NEOMED TEMPLATE

1. NEOMED TEMPLATE CampuS SAFETY AND MENTAL HEALTH: Developing a Comprehensive Mental Health Promotion and Suicide Prevention Plan for Ohio’s Colleges and Universities Department of Psychiatry Northeast Ohio Medical University Natalie Bonfine, M.A. Mark R. Munetz, M.D.

2. What is Northeast Ohio Medical University (NEOMED)? • Formerly known as Northeastern Ohio Universities Colleges of Medicine and Pharmacy (NEOUCOM) • Northeast Ohio: Recognizes the university’s history, heritage and the geographic region it serves • Medical: Recognizes its education, research and service mission in medicine, pharmacy, graduate research and graduate studies • University: Recognizes its three colleges and its status as one of 14 public universities serving the citizens of Ohio

3. Acknowledgements • Material in some of the slides was provided by: • Dr. Jerry Kay, Chair of Psychiatry, Boonshoft School of Medicine, Wright State University • Toni Notaro, Mahoning County Mental Health Board • Natalie Bonfine, NEOMED, Department of Psychiatry

4. Why is Campus Mental Health a Concern? • Nearly 18 million students attend colleges/universities • More students asking for help • More students presenting with acute or serious disturbances • More students matriculating with mental disorders • Campus administrators turning to mental health services for: • Binge drinking • Student stress • Suicide risk • Gender issues • Psychological trauma • Eating disorders

5. In the past 15 years on college campuses: • Depression doubled • Suicidal behavior tripled • Sexual assaults quadrupled • 45% of students self-report depression • 10% of students report suicidal ideation • 44% binge drink • Are college years the best years of your life? (Kadison, 2005)

6. 2005 National Survey of Directors of Counseling Centers (Gallagher, 2006) • Many student mental health services in large eastern universities do not participate • 9% of students sought mental health services and Depression on College Campuses Report indicated visits to 11 large Midwestern universities rose 42% over last ten years (Voelker, 2003) • 58.5% of schools offer psychiatric services and provide on average 23.8 consultations weekly (double since 2004) • 25.1% of students in mental health centers are on psychiatric medication (increased from 9% in 1994) and 95% of directors report an increase in students receiving medication • 90.3% of directors believe there has been an increase in number of students with severe psychological problems

7. 2005 National Survey of Directors of Counseling Centers (Gallagher, 2006) • 375 cases of obsessive pursuit reported with 92 students injured and 4 killed • 2,462 students were hospitalized for psychiatric disorders • Of 154 suicides in preceding year: • 26% used firearms • 21% hanged themselves • 14% took toxic substances • 13% jumped • 32% made previous attempts • 40% on psychiatric medication • 20% had a previous psychiatric hospitalization

8. National Survey of Directors of Counseling Centers (Gallagher, 2006) • Greatest concerns expressed in every category over previous survey • Increase in self-injury reports • Need to find better referral sources for longer term care • Growing demand for services without increased resources • Increased need for crisis intervention • Increased need for services for learning disabled students • Increase in number of eating disorders • Increase in number of sexual assault cases • Increase in number of students reporting earlier sexual abuse

9. Student Care PatternsUniversity of Michigan (N=2,843)(Eisenberg Medical Care, 2007) • 15% sought counseling or took medication • 9% took psychiatric medication • 48% got prescription from primary care doctor • 31% from psychiatrist • 13% from other MH professional (nurse specialist) • 9% got medication without a prescription • Those receiving psychotherapy/counseling • 50% went to university professionals • 25% went to local non-university professionals • 35% saw professionals in other communities (hometown) • Majority, therefore, are not treated on campus

10. Campus Safety Extremely small portion of the 18,000 homicides per year in the U.S. occur in the college setting • Body copy goes here. Bolded phrases in orange. • Second bullet. Drysdale, D., Modzeleski, W., and Simons, A. (2010). Campus Attacks: Targeted Violence Affecting Institutions of Higher Education. U.S. Secret Service, U.S. Department of Homeland Security, Office of Safe and Drug-Free Schools, U.S. Department of Education, and Federal Bureau of Investigation, U.S. Department of Justice. Washington, D.C., 2010.

11. Suicides on Campus • There are an estimated 1,100 suicides among our nearly 18 million college students per year

12. Violence Prevention and the Ohio Criminal Justice Coordinating Center of Excellence • What is the Ohio Criminal Justice CCoE? • Operated at NEOMED since 2001 • The mission of the Criminal Justice CCoE is to encourage communities throughout Ohio to forge collaborative relationships between the mental health and criminal justice systems so that individuals with mental disorders receive the care they need.

13. From Campus Safety to Campus Mental Health • The Criminal Justice CCoE’s most visible success has been Ohio’s statewide dissemination of Crisis Intervention Teams (CIT) • Early on, this included training campus police and security officers in a number of counties • After Virginia Tech, providing CIT training for campus police officers became a priority for CJ CCoE • FY 08 ODMH awarded Transformation State Incentive Grant (TSIG) funds to the CCoE to incentivize counties to start or expand CIT to campus police and security

14. Suicide Prevention is Violence Prevention • Deaths on campus are far more likely to be the result of suicide than homicide • Virginia Tech, Northern Illinois University were murder/suicides • Prevention of such incidents requires a comprehensive approachto addressing mental health on campus • Overarching issues to consider include: • Suicide prevention • Substance abuse issues • Availability of mental health services

15. From Campus Safety to Campus Mental Health • In 2009 and 2010 the CJ CCoE received small TSIG awards from Ohio Department of Mental Health to expand the campus safety initiative beyond CIT • Goal was to address mental health on campus in a more comprehensive manner

16. Education/ Awareness CIT on Campus A Comprehensive Mental Health Promotion and Suicide/Violence Prevention Plan for Ohio’s Colleges and Universities Outreach/ Stigma Reduction AddressingSystemsIssues Based on the Jed Foundation Framework

17. Advisory Committee on Campus Safety in the Mental Health Context • Statewide committee formed and operated by the Criminal Justice CCoE • Includes local and state partners from colleges/universities, community mental health, state advocacy, Ohio Board of Regents, Ohio Suicide Prevention Foundation, and Ohio Department of Mental Health

18. Focus of the Advisory Committee Stakeholders have focused on prevention of crises on campuses • Appropriate training for campus police/security (CIT) • Promote early identification of mental health problems, help-seeking behavior and stigma reduction • Better understanding of counseling services and health services on and off campus • Suicide prevention • Identifying and overcoming systems issues and barriers between the campus and broader community mental health system

19. Collaborative Program Development Grants

20. Psychological First Aid for Colleges/Universities • Experts from ODMH, Bowling Green State University and the University of Cincinnati adapted existing curriculum for college/ university communities • Train-the-trainer session held at NEOMED now on streaming video and available to all: http://cjccoe.neoucom.edu

21. Regional Suicide Prevention Gatekeeper Training • Partner with the Ohio Suicide Prevention Foundation • Two regionally-based gatekeeper training sessions in rural areas of the state • Key audiences: college/university staff, faculty, administrators and students

22. Ohio’s Program for Campus Safety and Mental Health, August 2011 • NEOMED received a three-year Garrett Lee Smith Suicide Prevention Grant from the national SAMHSA • The Margaret Clark Morgan Foundation and the Health Foundation of Greater Cincinnati provided matching funds for the first year • We are recruiting a full-time project coordinator

23. Next Steps • We want to expand our Advisory Committee on Campus Safety and Mental Health • We hope this will include statewide representatives from all institutions of higher education and mental health systems (ADAMHS Boards and others) in the state • We intend to send out Requests for Proposals for Collaborative Development Grants in the fall of 2011 • Requires a partnership between one or more institution of higher education and its local ADAMHS Board

24. Next Steps • Ideally, this effort will be ongoing. • As such, we need a sustainability plan. • If this is of the value we believe it will be, then each participant will need to contribute. • We hope to continue our conversation with the Ohio Board of Regents and others to develop a long-term sustainability plan.

25. Partners Going ForwardPlease join us! • The Margaret Clark Morgan Foundation • Health Foundation of Greater Cincinnati • Ohio Board of Regents • ODMH • ODADAS • Ohio Suicide Prevention Foundation • Ohio Association of County Behavioral Health Authorities • American Psychiatric Foundation • NAMI Ohio • The University of Akron • Bowling Green State University • Wright State University

26. What You Can Do Today • Let your colleagues know of this effort. • If you or anyone you know wants to join the network of professionals and advocates interested in campus safety and mental health, please contact me: Mark R. Munetz, M.D. mmunetz@neomed.edu 330-325-6690

27. Thank you!