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NCHA Data: Administrative and Clinical strategies for linking (mental) health and substance abuse disorders to academic success.

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Title: NCHA Data: Administrative and Clinical strategies for linking (mental) health and substance abuse disorders to academic success.


1
NCHA Data Administrative and Clinical strategies
for linking (mental) health and substance abuse
disorders to academic success.
  • Joy Himmel, Psy D.
  • Director, Health and Wellness Center, Penn St.
    Altoona
  • Keith Anderson, Ph.D.
  • Psychologist, Rensselaer Polytechnic Inst.

2
Objectives
  • Issues that influence student learning and
    academic progress.
  • Prevalence of disorders and a review of NCHA data
    and trends.
  • Identifying strategies to develop best practice
    guidelines that promote academic success.

3
Issues that influence student learning and
academic progress.
  • Determining barriers to academic success
  • Surveys
  • NCHA
  • Data collected from 2000 to 2005
  • Current analysis uses Spring 2005 data set
  • N 54,111
  • AUCCCD
  • Survey of Counseling center directors
  • Data is from Fall 2005
  • N 366

4
Impediments to Academic Success
  • Stress 31.6
  • Cold/Flu 26.5
  • Sleep Problems 24.8
  • Depression 15.3
  • Internet Use/ Games 14.2 (3-6 of students
    addicted to internet pornography 20 are women)

5
ACHA-NCHA Spring 2005
American College Health Association. American
College Health Association - National College
Health Assessment (ACHA-NCHA) Web Summary.
Updated April 2006. Available at
http//www.acha.org/projects_programs/ncha_sampled
ata.cfm. 2006
6
Academic performance impaired by impact of
Alcohol use
Percentage
7
Academic performance impaired by
Depression, Anxiety, Seasonal Affective
Disorder
Percentage
8
Academic performance impaired by
Drug Use
Percentage
9
Academic performance impaired by Internet/Computer
game use
Percentage
10
Evidence for Rise in Psychological Distress
  • Big 10 Universities Student Suicide Study
    (1980-1990)
  • CDCs YRBS ( 1999 - 2003)
  • CDCs NCHRBS (1995)
  • ACHA-NCHA - Spring 2000 - 2004
  • AUCCCDs Annual Surveys
  • Published literature

11
Rise on college campuses
  • Earlier identification and referral (high school)
  • Improved treatment options
  • Decreased stigma (high school college)
  • Increased accessibility/availability
  • Greater use of structured screening tools,
    web-based resources
  • Improved accommodations
  • Greater parity with physical health
  • More students working, increased stress

12
Consequences of increased demands for service
  • Advocating for more staff
  • Increased wait times
  • for intake and between sessions
  • premature drop out
  • if we focus on those with more severe disorders,
    do some students fall between the cracks?
  • Requires an analysis of our mission
  • Who should we serve?

13
Related (but often unapparent) concerns
  • Do some avoid treatment, problems stigma, center
    reputation, concerns about confidentiality.
  • How do we reconcile a high demand for service
    with concerns that some are still untreated.

14
Why Some Students Do Not Use University
Counseling Facilities
  • For help with all kinds of problems, friends were
    the first choice, parents were the second choice,
    and faculty and psychological services the last
    choice.
  • Counseling centers should begin to focus their
    attention on more preventive-oriented types of
    services rather than traditional remediation,
    which may include being available to the student
    in his own life space rather than in the
    counseling center.
  • Derksen, Timothy Hill, Clara Snyder, John. Why
    Some Students Do Not Use University Counseling
    Facilities. Journal of Counseling Psychology 19
    No.4 (1972) 263-268.

15
Stigma of Psychological Therapy Stereotypes,
Interpersonal Reactions, and the Self-Fulfilling
Prophecy
  • Negative attitudes were displayed toward people
    who sought psychological assistance from a
    clergyman or from a psychiatrist.
  • A person described as seeking counseling is rated
    more negatively than is a typical person.
  • Dovidio, John Sibicky, Mark. Stigma of
    Psychological Therapy Stereotypes, Interpersonal
    Reactions, and the Self-Fulfilling Prophecy.
    Journal of Counseling Psychology 33 No.2 (1986)
    148-154.

16
Finding value in our services Retention
  • 562 students asking for counseling followed over
    2 year period
  • 0 sessions 65 1-12 79 gt13 83
  • Several studies followed people over 5 years all
    showed dramatically higher retention rates,
    averaging more than 10 for students who used
    counseling services
  • Steve Wilson, Terry Mason, Evaluating the impact
    of receiving university based counseling services
    on student retention
  • Journal of Counseling Psychology 1997 vol 44. no
    3 p. 316-320

17
Retention
  • Social Isolation single most important
    determinant of dropout rates
  • Pascarella and Terrazini, 1979
  • Emotional- Social Adjustment items predicted
    attrition better than academic items
  • Gerdes and Mallinckrodt 1994
  • 5 year study of Berkeley students and those
    making use of counseling had higher graduation
    rates
  • Frank and Kirk 1975

18
Retention
  • Counseling records of 2365 students and student
    body records of 67,026 over 6 years(473 /13,400)
    at Western Land Grant University.
  • 70 report that personal problems were affecting
    their academic progress
  • 70.9 retention of students in counseling, 58.6
    retention in control group over 6 years (annual,
    eventual, graduation and total retention)
  • Annual rates were 85.2 vs. 73.8
  • Andrew Turner Journal of College Student
    Development, Nov. Dec 2000

19
Common Presenting Problems
  • Mood Disorders
  • In any given year- 9.5 of US population age 18,
    or 20.9 million adult Americans,
  • 16.3 indicate that depression/anxiety/SAD affect
    academics (NCHA, spring 2005)
  • Major Depressive Disorder
  • Dysthymic Disorder
  • Cyclothymia
  • Bi Polar Disorder
  • Depressive Disorder NOS
  • Twice as many women as men
  • NIMH Facts about Depression

20
Signs and Symptoms
  • Prolonged sadness/increased crying
  • Noticeable changes in appetite and sleep patterns
  • Worry, anxiety
  • Irritability, agitation, anger
  • Pessimism, indifference
  • Loss of energy, persistent lethargy
  • Unexplained aches and pains
  • Excessive feelings of guilt, worthlessness,
    hopelessness
  • Difficulty concentrating, indecisiveness
  • Social Withdrawal, loss of pleasure in things of
    interest
  • Excessive consumption of alcohol or other drugs
  • Recurring thoughts of death or suicide

21
The Prevalence of Depression as a Function of
Gender and Facility Usage in College Students
  • The rate of depression is 50 higher for college
    students than for non-student peers.
  • One-third of college drop-outs suffer depression
    just before leaving school.
  • Men are more likely to present psychological
    problems at a health facility with a
    nonpsychological image.
  • Students with somatic symptoms associated with
    depression are seen quite frequently at
    infirmaries.
  • Balzer, Diana Pillsbury, Elecia Nagelberg,
    Daniel. The Prevalence of Depression as a
    Function of Gender and Facility Usage in College
    Students. Journal of College Student Personnel
    (Nov 1983) 525-529.

22
Percentage of High School Students Who Felt Sad
or Hopeless, 1999 - 2003
Felt so sad or hopeless almost every day for gt
2 weeks in a row that they stopped doing some
usual activities during the 12 months preceding
the survey 1 No change over time
National Youth Risk Behavior Surveys, 1999 2003
23
2005 Spring Survey Results
American College Health Association. American
College Health Association - National College
Health Assessment (ACHA-NCHA) Web Summary.
Updated April 2006. Available at
http//www.acha.org/projects_programs/ncha_sampled
ata.cfm. 2006
24
Felt things were hopeless
Percentage
Number of Incidents
NCHA 2000/05
25
ACHA-NCHA Spring 2005
American College Health Association. American
College Health Association - National College
Health Assessment (ACHA-NCHA) Web Summary.
Updated April 2006. Available at
http//www.acha.org/projects_programs/ncha_sampled
ata.cfm. 2006
26
Felt so depressed it was difficult to function
Percentage
NCHA 2000/05
27
ACHA-NCHA Spring 2005
American College Health Association. American
College Health Association - National College
Health Assessment (ACHA-NCHA) Web Summary.
Updated April 2006. Available at
http//www.acha.org/projects_programs/ncha_sampled
ata.cfm. 2006
28
Seriously considered attempting suicide
Percentage
NCHA 2000/05
29
ACHA-NCHA Spring 2005
American College Health Association. American
College Health Association - National College
Health Assessment (ACHA-NCHA) Web Summary.
Updated April 2006. Available at
http//www.acha.org/projects_programs/ncha_sampled
ata.cfm. 2006
30
Percentage of High School Students Who Seriously
Considered Attempting Suicide, 1991 - 2003
During the 12 months preceding the survey 1
Significant linear decrease and quadratic effect,
p lt .05
National Youth Risk Behavior Surveys, 1991 - 2003
31
Summary of Suicide Suicide Attempts Comparing
18-24 year olds to total population 2001
  • Female youths attempt at a slightly higher rate,
    however
  • Male youths are more likely to have a fatal
    outcome

Source CDC WISQARS Fatal Non-fatal 2001
32
Risk Factors for Youth Suicide
  • Personal Characteristics
  • Psychopathology (mood disorders, substance abuse)
  • History of prior attempt
  • Cognitive and personality factors, including
    hopelessness and poor interpersonal
    problem-solving
  • Biological factors (primarily serotonin function)

Gould MS, Greenberg T, Velting DM, Shaffer D.
Youth suicide risk and preventive interventions
a review of the past 10 years. Journal of the
American Academy of child Adolescent Psychiatry.
200342(4)386-405.
33
Risk Factors for Youth Suicide
  • Family characteristics
  • History of suicidal behavior
  • Parental psychopathology
  • Adverse life circumstances
  • Stressful life events, loss, legal/disciplinary
    problems, bullying
  • Physical abuse
  • Sexual abuse
  • Socio-environmental
  • Academic problems/failure
  • Media influence (contagion)

Gould MS, Greenberg T, Velting DM, Shaffer D.
Youth suicide risk and preventive interventions
a review of the past 10 years. Journal of the
American Academy of child Adolescent Psychiatry.
200342(4)386-405.
34
Suicide Among College Undergraduates
  • Therefore, our best estimate of number of
    suicides and attempts among all U.S. college
    undergraduates to date,
  • approx. 1,305 will die as a result of suicide
    /year
  • approx. 31,469 will attempt suicide /year
  • Note suicides using Big Ten suicide rate for
    17-24 year olds 6.3/100,000 18-24 year old
    undergraduates 9,367,000 30 767 college
    undergraduate suicides/year
  • and using Harvard Pilot suicide rate for 18-24
    year olds 3.74/100,000 18-24 year old
    undergraduates 9,367,000 30 455 college
    undergraduate suicides/year
  • In order to know the true number of college
    undergraduate suicides attempts, we need to
    know the rate of suicide attempts among this
    population

Source rate is weighted average of 17-19 and
20-24 categories CDC WISQARS Fatal Non-fatal
2001
35
Academic Consequences
  • Consistently high/significant correlations
    between GPA and
  • Hopelessness
  • Feeling exhausted
  • Considering/attempting suicide
  • Feeling so depressed it was difficult to function

36
Bipolar Disorder
  • In any given year 5.7 million American Adults
    have Bipolar (2.6).
  • Commonly diagnosed in college age
  • 20-25 increased risk of committing suicide
  • Signs and Symptoms
  • Irritability, distractibility, increased energy,
    elation, racing thoughts, decreased need for
    sleep, reckless behavior, decreased need for
    sleep, loss or reason

37
Anxiety Disorders
  • In any given year, anxiety disorders affect about
    40 million Americans (18), NCHA spring 2005,
    (13.4)
  • All symptoms cluster around excessive, irrational
    fear and dread, subjective tension.
  • Generalized Anxiety Disorder
  • Panic Disorder
  • PTSD
  • Obsessive-Compulsive Disorder
  • Social Phobia
  • (NIMH-Facts about anxiety disorders)

38
Signs and Symptoms
  • Worrying about things big and small
  • Headaches or other aches and pains for no reason
  • Tense, difficulty relaxing, pressured speech
  • Trouble concentrating
  • Irritable
  • Trouble falling asleep or staying asleep
  • Sweats, hot flashes
  • On guard, hyper vigilant

39
Adjustment Disorders
  • Precipitators of stress
  • Common stressors include
  • Greater academic demands
  • Being on your own in a new environment
  • Changes in family relations
  • Financial responsibilities
  • Changes in your social life/fitting in
  • Exposure to new people, ideas, and temptations
  • Awareness of your sexual identity and orientation
  • Preparing for life after graduation
  • (NIMH)

40
National College Health Assessment Data - Alcohol
American College Health Association. American
College Health Association - National College
Health Assessment (ACHA-NCHA) Web Summary.
Updated April 2006. Available at
http//www.acha.org/projects_programs/ncha_sampled
ata.cfm. 2006 .
41
Major characteristics of abuse and dependency
  • Abstinence
  • Experimentation-episodic use without pattern or
    consequences
  • Social/Recreational- seek it out, no established
    pattern or negative consequences
  • Habituation- established pattern
  • Abuse- use despite consequences
  • Addiction- Abuse plus compulsion
  • (Inaba, 2003)

42
Cognitive impact of substance abuse
  • Two to three standard drinks can directly
  • interfere with restful sleep
  • Cause slow thinking processes- Lack of glycogen
    to the brain
  • Impairment in sustained concentration
  • Impairment in reaction time
  • Ability to use abstract thought processes
  • (Dodes, 2002)

43
Impact of Alcohol Abuse
  • The positive
  • 74.6 use a designated driver, 64.1 keep track,
    42 avoid drinking games, 33.9 determine in
    advance not to exceed a set number, 76.9 eat
    before they go out

44
Michigan Alcohol Screening Test Scores and
Academic Performance in College Students
  • Several studies have indicated that problem
    drinking behaviors among college students can
    lead to legal, academic, or social difficulties.
  • Freshman reported a significantly greater weekly
    drinking frequency, Sophomore weekly alcohol
    consumption was significantly greater than
    consumption frequencies reported by junior,
    senior, or graduate students.

45
Academic Consequences
  • A significant inverse correlation was obtained
    between GPA and weekly alcohol consumption. This
    was evident for persons with GPAs below 2.5.
    Students reporting lower GPAs (1.5-1.9) also
    reported a significantly greater weekly
    consumption of alcohol.
  • Data indicated negative correlation between the
    students average weekly alcohol consumption and
    their GPA. Students in the lowest GPA category
    (1.5-1.99) had the greatest mean alcohol
    consumption rate.
  • Lall, Rakesh Schandler, Steven. Michigan
    Alcohol Screening Test Scores and Academic
    Performance in College Students. College Student
    Journal (1988) 245-251.

46
Consequences to alcohol use and abuse
  • 37 did something they later regretted
  • 15 had unprotected sex
  • 30 experienced blackouts
  • 18.5 physically injured
  • Only 4.1 report experiencing substance abuse
    problems, 7.6 indicate that use affected
    academics,
  • (NCHA, spring 2005)

47
Other common problemsSleep
  • Correlations between sleep patterns and reported
    GPA
  • Consequences of sleep loss poor academic
    performance, increased medical illness and
    increased rates of depression and anxiety.
  • (Armitage, R., 2004)
  • 24.8 report that sleep has affected academics,
  • (NCHA, spring 2005)

48
Sleep Quality, Sleep Propensity and Academic
Performance
  • 15 of college students experience poor sleep
    quality.
  • The median length of sleep reported by college
    students has decreased by over one hour across
    the last three decades. (Hicks, Fernandez,
    Pellegrini)
  • Higher GPAs were associated with, waking up less
    often during the night, taking fewer naps, and
    sleeping somewhat longer on school nights.

49
Sleep Quality and Academic Performance
  • For a sample of 148 undergraduates that those who
    slept on the average less than six hours per
    night had lower self-reported GPAs than those who
    slept nine hours or more. (Kelly, Kelly, Clanton)
  • Lower GPAs were significantly associated with
    later weekday and weekend bedtimes, later weekday
    and weekend wake-up times, and longer hours of
    sleep on weekend nights. (Trockel, Barnes, Egget)
  • Howell, Andrew Jahrig, Jesse Powell, Russell.
    Sleep Quality, Sleep Propensity and Academic
    Performance. Perpetual and Motor Skills 99
    (2004) 525-535.

50
Sleep Problems
  • 35 of adult population experience insomnia
  • 11 of college students get a good nights
    sleep
  • Loss of cognitive functioning, driving
  • Increased risk of depression
  • lt 7 hours yields sleep deprivation

51
UA Student Quality of Sleep Project
  • Mean bedtime 1243, minutes to fall asleep-25,
    usual wake up time- 815, usual hours of
    sleep-6.8
  • Those with mental health issues and those
    drinking five or more standard drinks per
    occasion had greater levels of disordered sleep
  • Two-thirds of the students are dealing with
    anxiety and over half are experiencing
    depression.
  • Women are at higher risk for sleep disorders and
    negative outcomes
  • (Student Health Spectrum, November 2006)

52
Internet Use/computer games
  • 13.4 report interference with academics (NCHA,
    spring 2005)
  • 42 gambled in the past year and 2.6 gamble
    weekly or more frequently (JACH, Sept. 2003)
  • The Council on Compulsive Gambling of New Jersey
    survey, College age gambling moved from11.7 in
    2002 to 20.9 in 2005.(www.800gambler.org)
  • 80/15/5 Rule Social, Problem, Compulsive

53
Stress
  • 31.6 indicate that stress has affected academics
    (NCHA, spring 2005)
  • Evidence based interventions
  • CBT, changing thinking
  • Behavioral interventions
  • Wellness prevention and intervention programs
    involving nutrition, sleep, exercise

54
Influences of Stress and Situation-Specific
Mastery Beliefs and Satisfaction with Social
Support on Well-Being and Academic Performance
  • Stress was positively correlated with somatic and
    psychological disorder and negatively correlated
    with GPA. The correlations were modest for GPA
    (r-.21,plt.05), anxiety (r.35,plt.001), and
    somatic disorder (r.31,plt.001) but stronger for
    depression (r.47,plt.001).
  • Grade point average was negatively related to
    stress.
  • Stress was associated with increased somatic and
    psychological symptomatology and decreased GPA.
  • Felsten, Gary Wilcox, Kathy. Influences of
    Stress and Situation-Specific Mastery Beliefs and
    Satisfaction with Social Support on Well-Being
    and Academic Performance. Psychological Reports
    70 (1992) 291-303.

55
Eating Disorders
  • Females are much more likely than males to
    develop an eating disorder. Only an estimated 5
    to 15 percent of people with anorexia or bulimia
    and an estimated 35 percent of those with
    binge-eating disorder are male.

56
Bulimia
  • Recurrent episodes of binge eating
  • Recurrent inappropriate compensatory behavior in
    order to prevent weight gain
  • The binge eating and inappropriate compensatory
    behaviors both occur, on average, at least twice
    a week for 3 months

57
  • Anorexia
  • Resistance to maintaining body weight at or above
    a minimally normal weight for age and height
  • Intense fear of gaining weight or becoming fat,
    even though underweight
  • Disturbance in the way in which one's body weight
    or shape is experienced, undue influence of body
    weight or shape on self-evaluation, or denial of
    the seriousness of the current low body weight
  • Infrequent or absent menstrual periods (in
    females who have reached puberty)

58
  • Binge Eating Disorder
  • Recurrent episodes of binge eating
  • The binge-eating episodes are associated with at
    least 3 of the following eating much more
    rapidly than normal eating until feeling
    uncomfortably full eating large amounts of food
    when not feeling physically hungry eating alone
    because of being embarrassed by how much one is
    eating feeling disgusted with oneself,
    depressed, or very guilty after overeating
  • The binge eating occurs, on average, at least 2
    days a week for 6 months

59
Strategies that promote academic success.Share
information/dataRecruit allies
60
Identify Your Data Needs
  • How busy is counseling? Waiting lists?
  • Where else do students get care?
  • Retention track carefully. Who comes back? How
    is GPA affected.
  • How do students get medication? Insurance?
  • How many students are hospitalized?
  • Student Research gets students engaged

61
Identify barriers to treatment
  • What factors make it less likely that those in
    distress will seek help?
  • Hours of operation
  • Attitudes about seeking help
  • Reputation of the counseling center
  • Physical location
  • Integrated vs non integrated
  • Wait times
  • Welcoming environment
  • Outreach

62
Academic Difficulties
  • Encourage faculty to notice students who are
  • Absent
  • Withdrawn
  • Excessively anxious about performance
  • Engaging in disruptive behaviors
  • Exaggerated emotional response that is
    inappropriate to the situation
  • Talk about giving up
  • Present with hopelessness or helplessness

63
Screening Programs
  • A form of outreach and education
  • College Response National screening Program
    (Depression, Bipolar, GAD, PTSD, Eating
    Disorders, Alcohol)
  • Anonymous screening 24/7
  • 509 Colleges and Universities 2004, 130,000
    on-line screenings
  • 26 of college students who scored positive for
    depression, and 27 who scored positive for
    Bipolar had thoughts about or wanted to commit
    suicide (2003 results).

64
New Directions
  • Increase recognition, treatment and compliancy
    (less than 50 use psychotropic medication
    correctly and consistently, MDE- 6 wks,
    continuing through 6 months).
  • Incomplete remission of depressive symptoms is
    associated with higher rates or reoccurrence.

65
The opportunities and challenges of timely
diagnosis, inadequate treatment and
poorly-adherent patients
  • Early identification and intervention programs
  • Health risk assessments in Health Services which
    include depression, ATOD, anxiety, sleep, abusive
    relationships and stress.
  • AIP Programs utilizing a Comprehensive Wellness
    model
  • High school to college social norms based alcohol
    prevention programs

66
How Far High School to College Transition
Program Results After viewing the video
  • Participants were 2.62 more likely to say no to
    drinking games, 6 weeks later 2.23 times more
    likely
  • 2.5 times more likely to make a safety plan, 6
    weeks later 7 times more likely
  • 2 times more likely to intervene at mid-semester
  • 50 more likely to make plans to use a
    designated driver, 6 weeks later four times more
    likely
  • Keep track of number of drinks- 5, 16, 31

67
Perception changes
  • Five or more- reduced from 62 to 18 to 33
  • Three or more nights a week- 72 to 38 to 62
  • Number of college students who do not drink/drive
    -18. 49, 31

68
Primary care setting models-
  • Duke University/Dartmouth study
  • Structured rating scales for depression used by
    the primary health care provider
  • Behavioral health care manager
  • Counseling if necessary
  • (Friedlander,Student Health Spectrum, November
    2006)

69
Other models
  • Integrated vs nonintegrated centers
  • Community Mental Health Model
  • Depression Disease Management Program (Aetna),
    regularly checked on patients who were on
    antidepressant medication. They showed a 15
    improvement in adherence rates for participants
    compared to those not enrolled in the program.

70
Case management in College Health
  • Trained clinicians in motivational interviewing
  • Shared positions within integrated Centers
  • Red Flags
  • Co-morbid disorders
  • History of poor adherence to treatment
  • Crisis Center, ER, or inpatient admissions
  • Abrupt onset
  • Chronic and persistent mental illness

71
Creating partnerships.. From the very
beginning
  • Parent orientation welcoming session during
    drop-off day
  • Parent website
  • warning signs of
  • how to talk to your child about.
  • how to/when to reach us about ..
  • how we can help/what we can do about
  • identifying the limits of our service.

72
Training and Education
  • Techniques for assessment and identification
    (observing asking)
  • Skills for listening and providing support
  • Procedures for referral
  • What constitutes a cry for help
  • Audience faculty, coaches, clergy, residential
    staff, academic advisors, student advisors, tutors

73
Non-Clinical Student Support Services Network
  • A form of outreach and education
  • Telephone helplines
  • On-call services
  • Peer support groups
  • The Five Ds family deaths, disasters,
    divorces, debts, decay

74
Campus-Wide Public Health Education
  • Student newspaper articles/radio spots
  • How to be a good friend/neighbor
  • How to manage winter blues
  • How to seek help
  • How to recognize signs/symptoms of
  • What is a cry for help/warning sign
  • The role of alcohol in this community

75
How many students receive information on suicide
prevention?
  • Only 14 of students receive information on
    suicide prevention, the least of any health
    issue.
  • Most students receive their health information
    from their parents, leaflets, friends, and
    magazines, however
  • the most trusted believable sources are health
    educators student health service medical staff.
  • Important for college counseling staff to provide
    necessary information on suicide prevention,
    opportunity to fill void.

Source NCHA Survey 2004
76
Students Receiving Information from their college
Percentage
77
Rensselaers Self Assessment Program
  • Designed to identify students who might fall in
    the cracks.
  • Make use of technology to provide information
  • Effective prescreening
  • Information from, Counseling Center, Health
    Educator, Health Center, ALAC

78
(No Transcript)
79
  • I spend so much time online that my grades
    suffer.
  • 1. It is easy to spend more time on-line than
    you realize. Getting lost in the internet,
    playing games, on-line gambling, or surfing an
    auction site can be time consuming. Many people
    loose track of the time spent and as a result end
    up not getting their work done or sacrificing the
    social or recreational time.
  • 2. If you find yourself spending more time
    on-line and not getting your work done, or not
    leading a balanced lifestyle, you may need to
    consider ways of monitoring how much time is
    being used. Consider looking for strategies for
    monitoring how much time you spend on-line. If
    this time is making it difficult to keep up with
    your schedule or spending time with your friends,
    it may be time to cut back. If you find that
    cutting back is difficult, consider talking with
    someone who can help you with your schedule.
    Some sources include ALAC, the Health Educator
    and the Counseling Center.
  • 3. Spending large amounts of time on-line can
    have many negative effects on your grades and
    social life. If you find your losing track of
    time on-line, ignoring your other
    responsibilities, losing track of your friends,
    having difficulty keeping up with your class
    assignments, or getting behind in your work,
    contact ALAC, the Health Educator and the
    Counseling Center
  • 4. Some of the warning signs of internet
    addiction include, spending increasing amounts
    of time on-line, skipping meals when on-line,
    cutting back on important activities to spend
    time on-line, unsuccessful efforts to cut back on
    time on-line, spending time on-line even when
    doing so has negative effects. If you notice
    these, or any related symptoms, you should
    contact the counseling center.

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  • I believe that I know how to study for and take
    tests in the most effective ways. I know that
    studying doesnt just mean visually reviewing
    the course material.
  • 1. Knowing how and what to study is very
    important. Your resources include your
    professors and TAs (they make and grade the
    exams), your LA or TLA, and the Advising and
    Learning Assistance Center. We offer free
    tutoring and academic suggestions. We can teach
    you how to most effectively read your text book,
    take notes, practice problems, and the importance
    of studying alone and in groups. Take the time
    now to learn how to study. It will pay off in
    your understanding and preparation for your
    courses and your future career.
  • 2. Your confidence and grades will improve when
    you begin to understand how and what to study,
    and when you do so in a regular and planned way.
    If you need suggestions, contact the Advising and
    Learning Assistance Center, your LA or TLA in the
    Residence Halls. We can teach you how to study
    for and take tests successfully.
  • 3. Making the time to study adequately every day
    begins on the first day of classes. Regular
    review, plenty of rest and a healthy diet can
    also help with test taking. For more tips,
    contact your LA, TLA, or the Advising and
    Learning Assistance Center.
  • 4. Mastering the art of test preparation and test
    taking is a major feat at the college level!
    Keep up the great work, and always feel free to
    seek further fine tuning and assistance from your
    professors as you need it, or contact the
    Advising and Learning Assistance Center for more
    suggestions.

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  • I know my family history for Heart disease
  • 1. If you do not know your family history, ask
    your family the next time you visit. Knowledge
    of your family history will allow you to make
    healthy choices! You might want to know that
    cardiovascular disease is the leading cause of
    death in the US. Risk factors for cardiovascular
    disease include physical inactivity, high
    cholesterol, high triglycerides, diabetes,
    hypertension, excessive body fat, smoking,
    tension and stress, age, and personal and family
    history of CVD. If you find out that you have
    some of these risk factors and want to make
    healthy changes in your diet, exercise or talk to
    someone about your risks, make an appointment
    with the health educator or the medical clinic at
    the student health center.
  • 4. If you have no family history of heart
    disease, great! If you have cardiovascular
    disease in your family, you probably know this is
    the leading cause of death in the US. Risk
    factors for cardiovascular disease include
    physical inactivity, high cholesterol, high
    triglycerides, diabetes, hypertension, excessive
    body fat, smoking, tension and stress, age, and
    personal and family history of CVD. If you have
    some of these risk factors and want to make
    healthy changes in your diet, exercise or talk to
    someone about your risks, make an appointment
    with the health educator or the medical clinic at
    the student health center.

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Early Warning System
  • Service initiated by Academic Advising and
    Counseling Center
  • Administered by Registrars office
  • Formation of the Intervention team
  • ALAC, Counseling Center, Residence life
  • Required training of faculty as the first
    responders

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Stress Reduction Programs
  • Hygiene-diet, exercise, sleep
  • Social skills
  • Academic skills
  • Time management
  • Support groups (losses, bereavement, gender
    identity, etc.)
  • Dealing with stress during a time of war
  • Choosing courses and careers

84
Emergency Services
  • 24-hour access
  • Where to go/Whom to call/What to expect
  • Community emergency/Crisis intervention services
  • Mobile support services
  • Hotline numbers

85
Medical Leave Policies
  • Policies, procedures, protocols, panels, policing
  • Is the student able to function as a student?
  • Is the behavior disruptive to the community?
  • Re-entry protocols and criteria
  • Programs for returning students

86
Postvention Programs
  • Crisis intervention/Emergency teams
  • Support, assistance, direction
  • Bringing closure
  • Media relations

87
Faculty and Staff Consultation Services
  • Assessing the need for referral or intervention
  • Available Resources
  • Clarifying your own thoughts about the student
    and make recommendations
  • Discuss follow up concerns
  • Faculty and staff training

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Coordination of Care
  • Handbook expectations who gets notified about
    hospitalization/ return
  • Identifying high-risk students
  • How is residence involved with worrisome
    students?
  • Eating Disordered or Substance Abusing students
    in residence, what happens?
  • Contracts When to invoke them

89
Referral Network
  • Licensed and certified mental health
    professionals
  • Multi-disciplined
  • Multi-ethnic
  • Developmental perspective
  • Available locations
  • Accommodating hours
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