Genetic counseling students’ experiences with mental illness during training: An exploratory study

Mental illness is a substantive issue for graduate students. We investigated experiences of mental illness during training among genetic counseling students, a subgroup of graduate students for which little data exists on this topic. Genetic counseling students and recent graduates (n?=?227) completed an online survey, from who 11 were selected to participate in semi-structured telephone interviews. Thematic analysis and member checking were employed to interpret the interviews. An overarching theme of importance to participants’ mental health during genetic counseling training was safety, with subthemes of: trust/confidentiality, stigma and fear of labeling, developing a unique professional identity, and ability to engage in self care strategies. Our data could help genetic counseling training programs develop strategies to support students’ mental health.     

Mental health services: use and disparity among diverse college students

OBJECTIVE: In this empirical study, the authors examined (1) actual use of counseling for emotional problems and (2) the assumptions that ethnicity, sex, social class, and psychological distress are associated with disparities in use of counseling. PARTICIPANTS: Participants were 1,773 diverse undergraduate students at an urban university. METHODS: The authors collected data via self-administered questionnaires between 1999 and 2005; they used a cross-sectional correlational research design, including analysis of variance statistical procedures. RESULTS: Students' level of counseling use (10%) was similar to that estimated for a national college sample. Students reporting higher levels of distress were more likely to use counseling; however, more than three-fourths of students who reported clinically significant levels of distress had not received counseling. CONCLUSIONS: The authors observed no disparities in use of mental health services in terms of sex, ethnicity, and socioeconomic status.     

A women's support group for Asian international students

International students underuse counseling services, which are grounded in Western cultural values. The authors describe a support group for Asian international students that they launched at a large midwestern university to help students feel at ease with American university life, address homesickness, language problems, and academic and social stressors. Co-leaders created a safe and culturally sensitive atmosphere where the women could network, socialize, and address their issues. Group treatment offers many advantages over individual counseling and can enhance the health of international students.     

Mental health among college students: do those who need services know about and use them?

OBJECTIVE: The objective of this study was to examine connections between university students' mental health and their knowledge and use of campus mental health services. PARTICIPANTS AND METHODS: In March 2001, a sample of undergraduate students (N = 266) completed a Web-based questionnaire, providing information related to their mental health, knowledge of mental health services, and use of those services. RESULTS: Students who were mentally distressed were more likely to know about and use services; however, some students who reported to be mentally distressed either did not know about services or knew about services but did not use them. Living off campus, identifying as male, and having fewer years in college were related to less knowledge of campus mental health services. In addition, female sex and number of years in college were predictive of higher service use. CONCLUSIONS: With the high prevalence rates and severity of mental health problems, university mental health providers must continue to make strategic efforts to disseminate knowledge about mental health services to all students.     

Parent-adolescent concordance on perceived need for mental health services and its impact on service use

Mental health service underutilization among African American adolescents is well documented, yet not fully understood. Discordance between adolescents and their parents on perceived need for seeing a counselor for an emotional need or psychiatrist for psychiatric or medical services may help explain low service use among this population. This exploratory, prospective study examined the relationship between parent-adolescent concordance on perceived need for emotional counseling or psychiatric services and mental health service use. The relationships between gender and perceived service need and concordance and adolescent severity of depressive symptoms were also explored. Parent-adolescent dyads (n = 108) receiving community-based adolescent outpatient mental health services responded to interview questions concerning their perception of whether an emotional counselor and a psychiatrist were needed in the past six months. Findings revealed low parent-adolescent concordance on perceived need for an emotional counselor and a psychiatrist. A greater proportion of adolescents reported a need than parents. There was no association between gender and perceived need for an emotional counselor and a psychiatrist. Lower rates of parent-adolescent concordance were found among youth reporting elevated depressive symptoms compared to youth reporting normal range symptoms. Concordant dyads kept a higher number of appointments than discordant dyads. Implications for clinical social work practice and future research are discussed.     

FISHES, PONDS, AND PRODUCTIVITY: STUDENT-ADVISOR MATCHING AND EARLY CAREER PUBLISHING SUCCESS FOR ECONOMICS PHDS

We examine a unique data set containing information on a PhD recipient's dissertation advisor, graduate program, and early career publishing success. Regressions controlling for the ranking of both the student's graduate program and dissertation advisor confirm that, all else equal, students working with prominent advisors are significantly more likely to publish in their early careers, especially in top 36 journals, than students working with less prominent advisors. Moreover, predicted publication values suggest that students attending lower ranked programs but working with superstar faculty publish both more total and top 36 articles and more quality-adjusted pages than students attending top-ranked programs but working with less prominent advisors . ( JEL J24, A11, A23)     

Mental Health Treatment Barriers Among Racial/Ethnic Minority Versus White Young Adults 6 Months After Intake at a College Counseling Center

Abstract

Objective: This study examined mental health treatment barriers following intake at a counseling center among racially/ethnically diverse college students. Methods: College students (N = 122) seen for intake at a college counseling center in 2012–2013 completed self-reports of depressive symptoms, suicidal ideation, and mental health treatment barriers 6 months later. Results: Racial/ethnic minority students less often reported previous mental health treatment and treatment after being seen at the counseling center, compared with white students. They also endorsed more treatment barriers—most commonly, financial concerns and lack of time—and more often endorsed stigma-related concerns. Treatment barriers were associated with not following through with counseling center recommendations and with greater depressive symptom severity but not with suicidal ideation during follow-up. Conclusions: Improving mental health treatment seeking among racial/ethnic minority college students should involve decreasing treatment barriers, improving access to affordable options, providing flexible scheduling or time-limited options, and decreasing stigma.,     

Striving to help college students with mental health issues

Mental health problems in the college population appear to be increasing in number and severity. University counseling services are limited in the number of counselors they can hire to meet the increasing demands. In addition, it is believed that many students do not actually seek much-needed counseling services due to lack of knowledge about mental health problems or services, stigma, or denial of the severity of the problem. Left unrecognized and untreated, mental health problems may lead to students dropping out or failing out of college, attempting or committing suicide, or engaging in other risky, dangerous behaviors that may result in serious injury, disability, or death. Mental health nursing faculty can help address this problem on college campuses by offering courses on mental health issues and skills, becoming involved with NAMI-on-Campus groups, and seeking grant opportunities that can be used to help develop and enhance services for the college community. Information about how to establish a NAMI-on-Campus group can be obtained by accessing http://www.namioncampus.org or http://www.nami.org.     

Mental Health Among College Students: Do Those Who Need Services Know About and Use Them?

Objective: The objective of this study was to examine connections between university students' mental health and their knowledge and use of campus mental health services. Participants and Methods: In March 2001, a sample of undergraduate students (N = 266) completed a Web-based questionnaire, providing information related to their mental health, knowledge of mental health services, and use of those services. Results: Students who were mentally distressed were more likely to know about and use services; however, some students who reported to be mentally distressed either did not know about services or knew about services but did not use them. Living off campus, identifying as male, and having fewer years in college were related to less knowledge of campus mental health services. In addition, female sex and number of years in college were predictive of higher service use. Conclusions: With the high prevalence rates and severity of mental health problems, university mental health providers must continue to make strategic efforts to disseminate knowledge about mental health services to all students.     

Patient Rights: An Advocate's Perspective

Abstract

The current growing concern about patients' rights and the delivery of student health care precipitates an environment of fear, distrust, and uneasiness within university health services. This paper addresses several selected clinical, ethical, and legal issues which have come into conflict during recent years. Our examination surveys ethical and legal principles of confidentiality, defines areas in which breaches are most likely to occur, and suggests ways of preventing breaches of confidence between students and health services.

While the fundamental ethical principle underlying confidentiality is the individual's right of privacy, many issues of confidentiality are extremely difficult to resolve. University health services have expanded the concept of health care to encompass all the conditions — medical, emotional, social, economic and environmental — which affect the health of students. As a result, health service administrators should be fully aware of the laws and associated legal complexities in their own state which affect confidentiality. Furthermore, student health physicians, and particularly mental health therapists must be sensitive to needs for protecting the privacy of students.

Legal principles of confidentiality discussed in this paper with respect to specific problem situations which might arise in a student health center include: 1) right to privacy; 2) privileged communications; 3) releasing information from the medical record; 4) releasing information to the student; and 5) treating minors without parental consent. Finally, in addition to the responsibilities which must be assumed by the health professional, certain student responsibilities in the selection and utilization of health professionals are recommended.     

The Relation of Negative Career Thoughts to Depression and Hopelessness

Although some research literature focuses on the integration of mental health and career counseling, there has been little that examines both areas in relation to depression and hopelessness. This study investigated the relationship among dysfunctional career thinking, depression, and hopelessness in a sample of 139 undergraduate and graduate students seeking drop‐in or individual career counseling services at a university career center. The authors found that two aspects of dysfunctional career thinking, decision‐making confusion and commitment anxiety, accounted for a significant amount of variance in depression. Decision‐making confusion also accounted for a significant amount of variance in hopelessness. Implications for counseling practice include the need for more careful screening of career clients who present with high levels of anxiety and negative thinking. Future research could involve more diverse client populations, such as unemployed adults, and explore the use of additional screening measures to assess the intersection of career and mental health issues.     

Feasibility of Implementation of a Parenting Intervention with Karen Refugees Resettled from Burma

Parents and children exposed to war and relocation have high rates of negative relational and mental health outcomes. This study tested the feasibility of implementing an adapted evidence‐based parenting intervention for contexts of trauma and relocation stress. Eleven Karen refugee caregivers from Burma participated in the intervention. Participants and a focal child completed ethnographic interviews as well as structured assessments at baseline and follow‐up. Caregivers reported changes in their teaching, directions, emotional regulation, discipline, and child compliance. Children reported changes in these areas and in positive parent involvement. Caregivers reported higher mental health distress immediately after the intervention, potentially due to increased awareness. Researchers made personalized referrals for counseling services as needed. Children reported a decrease in mental health symptoms.     

Factors associated with undertreatment of medical student depression

The authors measured factors associated with under-treatment of medical students' depression. They administered a cross-sectional Beck Depression Inventory and sociodemographic questionnaire to students at 1 medical school, defining their outcome measure as the use of counseling services or antidepressant medication. Of an estimated 450 available student participants in the study, 322 (71.6%) completed the questionnaire. Forty-nine students (15.2%) were classified as depressed and 10 (20.4%) reported experiencing suicidal ideation during medical school, but only 13 (26.5%) of the depressed students reported treatment. The researchers observed no difference in treatment by year in school, completion of psychiatric requirement, race, or depression severity. Treatment for depression was significantly associated with older age and personal and family histories of depression. Despite the availability of effective medications and confidential mental health services, medical students with depression are undertreated. The authors' findings support the need for targeted messages to help medical students recognize their depression and refer themselves for appropriate treatment.     

Tobacco, depression, and lifestyle choices in the pivotal early college years

The author explored the correlates of tobacco use among 18- and 19-year-old students at a major midwestern university. A sample of 203 randomly selected freshmen and sophomore students completed a survey that included questions about tobacco use, other drug use, mental health issues, eating disorders, stress, smoking environment, and healthy lifestyles. The prevalence rate for tobacco use was 29% for the past year and 32% for the past month. Multivariate analyses suggested that students with a lifetime diagnosis of depression or treatment for depression were 7 times as likely as other students to use tobacco. In addition, marijuana and alcohol use and weekend exposure to smoke increased the likelihood of being a tobacco user. Stress and diet behaviors were found not to be significantly associated with tobacco use. Implications for health promotion among high school and college populations are drawn from the study findings.     

Health Services Utilization Among Graduate Students: Patterns of Use,Access, and Satisfaction

Abstract

Utilization of health services by graduate students has been a neglected area of college health research. This paper describes the access problems and utilization patterns of a systematic random sample of the graduate student population at the University of Mississippi.

Survey methodology was used to assess sociodemographic, health status, and attitudinal characteristics of the study sample. In addition to type and number of visits for various health services, other utilization-related items included access to and satisfaction with care, and information received about these health services.

The results indicated that graduate students and their dependents were reliant to a large degree on local health care. Inadequacy of information was viewed as a major problem relating to access. Satisfaction with care appeared to be a function of the quality of care received.     

Foster Care of Children: Nurture and Treatment,by Draza Kline and Helen-Mary Overstreet. Columbia University Press,New York, 1972. $12.50 Hardbound. 316 Pages

This article reports the findings of a study that explored the perceptions of 147 graduate social work students about their families of origin compared with the perceptions of guidance and counseling, business, and education graduate students. The authors surveyed respondents by means of a self-administered questionnaire to determine if the students had experienced any of the various forms of family dysfunction. Social work students were significantly more likely to come from families in which substance abuse was a problem and to have had a family member who was a victim of a violent act. In addition, social work students were significantly more likely to have been sexually abused. The authors discuss implications of these findings for social work education.     

Modeling the mental health service utilization decisions of university undergraduates: A discrete choice conjoint experiment

Objective: We modeled design factors influencing the intent to use a university mental health service. Participants: Between November 2012 and October 2014, 909 undergraduates participated. Method: Using a discrete choice experiment, participants chose between hypothetical campus mental health services. Results: Latent class analysis identified three segments. A Psychological/Psychiatric Service segment (45.5%) was most likely to contact campus health services delivered by psychologists or psychiatrists. An Alternative Service segment (39.3%) preferred to talk to peer-counselors who had experienced mental health problems. A Hesitant segment (15.2%) reported greater distress but seemed less intent on seeking help. They preferred services delivered by psychologists or psychiatrists. Simulations predicted that, rather than waiting for standard counseling, the Alternative Service segment would prefer immediate access to E-Mental health. The Usual Care and Hesitant segments would wait 6 months for standard counseling. Conclusions: E-Mental Health options could engage students who may not wait for standard services.     

Trauma screening in students attending a medical university

Clinicians seldom assess trauma history in patients who seek treatment for psychological problems, yet trauma exposure is often related to psychological distress. Assessing trauma history can provide valuable information for treatment conceptualization and provision, although patients may not spontaneously share their histories because of embarrassment, avoidance, or other concerns. The authors compared 73 students at a southeastern US medical university who sought counseling and psychological services and completed intake paperwork without a trauma screen with 130 students whose intake procedures included trauma screening. They found that (a) patients who were specifically asked about trauma history were more likely to report such events, (b) previous physical assaults with a weapon were related to current psychological distress, and (c) physical assaults with or without a weapon were related to clinically significant psychological distress. These findings suggest that screening for lifetime trauma history should be a standard part of mental health screenings in similar medical university counseling centers.     

One hundred years of college mental health

Although the first student health service is credited to Amherst College in 1861, almost 50 years passed before Princeton University established the first mental health service in 1910. At that time, a psychiatrist was hired to help with student personality development. Although other schools subsequently established such services, the first 50 years of college mental health were marked by a series of national conferences. At the American Student Health Association's annual meeting in 1920, "mental hygiene" was identified as critical for college campuses to assist students to reach their highest potential. However, it took another 40 years before mental health and psychological counseling services became common on college and university campuses. The American College Health Association formed a Mental Health Section to serve mental health professionals in 1957, and most colleges and universities have now developed mental health and counseling programs commensurate with the size of their student bodies.     

Trauma Screening in Students Attending a Medical University

Abstract

Clinicians seldom assess trauma history in patients who seek treatment for psychological problems, yet trauma exposure is often related to psychological distress. Assessing trauma history can provide valuable information for treatment conceptualization and provision, although patients may not spontaneously share their histories because of embarrassment, avoidance, or other concerns. The authors compared 73 students at a southeastern US medical university who sought counseling and psychological services and completed intake paperwork without a trauma screen with 130 students whose intake procedures included trauma screening. They found that (a) patients who were specifically asked about trauma history were more likely to report such events, (b) previous physical assaults with a weapon were related to current psychological distress, and (c) physical assaults with or without a weapon were related to clinically significant psychological distress. These findings suggest that screening for lifetime trauma history should be a standard part of mental health screenings in similar medical university counseling centers.