CHICAGO (AP) — Look around a waiting room at a university counseling center and you'll see students wrestling with all sorts of issues: The one who's failing because of binge drinking. Another who's struggling with a roommate conflict, or a recent break-up. Yet another who's stressed out and suicidal.
Many centers are more swamped than ever, college
therapists say, particularly at this time of year, in the frenzy of final exams
and job searches.
Though there's debate about why there are more
students seeking services, there is agreement on this: The increase in demand,
those therapists say, has made it even more crucial to zero in on the students
who are in the most distress.
"We used to worry about there being a stigma
about coming in for counseling," says Ian Birky, director of counseling
and psychological services at Lehigh University in Pennsylvania. Now, he says,
they're "overwhelmed" with students seeking help.
To help deal with the demand, more campus
counseling centers are using computerized questionnaires, some that generate
color-coded charts, to help them flag a serious problem more quickly than
traditional paper-and-pencil evaluations.
Though they stress that these evaluations are not a
replacement for in-depth questioning or counseling, many counselors say
high-tech methods like these appeal to students, who are often more comfortable
communicating with smart phones, iPads and laptops.
These therapists say these screenings also help
them do their jobs better, and fine-tune therapy.
One of them is Paul Toth, a staff psychologist at
Indiana University, where therapists began using a computerized evaluation
called the Behavioral Health Measure, or BHM, in November. He recalls one
student whose depression scores were improving but whose overall well-being
scores were not. Staffers then determined that, to truly get better, the
student needed to deal with academic issues that had been caused by the
depression.
Evaluations like these also shed light on topics
that students may not verbalize in therapy, such as a lack of trust, or
bonding, with their therapist. In some cases, Toth says he's found out that a
few students haven't liked it when he's suggested trying antidepressants with
therapy.
"So then I can back off on that," he
says.
Perhaps most importantly, therapists say these
instant evaluations show them more quickly when a student is seriously
considering suicide.
"I can look at that on my computer before the
student even walks into my office," says Birky, whose new clients sit at
private computer kiosks in the counseling center waiting room to take a
different evaluation called the Counseling Center Assessment of Psychological
Symptoms, or CCAPS.
CCAPS, which has versions with 34 and 62 questions,
is used on dozens of campuses across the country, including Penn State, where
researchers used national CCAPS data to generate an annual study on the mental
health of students on campuses across the nation.
Among other things, the research found that about a
quarter of U.S. college students sought mental health services last year.
"So as demand increases, you have to be more
objective about deciding who's in the greatest need," says Ben Locke, the
study's lead author and the associate director of research and technology at
Penn State's Center for Counseling and Psychological Services.
The newer BHM was developed by Mark Kopta, a
psychology professor at the University of Evansville in Indiana. So far, it is
used on just 15 campuses, from the University of Minnesota and Johns Hopkins to
tiny Fairmont State University in West Virginia.
But those who use it say it has some advantages
over more established evaluations.
For one, it has a 20-question version that takes
two minutes or less to complete, so it can be used more easily at every
counseling session.
"It doesn't take the place of an interview,
but it makes the interview much more efficient," says Kopta, head of
CelestHealth Systems, which markets the BHM questionnaires with a package other
tools that evaluate such things as the bond between counselor and client.
Factors students are asked to rate in the BHM
include:
—"Alcohol or drug use interfering with your
performance at school or work."
—"Thoughts of ending your life."
—"Powerful, intense mood swings or highs and
lows."
Results from that evaluation also are divided by
categories, including suicide risk, depression, anxiety and drug and alcohol
abuse. Each category is color-coded — green for normal, yellow for mild
distress, orange for moderate distress and red for severe distress.
Glenn Hirsch, head of counseling services at the
University of Minnesota, recalls one student whose suicide chart was flagged
with red, but who initially denied she was severely suicidal.
Her scores also indicated that she was mistrustful
of Hirsch and the counseling process, so he used those scores — and showed her
her charts at each session — to get her to open up and deal with her suicidal
thoughts.
"Showing that visually can really make a
difference," he says.
After initially dropping out of school, he says the
student client returned to the university and passed all her classes. She also
has regularly taken her medication, something she hadn't done before.
There are other ways mental health professionals
are using technology to help them evaluate clients, on and off college
campuses.
A psychiatrist at Johns Hopkins has developed a
free service called Mood 24/7 that sends a daily text message to its users,
asking them to rate their mood on a scale of 1 to 10. The data can then be
accessed by the user, their mental health counselor and even family and
friends.
Dr. Adam Kaplin, who came up with the idea, says
that typically clients are unlikely to remember how they were feeling between
visits, or to use paper and pencil charts to keep track.
"It's very simple. But there is power in
simplicity," Kaplin says of the system, which now has about 3,000 users,
from college students to older clients. Among other things, he says the system
helps psychiatrists do a better job of monitoring and adjusting psychotropic
medications.
All of these methods are fine for those who seek
help. But there's also concern that the large majority of suicidal and
depressed students still don't seek counseling and, therefore never are
evaluated.
"I've talked to graduating seniors who
literally didn't know that the mental health counseling center existed,"
says 23-year-old Jeff Brozena, president and founder of Penn State's chapter of
Active Minds, an organization aimed at raising students' awareness about mental
health.
His chapter is one of a few that hosted a traveling
exhibit called "Send Silence Packing," made up of 1,100 backpacks
representing the estimated number of college students who take their own lives
each year.
Counseling centers also have expanded outreach.
At Pace University in New York, counseling director
Richard Shadick and his staff give a presentation at each "University
101" class for freshman and give them a survey to help them get a read on
substance abuse and mental health problems they may be having. The mental
health staff also spends time on campus giving mini screenings called
"checkups from the neck up" and refers students who need help to the
counseling center.
Elsewhere, the National College Depression
Partnership has been working with campus health centers across the country to
do their own quick mental health screenings when students come in for regular
visits with the doctor.
Within the counseling field, there is no consensus
about whether there really are more college students with mental health issues
or whether they are simply increasingly willing to ask for help.
Some say that antidepressants and more support has
made it more possible than ever for a student who is mentally ill to attend
college. Others have noted that this generation of students seems less able to
cope with stress, for whatever reason.
"Maybe, in some ways, these kids are a little
bit less resilient," says Birky, at Lehigh.
Whatever the reason, it's an issue that's being
taken seriously.
A recent analysis of BHM questionnaires from 13,300
students who were treated at campus counseling centers found that those
students were, indeed, having significant psychological problems. Just over
two-thirds were clinically depressed at some level. Seventeen percent had drug
and alcohol problems. About 20 percent were suicidal.
And those figures do not include the students who
have yet to seek help.
Copyright
2011 The Associated Press.
(AP
Photo/Chris Howell)
