working relative to the volume and some of our more acute cases. One issue we’re looking at is supporting students who require chronic care. Besides the fact that this age cohort is when many mental health issues emerge, we are seeing a lot more students arriving having been in counseling and/or on medication in high
with them frequently to help them get to the counseling center if they’re not able to advocate for themselves. If a student has not shown up for several lectures in a row, there should be some alarm bells that indicate he or she needs a wellness check. MCQ: What are you looking at in terms of student life? AM: Creating a better student life experience is part of our approach, and we’re doing a number of things on this front in addition to a more stringent oversight of Greek life. I formed a student life review committee last year, which met regularly from January to May, had significant outreach to students, alumni and others, and generated a thoughtful report.
Photo by Kristie Gillooly
Tufts University President Anthony Monaco launched a sweeping Mental Health Task Force last fall.
school. We need to consider how we support the full range of students. On policy, we are looking at medical and personal leave issues, privacy concerns, and substance abuse. We’re also examining how we can improve the environment here so that students may feel 10
better-supported up front — within residential life, say — and how we can build support within the faculty and staff to help students who present with early warning signs. When students are struggling with mental health issues, it is really important for people who are interacting
The recommendations of the report covered safety issues related to fraternities and sororities as well as diversity and inclusion, and the ability for all students on campus to participate in robust, positive social activity. The implementation of the report involves student affairs, student leaders, and our operations team thinking about how we can open up social spaces available to students. One strategy for upperclassmen is the “villages” concept. A lot of students study abroad their junior year, and when they come back, they often
live off campus and may not feel as connected to the Tufts community as they did in their first two years. We own a number of wood-framed houses on campus that we’re going to renovate for upper class housing, so there will be a more connected social life for these students. MCQ: Is the school looking to do more in the wellness/ health promotion area? AM: Yes. This is part of the remit of the Task Force. Whenever we promote meditation or yoga classes, they rapidly become booked. The students appreciate ways to reduce stress, and we need to do more in this area to provide positive activities in their everyday life to deal with stress. When I was in medical school, they taught us all how to meditate, and I found it to be incredibly useful. MCQ: Do you think that there’s something about highly competitive schools that may drive some of the stress?
their exams. To get to Tufts, you’re most likely an A student in high school and you are used to being at the top of your class. Many students arrive here and deal with struggling academically for the first time in comparison to their peers. That’s probably generating a lot of stress. One of the things we need to help students overcome is that failure is actually part of normal life. That you actually make personal progress through becoming resilient to failures. We are striving to provide a network of support at various places where the students live, work, and study — whether it’s the residence halls or the organizations in which they are involved, or through health services — to help them cope better. MCQ: Do you anticipate the Task Force will recommend major changes? AM: Our number one goal at the moment is to assess what we’re currently providing and understand whether our model of care can continue to function well with increasing
need. After that, we will consider what changes need to be made. MCQ: Finally, tell us what kind of students come to Tufts? AM: Our students are looking for academic rigor and engagement in a vibrant residential community. Fifty percent of undergraduates are doing independent research or scholarship with faculty members. That is part of the transformative experience and intellectual and personal development. We also have about 50 percent of our students involved in civic engagement. We’re one of the unique universities with a college totally dedicated to civic life — the Jonathan M. Tisch College of Civic Life. Tisch College is very much focused on political and civic life: Getting students to vote, getting them involved in elections, bringing different politicians to campus to provide different views. Students are also very much involved in community partnership projects and volunteering.
AM: Perhaps in the sense that the academic rigor is high here, and students want to perform We’ve tried to frame this by looking at three well. They areas: our policies and practices; our services strive to do and resources; and then education, outreach, well on their papers, their and health promotion. problem sets,
Overall, our students are very engaged not only in the academic experience but also in co-curricular activities.
Opinion: Counselor self-care critical to quality care for all Acknowledging the need for counselors and other student affairs professionals to take care of their own mental health can prevent a crisis within a crisis By Zoe Ragouzeos senting with life-and-death concerns. According to the American College Health Association (ACHA), the suicide rate among young adults ages 15-24 has tripled since the 1950s, and suicide is currently the second-most common cause of death among college students.
Zoe Ragouzeos, Assistant Vice President, NYU Student Mental Health
THE sustained increase in the number of students seeking mental health services on college campuses is well documented. But what is less publicized is the stress this increased demand often causes the caregivers. Alongside the data that shows increases in levels of depression and anxiety among college students is an increase in the acuity of symptoms, including more students pre12
Added to this is increased pressure on counseling and student affairs staff to keep students safe from other concerns: sexual misconduct, substance misuse, and maladaptive eating and sleeping. It should be no surprise that working at this kind of pace — with a constant stream of high-risk symptoms — has put counselors in a constant state of worry. Is the student they’ve just seen going to follow up on a suicidal or homicidal threat? This worry can make counselors and other student affairs staff feel anxious, distressed, and burned out.
Counselors and other student affairs staff enter their professions because they are caring and compassionate people who want to help others. However, the very nature of their work can make them feel depleted — even on a good day. In fact, counselors can experience trauma themselves due to constantly working with trauma survivors, and many college students do have a trauma history. Acknowledging this phenomenon is the first step in preventing what could become a crisis within a crisis. An important connection exists between helping students become well and being well yourself. As counselors, if we neglect our own needs, we can quickly experience fatigue and burnout — which impacts the quality of care we can give students. Burnout can result in physical symptoms such as headaches and sleep difficulties that might affect a counsel-
or’s ability to come to work. We must encourage our col- properly managing cases, and There can be emotional man- leagues to seek self-care op- the sense of feeling isolated in ifestations that include feel- portunities both as part of decision-making. ings of depression and anxi- their jobs and — most imporWe should also ensure that ety, impeding their ability to tantly — outside work hours. there are adequate professionfunction. Burnout can cause This personal restoration can resentment, tardiness, and come in the form of their own al development opportunities other negative behavior that personal therapy, getting rest, available to staff — networkperpetuates low workplace and spending time with loved ing and social opportunities with peers and mentors — to morale. Counselors may even ones. ensure that they are constantdevelop negative attitudes ly rejuvenattoward their ed by their patients, rework. sulting in defensiveness, F i n a l l y, p e s s i m i s m , An important connection exists between helping c o u n s e l i n g and intolercenters can students become well and being well yourself. ance. offer the We must do everything possible to avoid these ramifications while balancing our number one priority – keeping our students safe and healthy. When there are patients to see and work to be done, it is difficult for leaders to make room for the needs of their staff. Nevertheless, doing so is of the utmost importance if we wish to provide excellent quality services to our students.
One way we can offer counselors care during office hours is to ensure adequate clinical supervision rather than leaving our staff to struggle with difficult cases on their own. We must ensure there are supervisors available for consultations, and to do this in both an individual and team setting where staff can interact and collaborate with peers. This can be helpful in alleviating their worry about
same kind of wellness activities for their staff that they do for their students, both on and off work hours. Mindfulness, yoga, and fitness activities before or after work is one way; access to nutritious food and a healthy, collaborative work environment is another. Zoe Ragouzeos is a board member of the Mary Christie Foundation.
UVM’s WEvolution How the University of Vermont is creating a wellness environment students want to be in By Marjorie Malpiede
AS colleges and universities consider how to create
healthier environments for students, the University of Vermont has leaped ahead of the trend and developed an entire ecosystem dedicated to wellbeing and the reduction of harmful behaviors. UVM’s Wellness Environment program (WE), which launched in 2015 with 110 students, has grown to 1,165 students in a little over two years. The WE program combines four pillars of wellness — fitness, mindfulness, nutrition, and relationship health — in a residential community where students are given incentives to pursue positive behaviors. It is the first environmental, college-based wellness program in the country. But what makes WE truly revolutionary is that its growth is student-driven, moving the concept of campus wellness from an institution-imposed strategy for high-risk behaviors to a sought-after lifestyle choice that appeals to a majority of students.
Good Stuff Let there be no doubt about it: There is nothing acetic or spartan about wellness living at UVM. The first-year WE dorm is a sparkling new residence hall with its own yoga studio, fitness rooms, and specialized dining hall. It is not unusual to see, at any given time of day, students riding peloton bikes, meditating, or conferring with their fitness mentors. Each of these activities earns them “WE Coin” that can be used to buy WE “swag” like hats and fanny packs, or discounts to the gym. Students sign on to the program quite literally. WE students put their name to a code of conduct outlining what is expected of them in terms of behavior and accountability. The residence halls are substance-free, though in contrast to sober homes, WE students are only expected to refrain from drinking or smoking in the residence — the premise being, the healthier their home environment, the healthier their outside choices.
Students are required to take a three-credit course called “Healthy Brains/Healthy Bodies,” which teaches the reciprocal relationship between brains and young adult behaviors: from diet, exercise, and substance abuse to relationships, sex, and love. The students in the WE program may only be tangentially aware that they are participating in a neuroscience-inspired, incentive-based behavioral change program. According to feedback, what they do know is that they feel good — some of them for the first time in a long time. The mastermind behind the WE program is Dr. James Hudziak, a neuroscientist and child psychiatrist, who in addition to being WE’s creator and director is the Chief of Child Psychiatry and Director of the Vermont Center for Children, Youth, and Families at UVM’s College of Medicine. The foundation for WE stems from Hudziak’s own Vermont family-based approach — a health-promotion, illnessprevention, family-based
intervention program for emotional and behavioral health. “WE is the Vermont family-based approach goes to college,” he said. “It is the same neuroscience/ genetic/ public health argument that says health promotion outperforms prevention, always and prevention outperforms intervention, always.”
It wasn’t until one of Hudziak’s daughters decided to attend UVM that he considered how he might partner with the university to apply his science and expertise to promote health and prevent illness, particularly anxiety, depression and substance abuse, in college students. He was surprised that the school had only one substance-free dorm amidst a well-known party culture on campus. Through his work, he was also acutely aware of the state of mind of many within the col-
lege-age population. “These are young people who want to be well, who want to do well, who are super stressed out, who are fearful of failing, fearful of letting their parents down, and really frightened of the future,” he said. “What if we gave these kids an environment that could help settle all that stuff?” 15
Hudziak disto be differcussed his apent, so get proach with The students in the WE program may only be ready.” Annie Stetangentially aware that they are participating T o d a y , vens, UVM’s a neuroscience-inspired, incentive-based S t e v e n s Vice Provost in is thrilled for Student behavioral change program. with the Affairs. Step r o g r e s s, vens had been and says she working on will be bevention and health promobehalf of UVM hind this program as long as President Tom Sullivan in tion. the students are. addressing substance use on “With success, you get buycampus, a problem identified in and momentum,” she said. Brain Power by Sullivan early on in his ten- “We were stepping into more Hudziak says his primaure as the primary barrier to of a prevention mindset right student success. Sullivan had at the same time Dr. Hud- ry theory is that if you give commissioned a committee ziak’s daughter decided to go young people the chance to make a healthy decision, they on alcohol, marijuana and to UVM.” will. The challenge is that colmisuse of drugs — made up of faculty, staff, students, and The establishment of the leges and universities are not parents — and asked Stevens WE program was remarkably always the best environments to co-chair it. The committee’s fast, given the speed at which in which to do so. WE offers task was to use quantifiable most change occurs in high- alternatives to the default metrics to inform the under- er education. With Sullivan’s behaviors that befall many standing of the problem and support, Stevens connected college students, such as exset measurable goals to move Hudziak with the appropriate cessive drinking, marijuana the numbers. people and departments, se- smoking, poor diet and sleep cured start-up funding from habits, even unhealthy relaThe school had some early other budgets (unheard of tionships. successes, and started to see typically), and directed him to The neuroscience behind the its high-risk drinking rates go get it done. program continues to evolve down with the committee’s recommended interventions. “We did what most institu- and has been developed For Stevens, this presented an tions do not do,” said Stevens. through years of published opportunity to focus on pre- “We said, folks, this is going work here and throughout 16
the world, including Hudziak’s own findings. Hearing him speak of the confluence of components that underlie WE, three things become clear: environment matters; incentives work; and the brain controls everything. “All health comes from emotional and behavioral health,” he said. “Whether we study or not; drink or not; smoke weed or not; hurt ourselves or our classmates, those behaviors all come from one protein — the human brain.” For college students, that can be a liability. The transitional age brain — that of a 17 to 24year old — is considered to be the most vulnerable among the brain development periods. As Hudziak points out, you take a very vulnerable organism like the transitional brain, and send it to college with no external controls, and you’ve created the perfect neurological storm. Hudziak teaches Healthy Brains/Healthy Bodies, where he and his colleagues from UVM medical school show
students how their brains impact their behavior and how their behavior impacts their brains’ development. It is factbased and non-judgmental. In the 300-person lecture hall, Hudziak breaks the ice and keeps students alert by tossing around a brain-shaped football, and expects them to throw it back. He hurls the ball back and forth, hoping to catch the least alert student, but no one is too surprised. They get the drill. Each class begins and ends with meditation which Hudziak calls “work-out sessions” for the brain. Mindfulness, like fitness, diet, and healthy relationships, is one of the wellness pillars and something for which students receive WE coins. Incentivization, along with neuroscience, is key to WE’s effectiveness,
and critical, according to Hudziak, to any successful behavioral change program. Students get “paid” to exercise, take a yoga class, study mindfulness, or have a kale smoothie instead of a coffee on their way to class. If they swipe their fitness card 40 times over the course of the year, it’s free. If they don’t, they have to pay the program back. Communication and a sense of community are also big here. “Kids say to me all the time, ‘I have attention issues, I’m anxious. I have asthma, I’m sad. I’m overweight, I’m withdrawn.’ These are the most common emotional and medical problems in the world that people don’t want to talk about. In our environment, we do.” Now in its third year, WE is attracting a wide range of students, from athletes and fitness enthusiasts to students with emotional and behavioral health issues. It includes those who choose not 17
Photos by Bear Cieri
WE Program creator Dr. James Hudziak throws a brain-shaped football out to students in his Healthy Brains/Healthy Bodies class, which is a requirement for all WE students.
to drink or use, and those who just want to avoid the usual residential disturbances that come from college partying. The UVM varsity hockey team lives in the WE dorms, as do kids of all social groups. Feedback shows that students are driving the WE attendance numbers, but their parents are definitely backing them up. “Parents love this program,” says Annie Stevens. “They are telling us by the dozens, Yep, 18
this is what I want for my son or daughter. This is the kind of college experience I want him or her to have.” Expanding the Circle As requests for WE membership continue to come in, Stevens and Hudziak are considering how to accommodate more students and expand the program’s value to the entire school. “I tease Annie that we’re not a residential learning commu-
nity,” said Hudziak. “We are a university-wide behavior change program with a residential component.” Many of the WE programs are open to all students, and Hudziak is currently testing an app he developed called “UVM WE,” which incentivizes students within the four pillars of wellness — and also gets people who don’t live in the wellness dorms to engage in health promotion. Hudziak has a grant from the
Conrad Hilton Foundation to develop the app and engage in continued research. Right now, WE is free in that is comes at no extra cost to the student. It is creatively funded with a mixture of health services money, in-kind investments on the part of Hudziak and others, and grant money. In light of its success, administrators are working on ways to sustain it, grow it, and help replicate it at other universities. As a whole, UVM has had a 30 percent decrease in alcohol and marijuana use in five years, in part attributed to intentional programming like WE. UVM president Tom Sullivan tells the story of bringing in an external, objective expert to evaluate how well the WE program was doing with respect to engagement with students and their overall success. The evaluator gave the school the good news that judging from the research, the WE program appears to have had a dramatic effect on the physical and mental health of students. What he said next
surprised Sullivan. “He told me that wellness has now become a key part of our brand,” said Sullivan. “‘What does that mean?’ I asked. He said, ‘As I survey students and parents, the University of Vermont now has a reputation for being very serious about wellness.’ I thought to myself, it wasn’t our purpose to help the admissions side of things but when I look at our numbers, I see this is an outcome.” Hudziak is well aware of the value of outcomes reporting, and points to national statistics indicating that every one percent increase in retention will result in significant savings to the university. The WE program has been collecting data since its inception, and will soon have numbers on retention and academic success as well as other indicators. “In three years, our provost will have all the data he needs to justify our investment, and all of the other provosts in the country will have all the data they need to say, ‘Wow, this could really save us money.’”
Stevens says she has received so many requests for information about the WE program from other colleges and universities that she can barely keep track of them. Hudziak is asked so often to visit other schools that he and Stevens are “kicking around” the idea of having schools come to UVM for an intensive training program. The “WE Institute” would require administrators to include the head of student affairs, as well as a neuroscientist or child psychologist, and attend a four-day training seminar. Not surprisingly, Hudziak is thinking big. Not only would administrators learn WE concepts, they could share data and reporting, maybe even form a consortium of wellness universities. “What we’re doing here can be done anywhere, with the right elements, but be warned this is behavioral change for the entire institution, not just the students in the program,” he said. “That’s why we call it the WEvolution.”
Young Voices: Exploring UVM from WE Program and beyond University of Vermont student Kyle Bodge on finding his niche on campus, starting in the Wellness Environment By Kyle Bodge tivizing healthy lifestyles. The program goes beyond providing a barebones dorm experience, giving its residents education on the neuroscience behind risk-taking behaviors and easy access to what they need for good nutrition, exercise, and mindfulness.
Kyle Bodge, Student, University of Vermont
BEFORE I decided to go to the University of Vermont, I hadn’t heard of the Wellness Environment. Choosing to live there was one of the many experiences my freshman year that allowed me to explore health, wellness, and activism. During my pre-college orientation, I learned about the WE, a new and innovative housing initiative dedicated to incen-
The WE initiative appealed to me on multiple levels. The free access to the local gym and nutritionist support were great perks, but I was especially intrigued by WE’s unique way of dealing with substance use and other unhealthy habits. While any other dorm will punish students for breaking drug and alcohol policies, WE encourages substance-free habits by providing positive diversions to encourage students to take charge and make healthier choices. I was one of 120 freshmen who joined the Wellness Environment for its first year. It came to be an important time of growth, both for myself and the program.
During our freshman year, I navigated new crowds, packed schedules, and the sometimes-daunting freedom that college provides, while WE worked out the kinks of trying to maintain a substance-free bubble in such high-risk surroundings and determined a response method for when students inevitably broke WE’s expected conduct. We both faced a number of challenges: I attended many difficult lectures and tests. Students who couldn’t abide by its code left the Wellness Environment. Ultimately, however, it all amounted to a good learning experience. The Wellness Environment program and I both developed greatly from everything we experienced during our shared first year at UVM. Due to its popularity, the Wellness Environment expanded in its second year, allowing prior freshman to stay on as sophomores. I decided
to continue with the program, as did the majority of my peers. I enjoyed the tightknit community and variety of activities available to WE students, including paint and movie nights, group fitness training, and priority access to interesting neuroscience courses like “Healthy Brains, Healthy Bodies” with curricula designed to be low-stress. I had come into WE with few expectations, mostly curious to see how much it could deliver what it had promised, and I came out of the program with a number of positive experiences that assisted me in maintaining my well-being. From the start of my college career, living in the Wellness Environment helped encourage me to prioritize my health — something I view as key for every university student — while also giving me creative and fun outlets through which I could practice healthy behaviors. I also quickly dove into extracurriculars outside of my dorm. Early in my first semester, I joined UVM’s chapter of One in Four, a group of men on campus dedicated to educating other men on topics like how to support sexual assault survivors, ways to intervene in situations where assaults
might occur, and methods for communicating consent and nonconsent with partners openly. I knew I was lucky to have received a comprehensive education on these topics through my family and the progressive circles I was involved with growing up, and I wanted to pay it forward to other University of Vermont students who might not have had the same opportunities to learn about healthy relationships and peer support. Using an approach called The Men’s Program, which connects with audiences non-confrontationally and encourages empathy with survivors, our chapter gives open presentations to the community at large and closed presentations to various clubs, sports teams, fraternities, and other organizations who invite us to talk to their members. One in Four is a group that has been shown nationwide to have a positive impact on the perceptions of men who attend presentations, increasing their empathy for survivors and lowering their
likelihood of committing sexual assault. I’m proud to take part in expanding its influence in my university community. I also joined UVM Students for Disability Advocacy and Awareness during spring semester of my freshman year. The group is often flexible in purpose as the needs of its members change, but it is primarily centered around providing both able-bodied and disabled students a space to connect and discuss the experiences of disabled students at UVM. Our conversations also include the experiences of disabled people out in the world brought to us through news stories, videos, and other media. I was drawn to SDAA because of the opportunity it gave me to do advocacy work in an area I didn’t have much previous exposure to. The group was new on campus, and I was eager to get involved. I started as our Marketing Coordinator during our first semester, and I was later offered the wonderful opportunity to become Presi21
dent of SDAA in the fall of my sophomore year. It has been a rewarding challenge this past year, as we have worked to expand our presence on campus through connecting with other advocacy-based clubs, creating and giving presentations, and maintaining engaging discussions for our own meetings. We’ve covered topics ranging from popular disabled social media stars to the intersection between gene editing in ova and disability politics. Though I initially joined the group out of mere
interest, it has grown into a strong passion of mine that I foresee impacting my activism even beyond my college years. Engaging in the organizations I have across UVM’s campus for the past two years has allowed me to participate in personal wellness, social activism, and minority advocacy spheres in ways I likely would not otherwise have been able to. I encourage all students, at all universities, to explore the opportunities made available
to them through clubs, housing programs, and other related campus associations while they have the unique chance to do so. Traversing the college extracurricular scene can help you to take healthy breaks from classwork stress, network with peers, find new passions, and collectively expand your horizons to make yourself into a more well-rounded person. Kyle Bodge is a member of the Mary Christie Foundation Young Adult Council.
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The Mary Christie Foundation’s weekly roundup of news and research on the health and wellness of young adults
New Framework Students of Color
The Steve Fund and the Jed Foundation co-created the unprecedented recommendations for students of color By Ashira Morris AS diversity and inclusion feel isolated, and less likely tify
continue to top higher education priority lists, there is now a framework for colleges and universities to better support the mental health and well-being of students of color. Co-created by the Steve Fund and the Jed Foundation, the Equity in Mental Health Framework consists of 10 expert-informed recommendations, each with strategies for implementation. The framework suggests steps that schools can take through both policy and practice to improve mental health care for students of color. Students of color tend to face higher barriers to mental and emotional health care on campus, a compounding effect of being less likely to arrive with a diagnosis than their white peers, more likely to
to seek help from a mental health professional, according to a 2016 survey by the Steve Fund and the Jed Foundation.
The framework provides an evidence-informed way to address those barriers. Based on an extensive literature review, a survey of colleges across the country, and input from campus leaders and mental health professionals, the framework is an unprecedented and promising tool to help colleges provide the necessary access and opportunities for students of color, who make up 40 percent of the 20 million students attending college in the U.S. Only 9 percent of students accessing mental health services iden-
as African American compared to 68 percent who identify as white, according to the latest annual report from Penn State’s Center for Collegiate Mental Health. Those numbers don’t even reflect the number of students on campus who may have needed mental health services but didn’t access them. “I believe it is our most important endeavor to date,” Evan Rose, President of the Steve Fund said at the foundation’s annual Young, Gifted & @Risk conference in November. “When we started the Steve Fund in 2014, we knew that colleges and universities had a vital role to play in filling urgent gaps to better support the mental health of young people of color. We did not suspect, however, that the situation would become even more dire as developments have unfolded over the past year.”
Away from a race-blind approach The first recommendation is to “identify and promote the mental health and well-being of students of color as a campus-wide priority.” To implement this recommendation — and to improve a campus health system — requires shrugging off a color-blind approach from the top down. Students of color face a host of challenges, from microaggressions to stigma around mental health care. When naming the framework, the foundations deliberately chose “equity” over “equality” to reflect that everyone is not starting from the same point due to forces beyond their control, like race or ethnicity. “Equality doesn’t do much for people who experience life differently due to their greater likelihood of exposure to bias or discrimination,” said Alfiee Breland-Noble, Senior Scientific Advisor to the Steve Fund, who worked extensively on the framework.
The response to the framework has been powerful. The foundations have connected with more than 500 higher education professionals interested in implementing it. Some college presidents have been on board from the beginning. John DeGioia, president of Georgetown University, spoke to the need for such a framework to a closed-door meeting of 130 higher education professionals in February before the recommendations were public. “This is a very special moment and we need to seize the opportunities present here to provide the best communities for all of our students,” he said. “I think every college and university president must understand how urgent it is to tend to these dynamics.” Beyond centering the issue administratively, the third recommendation goes a step further — advocating for efforts to actively recruit, train, and retain a diverse and culturally competent faculty and professional staff.
LeAnna Rice, a campus advisor with the Jed Foundation who is helping disseminate the framework, was a counselor before joining the foundation. She was often the only non-white counselor on staff, and as a result she had many students of color on her caseload. It’s no accident: when students are seeking help, they want to be understood. For a student of color walking into an all-white counseling center, the persistent question is, “Is this space for me?” “I feel so very strongly about this one,” Rice said while presenting the framework at Young, Gifted & @Risk. “Students want to feel there are people they can identify with in high positions that they can see themselves in. I don’t know how many times students have told me, ‘I didn’t know there were black people studying science at Ph.D. levels’ or, ‘I didn’t know I could be a black therapist.’“ The recommendation encompasses not only bringing diverse faculty on board, but investing in their success. It
steers schools away from hiring young faculty of color only to ignore their professional advancement and encourages a cycle that can inspire the next generation. “It’s not just about bringing people in to let them rot on the vine,” Breland-Noble said. “Students need to see that you’re not just here today but that they can be where you are tomorrow.” While most of the research was conducted at historically and/or predominantly white institutions, Historically Black Colleges and Universities (HBCUs) and Latinx-serving schools where students of color are the majority on campus
can also benefit. “At HBCUs, the issue is centering mental health within race and culture instead of centering race and culture within mental health,” Breland-Noble said. When the Black Lives Matter movement started, for example, Howard students were at the vanguard of the movement. The fourth recommendation suggests creating opportunities to engage around national and international events. In the context of a predominantly white institution, that conversation might be a safe space for black students to discuss the national movement. At a HBCU, it is still a necessary dialogue but for different reasons. “How do we help campuses teach students that activism is integral part of their culture as HBCU students, but also that they can do better than their ancestors by prioritizing their mental and emotional well-being?” Breland-Noble continued. “It becomes a process of working with the recommendations to infuse self-
care into the conversation.” Grounded in evidence The work began in 2015, when the foundations contacted Stephanie Pinder-Amaker, Director of the McLean College Mental Health Program, to collaborate on a comprehensive literature review of programs for the mental health and emotional well-being of students of color. It was about a year before students of color started receiving national media attention for coming to their school administrators and asking for change. Their requests often were for the types of services the framework now suggests. “The timing was really interesting because as that was evolving on campuses nationally, we were already entrenched in the study,” Pinder-Amaker said. Recommendations like engaging students to provide guidance and feedback on programs for their own well-being (the second recommendation) and actively training a
diverse counseling staff (the third) have frequently been on the list of changes students of color advocate for on their campuses.
aging the higher education community to use culturally relevant programs and collect data on its effectiveness.
“We have to connect our programming and practices to data if we want to be successful in improving mental health outcomes. ” — Stephanie Pinder-Amaker, Director, McLean College Mental Health Program Although they found numerous studies indicating that students of color have higher levels of distress and are less likely to receive services on campus, none of the studies in literature review included evidence-supported programs. They also asked 1,500 schools what programs they had in place for students of color, and how they assessed the success of those programs. Responses from 23 schools included a total of 84 programs. None were evaluating their success. Recommendation #9 addresses the lack of data on current programming, encour26
“It’s critical that we’re not going on gut instinct,” PinderAmaker said. “We have to connect our programming and practices to data if we want to be successful in improving mental health outcomes. We also need to share that information to move the dial forward in a timely way.” Anyone can access the recommendations online, where a representative from the foundations can lead them through a conversation about what they currently have available on their campus, and what they can do going forward. Administrators can
choose from a menu of options, and the organizations will collaborate to help schools decide what to “order,” from in-person trainings to webinars to campus workshops — a wealth of opportunities for schools to implement. Ultimately, it’s in the university administration’s hands to choose what to pursue. “We’re the GPS, not the driver,” Breland-Noble said. “You can choose to follow it or not.” “A life-saving checklist” The recommendations come nearly a decade after Atul Gawande wrote about the life-saving power of checklists in hospital Intensive Care Units for The New Yorker. The list, written by a doctor at Johns Hopkins Hospital, laid out specific steps toward preventing infection. The items to check were often simple, but before the checklist was implemented, doctors often forgot to do them. After a year of using the checklist in at the hospital, the infection rate in the ICU dropped from 11 percent to zero.
A decade ago, the Steve Fund didn’t exist. The foundation’s explicit mission is to advance the mental health and emotional well-being of students of color. They believe that the Equity in Mental Health Framework has similar life-saving potential.
When Breland-Noble was in grad school, she remembers feeling “in the hinterlands” researching these issues. Now, with an organization putting them on a national stage, “you have a galvanizing force,” she said.
Campus to Careers: connecting employers with talented college students with disabilities Career Opportunities for Students with Disabilities (COSD) and the National Organization on Disability (NOD) will host the first Campus to Careers in Boston. This event
will give progressive companies committed to disability inclusion the opportunity to recruit college students and graduates with disabilities.
“There’s a shared interest and a shared vision,” she continued. “Twenty years ago, we talked about it. Ten years ago, we wrote about it. Now we’re doing it. Ten years from now, I think people will say, ‘They gave us a foundation.’ They will have a model that can go even farther.”
Campus to Careers offers participating employers: • Access to an untapped talent pool of students with disabilities, prepared to succeed in the workplace, • Enhanced relationships with campus career and disability services offices, • Training for recruiters and hiring managers in disability awareness, etiquette and interview techniques as well as sharing employment best practices • Broad recognition for their commitment to disability inclusion in the workplace. To learn more, contact email@example.com.
Survey: College Administrators See Rise in Marijuana Issues More students see marijuana as safe, creating downstream effects on college campuses By Marjorie Malpiede A majority of college ad- professionals in the ministrators in a new sur- fields of academic afvey say that more students believe marijuana to be “safe,” drawing concern that changing national attitudes about marijuana might have downstream effects on college campuses. Administrators say the number of students with marijuana-related problems has either increased (37 percent) or stayed the same (32 percent), while almost none say such problems have lessened. And while they report a variety of negative impacts of marijuana use, and acknowledge the need to address the problem, they are also dealing with gaps in information and policy. These are the main findings of a groundbreaking national survey of higher education officials by the Mary Christie Foundation and the Hazelden/ Betty Ford Foundation in conjunction with the National Association of System Heads (NASH). The survey of 744
fairs, student affairs, and student health was conducted by The MassINC Polling Group and released at a national forum on college student substance use at the University of Maryland. There is broad consensus among administrators that colleges can and should implement strategies to reduce marijuana use among college students, but relatively few administrators think their own campuses are putting much emphasis on the issue. Barriers to tackling the problem include lack of information about effective approaches, and limited coordination and training. There is also more awareness of the problem among officials on the front lines compared to those in academic affairs or administrative roles. “This survey underscores what many of us have been
worried about: although data show that consistent marijuana use is a serious threat to students’ wellbeing and academic performance, there is a lack of urgency to address the problem in meaningful ways,” said Robert Caret, Chancellor of the University System of Maryland, and Vice Chairman of the Mary Christie Foundation. “While is it encouraging that administrators see a role for colleges in addressing this issue, we need more active leadership to share information and coordinate the response.” Public health experts have long warned that regular marijuana use among college students can lead to impaired memory, lack of moti-
vation (skipped classes), and 58 percent in 2000 to about 33 Among the key findings: problems with information percent in 2015. • Seven in 10 administraprocessing and executive Meanwhile, marijuana legaltors said that the number functioning. Marijuana use of students with marisignificantly overlaps with ization for medical and recreational use is becoming more juana-related problems excessive drinking and other on campus substance use had either rather than increased (37 being a sub- “This survey underscores what many of us have percent) or stitute and been worried about.” stayed the is associated with mental — Robert Caret, Chancellor of the University same (32 perhealth prob- System of Maryland and Vice Chairman of the cent) over the past three lems and an Mary Christie Foundation years. A maincreased jority (54 risk for psypercent) of chosis among respondents vulnerable individuals. The believe the number of survey demonstrated signifi- widespread at the state level as public opinion continues a students who perceive cant knowledge gaps on these marijuana to be safe has issues among many college decades-long shift toward favoring legalization. increased over the past administrators, but the need three years. for training to learn more was “Colleges are finding themclearly acknowledged. selves on the front lines of • A majority (55 percent) Between 2014 and 2016, annual prevalence of marijuana use among college students increased by 14 percent. The perception of personal harm caused by regular marijuana smoking among 18-22 year olds has decreased from about
this shift in attitudes and are playing catch up, in terms of education and training, as the problem continues to grow,” said Nick Motu, Vice President, Institute for Recovery Advocacy, the Hazelden/Betty Ford Foundation.
report marijuana use in college residence hall; 41 percent have observed academic problems related to marijuana use, and 36 percent have seen student mental health issues. Sixty-three percent 29
agreed that students who use marijuana are more academically disengaged than non-users.
use is a serious problem on their campuses, while majorities of the latter group think it is not.
departments and top-down communication that puts all student advocates on the same page.
• Eight in 10 (79 percent) believe college campuses should implement policies and programs to effectively reduce marijuana among college students, but only a third think their campus is putting a great deal (5 percent) or a fair amount (28 percent) of emphasis on preventing marijuana use right now.
• One way to address this gap could be to improve training and information sharing. Majorities of all types of administrators are interested in receiving training on how to handle various aspects of marijuana use among students, including impacts on student health and well-being and academic success.
“The primary mission of every institution of higher education is to promote student success” said Dr. Amelia Arria, Director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health.
• Majorities think that a lack of resources, coordination and information are barriers to successful marijuana prevention and enforcement on campus. Student opposition is also seen as a concern.
• Administrations say marijuana is not treated as seriously as alcohol. Screening for marijuana use is less common than screening for alcohol, and administrators are split on whether marijuana cause more academic problems than drinking, and whether marijuana users also drink to excess.
• There is a large gap in knowledge and perception of the issue between administrators on the front lines of combating substance abuse (health and wellness, prevention, residential life, and campus safety) and those a step removed (academic and student affairs). Majorities of the first group think that marijuana 30
Experts are urging college presidents to collect more regular data regarding the scope and consequences of student marijuana use and utilize evidence-based public health approaches to intervention. They are also calling for better coordination among college
“These new data from the unique vantage point of college administrators indicates that marijuana use is seen as a barrier to student achievement. Therefore, leaders of these institutions should intensify their efforts to develop comprehensive, scientifically-informed solutions to reduce student substance use.” The new survey was released in October at the national “College Substance Use: New Solutions to a Perennial Problem” forum at the University of Maryland, College Park. National leaders in higher education, policymaking and substance use prevention and treatment convened to discuss the latest trends, challenges and innovations in preventing and addressing substance use on America’s college campuses.
Science Summary A recap of research worth noting. By Dana Humphrey
The Deferred Action for Child-
DACA Program Linked to hood Arrivals (DACA) program, Psychological Wellbeing of Recipients announced in 2012, allows eli-
gible undocumented youth who entered the country as minors, to apply for temporary lawful status, work and attend school legally. Researchers at the University of California published a study that linked the “legitimizing effect” of the Deferred Action for Childhood Arrivals, or DACA, program with participants’ improved psychological wellbeing. Using cross-sectional survey data from 487 Latino immigrant young adults in California collected in 2014 and 2015, study authors Whitney Laster Pirtle and Caitlin Patler analyzed predictors of three outcomes related to immigrants’ psychological wellbeing — distress, negative emotions, and deportation worry — before and after a transition from undocumented to lawfully present status. They found that reports of current psychological wellness were predicted by DACA status. These findings demonstrate the positive emotional effects of transitioning out of undocumented status for immigrant young adults. DACA has “opened the door to so many opportunities and possibilities,” Patler said. “They [DACA recipient] know how life can be.” Patler theorizes that the federal government’s impending termination of the DACA program could diminish the mental wellbeing of these recipients to worse than it was before the program began, though further fieldwork is needed to test the theory.
Social Norms Marketing As a part of the Spit for Science Study, a longitudinal study of students’ substance Intervention Associated with use and emotional health, researchers Lower Alcohol Consumption studied the effect of a campus-wide social norms marketing campaign on students’ perceptions of their peers alcohol use, and their own alcohol consumption including frequency of blackouts. The study found that students who saw the campaign messages were more likely to hold accurate perceptions of peer alcohol use. Additionally, accurate perceptions of peer alcohol were associated with students reporting fewer alcoholic drinks per sitting and fewer blackouts. This program evaluation supports the use of social norms marketing as a population-level intervention to reduce high risk drinking.
LGBT College Students Are at Higher Risk for Depression and Suicidal Ideation
According to a new study, queer and transgender students experience depression and consider suicide at a rate four times higher than their heterosexual and cisgender peers. Researchers conducted a meta-analysis based on data from seven national student surveys representing nearly 90,000 LGBTQ students at 902 colleges and universities across the country. The analysis found that 17 percent of queer students and 20 percent of trans students reported self-injury over the past year, compared to only about 5 percent of heterosexual and cisgendered students. And 22 percent of queer students and 25 percent of trans students reported having seriously considered suicide during the previous year, three times the rate of heterosexual (8 percent) and non-transgender peers (9 percent). Queer and trans students reported being so depressed that it hindered their ability to function at a rate twice that reported by heterosexual and non-transgender peers. Maren Greathouse, director of the Tyler Clementi Center at Rutgers-New Brunswick who spearheaded the project said, “We’ve known that queer and transgender students suffer from depression and anxiety, but we’ve never had a nationwide sample of this size or such a diverse mix of public and private/religious schools. This finding was consistent across all datasets. This shows that this is not just a problem in rural America, it’s a problem everywhere.”
Self-Compassion Can Reduce A recent study published in the Journal of American College Health Suicidal Behavior in examines the association between College Students self-compassion and suicidal behavior among college students, and the roles that depression and wellness behavior play in the relationship between the two. The study authors theorized that a lack of self-compassion and failure to practice basic health behaviors among college students places them at higher risk for suicidal behavior. The study found an association between self-compassion and lower risk of suicidal behavior. Researchers determined that self-compassion protects against suicidal behavior due, in part, to reduced depressive symptoms and practice of wellness behaviors. They concluded that strategies promoting self-compassion and wellness behavior can be successful in reducing suicidal behavior and ideation among college students.
Student populations at community colleges differ significantly from those at four-year colleges; they are typically more diverse, with higher rates of first-generation and minority students. The educational technology company EVERFI published a report describing the distinct needs of community colleges regarding student substance use, sexual assault and mental health. While these issues are extensively studied and addressed at four-year institutions, community college have largely been left out of the conversation. According to the EVERFI report, community college students are 20 percent more likely to have experienced sexual assault, and 50 percent more likely to have experienced relationship violence before arriving on campus than their counterparts at fouryear institutions.
Community College Students Have Unique Needs Regarding Sexual Assault, Substance Use, and Mental Health
However, community college students are more aware of how to report sexual assault than students at four-year colleges and universities. The report also showed no significant differences in drinking rates between community college students and their peers at four-year residential schools, though the impact of alcohol use appears to be different between the two populations. Community college students who drink alcohol are less likely than students at four-year colleges to experience negative consequences associated with drinking, such as blackouts, hangovers, and academic issues. The report authors posit that this may be due to a lower likelihood of engaging in high-risk drinking behaviors, such as binge and high intensity drinking. Community college students face high rates of mental health issues, with 50 percent reporting having experienced an issue during the past year. Additionally, 36 percent of students reported struggling with depression, 29 percent with anxiety, and 11 percent reported suicidal ideation, rates that are higher than students at fouryear institutions. Furthermore, 70 percent of community college students who have experienced a mental health issue did not seek counseling or mental health services. The report states that â&#x20AC;&#x153;These findings illustrate the need for community colleges to increase outreach to students and ensure they have access to adequate resources both on campus and in the community.â&#x20AC;? Rob Buelow, vice president of prevention education at EVERFI says that he hopes the report will motivate community college administrators to educate both faculty and students about these issues.