; Providing Mental Health Services to Non-Traditional Student Populations RESEARCH ASSOCIATE Michael Ravenscroft RESEARCH DIRECTOR Christine Enyeart TABLE OF CONTENTS I. Research Parameters & Methodology II. III. IV. Executive Overview Online Stress Management Resources Engaging Non-Traditional Students
I. RESEARCH PARAMETERS AND METHODOLOGY Project Challenge A midsize private university in the Midwest approached the Council with the following questions: What online services and/or innovative programming do you provide to support students who are experiencing stress? Specific questions included: What are effective, low-cost methods that other institutions use to support for students experiencing stress? In particular, what types of programming are effective for assisting non-traditional student populations (who may take classes in the evening, on weekends, and off-campus)? Sources National Center for Education Statistics http://nces.ed.gov The Chronicle of Higher Education http://chronicle.com National Institute for Mental Health http://nimh.nih.gov National Alliance on Mental Illness http://nami.org Screening for Mental Health http://mentalhealthscreening.org Various university websites Research Parameters This research brief profiles midsize, private institutions that are located in an urban environment and have a substantial population of non-traditional students. The majority of contacts interviewed for this brief were directors of counseling. For the purposes of this report, the term non-traditional student refers to undergraduate students who are above the age of 25 and/or students who attend an institution with unconventional scheduling in pursuit of a degree due to family, career, or other commitments.
I. RESEARCH PARAMETERS AND METHODOLOGY A Guide to Universities Profiled in this Brief Institution Location Classification Enrollment (Total/Undergraduate) Carnegie Classification University A Large City Private Withheld to preserve anonymity Master s Colleges and Universities (larger programs) University B Large Suburb Private Withheld to preserve anonymity Doctoral/Research Universities University C Large City Private Withheld to preserve anonymity Master s Colleges and Universities (larger programs) University D Large City Private Withheld to preserve anonymity Master s Colleges and Universities (larger programs) University E Large City Private Withheld to preserve anonymity Master s Colleges and Universities (larger programs) University F Large City Private Source: National Center for Education Statistics Withheld to preserve anonymity Master s Colleges and Universities (larger programs)
II. EXECUTIVE OVERVIEW Key Observations Contact institutions recommend emailing all undergraduate students throughout the semester with information regarding online counseling resources. Counseling centers at several contact institutions email newsletters with information about general counseling center resources as well as information on various mental health issues. Mass emails are typically sent to the entire student body on a per semester basis. All institutions provide links to national mental health resources on their counseling center website. Several commonly cited resources include the National Institute of Mental Health, the National Alliance on Mental Illness, and other nationally accredited organizations. Contacts recommend providing free, online mental health screenings to students. Online mental health screenings are generally purchased commercially and are available for students to self-diagnose a variety of mental health conditions. All contact institutions keep an active list of individuals and organizations in the community through which students may receive mental health counseling. Contacts state that non-traditional student populations are often most effectively served by therapists, psychiatrists, and other resources in the community. Contacts recommend referring non-traditional students to career services for job-related stress management. Contacts recommend suggesting follow-up counseling sessions to students following their interaction with career services. The majority of contacts refrain from providing counseling services over email. Most institutions have decided against email counseling due to potential legal issues as well as concerns about the effectiveness of email or online counseling.
III. ONLINE STRESS MANAGEMENT RESOURCES Providing Students with Stress Management Resources Online All contacts state that their counseling centers are increasingly interested in providing stress-reduction services to students online in order to reach a wider percentage of the student population. However, few institutions have the resources to fund expansion of current online offerings. The majority of contact institutions recommend providing the following online services to students experiencing stress: Audio stress reduction exercises Downloadable informational pamphlets Online mental health screenings University A: Audio Stress Reduction Exercises University A has an extensive audio library available to all students through the counseling center website. The audio library was compiled by the University A counseling center in collaboration with the counseling center at a partner institution. University A students have access to additional audio files through the Kaiser Permanente website. Students can stream audio files on their computer or download them and listen to them on portable music devices. The audio files feature guided stress-reduction exercises set to relaxing background music. Students are guided in basic stress-reduction techniques such as deep breathing, muscular relaxation, mental relaxation and meditation. Contacts state that the audio library is highly effective for reaching students who are not routinely on campus and are not available to participate in stress-management workshops. Contacts also said anecdotal evidence suggests that students find these audio relaxation exercises effective at relieving stress. Audio stress-reduction techniques are helpful for any student experiencing stress. The best part is that they are easy to learn and students can listen to them on their ipods whenever they re feeling stressed. University A Sending Mass Emails from the Counseling Center to All Undergraduate Students Contacts agree that non-traditional students are often unaware of services that are available at the counseling center and online. As a result, several contacts recommend sending mass emails to all students several times throughout the semester. Emails typically include the following: General information about counseling services and hours of operation Links to any resources available on the counseling center website It s important that students understand what services are offered, and they need to be reminded that they re there, otherwise they are less likely to seek counseling services or use the resources online. - Associate Director of Counseling University F
III. ONLINE STRESS MANAGEMENT RESOURCES Publishing Online Newsletters and Digital Pamphlets Contacts recommend providing an extensive library of materials relating to stress-management on the counseling center website. The majority of contact institutions use informational pamphlets that are available in paper form in the counseling center and publish them online. University D: Digital Newsletters and Pamphlets The counseling center at University D produces a newsletter each semester to highlight various mental health issues to students. Newsletters generally feature information on a range of issues, as well as strategies and tips for coping with everyday stress. Newsletters also advertise upcoming groups and workshops sponsored by the counseling center, as well as general counseling center updates. Newsletters are sent out to all undergraduate students at the beginning of each semester. Compiling and Producing Informational Pamphlets: In addition to the newsletter, the counseling staff posts on the counseling center website a variety of informational pamphlets acquired from the American Psychiatric Association, the National Institute for Mental Health, and other nationally accredited organizations. Additionally, the counseling center produces a variety of pamphlets in-house that are tailored to address the direct concerns of University D students. Pamphlets written by University D counseling center staff are available in Word or PDF format. Reaching Non-Traditional Students: Counselors regularly produce several pamphlets geared toward addressing stress-related issues that pertain specifically to non-traditional students. Topics include: Working while in school Education for individuals with a family commitment Emotional strains of job searches Contacts note that these libraries are particularly effective for reaching students who cannot come into the counseling center to access information. Contacts recommend keeping pamphlets short and to the point, addressing student concerns and offering practical guidance for stress reduction. Digital newsletters and pamphlets are not only a good way to give students some practical information on issues they might be facing, but also keeping them aware of counseling center events, stressmanagement workshops, and community resources that are at their disposal. University D
III. ONLINE STRESS MANAGEMENT RESOURCES Providing Online Mental Health Screenings for Students Several contacts recommend offering online mental health screenings to students. Contacts state that online mental health screenings are effective for helping students to diagnose stress-related conditions and anxiety disorders. University A offers students a mental health screening purchased from Screening for Mental Health, Inc., a non-profit organization that provides educational screening programs. Using the online screening, students can screen for the following: Depression Anxiety/Stress Bipolar Disorder Eating Disorder Obsessive Compulsive Disorder Substance Abuse Following the screening, students are prompted with a message that tells them whether or not their responses are consistent with any of the conditions listed above. Students are also prompted to schedule a follow-up appointment with a counselor for a discussion of the screening results. Contacts at University A state that adult students find this service particularly useful for diagnosing conditions and seeking counseling to discuss the results. Contacts report that 12-15 students each year initiate counseling on the basis of online mental health screenings. Many of the adult students who come into the counseling center tell us that they have used the online screening. We find that it s an effective first step for getting students into the counseling center and addressing their concerns. University A
III. ONLINE STRESS MANAGEMENT RESOURCES Finding Alternatives to Email Counseling Contacts agree that providing counseling services over email and instant messaging is the subject of institutional and national debate. Contacts state that though some members of the national counseling community do consider online counseling an effective means for reaching a broader student population, various drawbacks are often cited, including the following: Legal Issues: University B explored the possibility of providing counseling services to students via web-cam sessions with counselors. Legal questions arising from this practice included questions of whether counselors were legally allowed to practice over the internet if the student is a distance learner taking courses in another state or country. Contacts at University C were advised by the university legal counsel that if a student commits suicide after receiving online counseling, counselors might be liable to malpractice lawsuits. Contacts at University A also note that email is an insecure means of communication and could potentially violate confidentiality laws. Questions about Effectiveness: All contacts state that email counseling should not be considered a substitute for in-person counseling. Contacts at University F, the only contact institution that conducts email counseling, state that though they consider email counseling helpful, students requiring extensive counseling for stress and anxiety are always encouraged to pursue in-person counseling. Additionally, most contacts state that the infrequent nature of email counseling sessions raises questions about the long-term effectiveness of the sessions. Contacts for the most part agree that the legal issues involved with email counseling outweigh the potential benefits, and recommend against counseling students over email or instant messaging. Spotlight: Encouraging Students to Email Counselors with General Questions Instead of providing counseling services online, the University A counseling center encourages students to submit general questions to counselors over email. Students are encouraged to refrain from including overly personal information in emails to counselors. Depending on the nature of the students questions, counselors will either refer students to the counseling center or to individuals and resources in the community. Emailing with a student regarding general questions can work for a while, but never on a long-term basis. There is simply no effective online substitute for in-person counseling. University A
IV. ENGAGING NON-TRADITIONAL STUDENTS Referring Students to Resources in the Community Contacts state that non-traditional students are often best served by individuals and resources in the community. All contacts recommend keeping an active list of therapists, psychiatrists, crisis hotlines, and other resources in the community available through the counseling center website. Spotlight: Strategies for Referring Students to Community Resources Contacts recommend evaluating all community resources before referring students to their services. Institutions should consider the following before referring students to any external online resources: Is this an accredited organization? Who is on the board of directors? Is the organization sufficiently established in the mental health community? I never feel comfortable referring students to either a community or online resource unless we have spoken with someone at the organization and have personal knowledge of their practices. These are often resources that are effective for non-traditional students, but you have to make sure that they will provide legitimate benefit for your students. University E Referring Students to Career Services Over the past year, counseling centers at most contact institutions saw a surge in students reporting stress related to the economic climate and job prospects following graduation. In light of these concerns, counseling centers at University C and University D have started referring students to career services if they report anxiety or stress related to the job market. Contacts at University D state that counseling centers generally only refer students to career services following an initial counseling session. Counselors advise students who call or email with questions about job-related stress to come in for a counseling session, after which they are directed to career services. The initial counseling session allows counselors to evaluate the student and determine whether to recommend further stress-related counseling. Contacts recommend suggesting follow-up counseling sessions to students following their interaction with career services. More and more students are coming to us with stress related to the economy. Even though we re directing students to career services, it s important to let them know that the counseling center is still open to them. We ve found that coordinating the efforts of both offices ensures that students are getting practical advice for how to deal with stress as well as practical advice about the economy. University C
IV. ENGAGING NON-TRADITIONAL STUDENTS Extending Counseling Center Hours Several Days Each Week In order to serve students who are unable to seek counseling services during traditional office hours, the counseling center at University B is open until 8:00 pm two days each week. Contacts at University B state that the majority of students who utilize late hours are primarily non-traditional students. Contacts state that there is high demand for after-hours counseling, and counselors routinely see substantially more non-traditional students after 5:00 pm than during the day. The after-hours counseling has been very successful at reaching students who wouldn t normally be able to find the time to seek counseling. We re currently considering expanding the after-hours counseling and even keeping the office open on weekends. University B
V. ADDITIONAL RESOURCES Online Resources Recommended by Contacts Contacts across institutions suggested a number of additional online resources to which they regularly refer students. The organizations are non-profit and are free for students to access, providing information on a variety of mental health topics. Contacts recommend the following websites: National Institute for Mental Health (NIMH) Website: www.nimh.org National Alliance on Mental Illness (NAMI) Website: www.nami.org Screening for Mental Health, Inc. Website: www.mentalhealthscreening.org All resources are free to the public Institutions register as members Institutions purchase access to online screening programs All publications are free of charge Publications range from brief pamphlets and fact sheets to detailed research on mental health disorders All materials are available in Spanish Streaming videos of selected NIMHsponsored lectures Links to online mental health selfassessments Peer education support programs On-campus education programs Publications include mental health fact sheets and informational pamphlets Non-profit organization that offers online screening programs for depression, bipolar disorder, generalized anxiety disorder, posttraumatic stress disorder, eating disorders, alcohol problems, and suicide prevention
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