Students who suffer from depression or anxiety can experience many adverse effects on their academic and social lives and, consequently, are more likely to drop out of school or achieve lower grade-point averages.1 NYU’s award-winning systems and services to address mental health in the university community include a collaborative approach among NYU primary care, counseling services, and care management; routine screening for depression in all primary care appointments; and the 24-7 Wellness Exchange hotline and crisis response. As the mental health needs of college students increase, both in the number of students seeking services and the severity of the pathology,2 it is imperative that NYU continue to develop innovative approaches to engage students in necessary treatments.
- Suicide is the third leading cause of death among 15-24 year olds.3
- 22.5% of NYU students reported that anxiety had impacted their academic performance in the past 12 months.4
- 55% of NYU students reported that emotional or mental difficulties had hurt their academic performance for one or more days in the past month.5
- 59% of NYU students demonstrating symptoms of depression reported that problems resulting from these symptoms had made it difficult forthem to do their schoolwork, take care of things at home, or get along with other people.5
- 17.9% of adults between the ages of 18 and 25 reported experiencing serious psychological distress in 2007.5
- 8.9% of adults between the ages of 18 and 25 reported experiencing a major depressive episode within the past year.7
- 90% of college or university counseling center directors in the United States report an increase in psychological problems among their students.7
- The proportion of students, nationally, with a previous diagnosis of depression increased from 10% to 15% between 2000 and 2005.8
- 75% of lifetime mental disorders have first onset by the typical college age range of 18-24.9
- Develop mental health outreach targeted to specific at-risk student groups to increase utilization of treatment.
Students from different backgrounds may experience greater levels of stigma toward mental health issues. For example, studies have shown that Asian international students - compared with American students - experience greater discomfort or shame with counseling, less openness to counseling, and a greater preference for a flexible counseling format.10 Young adults who perceive public stigma surrounding mental illness are less likely to perceive a need to seek help.11 This perception of stigma can contribute to underutilization of university mental health services, while concerns regarding language and culture can act as barriers to counseling.10 New models advocate for a culturally sensitive continuity of care which tailors mental health outreach and services to diverse groups of people.12 Ensuring that NYU’s counseling services are culturally competent to accommodate the needs of a diverse student population is a necessity.
- Raise student awareness of the impact of anxiety and depression on their ability to learn, function, and succeed.
Depression is a significant predictor of not only GPA but also the likelihood of withdrawing from the university.1 Untreated depression is associated with a decrease ofa 0.49 point, or half a letter grade, in a student’s grade point average.13 In contrast, treatment for depression is correlated with a protective effect of 0.44 points.13 Students who report greater psychological distress also tend to view themselves as less capable of succeeding, are more anxious about their class performance,14 and possess lower self-efficacy and resource management skills.13 With increased knowledge of the impact of mental health issues on their academic performance and college experience, students may be more likely to seek help or support.
- Educate university staff and faculty about the impact of anxiety and depression on learning outcomes, ability to function, and student success.
By virtue of their interactions with students, university staff and faculty are uniquely positioned to have a positive impact on their students’ mental health. Research has shown that when faculty and students are trained to recognize symptoms of depression, students may increase treatment-seeking behaviors.15 Studies have emphasized the importance of training faculty and staff to understand the relationship between mental health and learning.16 Additionally, graduate students who have functional relationships with their advisors are less prone to report emotional or stress-related problems.17 Creating a university-wide culture and environment that encourages inclusiveness and support to augment campus mental health services has been recommended to improve outcomes for students.16
- Expand the development and utilization of holistic therapeutic interventions.
Evidence-based holistic interventions, such as biofeedback, art therapy, and music therapy have been shown to supplement traditional mental health treatments. Participation in the arts can benefit those with mental health difficulties, particularly increasing feelings of empowerment18 and coping abilities.19 Students using biofeedback in combination with relaxation techniques reported significantly lower anxiety and less mental and physical manifestations of stress than did those using relaxation techniques alone.20 Music, as used by music therapists, has the potential to ameliorate the mental health of those with a variety of psychiatric conditions.21 The expansion of holistic therapeutic intervention offerings may be particularly effective for students with emotional adjustment problems and serve to augment treatment for students with a mental health diagnosis.
- Improve the coordination between NYU Counseling and Wellness Services and treatment providers in the community.
Fragmentation of the behavioral health service delivery system is noted as a significant obstacle to the receipt of quality mental health care.22,23 Monitoring treatment compliance and efficacy among students diagnosed with depression using a multidisciplinary, collaborative approach among NYU primary care and counseling services as well as case management has been shown to ensure that students with mental health needs receive optimal treatment.24 NYU students in need of long-term counseling are referred from Counseling and Wellness Services to high-quality clinicians in the community. Enhancing partnerships and improving coordination between NYU Counseling and Wellness Services and treatment providers in the community ensures that more students will receive effective and necessary mental health care.
- Strengthen connections between NYU Counseling and Wellness Services and student-run mental health interest groups and initiatives.
Student-run mental health initiatives, such as advocacy groups or peer-led education and support, are important components of suicide prevention and mental health promotion. Operating in conjunction with treatment, student mental health interest groups contribute to an atmosphere of inclusion and empowerment for mentally ill students.25 Research suggests that when students become involved with student-run campus mental health awareness and/or advocacy groups, such as Active Minds, their attitudes of stigma toward mental illness decrease.25 Furthermore, interpersonal contact between those with mental illness and those without is an effective strategy in reducing stigmatizing views of people with mental health issues.25
a) Engagement in mental health treatment among students who have seriously considered suicide
- Data Source: ACHA #30J & #31A1-31B7
- Survey Questions: Have you ever seriously considered suicide? & Within the last 12 months have you been diagnosed or treated by a professional for any of the following: anorexia; anxiety; ADHA; bipolar disorder; bulimia; depression; insomnia; other sleep disorder; OCD; panic attacks; phobia; schizophrenia; substance abuse or addiction; other addiction; other mental health condition?
- Definition: of students who have seriously considered suicide within the last 12 months, proportion who have been treated with medication and/or psychotherapy within the last 12 months
b) Depression interfering with ability to function
- Data Source: ACHA #30F
- Survey Question: Have you ever felt so depressed that it was difficult to function?
- Definition: proportion responding “in the last 2 weeks” or “in the last 30 days” or “in the last 12 months”
c) Negative impact on academic performance due to anxiety
- Data Source: ACHA #45A3
- Survey question: Within the last 12 months, have any of the following affected your academic performance: anxiety
- Definition: proportion received lower-grade exam; received lower-grade course; received incomplete/dropped; or significant disruption thesis
- Eisenberg, D., Golberstein, E., & Huntz, J.B. (2009). Mental health and academic success in college. The B.E. Journal of Economic Analysis & Policy (Contributions, Article 40), 9(1).
- Benton, S., Benton, S.L., Tsing, W.C., Newton, F.B., Robertson, J.M., & Benton, K.L. (2003). Changes in client problems: contributions and limitations from a 13-year study. Professional Psychology: Research and Practice, 34, 66-72.
- Xu, J., Kochanek, K.D., Murphy, S.L., & Tejada-Vera, B. (2010, May 20). Deaths: Final data for 2007. National Vital Statistics Reports, 58, 19.
- American College Health Association. (2009). American College Health Association - National College Health Assessment II Web Spring 2009 New York University Institutional Data Report. (2009). Hanover, MD: Author.
- Healthy Minds Study 2009 School Report: New York University.
- Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (2008). Results from the 2007 national survey on drug use and health: national findings (NSDUH Series H-34, DHHS Publication No. SMA 08-4343). Rockville: MD.
- Gallagher, R.P. (2008). National survey of counseling center directors. Alexandria, VA: International Association of Counseling Services.
- National College Health Assessment spring 2006 reference group data report (abridged). (2007). Journal of American College Health, 55,195–206.
- Kessler, R.C., Berglund, P., Demler, O., et al. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62, 593–602.
- Yoon, E., & Jepsen, D. (2008). Expectations of and attitudes toward counseling: A comparison of Asian international and U.S. graduate students. International Journal for the Advancement of Counselling, 30(2), 116.
- Golberstein, E., Eisenberg, D., & Gollust, S. (2008). Perceived stigma and mental health care seeking. Psychiatric Services 59, 392-399.
- Gray, J. & Muehlenkamp, J.J. (2010). Circle of strength: A case description of culturally integrated suicide prevention. Archives of Suicide Research, 14(2), 182 – 91.
- Hysenbegasi A., Hass S.L., & Rowland C.R. (2005). The impact of depression on the academic productivity of university students. Journal of Mental Health Policy and Economics, 8(3), 145-51.
- Brackney, B, & Karabenick, S. (1995). Psychopathology and academic performance: The role of motivation and learning strategies. Journal of Counseling Psychology, 42(4), 456–465.
- Thompson, D., Goebert, D., & Takeshita, J. (2010). A program for reducing depressive symptoms and suicidal ideation in medical students. Academic Medicine, 85(10), 1635-9.
- Warwick, I., Maxwell, C., Statham, J., Aggleton, P., & Simon, A. (2008). Supporting mental health and emotional wellbeing among younger students in further education. Journal of Further and Higher Education, 32(1), 1–13.
- Hyun, J., Madon, Q.B., & Lustig, S. (2007). Mental health need, awareness, and use of counseling services among international graduate students. Journal of American College Health, 56(2), 109-10
- Hacking, S., Secker, J., Spandler, H., Kent, L., & Shenton, J. (2008). Evaluating the impact of participatory art projects for people with mental health needs. Health and Social Care in the Community, 16, 638-648.
- Öster, I., Svensk, A., Magnusson, E., Thyme, K., SjÕdin, M., ÅstrÖm, S., & Lindh, J. (2006). Art therapy improves coping resources: A randomized, controlled study among women with breast cancer. Palliative & Supportive Care, 4(1), 57-64. Retrieved June 28, 2011, from ProQuest Medical Library. (Document ID: 1456907141)
- Fehring, R.J. (1983). Effects of biofeedback-aided relaxation on the psychological stress symptoms of college students. Nursing Research, 32(6), 362-6.
- Lin, S.T., Yang, P., Lai, C.Y., Su, Y.Y., Yeh, Y.C., Huang, M.F., & Chen, C.C. (2011). Mental health implications of music: Insight from neuroscientific and clinical studies. Harvard Review of Psychiatry, 19(1), 34 – 46.
- Pincus, H.A., Pechura, C., Keyser, D., Bachman, J., & Houtsinger, J.K. (2006). Depression in primary care: learning lessons in a national quality improvement program. Administration and Policy in Mental Health and Mental Health Services Research, 33(1), 2-15. doi: 10.1007/s10488-005-4227-1
- Mowbray, C. T., Megivern, D., Mandiberg, J. M., Strauss, S., Stein, C. H., Collins, … Lett, R. (2006). Campus mental health services: Recommendations for change. American Journal of Orthopsychiatry, 76(2), 226-237.
- Chung, H. & Klein, M. C. (2007). Improving identification and treatment of depression in college health. Spectrum, June, 13–19.
- McKinney, K. (2006). Initial evaluation of Active Minds: The stigma of mental illness and willingness of college students to seek professional help. (Unpublished graduate thesis). Colorado State University, Fort Collins, CO.
- Couture, S.M., & Penn, D.L. (2003). Interpersonal contact and the stigma of mental illness: A review of the literature. Journal of Mental Health, 12(3), 291-305.