Science Summary

Dana Baarsvik / July 12, 2016

A recap of research worth noting.

Early Intervention and Integrated Approaches to Mental Health
Research has repeatedly endorsed the importance of early intervention, along with integrated approaches for mental health issues - especially in early adulthood, when mental health disorders often emerge. MCF Expert Terry Fulmer participated in a panel discussion focused on finding solutions to combat chronic disease among young people. Mental health issues were a key topic of the panel, which produced a report on the discussion that emphasized the need for integrated approaches to behavioral health treatment. College health centers are adopting integrated behavioral health care models; one University found that underserved populations, including students of color and international students, are more likely to access behavioral healthcare in an integrated model than through traditional mental health services. The panel called for colleges and universities to put a higher priority on mental health screening, prevention and early intervention for young people. The consequences of falling short on prevention and early intervention for young adults with mental health disorders are made apparent in a recent New England Journal of Medicine case study, co-written by MCF Expert Dr. Derri Shtasel. In the study, which features 40 year old homeless woman with psychosis, Dr. Shtasel explains how the developmental complications of schizophrenia, commonly diagnosed in late adolescence and early adulthood, hinder educational, vocational and interpersonal development. She highlights how schizophrenia’s symptoms can create challenges for daily life. This case also underscores the need for an integrated approach to mental health care, one that incorporates both mental and physical health treatment.

Integrated Interventions Required to Fight Sexual Assault and Violence on Campus
An editorial by MCF Expert Dr. Paula Johnson on the subject of violence as a women’s health issue appeared in Science Magazine following the release of the disturbing results of the Association of American Universities' Campus Climate Survey, which showed that almost a quarter of female graduates from 27 colleges and universities reported having experienced sexual assault during their undergraduate career. Dr. Johnson called for investment in gender-specific research, and interventions that span science, public health, and healthcare systems, in order to address the widespread prevalence of sexual assault and exposure to violence, its immediate harm, and long term health consequences. Effective interventions will integrate public health’s surveillance and community-based research with screening and treatments of individuals in the context of the healthcare system. A recent article published in the Journal of American College Health suggests that college sexual assault interventions may benefit from programming that integrates primary prevention (preventing initial perpetration) and risk reduction approaches (aimed at teaching potential victims how to thwart and assault attempt). The study demonstrated that participation in a sexual assault prevention program combining these approaches directly lowered the odds of assault, and had a lasting change on students’ beliefs and attitudes.

Health Programming Has Financial Societal Benefits
Mental health programming produces benefits far beyond the individual; prevention and early intervention programming can produce great societal gains. Individually, mental health disorders are associated with worse educational outcomes in college: lower grades, delayed graduated, and higher rates of dropping out. A RAND Corporation study investigated the outcome of a statewide mental health initiative in California, the California Mental Health Services Authority (CalMHSA). The initiative allots public funding for prevention and early intervention mental health programs to 145 public colleges, investing $8.7 million annually. According to the RAND study, this investment led to a 13.2% increase in students receiving mental health treatment, and the researchers estimate an additional 329 students will receiving a college degree for each year of investment. Graduating from college has a direct result on lifetime earnings. RAND estimates that the benefits from the added 329 graduate’s will result in a $56 million societal benefit in the form of lifetime earnings, assuming the increase in mental health treatment is due to CalMHSAs initiative. That is a new benefit of $6 for each dollar invested in the programs, $11 for community colleges.

Black College Students Are Facing a Mental Health Crisis
College students of color have unique mental health needs, facing different obstacles than their white peers, and are less likely to seek and receive help. Researchers at Vanderbilt predict a looming mental health crisis for black college students, who they say must draw on “grit” to succeed on predominantly white college campuses. Grit, a buzzword in higher education, is used to describe the combined character traits of mental toughness and perseverance. Researchers argue that the added burden that black students bear - to prove their worth in predominantly white academic institutions, frequently in the face of overt and covert racism – takes a toll mentally, contributing to disturbingly high rates of anxiety, stress, depression and thoughts of suicide. A recent national survey of college students found discrepancies in first year college experiences between white students and students of color. The survey found that, compared to students of color, white students feel more academically and emotionally prepared for college, are more likely to report that college is living up to their expectations, and are more likely to feel that their college experience is good or excellent. Meanwhile, African American students were more likely than white students to report feeling overwhelmed and angry in their first year, and were less likely to seek help for their mental and behavioral problems. Three quarters of black students reported keeping their feelings about college difficulties to themselves, and white students were almost twice as likely to report receiving a diagnosis of anxiety, depression, or attention-deficit hyperactivity disorder.

Numbers of College Students Seeking Mental Health Treatment Rising, and for the Most Serious Issues
A recently released report by the Center for Collegiate Mental Health at Penn State provided a dire view of mental health on college and university campuses. Student demand is straining college health and counseling centers: the number of students seeking mental health services has grown at more than five times the rate of institutional enrollment over the past six years, and the number of counseling center appointments has grown at a rate of more than seven times that of institutional enrollment. At the same time, indicators of “threat to self” have been increasing at an alarming rate: lifetime prevalence of serious suicidal ideation has increased from 23.8% to 32.9%; among students with a history of serious suicidal ideation, the frequency of ideation within the past month has increased 7.2 to 8.3 over the past two years. The frequency that students in treatment express seriously having considered suicide has increased by 38% over five years. Positively, the percentage of students seeking counseling services for substance abuse, eating concerns, and academic distress, and sexual assault/harassment has remained stable or decreased slightly over the past five years. And the number of students seeking treatment for depression and anxiety has increased at a slow but consistent rate.