What could we have provided or done differently? A closer look at students’ suggestions for campus...

What could we have provided or done differently?A closer look at students’ suggestions for campus services. Ashley Boynton

Sarah ChristmanElizabeth Hentschel

Stuart IrvinErika Jonietz

with Dr. Chris Brownson

•Founded in 1991 at The University of Texas at Austin

•Six completed studies to date

•Membership in Consortium is determined study-by-study, and all are welcome and encouraged to participate

•In the process of developing two more studies

Overview of Presentation

•The Intervention Continuum

•Basics of 2011 study

•Themes of student responses

•Break into small groups

•Q&A

Basics of the 2011 Study

•Anonymous, web-based survey

•Random sample at each school

•73 colleges and universities participated

•Over 26,000 undergraduate and graduate student responses (≈101,000 surveys sent)

Basics of the 2011 Study

We looked at:

•Risk Factors and Protective Factors•Stressors•Distress and Suicidality•Coping Behaviors•Connectedness (family, friends,

university)•Sense of Coherence•Help Seeking

We asked students…

“Please reflect on the most stressful period of time that you have experienced in the past 12 months, including the present day. While it may be difficult to choose just one time, please think back on your experiences over the past 12 months and identify a single period when you were most upset, distressed, or overwhelmed.”

We then asked…

“What could your college or university have provided you or done differently to better help you manage during this stressful time?”

First, some numbers:

Blank — 9,229

+ “Nothing” — 4,851

+ “Not much” — xxx

+ “N/A” — xxx

+ “Not sure” or “Don’t know” — xxx _______________________ = 16,000 uninformative responses

≈10,000 suggestion

s!!

Themes we will not be covering:•“Less schoolwork.”

•“More financial aid.”

•Spreading out exams/finals.

•Requests for specific groups.

•Practicum student concerns.

A Matter of Balance:

•Students, Professionals, and Services

•Just because a suggestion is made, does not mean it is appropriate, possible, realistic, or within the scope of services that we could or should provide.

•In order for an intervention to work to the best of its capability, it has to work for us as well.

Availability of Counseling Services

Availability of Counseling Services•Themes:

- Session Limits- Frequency of Sessions- Eligibility for Services- Accessibility- Non-Traditional Services- Following Up

Session Limits

•“If they had offered more than 6 sessions with a counselor.”

•“They could have offered more than 10 sessions. I was afraid to go if I didn’t really need it that day for fear of wasting sessions.”

Session Limits

•“More free sessions provided by the college.”

•“We are only allowed a particular number of visits during our academic career... I reached my limit my first semester. I feel that if a student is serious about visiting the center to get help, that help should be available.”

Session Limits

•“I wish there wasn’t a session limit per student per year. My counselor went above and beyond to request a few extra sessions so that I wouldn’t feel so much like I was kicked out the door. It just would have been nice to not have a limit on your recovery.”

Frequency of Sessions

•“The ability to see my counselor more often (instead of every 2–3 weeks).”

•“To be able to talk to a professional for more than an hour or more than once a week.”

Frequency of Sessions

•“The counseling center was difficult to use because the counselors were very busy and were available only once every three weeks on average. It would be more helpful if I could see them once a week.”

Eligibility for Services•“My college, [XXX], requires that student take

12 credit hours in order to be eligible for counseling. As a student who takes 10 credit hours, I was seriously distressed and felt like I had nowhere to turn to. Finally, they saw me on a one-time, crisis basis.”

•“Allow students who were enrolled in the spring and fall semesters to utilize the counseling services in the summer if need be.”

Eligibility for Services

•“They denied me counseling services because I was not currently enrolled in any classes, even though I was enrolled in a program. If a student is enrolled in a program at the University, they should be able to receive services, whether or not they are currently taking classes. For example, during the summer.”

Eligibility for Services

•“I dropped a class when my father died. When I called to get grief counseling, they said I was ineligible because I wasn’t full time. I explained the situation, and they refused.”

Accessibility

•“Have quicker access to appointments. I found it difficult to get an appointment when I was feeling in crisis.”

•“Having therapists or psychiatrists available after business hours.”

•“Walk-in counseling. Emphasis on walk-in.”

Accessibility• “People aren’t 8–5, M–F. Be open when people

need help.”

• “Open up the counseling hours for students who are only on the campus in the evenings.”

• “Weekend counseling!! And more than five free sessions. That’d make it much more usable.”

• “Weekend and/or evening opportunities for counseling on campus.”

Accessibility

•“Help outside of counseling center hours. There were many times when I needed help when the counseling center was not open, and I did not know who to turn to.”

•“Being able to have a counseling session over the phone, maybe.”

•“Online appointment scheduling.”

Non-Traditional Services

•“So many students live off campus and participate in online learning. I think that the university counseling service should have online services [for] students.”

•“Provide some type of counseling service to non-traditional students who do not live on or near main campus.”


•“Provided online communities for distance students working on their graduate degrees. It is helpful to know that others are going through the same process.”

•“Random e-mail center where you could ask questions and receive anonymous responses.”


•“Online counseling. I am an online student.”

•“Perhaps outreach services of some kind for students who are off-campus. I am a distance education student so am unable to take advantage of the support on campus. Perhaps cohort or online groups for people struggling with similar problems.”


•“Live one-on-one online chat that did not have to be scheduled ahead of time.”

•“I am currently taking online classes. Internet resources would have been helpful.”

•“Anonymous chats or online counseling.”


•“It would have been nice to be on a online forum with people who were experiencing similar signs of depression, so I could have a community I could connect with at all times of the day.”

Following Up

•“The university referred me to a nutrition counselor when I came in at a low BMI... but then did nothing to follow up.”

•“The mental health department could follow up better when someone misses appointments because they may be missing the appointment because they are not functioning very well.”

Following Up

•“Provided more attentive medical staff. Checked up on me after my initial visit—rather than me coming to them.”

•“Asked me to come back for a follow-up appointment at the counseling center.”

Provider Options

•“Give me the option of [choosing] my psychiatrist, because I would have rather had a female than a male.”

Summary of Themes

•Session Limits- More free sessions, offering longer-term

services

•Frequency of Sessions- Allowing students to schedule with clinicians on a more regular basis

•Eligibility for Services- Part-time and summer enrollment

Summary of Themes

•Accessibility- Quicker access to appointments- Services available after business hours- Evening/weekend counseling

•Non-Traditional Services- Offer online counseling- Offer anonymous help services- Building online communities for distance

learning students

Summary of Themes

•Following Up- Checking in with students post-treatment/ contact

•Provider Options- Ability to request a male or female clinician

Miscellaneous(Not so helpful responses)

•“Puppies and kittens. Best destressors ever.”

•“A mass e-mail that told me that I am cool.”

•“Save me from the pirates.”

•“Um, added days to the calendar?”

•“Free beer would be very helpful.”

•“A better meal plan. The food is disgusting.”

Visibility of Counseling Services

Visibility of Counseling Services•Themes:

- Raising Awareness - Cost and Availability of Services - Advertising - Campus Policy Changes

Raising Awareness

•“Let me know it existed! Let me know it was available—in all 3 years as a student I did not know there was counseling services available.”

•“Make the students aware of the counseling services. I have been in school for two years and did not know about that. More awareness…”

Cost and Availability of Services•“Students need more accessible

information about what kind of help is available. I had no idea where to turn. I hadn’t even known about our counseling center. They need better publicity.”

•“Until this survey I had no idea there was any help available on campus, or if there was a fee to utilize this resource.”

Cost and Availability of Services•“Make the cost of the counseling services

better known to students.... Didn’t go because I didn’t think I could afford it and I do not have health insurance.”

•“I think the university could better publicize counseling options, particularly around exam weeks.”

Advertising

•“Well, they could have posters about counseling and where to go for it. I honestly don’t know if we have on-campus counseling.”

•“More increased visibility with flyers, e-blasts, posters, a Facebook page, advertising in the [campus paper], could really help.”

Advertising•“I wish I would have been tipped to helpful

resources, such as free counseling, by seeing a poster, or flyer, or even a couple bulletin boards solely dedicated to providing helpful resources concerning mental health problems, life stressors, and traumatic experiences. This way students who are having trouble with something in their lives, they immediately know where to go for help. Not only that, the students won’t see getting help as ‘only for crazy people.’”

Advertising

•“Not everyone knows about the free counseling. Facebook page maybe?”

•“Advertise on campus... target grad school students... we aren’t on campus in the same way as other students. I didn’t even remember that [XXX] had a counseling center.”

Advertising

•“I think that advertisements in bathrooms are pretty effective when it comes to displaying counseling because it is a private place and going to counseling is a private activity.”

•“More increased visibility with flyers, e-blasts, posters, a Facebook page, advertising in the [campus paper], could really help.”

Campus Policy Changes

•“Have this information in each syllabus for every course. Graduate students are disconnected from the university & don’t use as many resources.”

• “I wish I knew of counselors on campus sooner. Maybe letting it be known during orientation.”

Summary of Themes

•Raising Awareness - Many students are not aware counseling services exist

•Cost and Availability of Services - Inform students of cost of services - Inform students of type of services provided

Summary of Themes•Advertising - Facebook page - e-blasts - Flyers

•Campus Policy Changes - Inform students of counseling services at orientation - Information on counseling services included in course syllabi

Miscellaneous II(Not so helpful responses)

•“Cookies!”

•“Free Red Bull :)”

•“Mercy.”

•“Put antidepressants in the vending machines.”

•“38-hour days.”

•“Having a party planner who can give husbands or boyfriends some tips on how to prepare a good party.”

Discussion QuestionsAvailability & Visibility of Counseling Services

•Where do you see these suggestions falling on the intervention continuum?

•What interventions have you tried? What was your experience with them?

•What interventions would you like to try?

Psychoeducation

Psychoeducation

•Themes:- Faculty and Staff Training- Outreach- Tangible Resources

Faculty and Staff Training

•“Obviously this isn’t always possible, I just wish an adult would have noticed what I was going through, like an instructor or something. Maybe it wouldn’t have gone so far.”

•“There needs to be some sort of education for professors and TAs on how to react in situations such as these.”


•“Training staff with how to appropriately help or refer concerns to professionals.”

•“Understood that if I was not doing well in class it might be due to something else I was going through. And perhaps ask how I was.”

•“Instructors could provide student service information during first day of class.”


•“The people that come in close contact with people in pain have to have a genuine concern with that individual’s feelings. Maybe the RAs should be better trained in recognizing a stressed kid and assisting them.”

•“More reaching out by professors and friends. More knowledge of signs of suicidal behavior & mental problems.”


•“More RA involvement and more information about how friends can help a suicidal friend.”

•“They maybe could attempt to teach faculty, coaches, and students the signs of someone who may attempt suicide.”


•“When I e-mailed and talked to my professor about my absence that week, they could have given me more information on our schools counseling center.”

•“Train the instructors to recognize these issues, and teach them how to deal with them. All students can succeed.”

Outreach

•“Perhaps outreach services of some kind for students who are off-campus.”

•“They could have provided mindfulness classes or group yoga sessions designed to reduce stress.”

Outreach

•“They had the resources but students must go and find them. They don’t come to the students.”

•“The counseling department should hold a discussion educating people about depression. And it would be nice to find more literature from them on campus. The counseling department is not very visible on campus.”

Outreach

•“Teach us more about healthy masculinity.”

•“More stress management seminars.”

•“A personal visit to my program or class would make me be more likely to use the services.”

Outreach

•“I would like to have counselors make presentations during class time to explain services they provide.”

•“I wish someone came into classes and handed out contact info. It’s hard to get motivated to seek help; it helps if someone puts the solution right in my hands and gives me a face I can connect to.”

Tangible Resources

•“Send out coping strategies via e-mail to all students maybe.”

•“Maybe send out tips during finals time about how to manage stress.”

Tangible Resources

•“Maybe more pamphlets perhaps or posters?”

•“Maybe a brochure about how to deal with stress.”

•“Maybe if I had a pamphlet or something. I’m not going to go searching for help. If you want to help me, you’ll come to me.”

Summary of Themes

•Faculty and Staff Training- How to appropriately recognize, respond to, and refer struggling students

•Outreach- Classroom visits, presentations, trainings, etc.

•Tangible Resources- Offering health-promoting strategies via email, pamphlets, etc.

Miscellaneous III(Not so helpful responses)

•Umm…cancelled finals?”

•“They could have taken the MCAT for me.”

•“Time machine.”

•“Tell people never to attend graduate school.”

•“How about more electrical outlets?”

•“Not be in Illinois. I know it sounds strange. It’s complicated.”

Student Concerns

Student Concerns

•Themes- Confidentiality- Types of Services Provided- Stigma- Multicultural Concerns

Confidentiality

•“… if I were on campus I would have taken advantage of the university’s mental health program as long as I knew it was confidential, very confidential, and that no records were to follow me.”

Confidentiality

•“[XXX] counseling is not confidential. I would never go to them or recommend that my friends or peers go to them.”

•“Make it seem more anonymous. I don’t want my name attached to anything. I would not want to be walking down the hall and have a counselor acknowledge me.”

Confidentiality•“I don’t feel confident that this is a

confidential service. I also don’t feel confident that any medical records at the university would not be viewed by my program.”

•“I have neglected to seek mental health counseling for a number of reasons… Once you seek therapy for mental health purposes it leaves a paper trail of mental disorder.”

Confidentiality

•“There is too much fear to go to any counseling associated with [XXX] since I am in a gay/lesbian relationship. I fear the rejection and possibly discrimination. So if there was maybe a way to say that no one will find out... that might make it easier to seek help.”

Confidentiality

•“Assurance that I would not be judged or punished by administration. I just always felt that my school would hold my problems against me and would not understand how to help appropriately.”

Types of Services Provided

•“The [XXX] school associate dean gave me numerous contacts and resources to cope. I just didn’t know before that that the counseling center was for mental health/stress. I thought it was for academic advising.”


•“I think that it would have been good if I would have known what the counseling center was really about instead of thinking it was only for people who weren’t mentally right, or crazy.”


•“Advertise the counseling center more by giving students a list of things that they could talk about with the counselor while we are in there. Most students think that when you go to the counseling center [you’re] in there to talk about your grades and classes, but in all actuality students [can] talk about their feeling[s] about their life.”


•“Promote counseling in way that shows it’s for more than suicidal issues; it’s for the more common stressful issues. Also to remind people that they won’t judge.”

•“Nothing—I am a naturally anxious person. I don’t want to use any drugs or anything to make it better, so I need to be able to do it on my own.”


•“I was aware of the Mental Health Center but thought they only employed psychiatrists. I didn’t realize the university also employed counselors. It would have been helpful for me to see someone and engage in talk therapy.”

Stigma

•“Reduce the stigma involved.”

•“Make it seem like less of a scary option.”

•“Make it seem less taboo to get professional help.”

•“More publicity about counseling and having it seem less intimidating and more accepted.”

Stigma

•“In general, I think there is a social stigma around receiving counseling. This is really the primary barrier for people receiving help, and should be the main focus of the university. No matter how many resources are available, people will not take advantage of them if they feel that counseling is for other people, crazy people, etc.”

Stigma

•“There tends to be a stigma of being seen entering or leaving the counseling center. I know it’s hard to get rid of, but it seriously deterred me from going several times because I didn’t want people to see me leaving and think that I had some problem I couldn’t deal with.”

Stigma

•“I think they should have pushed the fact that going to see someone for help is more usual than people think and that it doesn’t mean that there is something wrong with you.”

Multicultural Concerns

•“Nothing. My culture doesn’t allow for counseling.”

•“They should learn about the peculiar challenges international students face.”

•“I don’t feel the university is supportive enough to international graduate students.”


•“I do not know. My culture is totally different, so I do not think an American can help to deal with stress.”

•“Our college needs more awareness about LGBT people.”

•“More trans awareness.”


•“Sent their counselors to ally training so that my university counselor would not have made me feel like she was judging me every time I had a session with her. Instead of focusing on my best friend’s suicide, she focused on the fact that I was bisexual like that was my problem.”


•“There is a great need for professionals who specialize in helping students of color and minorities with problems… [It’s] unlikely students feel comfortable to approach a mental health professional who does not make an initial contact with us.”


•“They could have provided someone who had a similar background, more experience, and who could put her biases aside. To her, race may not play a huge role in her routine, but for me it does; I have tried to pretend it doesn’t but the reality says otherwise.”

Summary of Themes

•Confidentiality- Raising awareness around the privacy and confidentiality of services

•Types of Services Provided- Demystifying the belief that the counseling center is only for “severe” conditions, and/or academic advising

Summary of Themes•Stigma

- Acknowledging that many students are hesitant to seek professional help for various fears- Encouraging people to believe that seeking professional help is a strength

•Multicultural Concerns- Requesting that faculty and staff be multiculturally competent and sensitive to diversity

Miscellaneous IV(Not so helpful responses)

•“Less pickles.”

•“Make all courses Pass/Fail? Hahahahaha.”

•“Get rid of the curve.”

•“More stress bears.”

•“Eliminate bottled water being sold on campus.”

•“More activities that were not dance oriented (I don’t dance!).”

Discussion QuestionsPsychoeducation & Student Concerns

•Where do you see these suggestions falling on the intervention continuum?

•What interventions have you tried? What was your experience with them?

•What interventions would you like to try?

Two Final Suggestions…

“Get more counselors and pay them more! They have an extremely important and stressful job and deserve to be treated very well. They’re a huge help to students, and I think that should be reflected.”

“Listen to students’ feedback on surveys.”

Thank you so much!

What could we have provided or done differently? A closer look at students’ suggestions for campus...

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