The Community College Imperative: Designing Solutions to Promote the Mental Health of Students
Community college, an important gateway to social mobility, is becoming more accessible especially in several states which are establishing plans to permit students to attend tuition-free. Removing barriers and increasing opportunities for people to receive a community college education is a laudable goal that will help meet the demand for skilled workers in our economy.
One important, yet often overlooked factor in successful community college experience is student mental health and well-being. While many community college students face mental health challenges, they often don’t seek help or help is not available. There is a significant need for support and services that could help students thrive academically, socially, and emotionally.
Public two-year community college students constitute nearly half of the 16 million students enrolled in college in the U.S. Nearly 50% of community college attendees are students of color and 36% are the first in their families to attend college, according to the American Association of Community Colleges.
The 2016 report, Too Distressed to Learn, found that community college students are more likely than students in 4-year colleges to experience risk factors associated with mental health concerns such as food and housing insecurity. In fact, 50% of community college students have a current or recent mental health condition, such as anxiety or depression, which can have a negative impact on academic performance and graduation. Community college students of color experience additional challenges to their mental health associated with racial discrimination, xenophobia, and hate crimes which have become more common in a polarized national environment.
Community colleges are facing a challenge in the disconnect between the high need for mental health services among students and the limited services on most campuses. Counselor to student ratios at community colleges (1:3000) are nearly half that of 4-year colleges (1:1600). As a result, 10% or less of community college students use on-campus mental health services compared to 50% of 4-year college students. Unmet mental health needs can have an adverse impact on overall health, relationships, economic status, and human potential.
The well-being of community college students took center stage at a recent Kaiser Permanente Community Health-sponsored convening in Oakland, California called, Mental Health and Well-Being by Design: Leveraging and Scaling High Impact Solutions to Support Community College Students of Color and All At-Risk Students. This design initiative, led by the Steve Fund, a non-profit focused on the mental health and social and emotional development of young people of color, brought together community college administrators and students, mental health experts, and mental health technologists. Participants tackled the challenge of meeting the mental health needs of community college students and designed potential solutions.
Attendees heard from a racially and ethnically diverse panel of community college students who shared their experiences of overcoming challenges to their mental health. The takeaway message from the students was loud and clear: solutions to the unmet mental health needs of community college students must include the use of peer support. Connecting with peers helps to remove the barrier of stigma usually associated with mental health help-seeking and provides a leadership role for people who have navigated the system and had their needs met. Peer connections may be especially important for men who are less likely than women to seek health and mental health services.
Indeed, emerging from the design process were several pilot projects which hinge upon face-to-face interactions with peer ambassadors and technology-enabled peer support. Other pilots included online screening to raise mental health awareness and online therapy to increase availability of and access to mental health services for community college students.
The anticipated implementation of these pilot projects provides hope that solutions responding to the mental health needs of community college students are within reach. Successful implementation of these pilots will require collaborative efforts including: 1) students who have the lived experience and know the realities of being in community college and balancing life challenges; 2) community college administrators who understand the boundaries, limits, capacities, and ecology of the community college landscape; 3) mental health professionals who understand the spectrum of mental health concerns among community college students and the extensive cultural diversity represented in that setting; 4) technology experts who can adapt innovative approaches to meet the mental health needs of community college students; 5) supporting organizations–the Steve Fund and Kaiser Permanente. Kaiser has been a leader in supporting innovative, upstream strategies to promote health and well-being in communities.
With community colleges being such an important stepping stone to work opportunities and economic independence, investments in solutions that attend to and maximize the mental health of community college students is a national priority which will ultimately yield a positive economic and social return.
Annelle B. Primm, M.D., MPH is currently senior medical adviser to the Steve Fund, and senior psychiatrist adviser to Hope Health Systems and several other organizations. During her career, Dr. Primm has been Deputy Medical Director of the American Psychiatric Association; Director of the Johns Hopkins Hospital Community Psychiatry Program; an editor of the books, Disparities in Psychiatric Careand Women in Psychiatry: Personal Perspectives; and a lecturer and video producer on the mental health of diverse and underserved populations.
Media Advisory: The Steve Fund and Kaiser Permanente Host Summit Addressing Mental Health Needs of Community College Students
On December 5, 2018, in Oakland, California, The Steve Fund and Kaiser Permanente are proactively addressing the mental health needs of community college students by convening a working group of community college leaders, investors, social innovators, and mental health experts to develop real-time, real-world technological solutions for community college students, with a particular focus on students of color.
The Steve Fund is the nation’s only nonprofit organization focused on promoting the mental health and emotional well-being of college and university students of color. It works with colleges and universities, students, non-profit organizations, researchers, practitioners, and with groups serving diverse populations. For more information on the Steve Fund, please visit: https://www.stevefund.org.
What: Mental Health and Well-Being by Design Summit
When: Wednesday, December 5, 2018, 12:00-pm – 6:00 pm PST
Where: Hilton Oakland Airport, One Hegenberger Road Oakland, CA 94621
- Dr. Byron Clift Breland, Chancellor, San Jose Evergreen Community College District, National Advisory Board Member, The Steve Fund
- Dr. Bechara Choucair, Senior Vice President and Chief Communication Health Officer, Kaiser Permanente
- Dr. Annelle Primm, Senior Medical Advisor, The Steve Fund
- Molly Harden, firstname.lastname@example.org, (202)-297-9678, The Steve Fund
- Anuja Khemka, email@example.com, (917)-690-5282, The Steve Fund
- Sara Vinson, firstname.lastname@example.org, (510)-368-8674, Kaiser Permanente
- Carolyn Pruitt, email@example.com, (512)-484-7180, The Raben Group
Steve Fund and Kaiser Permanente representatives and mental health experts can be available for interviews before, during, and after the summit.
By Carl C. Bell, M.D., D.L.F.A.P.A.
A recent research letter published in May of 2018 in JAMA Pediatrics entitled “Age-Related Racial Disparity in Suicide Rates Among U.S. Youths From 2001 Through 2015,” asserted that the suicide rates among black children, aged 5 to 11 years old, increased from 1993 to 1997 and from 2008 to 2012. While this finding was upsetting, the results are misleading and need to be explained.
The reality is that completed suicide is a very rare event. Overall suicide rates in the U.S. usually are 11 people per 100,000 people and for adolescents the suicide rates are a bit higher, 20 people per 100,000 people. One suicide is one too many, but in order to form public health prevention and intervention strategies, things need to be put in perspective.
For example, 20,000 out of 100,000 people get depressed, and about 5,000 out of 100,000 people attempt suicide, yet the actual deaths from suicide range from 11 to 20 per 100,000 people. Therefore, how does a public health response system identify those 11 to 20 people who are at risk for completing suicide out of the 20,000 people who are depressed or out of the 5,000 people who attempt suicide? It is like looking for a needle in a haystack.
Accordingly, the JAMA research letter reported that ‘the rates for African-American children rose from 1.36 to 2.54 per million and decreased among European-American children from 1.14 to 0.77 per million.’ The denominator is so large and the numerator is so small that there is virtually no difference in these numbers and statistics. The problem is that these rates are so low, even if there is a legitimate increase; suicide is a very rare event. So, technically, there was an increase in African-American youth suicides, but practically there has been no change.
A lesson from the Institute of Medicine’s report, “Reducing Suicide: A National Imperative”, was that something must be protecting the 19,980 youth who were depressed but did not complete suicide and the 4,980 youth who attempted, but did not complete suicide. Further, if we could increase the protective factors surrounding people at risk we might be able to lower suicide rates.
Shortly after the “Reducing Suicide” report was published, the U.S. was experiencing a “rise” in college suicides. As mental health treatments improved the outcomes of youths with mental illness, they were able to complete high school and attend college. Unfortunately, many colleges were ill-prepared to deal with students who needed mental health treatment at a time when traditional psychiatric support was limited.
Preventing risk factors from becoming predictive factors by using protective factors is one pathway to pursue. Decades of research on risk and protective factors for problems like violence, drug use, and other self-destructive behaviors have revealed seven guiding principles that can be extremely protective: 1) social fabric; 2) connectedness; 3) modern technology; 4) social and emotional skills; 5) activities that increase a sense of power, models, and uniqueness (i.e. self-esteem); 6) adult protective shield; and 7) the ability to minimize trauma.
People can be very emotional at times however, if they are surrounded by family, friends, neighbors, etc., they get influenced by informal social controls and behave in an appropriate manner. Some things are just not socially acceptable, but if people are shunned by social contacts and isolated, there is little to guide them and help them control their impulses and drives. So, one major recommendation is for learning institutions to foster connectedness and be inclusive and not exclude anyone. Modern technology in the form of digital communication and social media can facilitate connectedness when used appropriately.
Having social and emotional skills to resolve conflicts or have hard conversations with people guards against adversity and prevents people from engaging in rash or unhealthy behaviors. Self-esteem (a sense of power, models, and uniqueness) also buffers people from adversity. Accordingly, giving young people a sense of purpose and accomplishment is protective.
Adult protective shield is also protective against suicidal behavior. If a person was getting counseled for feelings of depression, it would make sense for a responsible adult to restrict their means of self harm, e.g. removing a loaded gun from the home.
Lastly, minimizing trauma is protective. It is not the stress, distress, or traumatic stress that are damaging to the human spirit, rather, it is the helplessness in confronting stressors that does damage. Helping people turn learned helplessness into learned helpfulness is a great way to combat stress and help people to be resilient.
It is very doubtful science and psychiatry will be able to identify the rare suicidal individual who will complete suicide, but we will continue to try. By adding protective factors to people’s lives, we can give them a better chance at thriving and flourishing.
Carl C. Bell,M.D., D.L.F.A.P.A.,is a professor of psychiatry and public health at the University of Illinois at Chicago. Bell is a National Institute of Mental Health international researcher, an author of more than 575 books, chapters, and articles addressing issues of violence prevention, HIV prevention, isolated sleep paralysis, misdiagnosis of Manic depressive illness, and children exposed to violence. Bell is the former President/C.E.O. of the Community Mental Health Council, Inc. a large not-for-profit community mental health centers in the U.S. He is also the Director of the Institute for Juvenile Research (Birthplace of Child Psychiatry) at the University of Illinois at Chicago. He is a staff psychiatrist at Jackson Park Hospital and Medical Center on Chicago’s Southside.
College Students Of Color: Overcoming Mental Health Challenges
July is Minority Mental Health Month which provides an ideal opportunity to talk about the mental health of young people of color. Our country is becoming more and more diverse—the proportion of children of color are projected to become the majority by 2020 and people of color are expected to make up the majority of the U.S. population by 2045. It’s crucial that we pay attention to the mental health of young people of color as they become the future of our nation.
Mental illness affects young people of color at similar rates as white young adults. However, they are less likely to be diagnosed or seek mental health services. This is largely due to stigma and a cultural mistrust of mental health professionals who lack cultural competence.
Not seeking needed mental health care is problematic for this (and any) population—but especially for college-aged people of color. Because 75% of all lifetime cases of mental illness begin by age 24, college is a time during which many mental illnesses first appear. Coping with an untreated mental illness can affect a student’s social experience and academic performance. And for students of color, there’s often more under the surface working against them.
How Discrimination Affects Mental Health
The social determinants of mental health include factors such as where people are born, live and work as well as their age. They also include things such as discrimination and exclusion, socioeconomic status and access to health care.
Some colleges and universities have recently become settings of discrimination, racial profiling and xenophobia. Universities that create these feelings of marginalization and isolation can be harmful to mental health, and for students of color who have a pre-existing mental illness, such acts of alienation can actually worsen their condition.
Many of us grew up hearing the adage: “Sticks and stones may break my bones, but words can never harm me.” Dr. Altha Stewart, who, in May 2018, became the first African-American President of the American Psychiatric Association, stated recently that “this old saying is incorrect and the truth is that negative words, can be damaging to mental health, especially for young people.”
Racially hateful expressions broadcasted on social media or communicated face-to-face are harmful to the mental health and well-being of college students of color. This is especially true when cyber-based comments are anonymous. Not knowing if comments are coming from a classmate or someone living next door in the dorm can be frightening and anxiety-provoking.
Colleges and universities should create environments in which young people of color are valued. This can be done by recruiting and retaining a diverse staff and faculty; establishing zero-tolerance policies to racist actions; and developing and maintaining cultural supports, such as culturally-themed clubs, dorms and diverse student identity groups.
Positive actions like these are delineated in the Equity in Mental Health Frameworkdeveloped by the Steve Fund in collaboration with the Jed Foundation. These resources can help young people of color thrive socially, academically and emotionally.
Annelle B. Primm, M.D., MPH is currently senior medical adviser to the Steve Fund, and senior psychiatrist adviser to Hope Health Systems and several other organizations. During her career, Dr. Primm has been Deputy Medical Director of the American Psychiatric Association; Director of the Johns Hopkins Hospital Community Psychiatry Program; an editor of the books, Disparities in Psychiatric Careand Women in Psychiatry: Personal Perspectives; and a lecturer and video producer on the mental health of diverse and underserved populations.Read the article
By: Anuja Khemka, Executive Director
As an organization dedicated to the mental health and emotional well-being of young people of color, the Steve Fund is extremely concerned about recent incidents at colleges and universities where college students of color have been racially profiled and subjected to harsh consequences. We recognize that when racial profiling is not acknowledged, the health impacts can be wide ranging.
At Yale University, a black graduate student fell asleep in her dorm’s common area and a white student called the police on her, because the white student believed she had no right to sleep there. Similarly, earlier this month, while two Native American young men were on a campus tour at Colorado State University, a visiting parent called campus police because she reported feeling anxious by the boys presence on the tour.
It’s clear that students of color experience a variety of difficult situations which can contribute to greater psychological distress, especially when they’re victims of microaggressions and racism. The incidents at Yale and Colorado State University are not only examples of racial profiling, but also examples of how there’s been a recent string of white people calling the cops on people of color for minor incidents. These incidents also highlight how racial profiling can have a negative impact on college students of color, because it can make them feel as if they have no real way to effectively respond or handle the situation, which, as a result, could lead to poor academic performance, feeling distraught and hopeless, and even becoming depressed.
Difficulties posed by these circumstances may be worsened when students lack a supportive social network and face barriers to seeking help, which is why it’s critical that we continue to talk about these issues and offer support for these students.
The Steve Fund has focused its efforts on reducing the risks that students of color face and removing the barriers to seeking help, before, during, and after college. In partnership with the JED Foundation, the Steve Fund has established an Equity in Mental Health Framework with a set of recommendations to support the mental health of college students of color, such as increasing diversity of faculty and staff, making resources that support the mental health of students of color available and publicizing them, and gathering data to increase understanding about how to meet students’ mental health needs.
However, this is just a start. More research, population-specific supports, and attention to campus climate are needed to improve college life so that all students can thrive
Join us at the 2018 Campus Prevention Network Summit
The Steve Fund is partnering with EVERFI to conduct the 2018 Campus Prevention Network Summit June 6 – June 8 in New Orleans, LA.
Join us! This three-day gathering of seasoned higher education professionals, prevention education leaders, health and safety stakeholders, and representatives from Student Affairs, Title IX, sorority and fraternity organizations, and HR offers opportunities to transform the discussions, strategy, and initiatives that keep campuses healthy and safe.
Stop by the Steve Fund’s exhibit to gain insight into the Equity in Mental Health Framework and discuss how it works to improve the mental health of students of color.
REGISTER HERE: https://annual.cpnsummit.com/2018/register/
As a Summit Partner in Thought Leadership, we are pleased to provide you with a special registration rate of $100 (a $349 discount!) using code stevefundsummit100
The Power of Self Care
Please read our April 2018 Newsletter for a full update.
Maintaining mental health and emotional well-being is a daily practice, and springtime is a great opportunity to renew our commitment to that discipline. Across the Steve Fund’s work with students, staff & faculty, and parents & families across the country, many students share their self care tips, but many others still see self care as indulgent or unproductive. Nothing could be further from the truth. Self care is how we cultivate the potent habit of treating ourselves well –both physically and mentally. This month’s newsletter outlines some resources we hope you’ll find helpful in maintaining your own self carepractice and to share with your peers as the school year marches on.
Celebrate Minority Health Month with us by participating in the Peer to Peer Self Care Tips Campaign
P2P Self Care Tips Social Card Gallery