Transcript GLACUHO Even Champions Have

Even Champions Have Their Down Days:
Helping Students in On-going Crisis
Presented By:
Megan Scott, The Ohio State University
Angelia Zielke, Ball State University
Why This Topic?
• “Many young people are coming to
college with an existing diagnosis and
treatment history. Some of those
students might not have made it
beyond high school in previous
generations, but this means that more
young people need access to
comprehensive mental health care.”
http://www.healthyminds.org/collegestats.cfm
Bleed like me
Garbage (2005)
avalanche is sullen and too thin
she starves herself to rid herself of sin
and the kick is so divine when she sees
bones beneath her skin
and she says:
hey baby can you bleed like me?
c'mon baby can you bleed like me
therapy is speedie's brand new drug
dancing with the devil's past has never been
too fun
it's better off than trying to take a bullet
from a gun
and she cries:
hey baby can you bleed like me?
c'mon baby can you bleed like me
chrissie's all dressed up and acting coy
painted like a brand new christmas toy
he's trying to figure out if he's a girl or he's
a boy
he says:
hey baby can you bleed like me?
c'mon baby can you bleed like me
it's gets all fucked up in some karaoke bar
after two drinks he's a loser after three
drinks he's a star
getting all nostalgic as he sings "I will
survive"
hey baby can you bleed like me?
c'mon baby can you bleed like me
doodle takes dad's scissors to her skin
and when she does relief comes setting in
while she hides the scars she's making
underneath her pretty clothes
she sings:
hey baby can you bleed like me?
c'mon baby can you bleed like me
you should see my scars
you should see my scars
you should see my scars
you should see my scars
and try to comprehend that which you'll
never comprehend
These lyrics are copyrighted by their respective owners (Garbage)
College Mental Health Statistics
• One out of four young adults will experience a
depressive episode by age 24.
• According to a 2004 survey by the American College
Health Association,
– Nearly half of all college students report feeling so depressed at
some point in time that they have trouble functioning,
– 14.9 percent meet the criteria for clinical depression.
• Students reported during the last school year feeling
the following:
– Over 60% of the students reported feeling things were hopeless
one or more times.
– Almost 40% of the men and 50% of the women reported feeling
so depressed that they had difficulty functioning one or more
times.
– 10% of the students reported seriously considering attempting
suicide at least one time.
http://www.healthyminds.org/collegestats.cfm
College Mental Health Statistics
• Anxiety disorders affect over 19 million
American adults every year, and anxiety
levels among college students have been
rising since the 1950s.
• In 2000, almost seven percent of college
students reported experiencing anxiety
disorders within the previous year. Women
are five times as likely to have anxiety
disorders.
• According to the Federal Centers for Disease
Control and Prevention (CDC), 7.8% of men
and 12.3% of women ages 18-24 report
frequent mental distress – a key indicator for
depression and other mental disorders.
http://www.nmha.org/camh/college/index.cfm
Resisting the Temptation to Diagnose
• Diagnosis and treatment are the
responsibility of counseling/mental
health professionals
• Not diagnosing doesn’t mean you can’t
observe
• Research and observation are
important
• Referrals
• Campus resources
Anxiety Disorders & Depression
• Who?
– Anxiety disorders and depression are the two most common
mental illnesses experienced by Americans.
– Approximately half of all people who suffer from anxiety
disorders also suffer from depression.
• What?
– Anxiety disorders are characterized by feelings of panic, fear, and
discomfort that arise with no clear cause, in situations that are
not usually stressful or dangerous
– Anxiety disorders are linked to depression. Two out of three
people with depression also have symptoms of anxiety.
• Treatment?
– Antidepressant medication
– Psychotherapy
– Combination of the two.
The Major Anxiety Disorders
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Generalized Anxiety Disorder (GAD)
– Six months or more of continual, extreme worry and tension
that is not based on real concerns.
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Obsessive-Compulsive Disorder (OCD)
– Marked by obsessions - repeated, upsetting thoughts and
images - that a person cannot control by self
– Repetitive rituals (compulsions) to combat these images and
thoughts and ease anxiety.
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Panic Disorder
– Often characterized by the presence of panic attacks, which are
feelings and symptoms such as a pounding heart, chest pain,
sweating, trembling, shortness of breath, numbness and fear of
dying.
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Phobias
– Deep-seated fears that are extreme, irrational and upsetting to
a person’s life.
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Post-Traumatic Stress Disorder (PTSD)
– Long-term, severe and continuing reaction a person may
experience following a disaster (such as a fire or earthquake) or
a very traumatic experience (war, rape, or sexual abuse).
http://www.nmha.org/infoctr/factsheets/index.cfm
Depression
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Who?
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What?
– Nearly one in 10 adults each year—nearly twice as many women
as men.
– Depression can strike at any time, but on average, first appears
during the late teens to mid-20s.
– A serious medical illness that negatively affects how a person
feels, thinks, and acts.
– Variety of symptoms, but the most common are a deep feeling
of sadness or a marked loss of interest or pleasure in activities.
– Other symptoms include:
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Changes in appetite Insomnia or oversleeping
Loss of energy or increased fatigue
Restlessness or irritability
Feelings of worthlessness or inappropriate guilt
Difficulty thinking, concentrating, or making decisions
Treatment?
– Antidepressants - correct imbalances in the levels of chemicals
in the brain. Full benefits require two to three months.
– Psychotherapy, or “talk therapy,”
http://www.healthyminds.org/multimedia/depression.pdf
http://www.nmha.org/infoctr/factsheets/index.cfm
Suicide & Depression
• In 1998, suicide was
– the eighth leading cause of death for all Americans,
– the third leading cause of death for those aged 15-24,
– the second leading killer in the college population.
• Although women suffer from clinical depression and attempt
suicide more than men, men are more likely to complete the
act.
• Depression alone or in combination with aggressive behavior,
substance abuse and/or anxiety is found in over half of all
suicides.
• If depression is present, substance abuse, anxiety, impulsivity,
rage, hopelessness and desperation may increase the risks of
suicide.
• Any talk of suicide by a student should be taken seriously and
help should be sought immediately.
http://www.nmha.org/infoctr/factsheets/index.cfm
Schizophrenia
• Who?
– About 1% of the world population.
– Symptoms usually appear between the ages of 13 and 25
– often appear earlier in males than females.
• What?
– Serious disorder which affects how a person thinks, feels and
acts.
– May have difficulty distinguishing between what is real and what
is imaginary; be unresponsive or withdrawn; and have difficulty
expressing normal emotions in social situations
• Treatment?
– If you suspect someone is experiencing symptoms of
schizophrenia, encourage them to see a medical or mental health
professional immediately.
– New generation of anti-psychotic medications - help to reduce
the biochemical imbalances and decrease the likelihood of
relapse.
http://www.nmha.org/infoctr/factsheets/index.cfm
Schizophrenia : Behaviors & Early Warning Signs
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A change in personal hygiene and appearance
A change in personality
Increasing withdrawal from social situations
Irrational, angry or fearful response to loved ones
Inability to sleep or concentrate
Inappropriate or bizarre behavior
Extreme preoccupation with religion or the occult.
Hearing or seeing something that isn’t there
A constant feeling of being watched
Peculiar or nonsensical way of speaking or writing
Strange body positioning
Feeling indifferent to very important situations
Deterioration of academic or work performance
Self Injury
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Who?
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What?
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Treatment?
– Experts estimate the nearly 1% of the population, with a higher
proportion of females than males.
– Typical onset is at puberty. Behaviors often last 5-10 years but
can persist much longer without appropriate Treatment?.
– Also termed self-mutilation, self-harm or self-abuse.
– Defined as the deliberate, repetitive, impulsive, non-lethal
harming of one’s self.
– A way to cope with or relieve painful or hard-to-express
feelings, and is generally not a suicide attempt.
– Can be a symptom of several psychiatric illnesses:
– Outpatient therapy
– Partial (6-12 hours a day) and inpatient hospitalization.
– Medication for management of depression, anxiety, obsessivecompulsive behaviors, and the racing thoughts that may
accompany self-injury.
– Contracts, journals, and behavior logs
http://www.nmha.org/infoctr/factsheets/index.cfm
Bipolar Disorder
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Who?
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What?
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How?
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Treatment?
– More than 2 million Americans suffer from bipolar disorder.
– Illness involving one or more episodes of serious mania and
depression.
– Causes a person’s mood to swing from excessively “high”
and/or irritable to sad and hopeless, with periods of a normal
mood in between.
– Although a specific genetic link to bipolar disorder has not been
found, studies show that 80 to 90 percent of those who suffer
from bipolar disorder have relatives with some form of
depression.
– Professional help and support from family, friends and peers
– Medication. A common medication, Lithium, is effective in
controlling mania in 60% of individuals with bipolar disorder.
http://www.nmha.org/infoctr/factsheets/index.cfm
Medications
• Depression
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Tricyclics (Dioxipin, Amoxopine)
Hetrocyclics
MAOIs (Nardil, Parnate)
Lithium (Eskalith, Lithobid)
• Anxiety
– Valium (Seduxen, in Europe Apozepam, Diapam)
• Bipolar Disorder
– Lithium
• Schizophrenia
– Antipsychotic drugs
– Glycine therapy
The Millennial Generation
• Parents
• Expectations
• Dependency
Are the mental health issues and crises
we’re seeing signs of a generation
without interdependence?
7 Characteristics of Millennials
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Special
Sheltered
Team Oriented
Confident
Conventional
Pressured
Achieving
Millennial Family Life
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Smaller families
Older parents
Highest parental education levels
Least Caucasian
Millennial Students & Relationships
• No memories of innocent times
• Accountability and standards
stressed
• Schools emphasize core subjects –
less on arts and music
• Character education in schools
• College education is expected
Bad things happen to good people
Is it possible, too, that mental health
crises are a result of
situations/events?
Sexual Assault
• Among college students nationwide, between
20% and 25% of women reported
experiencing completed or attempted rape
(Fisher, Cullen, and Turner 2000).
• Emotional consequences
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Numbness
Shock
Anxiety
Fear
Guilt
Shame
Depression
Loss of trust
• Recovery is a process; takes time
http://www.studentlife.villanova.edu/counselingcenter/psychtopics/sexualassault.html
http://www.cdc.gov/ncipc/factsheets/svfacts.htm
Drug & Alcohol Abuse
• Drug/alcohol abuse can be brought on from
the stress of broken relationships, loss of
employment, or other lifestyle stressors
• Risk factors include poor coping skills; lack of
rewarding and nurturing relationships;
failure in school; inappropriately shy and/or
aggressive behavior; and affiliation with
deviant peers.
• Rates are lower in women than in men.
• In a 1999 NMHA survey, 52% of
drug/alcohol abusers also experienced some
other kind of mental health disorder.
Dealing With Grief & Loss
• If a parent dies at a time when the student is
physically and emotionally pushing the parent away,
the student’s guilt feelings may be significantly
increased, especially when the student realizes that all
the ‘unfinished business’ can never be accomplished
(Berson, 1998, in Janowiak, et al, 2001).
• Death and loss can affect a student’s identity
development
• Even years after the death of a loved one, students are
commonly unable to talk about their feelings
regarding the loss (O’Brien, 1991).
• Students who want to help will avoid conversations
about loss because of the knowledge that those close
to them will someday die as well (Janowiak, et al, 2001).
Homesickness
• Homesickness, isolation, & feelings of
not belonging
• Homesickness occurs in both outgoing
and shy students
• Research has shown that a secure
attachment base (support from
parents) allows students to explore
new roles and explore independence
(Schwartz & Buboltz, 2004).
Providing Support
• Be honest and express your concerns.
– Be specific.
– Ask directly.
– If suicidal thoughts are expressed it is important to
contact the university counseling center, student health
center or the local mental health association.
• Offer emotional support, understanding
and patience.
• Listen
• Be nonjudgmental.
• Convey the message that mental health
issues are real, common, and treatable.
• Set aside time – don’t rush.
• Ensure confidentiality.
Tools for the Hall Director
• Know their Social Network
– Group who needs support as well
– Roommates & Friends
– Knowledge about student
• Internet Communities
– IM
– Facebook
– Live Journals
Tools for the Hall Director
• Research, Learn, Consult
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Supervisor
Counseling Services
Web
Police (procedures, consulting)
• Referrals
– Accompany Student
– Waivers
• Document
– Conversations
– Student Actions
Campus & Community Resources
• Supervisor
• Campus Counseling/Health Center
– Knowledge
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Intake process
Available sessions or groups
Emergency/On-call procedures
Services: Counseling, Psychiatric, Groups
– Action
• Call ahead (urgent appt., accelerate the process)
• Use the Website
• Consult/Advice
• Office of Disability Services
• Community Options
– Hospitals
– In-patient options
Know Your Campus Procedures
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Process for reporting?
Mandated response?
– Mandated counseling?
– Reporting/Documenting
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UIUC Suicide Report Form
BSU Self Injury Form
Parental Contact?
– Who, when, why, if?
Legal Considerations
• Most college mental health professionals look to their
university’s general counsel for guidance.
• Americans with Disabilities Act (ADA)
– Ensures that people with disabilities, such as severe mental
illness, have legal protection against discrimination in the
workplace, housing and residential settings, public programs,
and telecommunications
• Protection and Advocacy for Individuals with Mental
Illness (PAIMI).
– State programs to safeguard the rights of people with mental
illness
• Family Educational Rights and Privacy Act (FERPA)
– Confidentiality
– Different interpretations by university counsels
– Considerations when student in a risk to self or others
http://www.mentalhealth.samhsa.gov/publications/allpubs/ken98-0051/default.asp
http://www.sprc.org/library/college_sp_whitepaper.pdf
Relevant Court Cases
• Schieszler v. Ferrum College
– Federal court found that Ferrum officials had had a legal
duty to ensure the safety of the student, because they
knew of the "imminent probability" that he would try to
harm himself.
– Ferrum settled the lawsuit in 2003, admitting "shared
responsibility" for his suicide -- the first such
acknowledgment by an American college.
• Shin v. MIT
– In June 2005, state judge ruled that the parents can
proceed with their claims against MIT administrators
and staff members for failing to prevent student’s death
– Plaintiffs cannot seek damages from MIT itself
http://chronicle.com/free/v51/i49/49a00101.htm
Taking Care of Your Self
• Don't take it personally.
– Students in crisis are not in crisis to upset you or make
you feel guilty.
• Understand your feelings.
– Be honest with yourself about how the student's crisis
makes you feel.
– Don’t pretend that you are doing alright if you are not.
– Take a break when you need to.
• Don’t force things.
– Realize that developing trust and respect with a student
can take time.
– But remember to cover your bases as a university staff
member.
Resources
• Your Campus Counseling Services
• National Mental Health Association
www.nmha.org
1-800-969-6642
• American Psychiatric Association,
Healthy Minds
http://healthyminds.org/