As more students face mental health issues, MSU strengthens support — (Bozeman Daily Chronicle)

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Bozeman Daily Chronicle

Posted: Sunday, December 1, 2013 12:15 am

GAIL SCHONTZLER, Staff Writer The Bozeman Daily Chronicle

Sam Lombard was hard to miss driving around Bozeman in his 1981 Chevy Luv truck, adorned with a bison skull for a hood ornament and a pirate flag flying in the wind.

An architecture student at Montana State University, 22-year-old Sam had a winning smile, good looks and a sense of humor. He adored Calvin and Hobbes comics, and had skateboarded around campus in pink ski pants.

He didn’t drink alcohol, so he’d bring Popsicles to parties. His passion was snowmobiling in fresh powder, something that gave him peace.

Yet for years Sam had struggled with depression. Last spring semester, he was in “utter misery,” his mother, Marny Lombard, recalled. She traveled to Bozeman from her home in Spokane, Wash., three times trying to help.

Finally Sam started taking anti-depressant medications. After a rocky start, he appeared to be in good shape and was seeing a counselor, doing positive things, happy.

Then one day came the phone call. On Friday, April 26, Sam had taken his own life.

“My sense is those in depression feel there is no help, no future,” Marny Lombard said. “You just think the pain is enormous and you want the pain to stop.

“You cannot see a future, or think about the pain of others, of parents. It’s all-consuming.”

Sam Lombard is not alone. Four MSU students killed themselves last year, said Matt Caires, MSU dean of students.

Suicide remains a rare event. But it underlines how high the stakes can be for young adults grappling with emotional and mental health issues.

Today more MSU students than ever before are seeking help at MSU’s Counseling and Psychological Services. The number of student clients has grown dramatically — even faster than MSU’s enrollment growth – increasing 54 percent in the last five years.

“That’s huge,” said Pat Donahoe, longtime director of MSU’s Counseling and Psychological Services.

Donahoe and his team of counselors and psychologists offered free and confidential counseling last year to 1,336 students. That’s nearly 9 percent of the student body.

One out of every three or four students who sees an MSU counselor expresses suicidal thoughts or has made suicidal plans, gestures or even attempts.

“This generation is under a lot of stress, and it creates challenges for them,” Donahoe said.

At MSU and colleges around the nation, there is growing concern about students deemed at risk of harming themselves or others. And while they are primarily focused on education, universities can’t ignore mental health.

“Any suicide is a tragedy,” Donahoe said. “It is heart breaking.”

Roughly 1,100 college students kill themselves each year nationwide. And after the Virginia Tech massacre of 2007, when a senior shot and killed 32 people, colleges have heightened concerns about students who might harm others.

“Mental health issues are a national trend that deserve serious attention,” said MSU President Waded Cruzado. “In its most extreme manifestation, mental health issues are responsible for a large number of suicides across the nation.

“We’ve had our share at Montana State University. Our hearts go out to the parents and families,” Cruzado said. She has made it her role to call personally grieving families after every death of an MSU student.

“I’ve made a commitment to parents,” Cruzado said. “The best we can do is focus on prevention.”

‘We can help’

In the past two years, MSU has made it a priority to strengthen services for troubled students.

Two years ago the university’s Budget Committee made its No. 1 priority recommendation to invest $275,000 to expand student counseling services. That allowed hiring four more psychologists or counselors.

A record number of students had been coming in to the Counseling and Psychological Services office with depression, post-traumatic stress and suicidal thoughts, and counselors were concerned someone in crisis might end up on a two-week waiting list.

Last year the Budget Committee made one of its top priorities spending $72,600 to hire a new associate dean of students. Instead of the job’s previous focus on students’ rule breaking and discipline, the new associate dean’s focus is on students’ emotional or mental health problems. Aaron Grusonik, formerly a therapist with the counseling center, was hired for the job this fall.

Cruzado approved both budget recommendations.

Adding four people has made a significant difference in the Counseling and Psychological Services office, which now has a staff of 17, including 10 licensed people, Donahoe said. The center is located on the east side of the Strand Union Building, upstairs from the Student Health Service.

Still student demand for services has grown – 27 percent in the last two years, he said.

The center used to schedule 25 “intakes” of new student clients a week. Now it’s up to 41. Add the crisis clients who walk in unscheduled, and a typical week brings roughly 45 new student clients.

“MSU is typical. It’s happening nationally,” Donahoe said.

At the recent National Association of University Counseling Center Directors annual conference, some 700 counterparts gathered and talked of both increasing demand and increasing “complexity and severity of concerns students bring to us.”

To serve everyone, the MSU center just cut the number of free sessions it offers to any individual student from 12 to 10. The center also offers group sessions and couples counseling.

“There are a lot of reasons our numbers are up,” Donahoe said. “Part of it is reduced stigma, and part of it is at a younger age students are reaching out for mental health support.”

Downstairs at the Student Health Service, the number of student patients with mental health diagnoses has increased since 2010 by 20 percent, paralleling the growth in the overall student population, said Jim Mitchell, health service director.

About 24 percent of MSU’s counseling clients take psychotropic medications, including anti-depressants and anti-anxiety drugs, Donahoe said.

In the last four or five years, he said, there has been a shift in the most common problem student clients face.

Anxiety disorders have surpassed depression as the No. 1 concern. Students are reporting more panic attacks, social anxiety and performance anxiety. Some have a hard time functioning, meeting people, taking tests or even going to class.

One major reason seems to be a change in parenting styles, Donahoe said. Overly protective “helicopter parents” have created a millennial generation where, he said, “everybody is a star, everybody gets a medal, everybody is used to immediate gratification, and having things taken care of for them.”

“It creates a lack of experience coping with failure and dealing with frustration,” Donahoe said.

Another change is that the age of the Internet and texting creates “an illusion of connectedness,” he said. Students have fewer face-to-face interactions and lack interpersonal skills. Students express more loneliness and depression, and less empathy and compassion.

After anxiety and depression, the most common issues students bring to MSU counselors are problems with partners, post-traumatic stress, eating disorders, grief and loss, and dealing with family alcoholism.

“Nationally, one in four children grow up in a household with alcohol or substance abuse,” Donahoe said. “In Montana, it’s 40 percent.”

Donahoe said he and colleagues worked to make the counseling service more active and visible by reaching out to the MSU community. Now they train and give workshops to more than 2,000 students, residence hall assistants, faculty and staff members a year.

One example of outreach was a recent noon workshop, attended by five women students, on how to handle holiday stress. Leading the discussion was Leslie Trumble, who is working on her Ph.D. at George Washington University and is a pre-doctoral intern in MSU’s Counseling and Psychological Services.

“I’m amazed at how busy we are,” Trumble said. “I had the idea I’d come to Montana and nobody would have any problems – it’s so beautiful.”

A poster outside the counseling center’s door tells visitors that more than 1,100 students use the center, and that 90 percent of clients reported noticeable improvements. Another 93 percent would refer a friend. And 98 percent said it was important for MSU to have a counseling service.

Donahoe said the low points in his job were the “hard years” when they operated without enough resources. The high points are “seeing the impact our services have for students, increasing their ability to live really productive lives.”

“In my 34 years here, we’ve only had three completed suicides of students who have been clients,” Donahoe said. Each one is “devastating for all of us.” But considering that one of every three or four clients is thinking of suicide, it’s encouraging.

“If we can get them in the door,” he said, “we can provide help.”

Emergency threat

On Friday afternoon before the big Cat-Griz football game, an emergency meeting of MSU’s Behavior Intervention Team was called after a student made a threat against someone on campus.

Dean Matt Caires told a reporter he couldn’t discuss details of the threat, but it was “pretty incredible… It scared us.”

It was serious enough that police were called, said Aaron Grusonik, the new associate dean of students.

Caires wrote up paperwork necessary to “trespass” the student and kick him off campus, at least temporarily.

“Generally when a student makes a threat, we suspend and remove them from campus to give them some time to figure out what occurred and get some help.”

It was the third time this fall that MSU’s Behavior Intervention Team was called because of an emergency. The group, which meets on 30 minutes notice, is made up of roughly eight to 10 people, including leaders of campus police, campus housing, the counseling staff, disabled and veteran student services, and the dean of students office.

The same group also meets every other week on a non-emergency basis as the Safety and Welfare Team, to talk about students who may be at risk of harming themselves or others.

The Safety and Welfare Team has a list of about 200 students of concern. Often a student’s name comes to their attention because a professor has received a student’s email expressing thoughts of suicide. The team rates whether students seem to be at high, medium or low risk.

One thing Caires said he started when he came to MSU was a team to help prevent suicide and respond after attempts. “It’s not just the counseling center’s job,” he said.

“I wanted my office to be a clearinghouse of information and a bridge to other offices,” Caires said, from counseling and residence life to the off-campus Hope House and Gallatin County mental health.

But soon, he felt overwhelmed by all the calls about “students of concern.” That’s when he decided to ask last December to create an associate dean’s job.

After Sam Lombard died last spring, Caires said, he was very pleased to be able to tell Sam’s mother that funding had been approved to create a full-time job.

“It’s not guaranteed that Aaron’s job will prevent suicide, but it should help,” Caires said. “About two-thirds of his job is students who threaten themselves, and one-third threaten others.”

“Faculty are the eyes and ears for keeping campus safe and keeping students safe,” Grusonik said. But professors are trained in microbiology and engineering, not in helping troubled students, so they need someone on campus they can turn to. “They can talk to me before it becomes a crisis.”

In his new job, Grusonik said, he doesn’t do therapy. Instead he puts students in touch with counselors. That means he has less restrictive rules of confidentiality, and he can communicate with campus offices in ways a counselor cannot.

“I’m kind of in the middle, trying to connect as many people as I can with the student,” he said.

Grusonik also created a Safety and Welfare Guide, a small poster to help professors and others determine where to call if there’s a student with a safety risk, mental health issue, disruptive behavior, personal crisis or academic difficulties.

The guide points out that federal privacy laws protecting students still allow sharing personal observations and knowledge about a student among campus officials “when there is a legitimate concern related to campus safety.”

He also is working on creating a website, that would let professors report a student they’re concerned about with just a click.

One other part of Grusonik’s job is evaluating would-be students who apply to attend MSU and check off that they have been arrested before or suspended by another college. Some applications have come from people in prison or still on probation.

The new job is a work in progress, Grusonik said, but he feels so far safety efforts are working.

Of the students of concern the Behavior Intervention Team met about earlier this fall, he said, “Nobody got injured, and the students are back in class, getting services they weren’t getting before.”

All things considered at MSU, he said, “We are a safe place.”

Depression and suicide

Since her son’s death, Marny Lombard has dedicated herself to becoming an advocate for educating families and preventing suicide.

“We need to educate ourselves what it is our children are dealing with,” she said. One good resource for suicide prevention she found is the Jed Foundation and its website.

She said she’d like to see greater focus on depression, because by the time someone suffering psychologically shows telltale signs of being suicidal, like giving away their belongings, it may be too late.

One thing she’d like MSU to consider is how to help students who have a crisis at night or on weekends, when campus offices are closed. Right now the town’s Help Center hotline is the main 24-hour service available.

Lombard said she worries about the kids who never walk in the door of the counseling center. Campuses need to create a “culture of resilience” to help support them.

“I’m really glad to see that MSU has added resources” for helping students in crisis, said Lombard, editor of Gonzaga University’s alumni magazine. The new associate dean’s job, “to connect the dots around campus, that’s a wonderful thing.”

The memorial service for Sam in Bozeman was standing-room-only, Caires said. Popsicles were handed out in his honor.

Friends remembered Sam as kind, though his mother knows how hard he was on himself.

Marny Lombard is still grieving for her only child.

“It’s like walking through fire,” she said. Still, she strives to be positive.

“One hundred years ago, we didn’t know how to handle cancer, polio, heart disease,” she said. “I have to believe we can get much further down the road with suicide and depression.”

Gail Schontzler can be reached at gails@dailychronicle.com or 582-2633.

 

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Stressed out college students increasingly turning to anti-depressants — (Ottawa Sun)

Michael Robinson, Ottawa Sun

Every night, another prescription enters Monique Simonot’s bloodstream.

The University of Ottawa student takes an anti-depressant because it is too hard to sleep at night, yet too easy to pass out during the day. She faces a disorder of mood, a depression that delivers an overwhelming sense of defeat, nausea and abandonment.

“I’ve stalled but the rest of the world keeps moving forward without me,” the 21-year-old said.

But Simonot’s story is hardly unique.

Data provided by two of Ottawa’s post-secondary student unions detail which medications students are relying on the most, according to claims made through their prescription drug benefit plan.

At the top of the list: Anti-depressants.

They are one of the most claimed prescription drug expenses at both Algonquin College and the University of Ottawa.

Algonquin College Students’ Association (SA) statistics show there were $99,829 worth of anti-depressants claimed throughout the 2011-2012 academic year, the most recent numbers available. Of the total 11,729 claims, nearly 20% were for antidepressants.

In comparison, University of Ottawa students claimed $119,049 worth of antidepressants in 2011, second only to birth control. This year, the dollar amount has risen even further.

Security net

“I can tell you that the amount claimed (for anti-depressants) has increased again this year,” said Anne-Marie Roy, president of the SFUO.

By default, post-secondary students pay into their student union’s insurance plans, which cover prescription drugs, dental and other health care services. This has provided a security net for students like Christine Roy, who do not have private health insurance (students who do can opt-out of the plans).

The freshman suffers from anxiety, but finds relief in a 10 mg daily dose of Cipralex, a medication that costs her roughly $70 a month. Because her college health plan covers the majority of the fee, Roy’s expense is reduced to $15.

“If I didn’t have the insurance, life would be even more stressful,” she said. “Without it, I’d probably be on a cheaper medication that wouldn’t work as well for me.”

Both institutions’ anti-depressant use is consistent with a recently released national report that suggests Canadians are the world’s third highest users of the drugs, downing 86 daily doses per day for every 1,000 people in 2011 according to the Organization for Economic Co-operation and Development.

All this has happened while Canadian spending on private health insurance has more than doubled over the past 20 years, the latest results in a study published in April’s edition of the Canadian Medical Association Journal (CMAJ).

But increased usage of anti-depressants isn’t an automatic cause for concern says one of the Royal Ottawa Mental Health Centre’s top doctors.

“It’s not necessarily a bad thing that students are receiving treatment for mental health conditions when in the past they may have been reluctant to do so,” said Dr. Zul Merali, president of the Royal Ottawa’s Institute for Mental Health Research.

“The perceived stress that the students are feeling — leaving home, building new relationships, taking on responsibility for studies — are all certainly quite stressful and may contribute to triggering depression.”

Stress management

When it comes to potential over-usage, Dr. Merali said the issue needs more study.

“We haven’t seen long-term studies that answer the question: How long should somebody be on antidepressants when they are younger in a stage when they are still growing?”

Recognizing the increased demand for anti-depressants, Algonquin College invited former NHLer and mental health advocate Theo Fleury to bolster alternative measures to help students with mental health issues. Both the University of Ottawa and Algonquin College have also routinely organized pet therapy sessions to help students de-stress during midterm and final examinations.

But even outside of the classroom, many will find mental illness won’t disappear says Mike Sullivan, president of Cubic Health. Based out of Toronto, the health benefits analytics company measures insurance plan-specific drug claims data.

“What you are seeing in post-secondary education with anti-depressants is no different than what you see in the workforce,” said Sullivan. “Colleges and universities have to give students the tools on how to deal with the challenges they face because what we see from employers is that mental illness doesn’t go away, it is there and it is a big issue.

“The real situation here is that a lot of the people we surround ourselves with are struggling in different ways.”

 

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Crisis on Campus: the Untold Story of Student Suicides — (CDS College)

February 9, 2016

Hard numbers:

  • 6 % of undergraduates and 4 percent of graduate students in 4-year colleges have “seriously considered attempting suicide” in the past year—and nearly half of each group did not tell anyone.
  • 3X: The suicide rate among young adults, ages 15-24, has tripled since the 1950s and Suicide is currently the 2nd most common cause of death among college students.
  • 1,100: number of suicides that occur at colleges every year – that’s roughly 7.5 per 100,000 students. 1 in 12: number of college students who have actually made a suicide plan at some point 1.5: number of college students out of every 100 who have actually attempted it.
  • 2X as many young men, ages 20-24, commit suicide, compared with young women.
  • In the past 50 years, the suicide rate for those age 15-24 increased by over 200%.
  • 12 people aged 15-24 will commit suicide today – that is one about every two hours.

Demographics:

  • Caucasians account for over 90% of all completed suicides.
  • 2X: though Caucasians are twice as likely to commit suicide as African Americans; the rate of suicide is growing faster among young African Americans than among Caucasians.
  • Suicide rates from 1980-1995 increased 93% for African American females (age 15-24) and 214% for African American males (age 15-24).
  • Native Americans have the highest suicide rate among all 15-24 year olds.
  • Asian American women have the highest suicide rates among women ages 15 to 24.
  • Men commit suicide more than four times as often as women, but women attempt suicide about three times as often as men.
  • Suicide by firearm is the most common method for both men and women.

FACT: The emotional health of college freshmen — who feel buffeted by the recession and stressed by the pressures of high school — has declined to the lowest level since an annual survey of incoming students started collecting data 25 years ago.

The percentage of students who said their emotional health was above average fell to 52 percent.

It was 64 percent in 1985.

Campus stress producers

  • Cost: Financial pressure, tuition plus room and board, is a huge stress-inducer.
  • Competitiveness: How academically rigorous is the school?
  • Acceptance rate: More competitive schools generally produce a more competitive student body.
  • Crime on campus: is it safe?
  • It’s the economy, stupid: has added to the stress, not just because of financial pressures on their parents but also because the students are worried about their own college debt and job prospects when they graduate.

5 Most Stressful Universities

  1. Northwestern University Undergraduate Enrollment: 9,660 Total Price per Year: $58,829 Percent of Students Receiving Financial Aid: 51 percent Average Amount of Financial Aid: $23,337 Average of Financial Aid as Percentage of Total Price: 49 percent Percent of Applicants Admitted: 23 percent Crime Rank (among top 25): 23
  2. Harvard University Undergraduate Enrollment: 10,277 Total Price per Year: $56,000 Percent of Students Receiving Financial Aid: 47 percent Average Amount of Financial Aid: $33,276 Average of Financial Aid as Percentage of Total Price: 59 percent Percent of Applicants Admitted: 6 percent Crime Rank (among top 25): 13
  3. Columbia University in the City of New York Undergraduate Enrollment: 8,184 Total Price per Year: $59,208 Percent of Students Receiving Financial Aid: 50 percent Average Amount of Financial Aid: $31,796 Average of Financial Aid as Percentage of Total Price: 54 percent Percent of Applicants Admitted: 10 percent Crime Rank (among top 25):
  4. University of Pennsylvania Undergraduate Enrollment: 11,852 Total Price per Year: $57,360 Percent of Students Receiving Financial Aid: 50 percent Average Amount of Financial Aid: $25,952 Average of Financial Aid as Percentage of Total Price: 45 percent Percent of Applicants Admitted: 12 percent Crime Rank (among top 25): 9
  5. Washington University in St Louis Undergraduate Enrollment: 7,303 Total Price per Year: $58,901 Percent of Students Receiving Financial Aid: 50 percent Average Amount of Financial Aid: $23,963 Average of Financial Aid as Percentage of Total Price: 41 percent Percent of Applicants Admitted: 17 percent Crime Rank (among top 25): 6

Sizing up the risk factors include:

  • Prior history of suicidal behavior
  • Family history of suicide or suicide attempts
  • Suicidal behavior of a friend or colleague
  • Mental health problems like depression or substance abuse
  • Family history of depression or substance abuse
  • Easy access to lethal methods (like firearms)
  • Interpersonal isolation
  • Impulsive, aggressive or antisocial behaviors

History of abuse or family violence

Some common warning signs are when student:

  • Talks about suicide, death or having no reason to live
  • Is preoccupied with death and dying
  • Has trouble eating or sleeping
  • Experiences drastic changes in behavior
  • Withdraws from friends or social activities
  • Loses interest in hobbies, work, school, etc
  • Prepares for death by making out a will and final arrangements
  • Gives away prized possessions
  • Takes unnecessary risks
  • Relationship difficulties including a recent loss or threat of significant loss
  • Loses interest in their personal appearance
  • Increases their use of alcohol or drugs
  • Expresses a sense of hopelessness
  • Is faced with a situation of humiliation or failure
  • Performance difficulties
  • Legal or financial trouble
  • Is unwilling to “connect” with potential helpers

In America, someone attempts suicide once every minute, and someone completes a suicide once every 17 minutes. Throughout the world, approximately 2,000 people kill themselves each day.

What can parents do?

Stay in touch with your college kid. Freshmen especially need to know that the family support they relied on through childhood is still there, even long distance

Chat by phone, IM or Skype

Send care packages

Visit occasionally

Be a calming voice when things get rough

Do not undervalue the importance of sleep, diet, exercise and de-stressing activities

Familiarize yourself with the student health and mental health services available on campus, so you can remind your child of the support available on campus

Be sensitive to the signs of stress

What is being done to combat college student suicide:

The Garrett Lee Smith Memorial Act (GLSMA) is the first piece of legislation to provide federal funds specifically for youth, adolescent and college age suicide prevention. Included in the bill is $31 million for over five years to fund the matching-grant programs for colleges and universities to help raise awareness about youth suicide

The Campus Suicide Prevention Grants program supports colleges and universities in their efforts to prevent suicide among students and to enhance services for students with depression, substance abuse, and other behavioral health problems that put them at risk of suicide.

The National Action Alliance for Suicide Prevention is taking action on a broader scale. With this public/private partnership, leaders from Government, business, the advocacy community, and other groups are working together to advance the National Strategy for Suicide Prevention.

National Graduate Student Crisis Line, offers immediate help for grads in crisis

1-800-GRAD-HLP   (1-800-472-3457)

Sources:

http://www.thedailybeast.com/articles/2010/04/04/the-50-most-stressful-colleges.html

http://www.nabita.org/documents/NewDataonNatureofSuicidalCrisis.pdf

http://www.thedailybeast.com/newsweek/galleries/2012/08/05/college-rankings-2012-most-stressful-schools-photos.html#slide_3

Suicide statistics taken from numbers provided by the American College Health Association (ACHA)

http://youngadults.about.com/od/healthandsafety/a/5signsstress.htm

http://www.stateuniversity.com/blog/permalink/Suicide-and-Suicidal-Behaviors-Among-College-Students.html

http://facts.randomhistory.com/2009/07/15_suicide.html