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Com m unity College Student Com m unity College Student Mental Health: New Findings from The Healthy New Findings from The Healthy Minds Network

June 2014 | Presented by Sarah Ketchen Lipson 4 | y p

The Healthy Minds Network The Healthy Minds Network

Building a collaborative, international network (1) produce knowledge (research) (2) distribute knowledge (dissem ination) (3) use knowledge (practice)

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Research-to-Practice Agenda Research to Practice Agenda

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Prior Research on Com m unity College Student Mental Health

• Little known about the mental health of community college students
• Lack of mental health resources (Wood, 2012)

Lack of mental health resources (Wood, 2012)

• Top concerns of students (Gallagher, 2012):
• Depression
• Depression
• Anxiety disorders
• Stress

Wood, M. (2012). The State of Mental Health on College Campuses. Inquiry (Journal of the Virginia Com m unity Colleges), 17(1), 5-15.

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Gallagher, R.P. (2012). National Survey of Counseling Center Directors. Alexandria, VA: International Association of Counseling Services.

Healthy Minds Study (HMS) Healthy Minds Study (HMS)

About HMS About HMS

• Began in 2005
• Fielded at >100 four-year campuses
• >100,000 survey respondents to date

Main Measures Main Measures

• Mental health (depression, anxiety, self-injury, suicidality, positive

mental health) H lth b h i ( b t i l )

• Health behaviors (e.g., substance use, exercise, sleep)
• Attitudes and knowledge about services
• Service use
• Academic and social environment

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HMS at Com m unity Colleges HMS at Com m unity Colleges

Winter/ spring 20 14

• Beginning of focus on community colleges (CCs)
• Funding from University of Michigan and NEOMED (Ohio)
• Funding from University of Michigan and NEOMED (Ohio)
• Today: data from 3 CCs in Ohio

Fall 20 14

• Consortium of ~20 CCs
• Funding: SingleStop USA, University of Wisconsin (Professor Sara

Funding: SingleStop USA, University of Wisconsin (Professor Sara Goldrick-Rab), Association of Community College Trustees (ACCT)

• Modified survey to focus on low-income students
• Housing and food insecurity use of public services
• Housing and food insecurity, use of public services

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About Today’s Data About Today s Data

CC d t

• 2014 CC data
• 3 CCs in Ohio
• Invited sample=9,121
• Survey completers=1,419 students
• Overall response rate=15.6%
• Comparison data from 2013 four year schools
• Comparison data from 2013 four-year schools
• 16 schools
• Invited sample=59,162
• Survey completers=17,563 students
• Overall response rate=29.7%
• Adjusted for non-response bias

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Sam ple Characteristics Sam ple Characteristics

20 13 Four-Year Institutions (N=17,563) 20 14 Com m unity Colleges (N=1,419) Age (18-22) 74.6% Female 53.0% Whit % Age (18-22) 41.2% Female 47.3% Whit 8 % White 72.2% White 80.7%

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Prevalence of Mental Health Problem s

CC Student Perspectives [1] CC Student Perspectives [1]

• “I feel anxious a lot due to the pressure and amount of

I feel anxious a lot due to the pressure and amount of school work… finding tim e to do the work and stay afloat financially is a burden!...I do sometimes feel so overwhelmed, stressed, and anxious, and sometimes sad… It becomes emotionally overwhelming at times and I l ti ti t d h l k th t d d ill I lose motivation to do school work the next day and will procrastinate and take naps because I’m mentally drained”

• “I am now at a level of depression that I have
• I am now at a level of depression that I have

isolated m yself from m ost people. If I could afford to stay home and not work I prefer to do it but financially I have to work since I am sole provider for my two kids… I rarely see family other than my kids and I have no friends.”

• “Even though, most of the time I feel internally down, it

doesn’t always seem that way, externally. I put on a b f h I’ i bli b t I t d it it t brave face when I’m in public… but I must admit it gets pretty tough, makes me want to cry.”

CC Student Perspectives [2] CC Student Perspectives [2]

• “School can be very stressful on
• students. Especially those (including

myself) who have to work 45 hours a y ) 45 week, have a child at hom e, and still go to school 4 nights a week. Time management is very important.”

• “This year our house was foreclosed
• n and we have been looking for a

new place this is a very emotional new place, this is a very emotional time, but I am not depressed, because I do believe the living arrangements will work out ” work out.

CC Student Perspectives [3] CC Student Perspectives [3]

“ h hi h f h bl i h l f h f lfill h

• “I have a high sense of purpose, the problem is I have not got a clue of how to fulfill that
• purpose. My m ental health issues revolve around m y financial situation and

lack of it. While receiving financial aide my stress levels where down and grades where

• up. Now with working a job I hate, making not even enough to survive, my stress in way

up and my grades are way down just adding stress on top of stress ” up and my grades are way down, just adding stress on top of stress.

• “I am 36 years old and have spent, on and off, the last twenty years of m y life in

pursuit of a 2 year degree that will have virtually no benefit in today's saturated job m arket. I had a 12 year successful career that I loved, only to become j y , y medically/ physically unable to continue to perform daily tasks and had to leave the field. Because of my relentless pursuit of that now-ended career, I have approximately 2 friends within 1000+ miles and do not see or speak to them very often due to family/ class commitments. I also currently work in a dead-end position for a company that does not value their employees in any regard (benefit cuts in every possible way constant not value their employees in any regard (benefit cuts in every possible way, constant layoffs, 5-7x increased workload with no salary increase for anyone in 6 years, poorly maintained building, etc.) As such, I have felt frustrated and fed up with pretty m uch all aspects of life aside from m y fam ily (loving wife and 3 yr old child) with very little outlet for release or clear direction towards the future. Therefore I have little to no sense of purpose at the moment.”

Substance Use Substance Use

70 80 90 Community colleges Four-year colleges/ universities

57.3 49.9

45.7

50 60 70

28.5 23.6

30 40

12.9

10 20

Binge drinking Any substance use (lifetime) Cigarette smoking (lifetime)

Therapy am ong Students with Apparent Need

80 90 100

Community colleges Four-year colleges/ universities

45 5

50 60 70

31.7 42.7 31.5 27.2 39.1 31.2 28.9 34.8 37.7 39.7 31.1 27.3 45.5 32.8 30 36.6

30 40 50 10 20

Major Dep. (PHQ-9) Severe Anx. (GAD-7)

• Mod. Anx. (GAD-7)

Eating Disorder (SCOFF)

• Suic. Ideation (past yr.)

Self-Injury (past yr.) Any MH problem Co-occurring probl

Medication am ong Students with Apparent Need

80 90 100

Community colleges Four-year colleges/ universities

50.1 46 1 46 2 49

50 60 70

46.1 41.4 44.4 46.2 36.1 38.5 34.7 35.6 27 25.4 36.2 25.4 24.9 31

30 40 50 10 20

Major Dep. (PHQ-9) Severe Anx. (GAD-7)

• Mod. Anx. (GAD-7)

Eating Disorder (SCOFF)

• Suic. Ideation (past yr.)

Self-Injury (past yr.) Any MH problem Co-occurring probl

Any Treatm ent am ong Students with Apparent Need

100

C it ll F ll / i iti

70 80 90

Community colleges Four-year colleges/ universities

56.6 60.4 51 49 60.2 46.1 47.6 59 50.9 53.5 43.9 38.5 55.7 42.5 40.4 48.5

40 50 60 7 10 20 30 40 10

Major Dep. (PHQ-9) Severe Anx. (GAD-7)

• Mod. Anx. (GAD-7)

Eating Disorder (SCOFF)

• Suic. Ideation (past yr.)

Self-Injury (past yr.) Any MH problem Co-occurring probl

2 9% f CC t d t t i i i f l li / t f t l d 52.9% of CC students report receiving informal counseling/ support for mental and emotional health (e.g., from friends/ family).

Any Treatm ent am ong Students with Apparent Need (ages 18 -22)

80 90 100

Community colleges Four-year colleges/ universities

52.7 52.9 48.3 50.5 50 51.1 52.6 46 9

50 60 70

40.4 42.9 33.1 37.4 42.8 38.1 41.6 38.9 46.9

30 40 50 10 20

Major Dep. (PHQ-9) Severe Anx. (GAD-7)

• Mod. Anx. (GAD-7)

Eating Disorder (SCOFF)

• Suic. Ideation (past yr.)

Self-Injury (past yr.) Any MH problem Co-occurring probl

CC Student Perspectives [4] CC Student Perspectives [4]

• “This inspired me to seek information at my

p y campus regarding mental health.”

• “Mental health is a troubling subject for

d h i many more students than it appears. Addressing the problem correctly would require more than access to counseling, but the introduction of acceptance and the introduction of acceptance and understanding from the staff.”

Knowledge of Cam pus Mental Health Services

If you needed to seek professional help for your

70 4 80 90 100

If you needed to seek professional help for your m ental or em otional health while attending your school, you would know where to go.

48.8 70.4 50 60 70 Community colleges 30 40 50 Four-year colleges/ universities 10 20

Strongly agree/ agree

Public Perceived Stigm a Public Perceived Stigm a

80 100

Most people would willingly accept som eone who has received m ental health treatm ent as a close friend.

60 Community colleges Four-year colleges/ universities

33.5 31.9 19 1 37.5 27.6

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17.2 10.6 4.9 1.9 19.1 10.6 4 1.2

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Strongly agree Agree Somewhat agree Somewhat disagree Disagree Strongly disagree

Personal Stigm a Personal Stigm a

80 100

I would willingly accept som eone who has received m ental health treatm ent as a close friend.

52.6 50.8

60 Community colleges Four-year colleges/ universities

35.9 35.2

40

9.2 1.5 0.6 0.2 10.8 2.2 0.8 0.3

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Strongly agree Agree Somewhat agree Somewhat disagree Disagree Strongly disagree

Treatm ent Barriers am ong CC Students with Apparent Need

60 41.8 51.4 42.3 50 60 32.7 35.3 21 7 32.5 24.2 30 40 20.2 21.7 19.5 10 20

Have not had any need Prefer to deal on my own Financial reasons No time Worry what others will think Question whether tx is helpful Problem will get better by itself Question how serious my needs are Stress is normal in school Social suppor

O l 1 3% f CC t d t t h i h lth i 9 % f t d t t th t Only 15.3% of CC students report having no health insurance. 59.7% of students report that their health insurance would cover mental health treatment.

Applying these Findings in Practice

• Quantify problems, identify opportunities
• Evaluate programs
• Advocate for resources (and establish economic case)

Next Steps for HMN’S CC Research

• Modified HMS survey at ~20 schools in fall 2014
• Examine links between mental health and:
• Food insecurity
• Housing insecurity

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• Financial stress in general
• Use of supportive services and benefits

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• Academic outcomes
• Intervention research

Participation Process Participation Process

Research Study Coordinators Research Study Coordinators Odessa Despot (PsyD) and Mira Dalal: healthyminds@umich.edu Surveys P d li b HMN h ( k f ) Programmed online by HMN researchers (no work for campus contacts) Enrollment steps

• Sign participation contract
• Complete data agreement
• Send a file of students for survey recruitment
• Customize the survey with local resources and additional questions
• Submit payment ($500)

IRB requirements Attain IRB approval or exemption (main IRB at University of Michigan does not Attain IRB approval or exemption (main IRB at University of Michigan does not consider other campuses “engaged” in the research; letter available upon request)

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Uses of HMN Research/ Data Uses of HMN Research/ Data

• To assess need in the student population
• To raise awareness

T t th t li ti

• To strengthen grant applications
• To advocate for mental health services and programs on campus
• To evaluate existing programs (e.g., reductions in stigma

following a major campaign)

• To examine prevalence and correlates among sub-groups of

students

• To make comparisons with peer institutions
• Economic case for mental health services (option to link to

academic records) academic records)

Benefits of Participation Benefits of Participation

Our goal is to conduct research that can directly inform practice. M h i f hi i thi i Mechanisms for achieving this aim:

• Rapid access to data reports
• Data sets and statistical support
• HMN researchers available to discuss results
• Interactive data interface

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Participation Experience [1] Participation Experience [1]

Example school: “DC Community College” Example school: DC Community College Size: 7,000 Random survey sample: 4,000 Dates for data collection: February 1-22, 2015 Dates selected by school contact

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Participation Experience [2] Participation Experience [2]

After data collection: After data collection:

• Customized data report delivered in late Spring 2015
• Electronic and paper copies
• Full de-identified data set
• Access to secure portal of interactive data interface

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Interactive Data Interface Interactive Data Interface

The interactive data interface securely contains de-identified survey data and is available to all participating schools. Using a simple drop-down menu, the data interface allows users to:

• Auto-generate graphs/ tables for reports, presentations, meetings
• Compare sub-groups of interest
• e.g., depression among female vs. male students

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• Compare with peer institutions
• e.g., How does DC Com m unity College’s rate of anxiety

com pare w ith other com m unity colleges?

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com pare w ith other com m unity colleges?

Contact Inform ation

HMN Team : healthyminds@umich.edu y Web: healthymindsnetwork.org

Additional Findings g

• Sym ptom prevalence by gender
• Perceptions of cam pus clim ate
• Perceptions of cam pus clim ate
• Academ ic support

Prevalence of Mental Health Problem s across Gender

6 50 60 Females Males

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35.1

30 40

14.5

13.7 20.2 12.8 22.2

11 7 11 8 13.5 19.3

20 30

11 8.4 .8

11.7 9.4 8.2 11.8 10.9

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Major Dep. (PHQ-9) Severe Anx. (GAD-7) Mod Anx. (GAD-7) Eating Disorder (SCOFF)

• Suic. Ideation (past yr.)

Self-Injury (past yr.) Any MH problem Co-occurring probl

CC Cam pus Clim ate [1] CC Cam pus Clim ate [1]

At h l I f l th t th d i i t At m y school, I feel that the academ ic environm ent has a negative im pact on students' m ental and em otional well-being.

A t l h lth bl N t l h lth bl 50 60 70 Any mental health problem No mental health problem

15.6 40.3 27.3 13 2 33 37.7 12 4

20 30 40 50

10.6 5 6.3 3.7 13.2 12.4

10 20 Strongly agree Agree Neither agree Disagree Strongly g y g g g nor disagree g g y disagree

CC Cam pus Clim ate [2] CC Cam pus Clim ate [2]

At h l I f l th t th li t At m y school, I feel that the cam pus clim ate encourages free and open discussion about m ental and em otional health.

A t l h lth bl N t l h lth bl

51.5 56.9

50 60 70 Any mental health problem No mental health problem

18.5 16.5 24.4

20 30 40 50

4.8 8.8 7 10 1.7

10 20 Strongly agree Agree Neither agree Disagree Strongly g y g g g nor disagree g g y disagree

Academ ic Support Academ ic Support

During this school year have you talked with any academic personnel about any

Overall, how supportive was the response of the d i l i h h lk d?

During this school year have you talked with any academic personnel about any mental health problems that were affecting your academic performance? 9.8% yes

60 70

academ ic personnel with whom you talked? (N=10 3)

52.8 38.9

30 40 50 60

5.5 2.8

10 20 30 Very supportive Supportive Not supportive Very unsupportive