Does the Andersen Behavioral Model of Health Services Use predict college students’ use of on-campus mental health services?

Abstract

Objective: 10–50% of college students meet the diagnostic criteria for one or more mental illnesses; unfortunately, less than half seek treatment. This study assessed the predictive power of specific variables on students’ use of on-campus mental health resources using the American College Health Association’s National College Health Assessment (ACHA-NCHA) II. Participants: Respondents included undergraduate and graduate students ages 18–35?years (n?=?96,121). Methods: We analyzed data from the ACHA-NCHA II Fall 2014 and Spring 2015. Andersen’s Behavioral Model of Health Services Use enabled selection of predisposing, enabling, and need predictor variables; these were analyzed individually and collectively. Results: Predisposing, enabling, and need variables accounted for 9%, 2.3%, and 17% of the overall variance. Significant variables associated with a student’s decision to access on-campus mental health services accounted for 23% of variance total. Conclusions: This insight could allow universities to better recognize students at-risk for needing but not accessing mental health services.     

My Student Body: Effects of an Internet-Based Prevention Program to Decrease Obesity Among College Students

Abstract

Objective: To determine the impact of My Student Body (MSB)–Nutrition, an Internet-based obesity prevention program for college students. Participants: Three hundred and twenty ethnically diverse undergraduate students were randomly assigned to 1 of 3 conditions: MSB-Nutrition program, an on-campus weight management course, and a comparison group. Methods: Students completed baseline and follow-up surveys regarding their nutrition and physical activity behaviors, self-efficacy, stress, attitudes, and body weight. Results: Compared with the on-campus course and a comparison group, the MSB-Nutrition program increased fruit and vegetable consumption, reduced stress, and increased fruit and vegetable self-efficacy but had no significant effect on students’ exercise self-efficacy, exercise behavior, or weight loss. Conclusions: The MSB-Nutrition program was effective in changing students’ nutrition behaviors but had no effect on physical activity behaviors or weight loss. Suggestions for improving Internet-based interventions aimed at decreasing obesity rates among college students are offered.     

Undergraduate students survey their peers on mental health: Perspectives and strategies for improving college counseling center outreach

Abstract

Objective: The purpose of the study was to examine student perspectives about college mental health including the primary mental health issues affecting students, common college student stressors, student awareness of campus mental health resources, and mental health topics students want more information about. Participants: Participants were 822 undergraduate and graduate students enrolled in a private university. The study was conducted during September 2016. Methods: As part of a public health course in program planning, undergraduate students surveyed their peers about their experience with mental health and mental health resources. Results: Stress was perceived as the largest mental health issue. Students most wanted more information about school/work/life balance followed by stress management. Electronic newsletters, social media, and on-campus seminars were the top strategies that students suggested as ways to reach them. Conclusions: The results provide student perspectives on mental health that may be useful in developing effective outreach efforts.     

Human Resource Issues in University Health Services

Abstract

To provide first-rate services to students, college health services need the best possible staff. Managers and supervisors play a critical role in guiding the work of their employees so as to enhance performance. Reference checks for new employees and regular performance appraisal dialogues for ongoing employees are important tools in this process. The author discusses these issues and suggests formats for reference checks and performance appraisals.     

The Impact of Living in Co-ed Resident Halls on Risk-taking Among College Students

Abstract

Objective: Although previous research has suggested that college housing impacts student behavior and outcomes, recent research linking college housing to risk-taking has been limited. In this study, we investigate if patterns of risk behavior differ based on the type of college housing environment students reside in. Participants: This study utilizes 510 college students living in on-campus college housing. Methods: Students were recruited from 5 college sites across the United States. Participants responded to survey items online that measured current risk-taking behaviors such as binge drinking and sexual activity. Results: After controlling for an assortment of demographic and psychological variables, results indicated that students living in co-ed housing were more likely than students living in gender-specific housing to binge drink and consume alcohol, have more permissive sexual attitudes, and have more recent sexual partners. Conclusions: On-campus housing environments impact college student risk behaviors. Implications are discussed in light of the decline of in loco parentis on most college campuses.     

The Freshman 15: Is it Real?

Objective: The belief that college students gain 15 Ibs during freshman year is widespread, yet the evidence for this is limited. The authors aimed to determine whether college students gain weight during freshman year. Participants: The authors studied unmarried freshmen living on-campus at a private university in the northeastern United States. Methods: The authors used an online survey to collect information about social behaviors and weight. Results: The authors observed an average weight gain of 2.7 Ibs. About half of the students gained weight, and 15% lost weight. Men gained more weight than did women. Conclusions: Freshman weight gain was 5.5 times greater than that experienced by the general population.     

Campus-Based College Health Services Before the Amherst Program (1860): Military Academies Lead the Way

Abstract

Over the past 70 years a legend has evolved that the first college health program in the United States was established at Amherst College in 1861. Although the program at Amherst was innovative in its day and served as a model for the field of college health, several other institutions prior to 1860 appropriated funds, hired staff, and established on-campus programs to improve the health of their students. The military academies led the way, and the first of these early programs to become operational was located at the US Military Academy at West Point, New York, in 1830.     

Building,Engaging, and Sustaining a Continuum of Care From Harm Reduction to Recovery Support: The Rutgers Alcohol and Other Drug Assistance Program

Since 1983, the focus of the Rutgers Alcohol and Other Drug Assistance Program (ADAP) has been developing policies, training staff to identify students at risk, developing and implementing evidence-based screening and brief interventions, providing short-term counseling by professionals trained in alcohol and other drug abuse to assist students beyond brief interventions, identifying effective treatment for college students, developing a campus recovery program, on-campus recovery housing, and other supports for students in recovery. This article presents a case study of the Rutgers ADAP program, of building and sustaining a program committed to engaging students in both evidence-based risk reduction interventions and an on-campus recovery community given their stage of change and motivation to make changes. Historical milestones are described as part of a creative model for intervention. We identify the challenges of integrating substance abuse recovery into campus mental health programs, and of integrating recovery into other university communities.     

Stages of Change and Possible Selves: 2 Tools for Promoting College Health

When considering health promotion among college students, 2 questions that arise are how to (1) most effectively offer health initiatives and (2) motivate students to participate in these efforts. Objective: In responding to these questions, the author considered 2 health-promotion tools: the transtheoretical model and the concept of possible selves. Participants: There were 304 college students who participated in this study. Methods: To explore how such information can assist health-promotion planning by determining which behaviors to target and how to match interventions to the overall population's stage of change, the author had students report their stage of change for 6 health behaviors. In addition, to explore possible motivations for moving from the precontemplation to the preparation stage of change, the author had students generate future self-concepts regarding their health (health-related possible selves). Results: The number of illness-related possible selves cited was significantly related to stage of change for smoking and stress management. For smoking, precontemplators had the fewest number of illness-related possible selves; however, the author observed the opposite for stress management. Conclusion: The findings have implications for how the transtheoretical model and the concept of possible selves can serve as useful tools in promoting college health.     

Who is willing to come back? College students' willingness to seek help after using campus mental health services

Objective: To examine characteristics of college students who have previously received mental health (MH) services on campus and are willing to seek help again in the future. Participants: Spring 2015 ACHA-NCHA II (N = 12,501) undergraduate respondents who had previously used MH services on their current campus. Methods: Binary logistic regression with willingness to seek MH services in the future as the dependent variable. Results: Among students who had already utilized campus MH services, significant predictors for future help-seeking were: female, white, gay/lesbian, those not working for pay, having the college/university health insurance plan, and not currently/previously serving in the military (p < .05). Conclusions: The predictors for willingness to use services in the future were consistent with the existing literature related to initial use. Colleges and universities need to consider factors that influence openness to MH services after a previous experience in addition to initiating care. Implications for college MH professionals are provided.     

Perceived Built Environment Characteristics of On-Campus and Off-Campus Neighborhoods Associated With Physical Activity of College Students

Abstract

Objective: To identify differences in neighborhood environment and their association with physical activity (PA) levels of on-campus compared with off-campus students. Participants: Participants were 822 undergraduate students at a mid-sized mid-Atlantic university. Methods: Students completed the Neighborhood Environment Walkability Scale–Abbreviated and the International Physical Activity Questionnaire in October 2013. Results: Lower residential density, traffic safety, and crime scores and higher land-use mix diversity, aesthetics, and lack of parking scores were reported among on-campus residents. On-campus residents reported higher levels of active transportation PA, leisure PA, and total PA. Land-use mix diversity, aesthetics, and lack of cul-de-sacs were associated with physical activity level. Conclusion: The on-campus and off-campus environments differ in ways that may impact the ability of undergraduate students to be physically active. Strategies to promote continued active transportation and leisure PA are discussed.     

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.     

Abortion,Limited Medical Resources,and the Meaning of Health Care

Abstract

Although accidents are the leading cause of death among college students, literature about developing student health safety programs is limited. In this article, we present preliminary recommendations based on literature review, epidemiologic data, and Nominal Group Process (NGP) activities, for developing university student safety programs. Our recommendations include appointing a coordinator to oversee all on-campus safety activities, providing for university-wide education programs dealing with alcohol and drug use, promoting personal safety efforts in areas such as family violence and rape prevention, and encouraging students to use safe transportation alternatives.     

A Pilot for Improving Depression Care on College Campuses: Results of the College Breakthrough Series–Depression (CBS-D) Project

Abstract

Objective: To implement a pilot quality improvement project for depression identification and treatment in college health. Participants: Eight college health center teams composed primarily of primary care and counseling service directors and clinicians. Methods: Chronic (Collaborative) Care Model (CCM) used with standardized screening to identify, treat, and track depressed students for 12 weeks to monitor predetermined process and clinical outcomes. Results: Of all students receiving primary medical care services between January 2007 and May 2008, 69% (n = 71,908) were screened for depression. A total of 801 depressed students were treated and tracked; most predetermined treatment process and clinical outcome targets were achieved. Conclusion: The CCM for depression shows promise for improving depression identification and care for college students.     

Predictors of well-being in the lives of student service members and veterans

Objective: The current study examined predictors of well-being, including quality of life and academic engagement, in a sample of student service members and veteran college students. Methods: Eighty-seven student service members/veterans (SSM/V) completed an online survey containing questions about post-deployment social support, emotion regulation skills, psychological distress, academic engagement, quality of life, and demographics. Participants were recruited from September 2012 through May 2014. Results: Results provided partial support for the proposed bi-directional mediational relations between post-deployment social support and emotion regulation predicting to quality of life and academic engagement. Path models indicated that both post-deployment social support and emotion regulation skills partially mediated the relation with quality of life while accounting for the effect of psychological distress, and that emotion regulation skills fully mediated the relation between social support and academic engagement. Conclusions: These findings suggest that both social support and emotion regulation skills may be useful targets for health promotion and intervention efforts for this population. Limitations and clinical implications for the development of on-campus SSM/V focused health promotion services are discussed.     

The Theory of Planned Behavior as it predicts potential intention to seek mental health services for depression among college students

ABSTRACT

Background: Between 9.5% and 31.3% of college students suffer from depression (American college health association national college health assessment II: reference group executive summary spring 2013. Amer. Coll. Health Assoc. 2013; Eagan K, Stolzenberg EB, Ramirez JJ, Aragon, MC, Suchard, RS, Hurtado S. The American freshman: national norms fall 2014. Higher Educ. Res. Inst.; 2015). Universities need to understand the factors that relate to care-seeking behavior. Objective: Across 3 studies, to relate attitudes, social norms, and perceived behavioral control to intention to seek mental health services, and to investigate barriers to care-seeking. Participants: University college students (N = 845, 64% female, 26% male, and 10% unspecified). Methods: New measures were created in Studies 1 and 2, and were examined using structural equation modeling in Study 3. Results: Partially consistent with the Theory of Planned Behavior (Ajzen, I, Fishbein, M. Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, NJ: Prentice-Hall; 1980), a model with an excellent fit revealed that more positive attitudes about care and higher perceived behavioral control directly predicted higher intention to seek mental health services. Conclusions: Educating college students about mental health disorders and treatments, enhancing knowledge about available services, and addressing limited access to long-term care might improve treatment rates for students suffering from depression.     

Trends in college students’ mental health diagnoses and utilization of services, 2009–2015

Abstract

Objective: To examine changes in diagnoses/treatment for 12 mental health (MH) conditions, previous use of campus MH services, and willingness to seek MH services in the future. Participants: ACHA–NCHA II participants from 2009 to 2015 (n?=?454,029). Methods: Hierarchical binary logistic regression with step 1 controlling for demographics and step 2 considering time. Results: Time was significant except for bipolar disorder, bulimia, and schizophrenia with increases for all conditions except substance abuse. Anxiety (OR?=?1.68), panic attacks (OR?=?1.61), and ADHD (OR?=?1.40) had the highest odd ratios. Use of MH services at current institution (OR?=?1.30) and willingness to utilize services in the future (OR?=?1.37) also increased over time. Conclusions: Based on a national sample, self-reported diagnoses/treatment of several MH conditions are increasing among college students. This examination of a variety of MH issues can aid college health professionals to engage institutional stakeholders regarding the resources needed to support college students’ MH.     

Community college field placement internships: supervisors’ perspectives and recommendations

ABSTRACT

Community College human services students represent the future social service workforce. The defining feature of their training is 250 h supervised field placement internship. Despite burgeoning research describing best practices for supervision of Bachelors of social work (BSW) and Masters of social work (MSW), there is no research aimed at supervision for community college students, leaving a gap in our understanding of best practices for supporting community college students’ pedagogy and sustaining partnerships with agencies. This exploratory study offers recommendations for best practices supported by our discovery of the benefits, challenges, and strategies involved with offering community college student internships in New York City human services agencies. We analyzed data from semi-structured interviews with 30 field supervisors through qualitative content analysis. Community college students and agencies both benefit substantially from the field placement, however agencies identified significant social and structural challenges specific to working with community college students that require interventions for both field supervisors and students alike. Suggested interventions aimed at improving supervisor training, procedures for focusing goals of supervision sessions, assisting students in meeting their academic and social needs, as well as supporting supervisors’ professional goals to promote best practices are proposed.     

Depressive Symptoms and Mental Health Treatment in an Ethnoracially Diverse College Student Sample

Abstract

Objectives: To study (a) the prevalence of depressive symptoms and (b) the utilization of mental health treatment in an ethnoracially diverse sample consisting primarily of Asian Americans, European Americans, Native Hawaiians, and Pacific Islanders. Participants: Five hundred eighty-nine college students. Method: A questionnaire packet that included the Center for Epidemiological Studies Depression Scale (CES-D) was administered to students in introductory psychology courses. Results: (a) There were no differences among ethnoracial groups in levels of depressive symptoms as measured by the CES-D; (b) 71% of participants with high levels of depressive symptoms had not received any mental health treatment in the previous 12 months; and (c) European Americans were 3.7 times more likely to have received mental health treatment in the previous 12 months than other students. Conclusion: Outreach efforts designed to improve utilization of mental health treatment services by depressed college students, especially by members of ethnoracial minority groups, should be increased.     

The Power of Peer Support: The Development of the Empowerment Center

ABSTRACT

This article discusses the events and influences that led to the author’s contribution to the development of a mental health consumer-run organization, The Empowerment Center in Mount Vernon, NY. The author traces some events that influenced him personally and the evolution of the Empowerment Center from an organization that provided advocacy services (to those with mental health problems who were hospitalized) and community-based support services to people in mental health recovery, to an organization focusing on economic empowerment and economic development for the community of those in recovery. The transition of the Empowerment Center into an organization focused on economic empowerment underscores the importance of economic independence for people in recovery and the consumer-run organizations that support them. The Empowerment Center endeavors to demonstrate that mental health consumer-survivors can take control of their economic health as well as their physical and mental health.