Social Networks,Substance Use,and Mental Health in College Students

Abstract

Objectives: The relationship between social network risk (alcohol-using close friends), perceived peer closeness, substance use, and psychiatric symptoms was examined to identify risk and protective features of college students’ social context. Participants: Six hundred and seventy undergraduate students enrolled in a large southeastern university. Methods: An online survey was administered to consenting students. Results: Students with risky networks were at a 10-fold increase of hazardous drinking, 6-fold increase for weekly marijuana use, and 3-fold increase for weekly tobacco use. College students’ who feel very close to their peers were protected against psychiatric symptoms yet were at increased risk for marijuana use. Perceived closeness of peers was highly protective against psychiatric symptoms, adding a natural preventive effect for a population at great risk for mental illness. Conclusions: Results support targeting college students through network-oriented preventive interventions to address substance use as well as mental health.     

Disability Services and College Students with Psychiatric Disabilities

Abstract

Weiner (1999) has suggested that the process of accepting a disability and its associated limitations is often protracted for students with psychiatric disabilities, thus leaving many students unable to fully participate in services or in the design of academic accommodations. This research examines the relationship between psychiatric disability identity and use of academic accommodation services for 57 undergraduates with psychiatric impairments who are experiencing problems in their academic functioning. Willingness to utilize services was related to students' identification as having a psychiatric disability. Social work interventions are needed to support students in accepting psychiatric disabilities while concurrently crafting necessary accommodations.     

Characterization of psychiatrically hospitalized college students

Abstract

Objective: To characterize contemporary college students requiring psychiatric hospitalization. Participants and methods: Sociodemographic and diagnostic information was gathered retrospectively and analyzed from the electronic medical records (EMRs) of the consecutive inpatient hospitalizations of 905 college students admitted to a psychiatric inpatient unit. Results: Significantly more females compared to males experienced the following: more hospitalizations, more family and financial stressors, more depression, and less psychotic and bipolar disorder. The most frequent diagnosis was a depressive disorder, followed by bipolar disorder, psychotic disorder, and personality disorder, most frequently borderline personality disorder. Half of participants had comorbid diagnoses with substance abuse most common. More than two-thirds of students endorsed social or intimate relationship, academic, and family challenges as psychosocial stressors. In all, 15% of participants had repeat admissions. Conclusions: The present study provides demographic data from a sample of psychiatrically hospitalized college students. Findings can help improve screening and identification of decompensation in college students.     

University Students’ Views on the Utility of Psychiatric Advance Directives

Abstract

Objective: Rates of serious mental illnesses (SMIs) among university students are increasing, and universities are struggling with how to respond to students who show SMI symptoms. Psychiatric advance directives (PADs) allow individuals, when well, to document their wishes for treatment during a psychiatric crisis. This project explored the feasibility of using PADs in university settings by examining students’ views towards PADs. Participants: Forty university students with SMIs were recruited for this study from 1 large university. Methods: A mixed-methods design was used, with both quantitative survey instruments and qualitative interviews with students. Results: Respondents were positive about PAD utility for students. Respondents saw PADs as beneficial because PADs gave students control over their treatment. However, students also considered PADs potentially problematic because PAD use raised a risk of breaching student privacy and stigmatizing students with SMIs. Conclusions: Although a promising intervention for students with SMI, this approach requires further research.     

The Role of a Psychiatric Pharmacist in College Health

Abstract

Published evidence indicates there is a growing prevalence of psychiatric illnesses on college campuses, and that approximately one quarter of students may be taking psychotropic medications. But attracting and retaining experienced mental health care professionals to college health settings is a challenging task. The psychiatric pharmacist is one professional resource that can serve as both a clinical and educational consultant for college mental health services. A pilot psychiatric pharmacist service project is described.     

Mental Health and Clinical Correlates in Lesbian,Gay, Bisexual,and Queer Young Adults

Abstract

Objective: This study examined the prevalence of mental health disorders and their clinical correlates in a university sample of lesbian, gay, bisexual, and queer (LGBQ) students. Participants: College students at a large public university. Methods: An anonymous, voluntary survey was distributed via random e-mail generation to university students during April and May of 2011. LGBQ students were compared with their heterosexual counterparts on psychological and physical status as well as academic performance. Results: LGBQ students reported worse depressive symptoms, higher levels of perceived stress, considered themselves less attractive, and were more likely to be overweight. LGBQ students were significantly more likely to report histories of affective, substance use, and certain anxiety disorders as well as compulsive sexual behavior and compulsive buying. Conclusions: The higher rates of many psychiatric conditions among LGBQ students underscore the need for universities to provide LGBQ students a nonjudgmental environment to discuss sexual orientation and health issues.     

The Attitudes of Social Work Students and Practicing Psychiatric Social Workers Toward the Inclusion in the Community of People with Mental Illness

Abstract

This study measured and compared the attitudes of social work students and practicing psychiatric social workers to the inclusion in the community of people with mental illness. The Community Living Attitude Scale Mental Illness (comprising the four subscales of Empowerment, Exclusion, Sheltering, and Similarity) was administered to a random sample of 68 Israeli BA social work students (first year: n = 35; third year: n = 33) and 28 practicing psychiatric social workers. Overall, the participants endorsed Empowerment and perceived the Similarity of persons with mental illness to themselves more than they agreed with the Exclusion attitude of segregating those persons from community life. First-year students rated Empowerment and Similarity significantly lower than did the third-year students and rated Sheltering significantly higher than did psychiatric social workers. Psychiatric social workers did not differ from third-year students and did not have stronger attitudinal commitment to the inclusion paradigm. They differed from first-year students only in the sheltering attitude; they showed lower support for sheltering people with mental illness.     

Evaluating the consistency of scales used in adult attention deficit hyperactivity disorder assessment of college-aged adults

Objective: Neurocognitive evaluations are commonly integrated with clinical assessment to evaluate adult Attention Deficit Hyperactivity Disorder (ADHD). Study goal is to identify measures most strongly related to ADHD diagnosis and to determine their utility in screening processes. Participants: 230 students who were evaluated at the Vanderbilt University Psychological and Counseling Center between July 2013 and October 2015. Methods: We retrospectively examined charts, including clinical diagnosis, family history, childhood parental reported and current self-reported ADHD symptoms, psychiatric comorbidities, and continuous performance test (CPT). Result: Positive report of childhood and current ADHD symptoms, and lack of comorbid psychiatric symptoms were strongly associated with clinical diagnosis. CPT results were not associated with an ADHD diagnosis. The absence of reported childhood and current ADHD symptoms may serve as a contradictory marker for ADHD diagnosis. Conclusion: Clinical assessment of ADHD symptoms and ADHD childhood history, but not CPT, contributes to an accurate diagnosis of ADHD in college-aged adults.     

A Study on the Sleep Patterns and Problems of University Business Students in Hong Kong

Abstract

Objective: To investigate sleep patterns and problems of university business students. Participants: Undergraduate Chinese business students in Hong Kong. Methods: Self-reported questionnaires were completed during class lectures and through online system. Results: Of the 620 participating students (mean age 19.9 years), sleep duration was significantly shorter during weekdays (6.9 hours) than weekends (8.6 hours). Two thirds of students reported sleep deprivation. The following factors were associated with being a “poor sleeper” (Pittsburgh Sleep Quality Index > 5): attending early morning lectures (odds ratio [OR] = 1.90), living on-campus (OR = 1.89), Sleep Sufficiency Index less than 0.8 (OR = 2.55), sleep debt (differences of total time-in-bed between weekday and weekend ≥ 75 minutes) (OR = 1.58), and minor psychiatric disturbances (OR = 2.82). Conclusions: Poor sleep quality and sleep deprivation were prevalent in university business students in Hong Kong, especially for those attending early morning lectures and living on-campus. Systemic education on the importance of sleep and stress and time management is needed for university students.     

Implementing a college mental health program – an overview of the first twelve months

Objective: To evaluate the demographics and clinical utilization patterns among college students during the initial 12 months of a novel, multi-disciplinary, collaborative, college mental health program (CMHP). Participants: Undergraduate and graduate students receiving treatment at the CMHP from Jan-Dec 2015. Methods: De-identified data was obtained via electronic health records for all students receiving care through the CMHP. Results: 1.2 FTE clinical providers treated 278 undergraduate and graduate students during the year (65.1% < age 26, 53.6% female, 49.6% caucasian). There were 1822 CMHP outpatient visits, 318 other medical visits and 103 total emergency room (ER)/inpatient visits. Ten students were identified as high utilizers of ER/inpatient services, while charges to the CMHP totaled $470,157 and total charges to the Health System were $2,378,315. Conclusions: Students with complex psychiatric/medical co-morbidities received cost effective, convenient and integrative treatment. Over time, we hope to intervene earlier and decrease ER/inpatient visits.     

Life Stress and Depression in University Students: Clinical Illustrations of Recent Research

Abstract

Through the use of case vignettes, this paper demonstrates the clinical relevance of findings from previously reported research conducted at the University of Toronto. These published studies link life stress to depression in university students. Three psychosocial factors—a family history of psychiatric illness, stressful life events, and lack of social support—are found to be significantly related to depressive symptoms. A fourth psychosocial factor, childhood or adolescent loss of a nurturing person, was not significantly related to the occurrence of depression. However, that factor remains an important therapeutic focus for a number of depressed students. In addition, the absence of at least a single confidant and certain life events (recent loss of a significant person, changes in living arrangements or academic situation, and financial problems) were identified as specific risk factors for depression. Although depression experienced by students is often serious enough to warrant professional intervention, only a minority seek professional help. The majority of those who do seek help are women; male students are less likely to associate somatic symptoms with emotional problems and are less willing to seek psychiatric help. The four case studies presented illustrate the clinical relevance of these research findings.     

Factors Associated With the Psychological Well-Being and Distress of University Students

Objective: Because of the serious nature of psychiatric illness and related problems, the authors attempted to identify demographic, individual, and behavioral factors linked to university students' psychological health. Participants: They surveyed 353 (60.9% female) predominately Caucasian (88.7%) university students attending a large public university. Methods: The authors used a self-report questionnaire including valid and reliable psychometric instruments for all study variables. They conducted multiple regression analyses to examine associations among study variables using a cross-sectional design. Results: More favorable health states (ie, greater psychological well-being and less distress) were positively associated with optimism, health values, and religiousness and were negatively associated with spirituality and number of sexual partners. Conclusions: Results demonstrated that multiple protective and risk factors contribute to the psychological well-being and distress of university students. Health promotion practitioners should adopt strategies that strengthen the personality characteristics and values associated with university students' psychological health.     

Diagnostic sequence of cocaine use disorder in relation to other mental health conditions among college students

Abstract

Objective: Cocaine use is increasing. Comorbidities and diagnostic sequencing are needed among college students to inform treatment of cocaine use disorder (CUD). Method: Using electronic medical records from the psychiatric clinic at the student health care center of a large, public university from 2005 to 2015, patients diagnosed with CUD were identified. Their top mental health conditions were identified and assessed to see whether the first diagnosis of these conditions was made (1) before, (2) at the same time as, or (3) after the first diagnosis of CUD. Results: Among the 50 CUD patients, their most common mental health comorbidities were alcohol use disorder, anxiety, depression, and cannabis use disorder. Anxiety and depression were likely to be diagnosed before CUD; alcohol and cannabis use disorders were likely to be diagnosed concurrently with CUD. Conclusion: Diagnostic sequencing can be used to inform screening, workup, and treatment for patients with CUD.     

Psychiatric Symptoms and Perceived Need for Psychiatric Care After Divorce

Abstract

The study investigated level of psychiatric symptoms and perceived need for psychiatric care among recently divorced males and females. Furthermore, various demographic factors and characteristics of the marriage and divorce related to psychiatric symptoms and perceived need for psychiatric care, were identified. Six hundred fifty eight recently divorced males and females living in five different counties in Norway participated. Their level of psychiatric symptoms was compared with the general Norwegian population. Divorced individuals had substantially higher level of psychiatric symptoms as compared to the general population. No consistent gender differences were observed. For both males and females, level of conflict with the ex-spouse and being leaver or being left, were the variables being most strongly related to psychiatric symptoms and need of psychiatric care. However, the variables accounted for only a modest proportion of the variance in the mental health outcome.     

Self-rated Health in Relation to Rape and Mental Health Disorders in a National Sample of College Women

Abstract

Objective: The purpose of this study was to employ a multivariate approach to examine the correlates of self-rated health in a college sample of women, with particular emphasis on sexual assault history and related mental health outcomes. Participants: A national sample of 2,000 female college students participated in a structured phone interview between January and June 2006. Methods: Interview modules assessed demographics, posttraumatic stress disorder, major depressive episode, substance use, rape experiences, and physical health. Results: Logistic regression analyses showed that poor self-rated health was associated with low income (odds ratio [OR] = 2.70), lifetime posttraumatic stress disorder (OR = 2.47), lifetime major depressive episode (OR = 2.56), past year illicit drug use (OR = 2.48), and multiple rape history (OR = 2.25). Conclusions: These findings highlight the need for university mental health and medical service providers to assess for rape history, and to diagnose and treat related psychiatric problems in order to reduce physical morbidity.     

Addressing the Issue of Psychiatric Disability in Social Work Interns: The Need for a Problem-Solving Framework

Abstract

This article examines the issues that arise when field instructors encounter social work interns with psychiatric problems. The authors discuss how legal decisions and the Americans with Disabilities Act (ADA) provide the organizing framework for developing appropriate policies for addressing these situations. Findings from a survey that asked 61 field instructors about their experiences with such students and their knowledge of ADA guidelines provide additional information for policy development. Based on the survey and the legal guidelines, the authors present a problem-solving framework and recommendations to guide academic programs toward an approach that protects the rights of all parties involved.     

Teaching Note—Developing an Online Blended Learning Course on Psychiatric Diagnosis

ABSTRACT

It has been suggested that the task of teaching and learning social work practice in an online environment can greatly be facilitated if thoughtful attention is paid to course design. This article details the design of a blended-learning online course to teach MSW students the process of psychiatric diagnosis. First, the development of the course philosophy is discussed. Second, the choice of the VARK (visual, aural, read/write, kinesthetic) learning model is explained. Finally, the design of the course consistent with the philosophy and learning model is presented.     

Interpersonal Dependency Among Adult Survivors of Childhood Sexual Abuse in Therapy

ABSTRACT

This study investigated dependency in survivors of childhood sexual abuse (CSA). The Interpersonal Dependency Inventory (IDI) was administered at intake to 24 men and 85 women seen in therapy at a university-based community mental health clinic. In contrast to findings from earlier studies, no significant gender differences were obtained for IDI whole-scale or subscale scores. Analyses comparing CSA IDI scores with the IDI scores of previously studied groups indicated that among women, CSA survivors obtained higher dependency scores than non-CSA psychiatric patients, community adults, and college students. Findings for men were less consistent. Follow-up analyses revealed that commonly investigated CSA characteristics were unrelated to survivors' dependency scores. Implications of these findings for future research and clinical practice are explored.     

The Impact of Internships on Recruiting and Retaining Mental Health Workers: Views From Students and Their Supervisors

ABSTRACT

In 2015, 81% of counties in Texas were designated as full or partial Mental Health Professional Shortage Areas. To address this problem, we worked with a community-based association of mental health practitioners, using the social theory of career selection, to explore factors that influence students to join the mental health field. Our goal was to better understand how to recruit and retain mental health-trained students. We interviewed bachelor and master-level mental health interns in social work, counseling, and psychiatric nursing and field instructors using semistructured, open-ended interviews. Five themes emerged from the interviews: 1) attraction to mental health; 2) professional experience; 3) impact capacity; 4) develop social work skills; and 5) intern preparedness.