by Shannon Savell, M.A., University of Virginia
Many clinical psychology graduate students serve the college students at their home institutions in their training clinics. In my opinion, it is essential that we are also critically thinking and contributing to structural and systemic efforts to help close the mental health treatment gaps for college students seeking mental healthcare. Even prior to the pandemic, it was well known that college students at highly selective institutions experience a significant amount of stress (Krieg, 2013) and depressive and anxious symptoms were quite prevalent (Eisenberg et al., 2013). Preliminary evidence suggests that the number of college students who suffer from mental health disorders has substantially increased during the pandemic (Kim et al., 2022; Klass, 2020). Stress negatively impacts academic performance, characterized by missing class, dropping classes, and receiving lower grades. Given the heightened levels of anxiety and stress in the current global climate related to the COVID-19 pandemic (Klass, 2020), it is necessary to examine means by which interventions could be interwoven into college curriculum to help alleviate student stress and better prepare students for how to cope as they begin their post-college careers.
The effects of stress on college students are substantial and many college administrations are taking note and trying to address students’ mental health needs accordingly (Mull et al., 2020). One such example of collegiate administration response has been in expanding mental healthcare services as stress levels and maladaptive coping are among the presenting concerns shown to be related to marked increases in the use of college mental healthcare services (Kitzrow, 2003). Many universities have hired additional staff psychologists, increased options for online screenings and web-based services, and trained lay persons to address college student stress through peer support programs and faculty trainings (Wolverton, 2019).
However, with such large study body populations it is difficult to thoroughly meet the demand for mental healthcare services (Ketchen Lipson et al., 2015; Tugend, 2017). Many college mental healthcare services are focused on crisis intervention to triage the surge in demand as the semester progresses. Thus, preventative services understandably receive less attention. Beyond increasing access to mental healthcare services for college students, it is necessary to develop interventions that can be rolled out at the student body population level. One such sustainable and scalable strategy is to build the introduction of evidence-based principles of psychological coping into the core curriculum in college. Group psychoeducation in an academic setting not only targets mental health issues, but also counteracts the stigma related to mental health treatment by making mental illness easier to talk about and by demonstrating that many individuals suffer from mental illness, conveying the message that it is not something to be ashamed of or hide or something that can only be addressed outside of the classroom (Hobbs et al., 2022). Psychoeducation in an academic setting can reassure students that they are not alone in their struggles and validate the feelings of confusion and anxiety surrounding college.
There have been several universities that have implemented psychoeducation courses as a method of decreasing the mental health treatment gap and serving as a protective factor for college students’ mental wellbeing (Hobbs et al., 2022; Young et al., 2022). Hobbs and colleagues (2022) found that college students who took a psychoeducation course offered on the “Science of Happiness” experienced and maintained positive mental health effects in comparison to students who did not take this course. Further, Young and colleagues (2022) found that university students who received a positive psychology intervention through a psychology course saw improvements in their wellbeing, positive affect, and negative affect, and that this course acted as a buffer against stress. In my own work (Savell et al. 2023), I have also found that participating in a course on “using principles of clinical psychology in everyday life” as compared to participating in other standard psychology courses is beneficial for mental health. Students learning how to apply cognitive-behavioral principles to their everyday life for stress management and coping were experiencing lower levels of academic distress and had more positive perceptions of mental healthcare at follow-up assessment. Psychoeducation embedded into the core curriculum may be one potential means of mitigating the college student mental health crisis by providing information about effectively managing mental health and treatment options to students.
Below are psychoeducation topics included in the course described above by Savell et al., 2023 that could be utilized in future initiatives to disseminate evidence-based coping strategies to college students at other universities:
Addressing unhelpful thoughts:
- Identifying and managing cognitive distortions through developing flexible, balanced thinking through cognitive restructuring and/or cognitive de-fusion
Managing difficult emotions:
- Emotion-focused self-regulation strategies including distress tolerance techniques (e.g., grounding)
- Relaxation strategies including diaphragmatic breathing and progressive muscle relaxation
Strengths-based behavior change:
- Basics of sleep hygiene, exercise, and mindful eating
- Interpersonal effectiveness strategies to facilitate communicating and asserting needs in relationships
- Developing SMART (small, measurable, achievable, realistic, time-based) goals and time management strategies
Identifying the impact of the environment/social systems and structures:
- Building awareness of the impact of discrimination on mental health
- Identity affirmation exercises
- Exploration of values-based actions
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References
Eisenberg, D., Hunt, J., & Speer, N. (2013). Mental health in American colleges and universities: variation across student subgroups and across campuses. The Journal of Nervous and Mental Disease, 201(1), 60-67.
Krieg, D. (2013). High expectations for higher education? Perceptions of college and experiences of stress prior to and through the college career. College Student Journal, 47(4), 635-643.
Kim, H., Rackoff, G. N., Fitzsimmons-Craft, E. E., Shin, K. E., Zainal, N. H., Schwob, J. T., Eisenberg, D., Wilfley, D., Barr Taylor, C., & Newman, M. G. (2022). College mental health before and during the COVID-19 pandemic: Results from a nationwide survey. Cognitive Therapy and Research, 46(1), 1-10.
Ketchen Lipson, S., Gaddis, S. M., Heinze, J., Beck, K., & Eisenberg, D. (2015). Variations in student mental health and treatment utilization across US colleges and universities. Journal of American College Health, 63(6), 388-396.
Klass, P. (2020, August 24). Young Adults’ Pandemic Mental Health Risks. Retrieved October 18, 2020, from https://www.nytimes.com/2020/08/24/well/family/young-adults-mental-health-pandemic.html
Hobbs, C., Jelbert, S., Santos, L. R., & Hood, B. (2022). Evaluation of a credit-bearing online administered happiness course on undergraduates’ mental well-being during the COVID-19 pandemic. PloS one, 17(2), e0263514.
Mull, A. A., Cleveland, C., Robinette, R., & Dixon, L. H. (2020). Pathways: An innovation in the delivery of college counseling services. Journal of College Student Psychotherapy, 34(1), 40-58.
Kitzrow, M. A. (2003). The mental health needs of today’s college students: Challenges and recommendations. Journal of Student Affairs Research and Practice, 41(1), 167-181.
Savell, S. M., Lee, J., Stern, J. A., & Wilson, M. N. (2023). Exploring the benefits of psychoeducation on college students’ mental health during the COVID-19 pandemic. Journal of American College Health, 1-10.
Tugend, A. (2017, June 07). Colleges Get Proactive in Addressing Depression on Campus. Retrieved December 21, 2022, from https://www.nytimes.com/2017/06/07/education/colleges-get-proactive-in-addressing-depression-on-campus.html
Wolverton, B. (2019, February 21). Colleges Expand Their Reach to Address Mental Health Issues. Retrieved December 21, 2022, from https://www.nytimes.com/2019/02/21/education/learning/mental-health-college-examples.html
Young, T., Macinnes, S., Jarden, A., & Colla, R. (2022). The impact of a wellbeing program imbedded in university classes: the importance of valuing happiness, baseline wellbeing and practice frequency. Studies in Higher Education, 47(4), 751-770.
Disclaimer: The views and opinions expressed in this newsletter are those of the authors alone and do not necessarily reflect the official policy or position of the Psychological Clinical Science Accreditation System (PCSAS).