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The lack of formal education for college faculty and staff on how to assess and manage students with mental health issues, particularly suicidal students. It highlights the increased number of college students suffering from mental health concerns and rising suicide rates. The document proposes providing education to faculty and staff to raise awareness and decrease acute episodes experienced by students. It also discusses gatekeeper training and the use of Behavior Intervention Teams as resources for faculty and staff.
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Running head: MENTAL HEALTH AWARENESS EDUCATION 1 Mental Health Awareness Education for College Faculty and Staff By Marcella A. Miner A Directed Scholarly Project Submitted to the Department of Nursing in the Graduate School of Bradley University in partial fulfillment of the requirements for the Degree of Doctor of Nursing Practice Peoria, Illinois November 3, 2019
Abstract Mental health is prevalent in the college-aged population. Many individuals that work closely with this population do not receive mental health awareness education. This includes college faculty and staff. By providing college faculty and staff education, college-aged individuals with mental health concerns can be recognized and potentially receive the support they need to be successful. This project focused on providing education to college faculty and staff on the prevalence of mental health in the population they serve. Signs and symptoms of mental health issues were presented as well as campus resources that could be utilized. Information was collected from the project participants prior to the delivery of education and again after. The data collected reinforced the positive effects of the education. Faculty and staff who participated in the educational session recognized an improvement in their understanding of mental health, how to identify, approach, and refer a student in need. This data supports continuation of the project with possible implication for mandatory training for faculty and staff at the institution.
Mental Health Awareness Education for College Faculty and Staff Chapter I College faculty and staff typically have no formal education on how to assess and manage students with mental health issues, particularly suicidal students (Black Hawk College, 2018c; Black Hawk College, 2017). This is unfortunate because of the increased number of college students that are suffering from mental health concerns (Centers for Disease Control and Prevention [CDC], 2018; American College Health Association-National College Health Assessment [ACHA-NCHA-II], 2018). Suicide is rising in this population (CDC, 2018). Providing education to the faculty and staff at colleges may help to raise awareness and decrease the acute episodes experienced by students. The project has the potential to be accepted by the institution and become part of the employment process for faculty and staff. Background The National Alliance on Mental Illness (NAMI) & JED identify 75% of all lifetime mental illness are diagnosed before the age of 24 (2016). The traditional college student is between the ages of 18 to 24 years old. Across the United States, approximately 18.3% of adults will have a mental health issue in a year's time, and college-aged individuals have higher incidence at approximately 22.1% (NIMH, 2017). Studies have found that it is less likely that young adults will seek mental health treatment (Albright & Schwartz, 2018; Wyatt, Oswalt, & Ochoa, 2017). In 2016, there were 4,631 suicide-related deaths for this age group (CDC, 2018). National and Illinois statistics for suicide and mental illness rates are comparable (Substance Abuse and Mental Health Services Administration, 2015). When looking at Rock Island County, there is a very high percentage of individuals ages 18-39 stating they have had chronic depression symptoms (Professional Research Consultants, Inc., 2018). Chronic depression in this
students face. Haq et al. (2018) identified increased stress, anxiety, and depression levels among college students, especially males. Needs Assessment Hawley et al. (2016) conducted a baseline assessment at a mid-sized Midwestern university, looking to identify the mental and physical well-being and needs of college faculty, staff, and students. Researchers concluded a need for increased physical and mental well-being resources for students (Hawley et al., 2016). The results of this assessment support other research regarding the increased need for mental illness awareness. By providing mental health education for educators, college students will feel more supported and understood. Faculty and staff were surveyed by Albright and Schwartz (2018) on their readiness to deal with a student who may be experiencing a mental health issue, and sixty-six percent revealed that they “don’t feel adequately prepared.” The same study uncovered that faculty and staff feel supporting students with a mental health issue is part of their job at the institution. Unfortunately, there are no legislative requirements for a college or university in Illinois to provide training or support to college faculty or staff regarding mental illness and suicide. The focus of this proposal is a community college benefiting roughly 225,000 residents in a 2,200 square mile area (Black Hawk College, 2018d). There are two campuses and multiple outreach facilities to serve the community. This college’s mission and vision support the continued education of individuals in the community (Black Hawk College, 2018e). The student- centered approach adopted by the college encompasses the mental well-being of students as well as the educational goals. Institution support. The SWOT analysis for the project identified an opportunity for better support from the institution's administration and the institution’s board support. Support
from the institution’s administration and the board is necessary for the project to be successful. Providing data on mental illness in the college-aged population will help the board and the administration to see the significance of the problem. Additionally, identifying where the funding is to come from will assist in obtaining the institution’s administration and the institution’s board support for the project. The college’s administration and board support the college’s core values (Black Hawk College, 2018e). This project also supported these including, caring and compassion, fairness, honesty, inclusion and diversity, integrity, respect, and responsibility. After presenting the project and explaining its relationship to the college's core values, the college's administration and the board supported it. Counseling support. The college has a single counselor who must divide hours worked between the two campuses. Although the counselor is active in many student activities across both campuses, the students are not routinely seen in the classrooms or corridors by the counselor. Students at postsecondary institutions do not seek help on their own for mental health needs (NIMH, 2017; Yakushi et al., 2017). Since professors and other staff of the college see students on a more regular basis, the counselor is supportive of educating the faculty and staff on the warning signs of a person in need of mental health support. The education was provided to give faculty and staff the knowledge they need to recognize warning signs and the ability to respond appropriately to the student. The project also provided faculty and staff of the institution with information about campus resources and how to make the referrals. Funding. Funding was available for staff development projects, through a variety of sources. Some funding may be available at the designated college through the counseling office,
institutions should take note (ACHA-NCHA-II, 2018; CDC, 2018; Wyatt, Oswalt, & Ochoa, 2017). Finding a way to assist students in this time of difficulty will help them be more successful students and productive young adults while decreasing the suicide rate among 18- 24 year-olds. These effects would be felt not only throughout college campuses but also throughout the communities they serve. The education offered to faculty and staff of the college would provide a skill that can be reinforced regularly to continue the positive effects of the project. Providing education to college faculty and staff members was the focus of this project. The education provided included information regarding the recognition of student behaviors that may be associated with mental health issues. Also, faculty and staff were provided with tactics to address the individuals experiencing a mental health issue. Nonjudgmental speech, resources to contact, and referral alternatives were part of the education. This project addresses the needs of colleges and universities and may be modified to meet the needs of other institutions. The overall objectives for the project are as follows: ▪ Implement an interprofessional team of faculty and staff to assist in the creation of educational material to other faculty and staff with regularly scheduled meetings by the second week of March 2019. ▪ Design a fiscally responsible plan to cover the cost of the creation and implementation of the project with the approval of college administration by the end of February 2019. ▪ Analyze the current knowledge level of faculty and staff on suicide or self-harming behaviors of students through an anonymous survey by the end of May 2019. ▪ Implement educational opportunities for faculty and staff to enhance their knowledge of student behaviors that may indicate suicidal tendencies, self-harming behaviors, or mental health issues during August 2019.
▪ Analyze the knowledge retention of participants as proven by a post-assessment survey completed at the end of September 2019. PICOT In college faculty and staff, what is the effect of mental health education in the form of a presentation/lecture compared to no education on the comfort level of addressing students with potential mental health needs over a period of three months? This project focused on college faculty and staff and whether mental health education in the form of a presentation/lecture compared to no education improves the comfort level of addressing students with potential mental health issues. The increased comfort level of college employees to address and assist students who are experiencing a mental health issue was the goal. Ultimately, this project will show higher rates of students receiving appropriate assistance with their mental health issues. Congruence with Organizational Strategic Plan The vision statement of the college selected for this project is “Total accessibility, quality instructional programs, student-centered services, and strategic alliances position Black Hawk College as the preferred choice for education and training” (Black Hawk College, 2018e). The project focused on the faculty and staff’s ability to assist students. There are many ways college staff and faculty can assist students to be successful, in the classroom is only one of those ways. Core values of the college support the project’s primary objective (Black Hawk College, 2018e). The first is caring and compassion. Another value, inclusion, and diversity, is the acceptance of all individuals including those with mental illness. Creating an environment that is free of stigma will also be a talking point in the educational piece of this project. Responsibility is defined as a commitment to providing service to others. Again this value supports the
Appraisal of evidence. The articles utilized in the project's research included a variety of methodologies and levels of evidence. Five of the selected research articles are level one. They are all quantitative studies providing quality evidence for the project. The majority of research articles used in this project are level three. Quantitative articles with level three evidence provided a good foundation for the educational program being offered in the project. There are also a few qualitative, level three articles that were selected for the project. These level three articles give support for addressing concerning behaviors in individuals suffering from potential mental health issues. There were three level four and five articles used for the project’s research. All of these were chosen because of their specific focus on college and university populations. This population is the focus of the project as well. The articles are explained according to their content. Suicide and mental health awareness. Challenges faced by college students may lead to issues with depression, anxiety, and suicidal ideations (Hawley et al., 2016; Wyatt, Oswalt, & Ochoa, 2017). College stressors are very likely in the first year of post-secondary school (Wyatt, Oswalt, & Ochoa, 2017). The prevention and awareness of suicide across college campuses is a growing focus (Shadick & Akhter, 2014). Students within institutions need to receive appropriate support to handle the challenges faced in their transitions to college life (Schwitzer, & Vaughn, 2017; Wyatt, Oswalt, & Ochoa, 2017). Students in post-secondary institutions understand they are having difficulties but are many times unwilling to ask for assistance (Yakushi et al., 2017). Hawley et al. (2016) surveyed students, faculty, and staff at a public university to determine the baseline status of their mental and physical health. The students, faculty, and staff also reported on their knowledge of suicide and previous experiences with it. After the
completion of the study, Hawley et al. (2016) determined there is a great need at the college level to assist individuals with efforts for thriving mental and physical health. Knowledge regarding suicide was also determined to be a need for the college population (Hawley et al., 2016). Looking at multiple colleges and universities, Wyatt, Oswalt, & Ochoa (2017) surveyed only students to determine the correlation between mental health and academic success in first- year college students and upperclassmen. Online surveys that were done for the American College Health Association-National College Health Assessment II were reviewed for this study. Findings of the review showed first-year students to have a higher incidence of suicidal thoughts and self-harming behaviors (Wyatt, Oswalt, & Ochoa, 2017). The study also identified an increased need for gender-specific and cultural mental health concerns. Students of different ethnic or cultural groups at Pace University were the focus of Shadick & Akhter’s (2014) research. The goal of the project was to decrease the rate of suicide through the creation of an educational toolkit for the college's administration and faculty. After delivery of the education, it was noted: "over 95% of participants indicated that they feel more confident in handling students with a mental health crisis,” (Shadick & Akhter, 2014). Shadick and Akhter (2014) note their continued efforts and modifications to the project in order to assist the students at Pace University and other post-secondary institutions with emphasis on minority groups. Stigma with depression and mental illness was the center of Yakushi et al. 's (2017) study. In their research, individuals were recruited to attend a lecture. Some of the participants were given a neutral lecture on depression while others were given an anti-stigma depression lecture. The participants were surveyed after the lecture to determine if there was an influence in disease model attitudes, help-seeking behaviors, negative affect toward depression, and non-
staff reporting, identified they are not well prepared to recognize or assist someone who may be experiencing a mental health issue (Albright & Schwartz, 2018). Sixty percent of participants who acknowledged witnessing a student in a mental health issue denied assisting the student or referring them to additional resources. De Somma et al. (2017) were trying to establish if consistency existed between postsecondary institutions across Canada in regards to mental health policies. The survey created for the study was distributed through email to identified college mental health services personnel and had a 96% return rate. The survey utilized a Likert-scale to answer questions and allowed for comments as well. The majority of respondents noted mental illness is an issue for students, but less than half identified having a policy in place to identify students at risk of mental illness (De Somma et al., 2017). Results of the survey varied on overall understanding of mental health awareness and campus policies, supporting the idea that increased mental health awareness is needed. Specifically, in postsecondary institutions, Jaworska et al. (2016) looked into the mental health services provided to students. Mental health services personnel within Canadian universities that are publically funded were contacted and sent the survey created by Jaworska et al., (2016). Data collected was divided into three categories depending on the size of the university. The conclusion of the survey showed that 73% of campuses have mental health promotion programs, but only about 8% have students complete a mental health assessment (Jaworska et al., 2016). Gatekeeper training was reported to be available at many of the institutions. Eighty-four percent of respondents felt additional mental health promotion and outreach could be offered at their institution.
Researchers have identified those with suicidal ideations also have an increased mortality rate (Cain and Loprinzi, 2018). Cain and Loprinzi used the Center for Disease Control and Prevention’s National Health and Nutrition Examination Survey results to conduct their research. Data from 2005-2010 was used to identify individuals between the ages of 20-85 years of age that reported suicidal ideation assessment and those with mortality assessments. Those reporting any suicidal ideations were found to have a “2.1 times greater risk for all-cause mortality” (Cain & Loprinzi, 2018, p. 6). While those with more frequent suicidal ideations were found to have a three to four times greater risk, the researchers suggest person-in-environment treatment may assist in decreasing the mortality rate of these individuals (Cain & Loprinzi, 2018). A limitation identified is the idea that the suicidal ideations are self-reported by individuals completing the survey. This limitation supports the project by assisting the faculty and staff of the institution to identify those experiencing a mental health issue. Education to assist at-risk students. There is a need for additional education for individuals that work with those who may have issues with mental illness (Albright & Schwartz, 2018). Post-secondary educators typically do not have medical training to work with individuals with mental illness (De Somma et al., 2017). There is a gap between educators and their comfort level of identifying and approaching students for these reasons (De Somma et al., 2017; Schwitzer & Vaughn, 2017). Since educators are in touch with students on a regular basis, they can form a better understanding of each individuals' personality. They are better suited to identify some of the changes that may occur in a mental illness exacerbation. Schwitzer and Vaughn (2017) state “stepping out” of professional roles is necessary to aid these students. Several programs exist to provide “gatekeeper” training to particular groups including non-medical and educators (Booth et al., 2018; Hashimoto et al., 2015; Ketchen-Lipson, Speer,
Another group of researchers, Rossetto, Jorm, and Reavley (2018), looked to university faculty and staff members who had already completed an MHFA course. They solicited participants with advertisements placed at the University of Melbourne. The 16 participants were interviewed with questions generated by Rossetto, Jorm, and Reavley (2018) looking at experiences helping individuals with mental health issues. Questions included determining what motivated or stopped the respondent from getting involved with the person in crisis. From the information gathered in the interviews, Rossetto, Jorm, and Reavley (2018) created a model to be used for future mental health awareness courses. This model includes the presentation of material found helpful from the survey respondents. In the Netherlands, Question, Persuade and Refer (QPR) is used (Terpstra et al., 2018). Terpstra et al. (2018) conducted a study to evaluate the effectiveness of QPR training. QPR education was offered to 526 individuals. Pre and post-questionnaires were given to participants. The results showed that individuals in all professions gained knowledge of suicide and increased confidence to confront someone exhibiting suicidal behaviors (Terpstra et al., 2018). Even with positive results of increased knowledge and confidence, there were no reports of increased referrals for suicidal individuals. Comparing QPR to Applied Suicide Intervention Skills Training (ASIST) was the focus of another study (Condron et al., 2018). QPR is a brief form of gatekeeper training that lasts only an hour or two. ASIST is a two-day training program providing more in-depth information. In this study, researchers surveyed K-12 educational settings, community settings, and mental health settings. All of which participated in one of the mentioned mental health awareness training programs. Data from this study identified a more in-depth training program offered more behavior modifications of the trainee, but it came at a much higher financial cost (Condron et al.,
2018). The comparison was that 4,509 individuals could be provided in-depth training for the same cost as 31,103 individuals in a brief training program. The conclusion supports an idea to integrate mental health awareness into schools, especially in rural areas (Condron et al., 2018). Providing this education to non-mental health professionals may help identify students in need of mental health resources. Mental health training for non-mental health trained professionals was the focus of Scantlebury et al. (2018) literature review. By conducting database searches, 19 articles were identified as meeting the specified criteria. These articles were examined for barriers and facilitators to delivering mental health training, as well as the perceived impact of training. Based on the data collected from the chosen articles, Scantlebury et al. (2018) created a list of recommendations for anyone looking to conduct a mental health education program for non- medically trained individuals. These recommendations include the design, implementation, and evaluation of the training. Hashimoto et al. (2016) created a program to educate Japanese university administration in identifying and assisting students with mental health issues. This program was mirrored off the widely known MHFA program and adjusted to meet the needs of the university. Hokkaido University was the site of the study and included 76 administration staff members. After delivery of the education, participants were surveyed to identify confidence in the new skill. Another questionnaire was given one month later. The program was rated as very useful by 77.5% of participants, and 16.9% stated it was useful (Hashimoto et al., 2016). Thus, supporting the effectiveness of the educational program. Identifying that stress-related mental health issues of college students exist, Saleh, Camart, Sbeira, and Romo (2018) tried to assist students through an online program stress
